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SOAPE NOTE

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In a SOAPE NOTE, S is the subjective data, O is the objective data, A is assessing the problem, P is the plan of care, and E is Evaluation. The types of professionals who would use the SOAPE note form are mainly the; Physicians, veterinarians, nurse practitioners, behavioral healthcare professionals, counselors, nurses, and doctors.

 

There are two significant ways in which SOAPE NOTES help professionals; first, they are used for recording a patient’s initial visit. Second, they are also used for recording follow up on treatments administered by a physician.

 

28.

For a patient who was just diagnosed with a disease but does not want to follow up, I should first respect their decision for refusing to follow up even though their decision may be irrational. I can go on and offer the patient with my clinical opinion without forcing him or her to accept my opinion.

 

For a patient who refuses treatment, I would respond by explaining to the patient the possible implications of his or her action, without forcing him or her to abide by my clinical opinion.

 

The communication skills that I must use to talk to a patient who refuses treatment are; good first impression, emotional control, and empathetic listening.

 

I would approach a patient who refuses treatment by first, showing a good first impression whereby I can smile to the patient, give my hand for a shake, and look into the patient’s eye. Second, I can have emotional control, whereby I can consider speaking slowly and quietly and avoiding reacting to a patient’s statements. Finally, I can have empathetic listening, whereby I can echo what the patient is saying and issue an acknowledgment of the patient’s feelings.

  Remember! This is just a sample.

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