Billy Bob a 72-year-old male with a history of strokes comes into the clinic for his annual checkup that was scheduled by his wife.

When the nurse practitioner walks into the room to introduce herself the patient is sitting on the exam table in a gown. The patient states “ I’m not going to be taken care of a woman, who should be at home washing dishes, I want a man.” This is verbalized sharply and directly. The nurse practitioner explains there are no make providers that work at the facility, and she is licensed and able to treat patients which would include being able to perform an annual checkup on the patient. Billy Bob states this is ridiculous and begins to get off the examination table.  The nurse practitioner explains to the patient that she won’t keep him but states the exam will be thorough but will not take long to complete. The nurse practitioner explained to the patient where she would start and walk him through the processes and if he would like she could refer him to a male doctor at another clinic. The patient sits back down on the examination table and states “ Just do the damn checkup, you women are always so argumentative.” The nurse practitioner was able to complete her examination and refill the patients’ prescriptions. The patient asked for the referral and the nurse practitioner gave him the contact for across the street. The patient states “Thank you for the referral but that’s the last time my wife makes my appointments as I will not have another woman take care of me.”

Challenging behaviors in this scenario would be the patient not wanting to be seen by a female provider. The patient makes discriminatory remarks about how a woman should be home washing dishes and that a man should be working and seeing patients. The patient’s behavior was direct and demanding. The patient was getting up to leave due to not wanting to be seen. EvenEven after the appointment, the patient made it clear that he would not be seeing a woman again. Although the patient was able to get examined and his medications were filled, he still wanted to be referred and be seen by a male provider.

Due to the patient’s behavior, this negatively impacts the patient-provider relationship. This is due to the discriminatory behavior of the man. This would be enough for the provider to not want to see him again as a provider. This can place strain on the provider and even make the situation tense. If the provider was rushed during this assessment the provider may have missed essential findings in the patient’s exam. The patient could have made the provider stressed or even made her feel intimidated or scared.

Techniques included to help enhance communication would be to remain calm and professional, which the provider did maintain while dealing with this patient. The provider educated the patient on how the exam would go but did state he was welcome to leave if that is what he wished. The provider did not engage in the argument but gave the patient options (Chary et al., 2021). The provider did use active listening as the patient was voicing his wants in a provider.

Billy Bob a 72-year-old male with a history of strokes came into the clinic for an annual checkup. On introduction of the nurse practitioner, the patient was sitting in a gown on the edge of a bed when the patient realized that the nurse practitioner was a woman, he was very upset stating he wanted to have a male examine him and that a woman should stay home and wash dishes. Do you know if the practitioner educated the patient on what would happen during the exam and that references could be provided for future visits, but he was free to leave if he would like. The patient decide