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Subject Area
Enhancing communication skills
Focus
Recognizing and handling manipulative behaviour
Simulation Title
A manipulative patient in A&E
Introduction Theoretical Background Exercises Videos Role-play Cards Facilitator's Notes Extra Resources
Learning Aim

To develop and refine the communication skills of healthcare personnel

Learning Objectives
  1. Apply effective communication techniques to manage potentially manipulative patients
  2. Recognise verbal and non-verbal cues associated with drug-seeking behaviour
  3. Develop an empathetic but firm approach to managing drug-seeking behaviours
  4. Develop the ability to maintain professional boundaries in emotionally charged situations
  5. Understand the importance of having a full patient history and medical records when assessing patients.
Simulation Scenario

Characters

Patient: Alex, a 32-year-old male presenting with severe back pain. Alex appears distressed and insists on requiring strong painkillers, specifically naming opioids. Known for frequent A&E visits.

Nurse: An experienced A&E nurse tasked with assessing and managing Alex’s complaint. Must apply clinical guidelines and maintain professional demeanour.

Background

Alex has presented at A&E several times over the past months, each time reporting severe pain (migraine, back pain, kidney stones, dental pain) and requesting opioids. Medical imaging has shown no abnormalities, and alternative painkillers were suggested to him. Today, Alex claims his backpain is unbearable. The nurse needs to balance compassion for his pain with concerns about substance abuse.

Setting

A triage room equipped with a computer for accessing patient records.