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Patients Needs
· They are in an altered state of awareness
· Fear or unkown is profound
· They fear loss of control
· Emotions may be unnatural
Personal needs as a Tech
· Helping others
· Working with people
· Making a difference
· Thinking critically
· Demonstrating creativity
· Achieving results
Maslow’s Hierarchy of Human Needs
· People strive from a basic level of physiologic needs toward a level of self-actualization
· Each level of needs must be satisfied before an individual proceeds to the next level
· Patient’s are often at the lower levels of Maslow’s hierarchy
Patient Dignity
· Deals with a patient’s self-esteem
· Patients feel a strong loss of power over their fate
· Embarrassing situation that they feel isolates them from others
· Loss of privacy and access to loved ones
Communication Process
Sender->Message->Receiver->feedback->
Communication Essentials
Scope of practice (can’t tell if something is broken or wrong)
Communicate with the Radiologist
Communication needs to be Accurate and timely
Verbal Communication
· Spoken words
· Written words
· Voice tone
· Slang and jargon
· Organization of sentences (sound professional)
· Humor (read the room)
Nonverbal
· Body language
· Touch
· Professional appearance
· Physical presence
· Visual contact
· Personal hygiene
3 types of touch:
1. Touching for emotional support
2. Touching for emphasis
3. Touching for palpation
Palpation
· Application of light pressure with the fingers
· In x-ray we do this a lot
· It takes practice to do correctly so the patient experience is a professional one
Points to Consider
· The average American reads at the eighth to ninth grade level
· 44% of people age 65 and older read at about the fifth grade level or lower
· 48% to 80% of patients age 60 and older have inadequate functional health literacy
Common Patient types
· Seriously ill and traumatized patients
· Visually impaired patients
· Speech- and hearing- impaired patients
· Non-English-speaking patients
· Mentally impaired patients
· Substance abusers
Mobile and Surgical Patient Communication
· Begin by calling the patient’s name, identifying yourself and your qualifications to the patient, and explaining the procedure.
Communication with patient family and friends
· Professionally introduce yourself
· Briefly explain (the procedure) why you are there
· Explain why they must leave the immediate area during exposure
· Most of your communication should be with the actual patient.. depends on the circumstances
Pediatric Patients
· Come down to their eye level and talk
· Speak softly and less authoritatlively
· Set up equipment before the child enters the exam room
· Soften room lighting
· Avoid loud and dramatic equipment movements
· Use gentle touch
· Maintain eye contact
Physical changes of functional Aging
· Slower psychomotor responses (moving hands)
· Slowing of info processing
· Decreased visual acuity (can’t see as well)
· Decrease in senses
Respiratory System
· Decreased cough reflex
· Shallow breathing
· Decreased pulmonary capacity
· Kyphosis (hunched forward)
Musculoskeletal System
· Osteoporosis
· Arthritis
· Decreased muscle strength
· Atrophied muscle mass (muscle is dying)
· Fear of fractures
Cardiovascular System
· Decreased cardiac effieciency
· Orthostatic hypotension (low blood pressure)
· Arteriosclerosis (stiff arteries)
· DVT (blood clot)
· General feeling of tiredness (malaise)
Integumentary System
· Loss of skin elasticity
· Change of skin texture
· Loss of touch sensation
· Diminished sensation of heat or cold
· Loss of subcutaneous fatty layer
Gastrointestinal System
· Loss of appetite
· Decreased secretions
· Decreased GI motility
· Decreased sphincter muscle control
Terminal Patients (dying)
It is important to understand that death is part of the cycle of life
Advanced directives
· Legal document prepared by a living competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding their care
· Aka: living will, durable power of attorney for health care
Patient autonomy
Ability and right of patients to make independent decisions regarding their medical care
Five Stages of Grieving Process
1. Denial (grieving)
2. Anger
3. Bargaining
4. Depression
5. Acceptance (put on hospice or accept death is coming)
Patient History Process
· Look at taking a patient history as an interview of the patient.
· In many cases the radiologic sciences professional is the eyes, ears, and mouth, of the radiologist.
· Possessing good history-taking skills is an essential responsibly of the radiologic sciences professional
· Info gathered needs to be accurate and specific in detail, if possible
· Genuine interest in what the patient has to say, attentiveness, and an aura of professional competence can provide patients with a real sense of caring
Qualities of the Interviewer
· Acknowledge patient’s anger, if present
· Respect patient
· Be genuine
· Empathize (not sympathize) with patients condition (feel for them)
· Patients need to feel the info they are providing important
· Don’t intimidate patients
· Be attentive to detail
· Demonstrate accurate note-taking skills
· Multitasking
· Polite
Data Collection Process
· Most patients understand the importance of a history and will provide info as requested
· Remember, the info needed by the radiologist is specific to the patient’s reason for the examination
· Never disregard anything the patient says, especially if it does not fit with the opinion you are forming about the patient’s symptoms
· What do radiologists want to know about the patient history?
· Why is this examination being done?
Questioning Skills
· Use open- ended questions
· Avoid Leading questions
· Facilitate a response from the patient
· Remain quiet to get a response
· Use probing questions to focus in on more detail
· Repeat patient response to clarify and conform
· Summarize to verify accuracy
Objective data
· Perceptible to senses
· Able to be measured
· Often physiologic signs that can be seen, heard, felt and so on
Subjective Data
· Patient feelings
· Pain level
· Attitude
· Opinion of observer
· Subject to interpretation
· Symptoms of illness
Chief complaint
· MDs tend to focus on this
· Allow the patient to add more than a single complaint wheni t appears multiple complaints are valid
· Ignoring all symtoms except the most predominant can cause you to miss other important clinical info
Chronology
· Timing of the history of the onset, duration, frequency, and course
· “first symptom”
· “when”
Sacred seven of medical histories
1. Localization (precise area)
2. Chronology (time frame)
3. Quality (Character)
4. Severity (Intensity/Quantity)
5. Onset ( when was the first time)
6. Aggravating or alleviating factors (what makes it worse)
7. Associated manifestations (other issues accompany the chief complaint)
Patient History Considerations
· Does patient history data match requisition?
· Do symptoms support exam?
· Verify symptoms with exam request
How would you describe the pain?