Chapter 7 Flashcards
Listening
Paying undivided attention to what the patient says and does
Encourage patient to speak by saying “I see” and “Go on,” etc.
Attending
Giving full attention to verbal and nonverbal messages
Body language may signal information that the patient may have omitted intentionally or unintentionally.
Maintain consistent, appropriate eye contact and use proper body positioning.
Paraphrasing
Restating the patient’s message
Leading
Helpful when starting an interaction or trying to get the patient to discuss specific health concerns
Direct leading, focusing, and questioning
Questioning
Direct way of speaking with patients to obtain subjective data for decision making and planning care
Reflecting
Repeating the patient’s verbal or nonverbal message
Silence can also be therapeutic.
Summarizing
Reading the patient your notes and asking, “is that correct?”
False Reassurance
Deprives right of patients to communicate their feelings
Includes “Everything will be all right” or “Don’t worry, you’ll be fine”
Can be implied by tone of voice
“You have a good surgeon, we’re trying our best”
Passing Judgment
Convey a strong message that the patient must live up to the nurse’s value system to be accepted
Cross-Examination
Helpful to pause between questions and ask how patient is tolerating the interview to this point
Encourage patients to express their feelings about the pace and nature of the interview
Unwanted Advice
Nurse’s role is to offer expert guidance based on therapeutic principles intended to promote health and wellness.
For example, focus on physiological effects rather than social stigma when encouraging smoking cessation
Technical Terms
Avoid jargon, slang, or clichés, initials and acronyms
Sensitive Issues
Be sensitive to patient’s need for silence
Watch for nonverbal signs such as tear-filled eyes
The Influence of Culture on Nurse–Patient Interactions
For example, silence may be viewed as uncomfortable in some societies but respectful in others.
Avoid stereotyping based on cultural background
Carl Rogers
Patient-centered therapy
Promoting growth, development, maturity, improved functioning, and improved coping with life of the other
Attitude plays a key role in success.
Positive Regard
Ability to appreciate and respect another person’s worth and dignity with a nonjudgmental attitude
Patients sense positive regard by nurses’ demeanor, attitudes, and verbal and nonverbal communication.
Empathy
Capacity to respond to another’s feelings and experiences as if they were your own
Concreteness
Promotes understanding and a sense of security in the patient
Implies that the nurse respects the patient’s ability to understand
Recognizes the patient’s right to know the details of the plan of care
Sources of Information (health history)
The primary source: The patient is the only one who can describe personal symptoms, experiences, and factors leading to the current health concern.
If patient unable to provide accurate information, another source of information is indicated.
Secondary source: Person or record providing additional information about the patient
Obtain patient’s permission before requesting information from another person
Phases of the Health Assessment Interview
Phase I: preinteraction
Collect data from the medical record, previous health screenings, therapists, dietitians, and other professionals
Phase II: the initial interview. Health history form often used. Responsibility to allay anxieties so patient can communicate as effectively as possible. Begin by describing the interview process and its importance.
Allow patient opportunity to express any final questions or concerns. Thank the patient
Phase III: the focused interview
Clarify previously obtained assessment data
Gather missing information about a concern
OLDCART & ICE
Focused Interview for Pediatric Patients
Determine relationship between child and caretaker
Ask preschoolers and older children about complaint even if the information they provide is incomplete.
Determine whether primary caregiver is stressed or distracted prior to interview
Sleep deprivation can result in altered recall.
Focused Interview for Older Adult Patients
Interview alone unless compromised mental status is previously known
Frailness does not mean an inability to respond appropriately.
Minimize background noise
Address patient by appropriate title
Know whether the patient is in pain and whether pain reduction therapies should be considered prior to interview
