mymrcgp ©

Case 2

 

 

Candidate Information:

 

Jane Harris, Age 30

Significant Past History: Asthma

Current Medication: Salbutamol 2 puffs as required, Micrognon 30

 

 

 

Actor Instructions:

 

You are Jane Harris, a 30 year old single mum to Joshua who is 2 years old. You have come to the GP as you are very concerned about Joshua. Joshua has been left him with your mum whilst you attend this appointment.

 

Information freely divulged

Two nights ago you had to call a 999 ambulance for Joshua because he had started fitting. Joshua was taken to accident and emergency. You found the experience very frightening and at the time feared that Joshua might die. The fit stopped in the ambulance and the doctors in A&E gave Joshua paracetamol and ibuprofen. Joshua was monitored and then discharged later that day. The hospital doctors  told you that the fit may have been caused by a virus. Due to the stress of the situation you were unable to retain any further explanation given by the doctors at the hospital. You don’t understand why they didn’t do any further tests such as a brain scan or EEG.  You are worried that Joshua might have epilepsy and that he will have further fits.

 

 

Information divulged if asked

  • Joshua has had no previous fits.

  • A few days before the fit Joshua had a runny nose, loss of appetite and fever.

  • You had been giving calpol to Joshua for his mild fever.

  • Joshua was born at full term, with no complications by vaginal delivery.

  • Joshua has been fit and well to date with no significant past medical history

  • Joshua has had all of his childhood immunisations to date.

  • You have no concerns about his development

  • There is no family history of epilepsy

  • Joshua seems well now.

  • If asked about your underlying concerns reveal that you are anxious because you have read about a child aged 6 who had a brain tumour which was identified after she had a fit.

  • If asked about your expectations reveal that you are hoping the doctor will arrange a brain scan to check for a tumour or epilepsy.

  • If asked how you are coping reveal that you have been tired recently. Your are a single mother and find balancing work and caring for your son exhausting. Your mother is supportive and you have a good network of friends. Despite your hectic life you are happy and coping.

 

If the doctor explains what has happened to Joshua (febrile convulsion) in a way you can understand and is empathetic you feel happy to bring Joshua in for a review appointment at the surgery and will accept that no further investigations are necessary

 

If you feel the doctor is not empathetic or does not explain clearly then you will say that you want to see a specialist for a second opinion and reveal that you are not happy with the consultation.

 

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