Consider interactions you have had with a primary care health care provider in recent years. Now that you have reviewed models for clinical decision-making construct a discussion that reflects on an encounter you have had with a primary care provider.

           An encounter I have had with a primary care provider was one where I came in for a well visit, and the primary care provider spent three hours on this visit. She was very thorough, and she had seen me before, but this visit was entirely too long. I have no disease or family history of diseases. It became excessive. She did a full head-to-toe evaluation, but I felt an experienced clinician should have been able to wrap up the whole discussion in a much shorter timeframe. Each visit ends up being the same length, regardless of what I am coming in for.

          The same primary care provider one visit went in a direction I felt highly odd. I came in for status migrainosus, and she started to try and get me to sign up for surgery. She did not ask me if I wanted surgery, or even talk to me about it. She had her medical assistant come in with a form for me to sign giving her approval to operate on me. I immediately said no, and that surgery was never something discussed. The same medical assistant came in with another form for me to sign, saying I agreed to try some new medication. She never spoke about this medication to me. When I asked about the surgery and the medication, she rolled her eyes and just said I needed it and that I should just sign both papers. She even tried to look at my knees, which had no problems and told me I should have a knee scope. I felt very much like she was trying to profit from me and had zero intentions of listening to me or my concerns. The outcome was that she scared me, and I never came back there again.

Utilize one of the models presented in your lecture materials, or any other model that you may like, to frame your discussion of the experience with the primary care provider that you are reflecting on. 

          A model I chose was the SHARE approach model. It incorporates 5 steps. Step 1, seek your patient’s participation. Step 2, help your patient explore and compare treatment options. Step 3, assess your patient’s values and preferences. Step 4, reach a decision with your patient. Step 5, evaluate your patient’s decision (Agency for Healthcare Research and Quality, 2020). This model outlines ways to include the patient as well as treat the patient. Had that same provider utilized the SHARE model and had better etiquette, the outcome would have been far more substantial. She did not include me in the treatment. She did not look at my values or preferences. She did not even ask. She did not come to any decision with me. She just went on her own trying to create a financial resource for herself. Nursing is one of the most trusted fields. Nurses have the authority, education, and experience to lead multiorganizational coalitions in improving outcomes and reducing disparities. This requires activities that evaluate the strengths and common goals of the patient (Hartson et al., 2023). It should never be devalued by one person’s desire to create problems that do not exist for the provider’s personal gain.

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