Consultation Models: Nursing Practitioner's Guide

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Consultation is the process of communication/interaction between the clinician and the patient in clinical setting (Pawlikowska, et al., 2007). The right consultation process could directly impact the final primary care given to patients as the pivotal contribution of the patient’s history obtained through consultation stands at 82% (Mcwhinney, 1972). Consulting with patients is considered to be the domain of medical practitioners and an appropriate consultation model helps in providing structure and right guidance to the overall process of interaction between clinician and the patient (Baird, 2006). In order to provide the best care to the patients, the nurses need to understand the common models of the consultation that has been proposed by various practitioners over time as well as they should devise their future consultation behavior by using and reflecting on these models.

 All the models (including Weiners, Maslow’s, Balint’s, Helman’s, Pendleton’s etc.) look at the consultation in different manner. In order to find the best suiting consultation style, it is important to understand each consultation process at an individual level (Lusignan et al., 2003). Many of the authors have devised consultation models differently ranging from those being doctor-centered to the ones where patient and doctor share equal responsibility throughout the consultation process (Lusignan et al., 2003). In order to devise a consultation model that best suits’ one’s consultation style, this assignment has been structured. This report will discuss various models of consultation considering both approaches of biomedical and psychosocial and reflect on their evolution over time. Ultimately, the role of communication skills of clinicians/nurses will also be discussed along. Finally, a best-suited nursing consultation model will be developed using the already constructed consultation models. 

Defining Consultation

Consultation is an intimate and private communication process between the patients and the clinicians (Kaufman, 2008). It aids the clinicians in assessing the health problems and patients’ medical history in the clinical settings. As nurses expand the practice boundaries, the consultation and history taking skills of them are emerging out to be extremely important. Consultation process builds a therapeutic relationship between the practitioners and the patients in which the symptoms, problems and feelings of the patients are diagnosed (Walsh et al., 2006). All the consultation processes aim at either diagnosing the patient’s medical issues or discovering the actual needs of the patients. With different aims in mind, several consultation models have already been devised with a mutual aim of obtaining a medical history from the patients (Baird, 2004). Some of the concepts of nurses undertaking the consultation are relatively new; however, various consultation models and communication skills are famous in the medical literature. Some of the consultation models are discussed as below.

Poorly defined scope of Chunnel Tunnel also led to scope creep resulting in substantial increase in cost estimates and time delay. No attention was given to protecting scope creep especially during the development phase. The scope creep of Chunnel Tunnel also incurred due to the bi-national working arrangement between Treaty of Canterbury and IGC as the later body was given huge bureaucratic power but wasn’t given any financial retribution due to which cost and time overruns incurred while causing scope creep  (Giammalvo, et al., 2005). 

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