A weight discussion that feels judgemental

Setting: A primary care nursing room

A patient has attended a scheduled review but does not want weight to dominate the visit. The supplied plan permits asking permission to discuss priorities and offering a later appointment for that topic.

Task

Explore the concern behind the opening: "If this is another lecture about my weight, I would rather leave."
Clarify the specific barrier and acknowledge its effect on the patient.
Explain the supplied next steps and respond to this possible question: "Will refusing that discussion mean I cannot get help with the tiredness?"
Check the patient can distinguish what is agreed from what needs confirmation.

A weight discussion that feels judgemental supplied plan

A patient has attended a scheduled review but does not want weight to dominate the visit. The supplied plan permits asking permission to discuss priorities and offering a later appointment for that topic.
The nurse can record the patient's fatigue concern and arrange the appropriate clinical review under the practice process.
The nurse may ask permission to discuss weight separately or offer a later appointment if the patient prefers.
Do not attribute fatigue to weight, diagnose its cause or prescribe a diet from this conversation.
Let us hear about the tiredness: when you notice it, how it affects your shifts and what has changed. I can document that account for the appropriate review through the practice.
We can leave weight off today's agenda if that is your preference. If you later want a separate conversation about it, we can discuss an appointment; that is not a condition of getting your tiredness reviewed.

Fictional exam scenario only. Supplied arrangements are not medical guidance for a real patient..