Providing an answer
The tutorials on this website equip you with background knowledge, show you how and why to ask for more data, and assist you in finding and assessing relevant information. But providing an answer is specific to each individual clinical situation, and we can only give you some general guidance about that.
Providing an answer will require decision-making, maybe some critical evaluation of evidence, and certainly communication skills to tailor your response to the other person’s needs.
Sometimes you'll find that the person you're dealing with hasn't asked the right question in the first place, and your answer needs to reflect this. For example, maybe the question was about a side effect of simvastatin, but your investigation points to the patient's symptoms being caused by an interaction or by a side effect of a completely different drug. You shouldn’t just blindly answer the question asked, if your research and analysis show otherwise. Evidence suggests that experienced pharmacists answer a different question to the one they were asked about once in every four times.
Here are our top three tips on answering a clinical problem:
1. Give a PRACTICAL answer
You need to give a practical, relevant answer to the question you’ve been asked. Try not to be 'theoretical', or to just quote books and guidelines when something more individualised is required. Always keep this in mind: Can my answer be used to help the care of the patient?© Crown copyright 2017 |
Expert knowledge, personal clinical experience, evaluation skills, and professional judgement allow you as the pharmacist to tailor your answer to the needs of an individual patient. In other words, pharmacists offer clinical advice. This distinguishes what you do from the valuable role played by the hospital library, for example, which provides information.
So, don’t tell a doctor that a medicine is contraindicated in renal disease. Instead, explain how they can modify the dose, monitor the patient, or choose a different medicine that’s safer. Similarly, don’t tell a nurse that there’s an interaction in the BNF – explain how to avoid or manage the situation.
A lot of the time, giving a practical answer means anticipating further questions. You might give a wonderful explanation of the clinical presentation of a side effect. But what the doctor will be thinking is:
- Should I stop the drug or can I just lower the dose?
- Can I use a different drug? Which one?
- When will the side effect go away? Does it need treating?
2. Assess the URGENCY
Make sure you know how urgent the situation is. Clinically urgent problems will generally be obvious. But sometimes there may be time pressures for practical reasons: the doctor is going off duty, the patient has a taxi waiting etc. Always ask about your enquirer’s deadline. This also helps you manage priorities in your own workload.If you’re not going to be able to make the deadline, contact them and let them know. Don’t provide a wonderful answer that’s too late to be useful. At the same time, if clinical urgency means you can't research an answer as completely as you would like, then you need to explain this (see below).
© Crown copyright 2017 |
- We all need help sometimes. Ask for help when you need it. A second opinion may give you a different perspective.
- Your professional judgement will be valued by other professionals, but don’t guess an answer in order to be helpful and don't offer a solution that you're not sure about. If you answer a question, but worry about it afterwards because you know you've stuck your neck out too far then you’ve behaved inappropriately and might be putting the patient at risk.
- Discuss any limitations to your answer openly. Is your advice based on limited data? Is there a difference of opinion about what to do? Do you need the clinician to monitor the patient in a particular way?
- There may be occasions when you cannot provide an answer at all. Admit it, when you can't help. Try and signpost the enquirer to another person who might be better placed to help if you’re stumped or think it’s not your role.
- If you are just starting out, it can sometimes be difficult to find the right words to get your message across clearly, especially if you are providing a written answer. The University of Manchester have developed a useful Academic Phrasebank that may help you.