NURS 6512 Week 1 Essay Discussion
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.NURS 6512 Week 1 Essay DiscussionFor this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:
76-year-old Black/African-American male with disabilities living in an urban setting
Adolescent Hispanic/Latino boy living in a middle-class suburb
55-year-old Asian female living in a high-density poverty housing complex
Pr-school aged white female living in a rural community
16-year-old white pregnant teenager living in an inner-city neighborhood
To prepare:
With the information presented in Chapter 1 in mind, consider the following:
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?
What risk assessment instruments would be appropriate to use with each patient?
What questions would you ask each patient to assess his or her health risks?
Select one patient from the list above on which to focus for this Discussion.
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.NURS 6512 Week 1 Essay Discussion
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3
Post a description of the interview and communication techniques you would use with your selected patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days who selected a different patient than you, using one or more of the following approaches:
Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research.
Communication skills needed for patient-centered care include eliciting the patient’s agenda with open-ended questions, especially early on; not interrupting the patient; and engaging in focused active listening. Understanding the patient’s perspective of the illness and expressing empathy are key features of patient-centered communication. Under–standing the patient’s perspective entails exploring the patient’s feelings, ideas, concerns, and experience regarding the impact of the illness, as well as what the patient expects from the physician. Empathy can be expressed by naming the feeling; communicating understanding, respect, and support; and exploring the patient’s illness experience and emotions. Before revealing a new diagnosis, the patient’s prior knowledge and preferences for the depth of information desired should be assessed. After disclosing a diagnosis, physicians should explore the patient’s emotional response. Shared decision making empowers patients by inviting them to consider the pros and cons of different treatment options, including no treatment. Instead of overwhelming the patient with medical information, small chunks of data should be provided using repeated cycles of the “ask-tell-ask” approach. Training programs on patient-centered communication for health care professionals can improve communication skills. NURS 6512 Week 1 Essay Discussion
The history is the foundation of comprehensive assessment. It is a written picture of the patient’s perception of his or her past and present health status and how health problems have affected both personal and family lifestyle. Properly recorded, it generally provides an organized, unbiased, detailed, and chronologic description of the development of symptoms that caused the patient to seek health care. The history guides the rest of the assessment process: physical examination, x-ray and laboratory studies, and special diagnostic procedures. When skillfully obtained, the history often contributes in a significant way to an accurate diagnosis. It is believed by many clinicians that an accurate diagnosis can often be made after the history has been obtained and before the physical examination begins.
Traditionally, the task of obtaining a patient’s complete history has belonged to the physician, and only sections of the history were taken by other members of the health care team. Today, however, complete health histories are taken by nurses and physician assistants. Physical therapists, social workers, dietitians, and respiratory therapists (RTs) obtain medical histories from patients with an emphasis on information pertaining to their specialty.NURS 6512 Week 1 Essay Discussion
Regardless of whether a student or clinician is expected to obtain and write a comprehensive history, each must be able to locate and interpret historical information recorded in the patient’s medical record. The information is used with other assessment data and provides the foundation for inter professional communication to enable many medical disciplines to collaboratively develop or alter a plan of care. In addition, identifying the patient’s symptoms and changes in those symptoms permits the patient care team to assess the effect of therapeutic interventions and overall progress.
This chapter highlights interviewing principles and describes the types of questions used in history taking and the content of the comprehensive health history, emphasizing specific information needed for assessment of the patient with cardiopulmonary complaints. Chapter 3 discusses the most common cardiopulmonary symptoms.NURS 6512 Week 1 Essay Discussion