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I’ve encountered a number of patients at my clinical rotation in the past week
Peer Responses:
Length: A minimum of 180 words per post, not including references
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
Relate to another journal
I’ve encountered a number of patients at my clinical rotation in the past week. One in particular is a 46-year-old female came in for localized pain on her left breast that has worsened since January. She describes her pain as soreness from mild that increases to severe on movement. During the interview, she reported that is her first time seeing a doctor here in the US as she is originally from Mexico. Her last mammogram was 3 years ago that showed no abnormalities according to the patient. She denies any past medical history and has no family history of any type of cancer. During the physical examination, a round firm lump was palpated on her upper left quadrant of breast and no nipple discharges was noted.
This case was interesting as this is my first encounter were I had to be addressing the concerns of the patient, discussing the diagnostic and treatment while maintaining the tone on not to put fear on the patient regarding the possibility of cancer. Acknowledging the patient’s perspective such as her worries, fear and misconceptions plays a big factor in this patient encounter. Fostering patient center communication will ensure individualized and responsive to patient health concerns, beliefs, and contextual variables (Kwame and Petruka, 2021). Furthermore, in order to achieve best possible patient outcomes, the approach needs to be based from clinical practice guidelines. Clinical practice guidelines (CPG) are developed to assists health care providers such as nurse practitioners, physician assistants and doctors in clinical practice to make the best medical decisions and recommendations for their patients. The importance of clinical practice guidelines is it “play a fundamental role in improving healthcare and patients’ outcomes by helping clinicians make the best evidence-based decisions for their patients in a time-efficient manner” (Guerra- Farfan et al., 2022).
The approach in the management of this patient encounter was cross-referenced to the published guidelines by the American College of Obstetricians and Gynecologists as recommended by my preceptor. Timely diagnosis and referrals are crucial in breast disorders. Therefore, per the recommended guidelines, mammogram and ultrasound with a possible biopsy were ordered (American College of Obstetricians and Gynecologists, 2016). Furthermore, a referral request to OB/GYN was also sent. The American Cancer Society (2021) suggest that most breast lumps are benign and not cancerous however every lumps encountered on patient my be checked and confirmed whether it is benign or malignant. A delayed or missed breast cancer diagnosis can severely affect patient outcome. A triple test of clinical breast exam, imaging (e.g., mammography and ultrasonography), and needle biopsy can lead to a definitive diagnosis in nearly all cases (American Cancer Society, 2022). This is an interesting case as it comes close to me as one of my family member is a victim of this preventable and curable disease as long as it is detected and treated timely.
References
American Cancer Society. (2022, January 14). Breast ultrasound. https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/breast-ultrasound.html
American Cancer Society. (2021, November 19). What is breast cancer?https://www.cancer.org/cancer/types/breast-cancer/…
American College of Obstetricians and Gynecologists. (2016 June). Diagnosis and management of benign breast disorders. https://www.acog.org/clinical/clinical-guidance/pr…
Guerra-Fafan, E., Garcia-Sanchez, Y., Jornet-Gibert, M., Nunez, J., Balaguer- Castro, M. and Madden, K. (2022, January 22). Clinical practice guidelines: The good, the bad, and the ugly. https://doi.org/10.1016/j.injury.2022.01.047
Kwame, A. and Petruka, P. (2021, September 3). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. https://bmcnurs.biomedcentral.com/articles/10.1186…
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