Powerpoint Handling Difficult Situations

Anne Kendall, PhD, RD, LDN Susan Brown, MS, RD, LDN

Primary Prevention: prevent the problem before it occursOrient the intern wellSet clear expectations and goalsDetermine the interns expectations and goalsReassess mid-rotation

Secondary Prevention: early detectionPay attention to your hunches/cluesDont waitGive specific feedback early and monitor closely

Tertiary Prevention: manage the problem to minimize impactSeek helpDont be a martyrDo not pass an intern who has not performed satisfactorily

SOAP ApproachSubjective: what do you and others think?Objective: what are the specific behaviors observedAssessment: form a differential diagnosis of the problemPlan: what next?

SubjectiveChief complaint: what made you think there was a problem?Has the intern been labeled?What do you/others think?What does the intern think does s/he perceive a problem?

ObjectiveIdentify and list specific instances of the behavior to document the issuesNeed specific information to intervene effectively

AssessmentCognitive knowledge baseClinical skills less than expectedAffective issuesValuesEnvironmentalMedical

PlanGather more data?Get helpIntervene

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