Who controls the session?
I thought I had a simple case today since the patient is a nurse. However, I learned two lesions form this case. 1) Don’t let assumptions control you; 2) don’t let patient control the session, especially while taking pedigree.
Because the patient is a nurse, so she talked a lot when I took pedigree, including every little detail. I didn’t stop her because I felt rude or less concern for a patient if I interrupted. So as XXX commented, she controlled me. In this case, I should highlight that we are more concern health issues related to her current pregnancy, that anything would put the baby at increased risk rather than any health problems. How to bring a patient back without hurting their feelings when they are going too far is an art and also main counseling skills, I think. Only by doing so, we actually have enough time to address her real concerns and questions.
One of the patient’s concern is her sister is a CF carrier. Her CF carrier screening is negative for 32 mutations. I assumed without careful thinking that her baby’s risk to have CF is very low given the fact she is not a carrier. My assumption is she had the same CF carrier testing as her sister. It is possible but could be wrong. The best way to deal with it, as XXX jumped in, is to get hold of her sister’s record and see if she carries the particular gene mutation. Alternatively, testing her husband to rule out him as a carrier.
I realize that my assumption sometimes blocks my thoughts and performance. As a GC, getting rid of assumption in the first place is essential.
