Consultation In Nursing Case Study

Question #6

In advanced practice nursing (APN), consultation has multiple definitions depending on the context and setting. Nurse practitioners (NPs) can be in consultation with a patient or the term can be interchangeable with referral and collaboration.1 The goal of consultation is to enhance patient care through the improvement of skills and building confidence to promote positive interprofessional relationships. Unlike referral and collaboration, the practitioner may not physically see the patient during consultation and the advice given is solely left up to the consultee and patient to accept or reject. In client-centered case consultation, the most common type of consultation, the APRN usually sees the patient in person to complete

The APRN (consultant) has to evaluate the consultation request and determine its clinical appropriateness. If the request is not appropriate, the consultant may collaborate with the consultee to co-manage the patient or refer. In my current skill level, I can confidently identify when help is need in managing a patient and clearly articulating what I have attempted already with the consultant. Sometimes, my reason for consultation can be due to a lack of knowledge in a particular disease management. Also, I lack experience in being the consultant, and I realize this will only come with time and practice. My goal will be to work, read guidelines and journals to work toward expertise knowledge in geriatric syndromes for my specialty. Also, to increase my consultation skills, I will self-reflect when I have been the consultant or consultee and the clinical outcomes that arise. I need to keep track of the clinical scenarios encountered so that I can build my confidence and knowledge when encountered with the same patient problem in the

The consultant must remember that the consultee is ultimately responsible for the clinical management of the patient, as recommendations are only offered and up to the consultee to accept or reject them. Having the knowledge regarding various geriatric syndromes such as delirium and dementia, makes me an easy target in helping to manage our older adult patients in the hospital. My weakness is learning to let go after giving advice and to not become so entrenched with the patient case that my role crosses over as the primary team managing the patient, when in reality I am only consulting. I will make sure to delineate my role beforehand and to uphold to what is agreed upon to prevent malpractice and mismanagement of the patient. Moving forward, the consultee starts to collect information from the consultant regarding the patient and background of the problem and identifying the type of consultation: the patient has a complex and unusual problem (patient centered) or the problem stems from a lack of knowledge, skill or confidence from the consultee (consultee centered). Once the type of consultation and exact problem is identified, then interventions can be made to address the problem. If the problem is due to a lack of experience on behalf of the consultee, the consultant may intervene by