step 2 cs counselling

Smoking cessation - SPANCSTER
Stressor
Problem (heart lung cancer)
A dvantages(improved breathing and increase energy)
Nicotine patch (i can offer u reading materials)
Counselors (i can refer u/give u their number)
Suport system
Taper down (try to teper doen if its hard)
Exercise program for u to quit right away
R ewards ( treat urself with a nice gift with the money u save from not smoking)
 
How to approach and council a patient who is a smoker:

• Physician: Do you smoke cigarettes?
  Patient: Yes, I do.
• Physician: How many packs of cigarettes do you smoke per day and for how many years have you been smoking for?
  Patient: One pack per day for the last 15 years
• Physician: Have you ever tried to quit smoking?
  Patient: Yes, but its really hard so I always give up and start smoking again.
• Physician: Well, I strongly recommend that you quit smoking. Smoking is a major cause of cancer and heart disease. It can lead to lung cancer, COPD, bladder cancer, heart attack and stroke. Are you interested in trying to quit now?
  Patient: Yes. (If the answer is “no”, see below.)
• Physician: I would be happy to help you quit smoking. We have many resources to help you do that and I will be with you every step of the way to support you. Let’s set up an appointment for two weeks from today, and we can get started on it then. Is that ok with you?
  Patient: No, I don’t want to quit.
• Physician: I understand that you are not ready to quit smoking yet, but I want to assure you that whenever you are ready, I will be here to help you.

 Alcoholic

• How many drinks do u have in a week
• how many drinks do u have per day
• CAGE
• have u ever felt the need to cut down on ur drinking?
• have u ever felt annoyed by criticism of ur drinking?
• have u ever felt guilty about drinking?
• have u ever had to take a morning eye opener?

• I am concerned about ur drinking . It can lead to liver disease,cause problems with bleeding, or even predispose you to early dementia.

• Are you interested in cutting down or quitting.?
• YES : i am glad that you want to quit. a variety of resources is available to help u quit drinking,and i would like to discuss them with u. let"s make an appointment later this week to talk about ur options.in the meantime, i have printed up a list of resources,and my office assistant will bring it to u.

• NO : i realized that u r nt ready to quit drinking ,but i want to assure u that if u decide to try ,i will be here for u ,ok?