Epte Case Study

The case study of Eileen Poole as presented by IPE for QUM presents two scenarios in which a Practice Nurse, General Practice Doctor and a Pharmacist interact with a patient, Eileen, when it becomes necessary to switch one medication, and an additional medication is introduced in response to the patient’s changing situation. In the first scenario each healthcare professional interacts with Eileen and other healthcare professionals from what could be termed the ‘practitioner’s natural attitude’, that is they operate in a manner consistent with a traditional view of their profession. In the second scenario the practice nurse and the pharmacist adopt an approach known as a patient centred care which is care provided that is responsive to a patient’s
The pharmacist did at one point explain to Eileen that the pharmacy was short staffed but this seems a poor excuse for the interaction that takes place. The pharmacist clearly didn’t listen to the patient. This was evident when she examined the scripts the patient presented after the patient had already explained what she had for the pharmacist, and by twice ignoring comments the patient had made about concerns regarding taking the correct medications at the correct time, and about not being able to read the writing on the label. The pharmacist also fails to make time for the patient. From placing the emphasis on answering the ringing phone, to not showing the patient her new medications appropriately, or offering anything in the way of information and education. The pharmacist failed to obtain a medication history to allow checking for interactions. The pharmacist even offered to sign the scripts for the patient later. These shortcomings may have massive implications for medication safety. Eileen complexion appears pale at the end of this scenario, as if she is in a state of shock at having been treated so poorly. Given any alternative I don’t think she would return to this pharmacy
In this scenario the pharmacist acknowledges that the patient’s time has value and apologises for keeping Eileen waiting. Following this, the pharmacist acknowledges that the patient has already mentioned the scripts she has with her. When talking to the patient the pharmacist uses appropriate language and a mix of appropriate open ended and closed ended questions with the patient. Additionally the pharmacist uses eye contact and body language which engage the patient in a question and answer style discussion. This time the pharmacist takes a full medication history from Eileen including prescription, over the counter and complementary (e.g. herbal) medications, and as with the practice nurse, focuses on resolution of the patient’s issues, and ensures that the medications are appropriate and safe for the patient to take. Finally the pharmacist is much more engaging when showing the patient her new medications and discusses adverse reactions that may occur, as well as what to expect. The pharmacist makes appropriate use of the ISBAR protocol when talking to the doctor to quickly convey information and reach appropriate outcomes. However the pharmacist does not introduce herself (although if the patient is a regular this may not be required), ask the patient if she can spare a few minutes