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Subject Area
Enhancing communication skills
Focus
Recognizing and handling manipulative behaviour
Simulation Title
A manipulative patient in A&E
Learning Aim

To develop and refine the communication skills in healthcare personnel

Learning Objectives
  1. applying effective communication techniques to manage potentially manipulative patients
  2. recognizing the verbal and non-verbal cues associated with drug-seeking behaviour
  3. developing an empathetic but firm approach to managing drug-seeking behaviours
  4. developing the ability to maintain professional boundaries in emotionally charged situations
  5. understanding the importance of patient history and medical records in assessing patient needs
Simulation Scenario

Characters

Patient: Alex, a 32-year-old male presenting with severe back pain. Appears distressed and insists on needing 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.