PATIENT SITUATION

Select one of the challenging patient situations and behaviors referenced in Chapter 2 of this week's assigned reading. Discuss best practices in managing this scenario in the context of the focused history and physical examination encounter. Support your response with a minimum of two APRN-approved scholarly resources.
PATIENT SITUATION
Patient Who Is Silent Novice interviewers often feel uncomfortable with periods of silence and try to keep the conversation going. Silence has many meanings. Patients fall silent to collect their thoughts, remember details, or decide if they can trust you with certain information. Periods of silence usually seem longer to the clinician than the patient. Be attentive and respectful and encourage the patient to continue when ready such as “You are quiet . . . What are you thinking about?” Watch the patient closely for nonverbal cues, such as difficulty controlling emotions. Being comfortable with periods of silence may be therapeutic, prompting the patient to reveal more profound feelings.At times, silence may be the patient’s response to how you are asking questions. Are you asking too many short-answer questions in rapid succession? Have you offended the patient by showing disapproval or criticism? Have you failed to recognize an overwhelming symptom such as pain, nausea, or shortness of breath? If so, you may need to ask the patient directly, “You seem very quiet. Have I said something that has upset you?”