GP Stage 3 Simulated Consultation - Relative 8
You are an SHO on a paediatric ward, looking after 7 year old Christopher who was admitted two days ago with a cystic fibrosis exacerbation. This was Christopher’s fifth admission in the last five months. Christopher’s parent has arranged to see you to discuss Chrisopher’s progress. To your knowledge, Christopher has improved well and the plan is to consider discharge in 24-48 hours, with oral antibiotics.
You are Brook the parent of 7 year old Christopher who was admitted two days ago with an exacerbation of cystic fibrosis. You would like an update on Christopher is likely to be discharged; on the whole, you are pleased with how he has improved over the past 48 hours and believe that he should be ready for discharge in the next 24-48 hours.
In addition to discharge plans, you would also like to discuss the frequency of Christopher’s admissions. You believe that this is largely contributed by the neglectful actions of other parents at Christopher’s school as well as the school teachers who encourage students to attend class when they are unwell. You would like the doctor to confirm your suspicions, and would appreciate if the doctor could provide a strongly worded letter so that you can take this to the school regarding their neglectful actions. If advised that this is not possible, you become upset and question whether the doctors have Christopher’s best interests at heart.
At home, you have three other children under the age of five, two of whom have moderate learning disabilities. Your partner is away for work most of the time, and you rely on the voluntary help from your mother when she is available. Any offers for further assistance would be very much appreciated. Given your numerous demands, you do not have time presently to arrange or attend a GP appointment. You are otherwise well, with no personal medical concerns.
The key to this consultation is understanding why Christopher’s parent is making this unreasonable request which as a doctor, you are not qualified to assess or indorse. Exploring alternative reasons for Christopher’s recurrent hospital admissions (eg. Treatment compliance/community follow up) would be appropriate. In relation to the additional support predicament, a GP appointment would be ideal, however given that Christopher’s parent is not receptive to this, arranging a health visitor appointment or GP home visit may be appropriate.