PATHWAYS TO SAFER OPIOID USE REFLECTION

I assumed the role of James Parker who is a patient, living with chronic back pain, and uses pain medication to alleviate the pain, but it does not always works and at times Mr. Parker feels hopeless. In the first activity I decide for Mr. Parker to pick an 8 and explain the reason why. The physician’s response made Mr. Parker feel like the physician did not believe him because on his last visit he also said his pain was an 8 on the pain scale. The physician did not seem interested in Mr. Parker’s pain level; he automatically diagnosed the patient with depression, prescribing antidepressant, antianxiety and insomnia medication, along with the opioids. I asked for alternative option because he is taking more medications but nothing to treat the actual back pain. The physician did not take the patient’s pain serious, just brushed off Mr. Parker concern; he tells the patient the medications are his best option. The physician should of given the patient the respect to allow him to participate in his treatment, but did not provide alternative treatments that the patient was requesting because he was in a rush to see the following patient.

When it came time for the patient to pick up his medication at the pharmacy, I decided for Mr. Parker to discuss his medication with the pharmacist. The pharmacist provides the patient with information, on frequency, how much to take and possible side effects, this alerted Mr. Parker into reconsidering if he should take all his medications.

At the visit with the other physician, Mr. Parker asked the nurse why is the urine test necessary. If the patient has any concerns they should always ask questions. The nurse explains the reason for lab work and urinalysis, she went into detail and described that it was routine, and made Mr. Parker feel comfortable. The communication between Mr. Parker and the nurse allows for a trusting relationship between them. Mr. parker had a great experience with Dr. Bright, he provided so much information and wanted to help the patient find alternatives. The physician showed he cared and was concerned about his patient. When it came to prepare for the follow up appointment, I think it is best from the patient to keep the pain log for the physician to see, and ask his wife to join. The wife can play an important role in supporting the patient through this journey and also be encouraging. Mr. Parker was not confortable with taking the depression and anxiety medication that was prescribed by the previous provider, the best choice was for him to see a psychologist and discuss his issues first.

At the end of the simulation I felt I did a good job in making the decisions for the patient. I successfully helped Mr. Parker take ownership of his care and make a decision that would ultimately help him through one of the hardest nights of his life. I proactively engage the health care team and help James become informed and engaged in his care.