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"Ain't Nobody Got Time for the Drip": The Art of the Teenage/Young Adult Wellness Exam

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milwerica has 9 years experience as a MSN, APRN and specializes in Family practice.

2 Articles; 6,324 Profile Views; 38 Posts

All too often safe sex practices, drug and alcohol consumption are not mentioned during a teenage/young adult wellness exam. Here are some ideas to help stimulate the discussion. I have had some interesting conversations with teens and parents with these friendly healthy reminders.

"Ain't Nobody Got Time for the Drip": The Art of the Teenage/Young Adult Wellness Exam

As a healthcare field we are stressed to get enough patients in for the day, phone calls, follow up labs, charting and on I could go. When providers see a teenager/young adult wellness exam on their schedule a sigh of relief and a time to "catch up" is felt. Though, I tend to take this time to educate and help a teen know that healthcare providers are here to listen.

I go through the routine typical wellness exam topics. We discuss food choices, exercise, sports, bullying, vaccinations and mental health. One of the things that I try to emphasize in emotional health is safe sex , safe alcohol use and avoiding drug abuse. I am not condoning sex or alcohol use for teenagers at all, but I want those that may partake in such an escapade to be safe. Being a teenager is a journey we all must remember. Alliances with friends, fitting in and "experimenting" are all part of the teenage rite of passage.

I start off with letting the patient know that birth control does not "mean the person is clean". The use of condoms is a better option because "ain't nobody got time for the drip." STD's or STI's are around and even though a person is "clean" does not mean they have been tested. Most are asymptomatic. I talk about chlamydia, gonorrhea, trich, then mention syphilis and HIV. With a special shout out regarding warts and "the herp." Most are curable but some are forever. You don't want to make your first "forever" to be an STD.

Most teenagers at this point are laughing and nodding their head. Some have questions regarding the different STD's and the best ways to help prevent transmission. If time permits, I also show pictures of common manifestations of STD's to help facilitate discussion, though this can backfire if using a Google search engine and click on images. I suggest having paper handouts or previously saved images when venturing to show pictures.

I also mention safe drinking. I do not condone drinking in underage but advise that when they do turn 21 years old that there should be some safe practices. There should always be a sober person in the group. Regardless if driving or not. Poor decisions are made when inebriated. Having that sober person to help others make better decisions is always welcomed the next morning. Again, "ain't nobody got time for the drip." This is a time I also bring up the HPV vaccination.

Along with safe drinking and a sober person I emphasize the trend of young adults walking home alone at bar close and ending up dead in a river. This may sound harsh but I am always overcome with sadness when I hear of young adults drowning when on their way walking home, alone, after a bar crawl or a party. Please do not drink. If drinking, drink with a sober person, do not walk home alone and let others know where you are.

I tend to conclude with "you don't want to end up dead in a river with chlamydia." Most teens/young adult are laughing and more open by the end of the visit. I tend to get more questions and "real" conversations with the patient after going through my speech.

Next time when a teenager/young adult wellness exam happens on your schedule take the time to help gain some trust with the patient. Time to develop a strong working foundation for a future healthy adult. I have had many teens/young adults in my office say "my mom made me come." Emphasize the wellness aspect, discuss the routine but make sure to mention sexuality and drugs. Parents do look to healthcare providers to help instill these ideas also.

FNP-BC, APNP Specialty: 4 year(s) of experience in Family practice

2 Articles; 6,324 Profile Views; 38 Posts

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224 Posts; 6,502 Profile Views

Bravo! We are a nation in DENIAL. Our "puritanical heritage" does NADA to address the appalling rates of teenage pregnancy and STD infection within our borders. We spend countless $$ keeping "boobies" and legitimate sex ed from our youngsters while ensuring they've got 24/7 access to wholesome bloody violence on both "news" and "entertainment" programs. Every wonder where we went wrong? It ain't where the politico point, my friend. Follow the $$.

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224 Posts; 6,502 Profile Views

I meant to also mention that a huge percentage of American youths are prevented access to basic sex ed. Some will argue this point. Some will say that issues of sex are best addressed in the home. Know what? That doesn't work. YOU may be a great educator because you are a healthcare professional reading this board. Your neighbors, however, probably suck. So please be sure not to vote for your neighbors being the sex educators of the neighborhood.

OMG I am over-tired.

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Can you show me the links to research that "huge percentages" of American youths are prevented access to basic sex ed? And how that prevention part works? Who stands at the door and bars the sex ed teachers from the classroom?

I am a school nurse and basic sex education is taught. Parents do have to sign a permission slip. Rarely do folks opt their kids out. Those that do, in my experience, do a very good job of teaching them at home. Anecdotal I know.

I just did a search here on AN for Sex Ed and came up with many great old threads; many talking about what programs school nurses used to teach sex ed. I just spent an hour re-reading them!

I found this too:

Our local women's health NP gives teens this questionnaire to fill out when they come in for birth control.

Ask Yourself These Questions

Here are some questions to think about. They will help you decide whether teen sex has a place in your life and your goals.

1. How would I feel about having to choose between abortion, adoption or raising a child?

2. Am I ready to give up my freedom to parent a child?

3. Can I afford to raise and support a child?

4. What if I had to pay hundreds of dollars every month in child support until I am middle-aged?

5. If my partner and I were faced with an unplanned pregnancy, how would our relationship be affected? How would our families be affected?

6. How would my education and chance at a good career be affected by a pregnancy?

7. If I got a sexually transmitted disease, what would happen to my health? How would I feel about myself?

8. If I began having sex with my partner, and they walked out on the relationship, how would I be affected? What if this happened several times - as it does to most sexually active teens?

9. Deep in my heart and mind, do I think having sex as a teenager is right, wrong, moral or immoral?

10. Is there something special about my virginity?

11. Do I "live for the moment" without thinking of how my behavior might hurt me or another person later on or do I carefully consider the consequences of my actions?

12. Do I believe that sex should take place only with a serious, long-term commitment from both partners?

13. Do I assume that a sexual relationship will create a long-term commitment?

14. How can I live my life now in order to give myself the best possible chance for a successful future?

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tbaughm specializes in FNP.

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In (the great state of) Texas, abstinence is still taught in many school districts (as of 2010, about 75%) with no education on STI or pregnancy prevention. So yes, there are still barriers to basic sex ed for many adolescents. We also have high STI rates and teen pregnancy rates relative to other states...go figure:down:

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PG2018 specializes in Outpatient Psychiatry.

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It continues to amaze me how people can get health pounded unto them from elemtary through high school and not be aware of STDs. Go America.

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