Q1 – I would choose option 2. Showing Charles how to use the app there and then will be beneficial to him as he can see it physically step by step. It will also be fresh in his mind for when he goes home and can tell his wife – this will be helpful as he will have a second pair of eyes helping him with it. However, I would also consider option 3 after having explained it to him as he does need to practice to get the hang of it. I also believe if the app isn’t working for him by the next appointment, then changing the plan is actually a good idea as there is no benefit trying something that isn’t tailored to the patient. With Charles being 65 he may not be great at technology regardless so there should be alternatives such as writing his observations down on pen and paper and bringing them for his next appointment.
Q2 – I would choose option 3 in regards to Charles returning to cycling straight away. The medical team and senior nurses will be able to advise him what is best. I can only tell him what I think and what medical advice is available – he also does have the option to refuse medical advice as he has capacity. However I do believe that senior staff members should be consulted in giving Charles a plan of when to begin cycling again and especially how often. They may suggest for example getting a lift to work 4 times a week and cycling once to ease himself (and his heart!) back in to the activity.
Q3 – I would advise Charles with option 1. As a nurse it is instinct to reassure the patient and tell them that ‘he will not have a stroke’ or ‘it is unlikely’ but this isn’t feasible as it can give them false hope and may not be true. Therefore, option 1 is the best in explaining to him what to look out for, also to explain this to his wife and relatives so that they know what signs to look out for too. Encouraging to call 999 if any of the symptoms are present is also a good idea as Charles will be reassured that help will is there if necessary.
