Oh the dread! If you’re a nurse practitioner student going through a tough round of clinicals, one cause of your education-related anxiety is likely presenting patients to your preceptor. Summing up a patient in a brief on-the-fly presentation is tricky. Although you’ve written plenty of SOAP notes, nurse practitioner students often struggle with communicating this kind of information verbally. So, how do you neatly package your next patient encounter and deliver the message in a svelte manner?
Here’s a little advice from someone who’s been there.
1. Take a Formulaic Approach
As a nurse practitioner, I often completely ignore everything I’ve done in written format when it comes to verbal presentations. But, there’s no need to reinvent the wheel here. Stick with a SOAP (Subjective, Objective, Assessment, Plan) format as you verbally present patients to your preceptor. This keeps your communication organized and prevents you from repeating information.
Begin your presentation with an opening line that packs a punch. Explain who the patient is and why they are being seen today. You may also include a bit of information about your overall impression of the situation if it will affect patient flow or demands immediate attention, for example if the patient is in distress or you suspect may need to be admitted to the hospital.
2. Be Prepared
Before bounding over to your preceptor and presenting your most recent patient encounter, take a step back and think through the scenario at hand. Gather any information that will be necessary for your presentation, and do so directly from the patient. Ask about pertinent allergies or medical history, to name a few. If you have a patient presenting for dyspnea, for example, your preceptor is likely to ask if the individual is a smoker. Anticipate the questions your preceptor will ask. Make sure you’ve gathered relevant information before you present.
Tip: Charts have a tendency to be inaccurate when it comes to patient histories. So, ask the patient about pertinent information yourself.
3. Know Your Audience
Preceptors come in all shapes and sizes and vary when it comes to how they prefer patient presentations from nurse practitioner students. Some preceptors may value succinct overviews. Others will appreciate a more detailed rundown. Some preceptors may be casual and conversational in nature. Others will expect nothing but professionalism. Get a feel for your preceptor’s preferred presentation style and adjust your delivery accordingly.
Practicing your presentation briefly in your head, or audibly if the environment allows, gives you the greatest chance of success in your delivery. Hone the presentation until you can recite the information in the most concise manner possible. Time is of value in clinical practice. If your preceptor would like you to elaborate on the patient, he or she will ask. Along similar lines, present only pertinent information – everything you say should apply to the patient at hand and their current issue.
Practice your presentation until you can deliver it without glancing at notes. Ideally, when you present a patient you should have the HPI memorized at a bare minimum. Notes should be used only to recall labs values or medications – otherwise you look like you don’t know what you’re talking about.
5. Propose a Plan
Nothing strikes a nerve with preceptors more than when NP students present patients without a plan of care. Even if you’re wrong, it shows initiative to state what you think the best course of action should be for the patient. So, take your best guess and suggest the interventions you think would be appropriate for the encounter.
6. Ask for Feedback
Presenting patients verbally takes a lot of practice. As a nurse practitioner student, you won’t get it right on the first, second or even third try. Remind your preceptors that discussing patients in the provider role is new to you and that you value any feedback they can offer to improve your presentation style. This also helps you determine the individual preferences of your preceptor so you’re not shooting in knowing your audience.
7. Be Honest
When your preceptor asks a question about the patient and you’re not sure, don’t make something up. Ever. Your preceptor will find out and your credibility will take a turn for the worse. If you neglect to gather relevant information or assess an aspect of the patient’s problem, a “Let me find out!” will do.
The way you present patients as a nurse practitioner or student will be seen as a reflection of your capability as a provider. If your presentation isn’t on point, it makes you look disorganized or incompetent. So, practice, practice, practice until you’ve got your presentation style down pat.
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