Chapter 3 - The Interview NU204B

What is the first part of client interaction?

The interview

Why is the interview important?

It provides a foundation to the nursing process and is the most critical part to data collection

Why is it important to not assume during the interview portion?

We know nothing about the patient, so jumping into conclusions may stray us from proper patient care

Why is the interview similar to a contract?

The patient provides their expectations and addresses their problems, while the clinician offers a solution

What process is used so each person can understand each other cleaerly?

Communication

What type of communication is said to express true feelings? Why?

Nonverbal because movements may be less conscious

When sending a message, what are the two ways of delivering communication?

Nonverbal and verbal

Why is it that the reciever may interpret a message differently?

Our perception is based on our values and culture, and many individuals respond and interpret differently

Should you assume receiver understood the message?

No. Always clarify that the receiver understood the message

Why do mishaps occur in the hospital with patient and clinician?

Patients tend to focus on their illness and many not process the communication appropriately

Why is liking others (an internal factor) important in being successful?

Understanding and compassion is present and it advocate's for the patient's health

What is empathy?

Understanding and viewing the patient's problems, while separating yourself from the client

Why is the ability to actively listen important?

Allows for the clinician to fully pay attention to the client and take note of the things said and unsaid

How does self-awareness play a role in healthcare?

We all have our own biases. Knowing them allows us to better care for the patient

Why is privacy important for patients?

They are at their most vulnerable. Privacy allows them to be comfortable

Why is it critical to avoid distractions when talking to a patient?

It destroys their trust, and it causes them to feel like they aren't important

What kind of physical environment should a clinician prepare for a patient?

Private room, sufficient lighting, quiet environment, and remove distracting objects

Intimate zone (0-1.5ft)

visual distortion occurs; used when assessing patient's lung sounds and heart

Personal space (1.5-4ft)

Can't really smell body odor, no visual distortion, physical assessment occurs here

Social distance (4-12ft)

Perceptual image less detailed, interviews occur at this stage

Public distance (12ft+)

Speaker's voice is projected, faces are hard to recognize

How should you face a client during an interview?

Equal status seating; chair should be faced at 90 degree

Is it okay for the clinician to stand when talking to a patient?

No. It creates a feeling of rushing and it embodies superiority

When interviewing a bed-ridden patient, how should the clinician face?

It is important for the position to be face to face.

Why is eye contact important during interview/while positioning the chairs and bed?

It signals proper communication

Should a patient where a hospital gown during the interview? Why?

No. Patient may feel too exposed. Comfortable clothes are recommended to ensure comfort.

What is important to understand when note taking during an interview?

Keep it to a minimum and ensure the focus is on the patient

What occurs during introducing the interview?

The clinician introducing themselves and their role and what they will be performing on the patient. It is important that an open ended question is asked at the end.

What occurs during the Working phase interview?

Data gathering. Clinician will use open ended and close ended questions. Ability to form questions and answer questions.

Why are open ended questions important?

Non biased. Allows the clients to continue explaining and talking; open narrative

What are the benefits to using close ended questions? What are things to avoid with close ended questions?

Allows you to be specific to the problem; avoid bombarding patients with a long list of close ended questions

Identify the type of response and what it is

Encourages clients to say more; shows a person you are interested

General leads/facilitation (Client's perspective)

Communicates that client has time to think, provides you with chance to observe client and note nonverbal cues

Silence (Client Perspective)

Mirroring client's words; echoes client's words by repeating a part of what was said

Reflection (Client Perspective)

Names a feeling and allows its expression; allows person to feel accepted and strengthens rapport

Empathy (Client Perspective)

Used when person's word choice is ambiguous or confusing; simplify the statement

Clarification (Client Perspective)

Identify the type of response and what it is

Clarifying inconsistent information; focusing client's attention on an observed behavior, action, or feeling

Confrontation (Examiner's perspective)

Links events, makes an association, and implies a cause; based on inferences and conclusions

Interpretation (Examiner's perspective)

Informing person; sharing factual and objective information

Explanation (Examiner's perspective)

Condenses facts and validates what was discussed during the interview

Summarizing (Examiner's perspective)

what happens during closing interview?

Clinician gives a summary of what happened and what has been learned

Why is it important to ignore the child (1-6yr olds)

Allows children to get comfortable with you by seeing how clinician interacts w/ caregiver

What is important to note when interviewing the Parent/Caregiver?

Never assume the relation of the adult and the child refer to them by their surname and ensure to use open ended questions rather than coming off as judgmental; finally, include children in little by little

What is the primary method of communicating/interviewing an infant (12months)?

Nonverbal communication

What is the primary method used to communicate with Toddler's? (12-36months)

Short simple explanations.

Method used to interview a preschooler (3-6yrs)?

Short simple explanations

Method used to interview a school age child? (7-12yrs)?

Interview caregiver directly, and ask the child questions afterwards

Method used for talking to an adolescent?

Respect and keeping the professional tone

Method used for talking to an older adult?

Avoid elderspeak, diminutive language, and always address them with their surname

Method used for talking to Hearing impaired people?

Focus on nonverbal cues and ask them for their preferred style of communication

Acutely III People (very ill patients method of interview?

Paitent information only, history of present illness, keep responses short and statements clear

What should be done when a patient asks the clinician personal questions?

Clinician does not need to answer it, if questions are too provoking or inapropriate then patient can be transferred; important to note that some of the questions can be signs of further ilness

Method of handling sexually aggressive people?

Explain boundaries or remove yourself from the situation

Method when a client cries?

Use silence or touch and explain you are here for them; ensure to not change the topic

Method when a client is angry?

Ask about the anger and listen to the patient; angry patients are not effective during a health interview

What should you do when a clinician feels threatened?

Position yourself between the door and act calm

Method of talking to patient's who are anxious?

Listen to them and act calm

What type of jargon should you use when talking to patients?

Easy simple language

How should you speak to others in healthcare? (standardized communication)

SBAR

Describe situation, background of patient, assessment of patient, and recommendation of requestion