OET Speaking - Medicine - Discharge

OET Speaking - Medicine - Discharge

 Roleplay Card

Setting: Medical Ward

DOCTOR: Your patient is 54 years old and was admitted 2 days ago with right lower lobe pneumonia. He/she has made significant improvement with intravenous antibiotics and the decision made by the team to discharge home with a further 3 days of oral antibiotics from today. 

TASK

*Explain the reason for today's visit (discuss discharge decision)

* Reassure the patient (antibiotics cured pneumonia, satisfactory blood tests, and vital signs, continue oral antibiotics for 3 days etc)

* Find out about his/her home and work situation.

Stress the importance of rest at home (recovery, prevent communicable diseases, etc). Recommend a medical certificate for a further week off work.

* Advise when to return to hospital (not better after 1 week/sooner if symptoms worsen, chest pain, acute shortness of breath, high fever etc)

* Inform about follow-up visit (chest x-ray in 6 weeks) Find out any concerns/questions.

* Explain the need for an x-ray (eg., rule out the possibility of serious underlying disease, like cancer) Reassure that appointments for x-ray can be flexible around  working hours.

(Now, Your prep time is over and you can start).

Doc: Good morning, Paul. How're you feeling today?

Pt: Good morning doctor. I'm feeling a bit better. Thank you.

Doc: Glad to hear that. [ * 1. Explain the reason for today's visit (discuss discharge decision)]

I've come to discuss your progress and plans for discharge today. Your pneumonia has responded well to the treatment and the team has decided it's better for you to continue your recovery at home. 

Pt: That's OK doctor, but I'm not sure that I'm ready to go home yet. I don't still feel quite back to normal. 

Doc: [*2. Reassure the patient (antibiotics cured pneumonia, satisfactory blood tests, and vital signs, continue oral antibiotics for 3 days etc)]

I completely understand your apprehension, Paul, but please know that we have closely monitored your progress and the anti-biotics have effectively treated your pneumonia. Your blood tests and vital signs are showing positive signs of recovery and we will continue with oral antibiotics for the next 3 days to ensure everything clears up completely. I reassure that you are safe in our hands and we are here to support you every step of the way.

Pt: OK, doctor. but when I get home?

Doc: That's good question, Paul. [* Find out about his/her home and work situation.] 

 Could you please tell me a bit about your home and work situation? It's important for us to understand your environment to a smooth transition back to your daily routine. 

Pt: Sure. I live with my partner and 2 teenaged children. I work in a busy supermarket and I will have to re-join as soon as possible. I'm worried about finances and I'm not sure if I can afford to take more time off work. 

Doc: [Stress the importance of rest at home (recovery, prevent communicable diseases, etc). Recommend a medical certificate for a further week off work.] It's important to prioritize  your health, Paul. Mind you, rest is crucial for a full recovery and prevent spreading any communicable diseases. I would recommend your taking at least a week off work. Returning to work soon could potentially prolong your recovery and even put others at the risk of contracting any lingering infections. Your body needs time to recuperate and resting at home will greatly aid your recovery process. I will provide you a medical certificate to support for your absence. Again, your well-being is paramount and we want to ensure a full and speedy recovery. How do you feel about it, Paul?   

Pt: Thank you, doctor. I appreciate your concern. I will follow your advice and take a week off work to rest properly.

In the meantime, is there anything specific I should watchout for once I'm home? 

Doc: Absolutely, Paul.  [Task * Advise when to return to hospital (not better after 1 week/sooner if symptoms worsen, chest pain, acute shortness of breath, high fever etc)]

It's important to keep an eye on your symptoms, once if you are not feeling any better or if you experience any concerning symptoms like chest pain, acute shortness of breath, or a high fever, don't hesitate to contact us or return to the hospital as soon as possible. 

Pt: OK doctor. I understood it. What if I don't have any issues? 

Doc: Great.  [Task * Inform about follow-up visit (chest x-ray in 6 weeks) Find out any concerns/questions.]

Even if you don't have any other issues, it's still important to follow-up to ensure everything is fully resolved. We will schedule a follow-up visit for a chest x-ray in 6 week's time. This is a standard procedure that will help confirm that pneumonia has completely cleared up and rule out any underlying concerns. 

Do you have any further questions?

Pt:  Doctor, I understand the significance of follow-up, but when my symptoms have improved, I really don't want to take more time off work. Is there any flexibility in scheduling my follow-up without affecting my working hours fully?   

Doc: Well, your concerns are appreciated. [ Task * Explain the need for an x-ray (eg., rule out the possibility of serious underlying disease, like cancer) Reassure that appointments for x-ray can be flexible around  working hours.]

But remember, the follow-up of chest x-ray is essential for ensuring that the pneumonia has fully resolved and rule out any potential underlying issues such as cancer . I want to reassure you that you can be flexible in scheduling the appointment according to your work schedule. We will find a time that suits you best.

Pt: Thank you doctor for your flexibility in scheduling the follow-up. and it's a great relief for me. 

Doc: You are welcome. Wish you a speedy recovery.

                      ... The End...