Chapter 3 The Interview NURS221

Ad hoc interpreter

using a patient’s family member, friend, or child as interpreter for a patient with limited English proficiency

Animism

imagining that inanimate objects come alive and have human characteristics

Avoidance Language

the use of euphuisms to avoid reality or to hide feelings

Clarification

examiner’s response used when the patient’s word choice is ambiguous or confusing

Closed Questions

questions that ask for specific information and elicit a short yes or no answer

Confrontation

response in which examiner gives honest feedback about what they have seen or felt after observing a certain patient action, feeling, or statement

Distancing

the use of impersonal speech to put space between oneself and a threat

Elderspeak

infantilizing and demeaning language used by a health professional when speaking to an older adult

empathy

viewing the world from the other person’s inner frame or reference while remaining yourself; recognizing the accepting the other person’s feelings without criticismE

Explanation

examiner’s statements that inform the patient; examiner shares factual and objective information

Facilitation

examiner’s response that encourages the patient to say more, to continue with the story

Gender identity

how a person sees themselves in relation to roles and behaviors that are socially assigned to different genders

Geographic privacy

private room or space with only the examiner and patient present

Interpretation

examiner’s statement that is not based on direct observation, but is based on examiner’s inference or conclusion; links events, makes associations, or implies cause

Interview

meeting between examiner and patient with the goal of gathering complete health history

Jargon

medical vocab used with a patient in an exclusionary and paternalistic way

Leading Question

a question implying one answer is better than another

Nonverbal communication

message conveyed through body language (posture, gesture, facial expression, eye contact, touch, where one places a chair, etc.)

Open-ended Questions

asks for longer narrative information; unbiased; leaves the person free to answer in any way

Reflection

examiner response that echoes the patient’s words; repeats part of what the patient has just said

Sexual Orientation

refers to sexual and emotional attractive to others (heterosexual, bisexual, etc)

Summary

final review of what examiner understands patient has said, condenses facts and presents a survey of how the examiner perceives the health problem or need

Telegraphic Speech

speech used by age 3 or 4 years in which three or four word sentences contain only essential words

What is the first step of assessment?

Gather complete and accurate data about person’s health state including description and chronology of any symptoms; gather data; chronic or acute

What is the second step of assessment?

Establish Trust to foster acceptance and allow for data sharing; trust; cannot restore trust once it is broken

What is the third step of assessment?

Teach person about individual health state; how to treat patient based on their history; every patient is different

What is the fourth step of assessment?

Build rapport to continue therapeutic relationships

What is the fifth step of assessment?

Discuss health promotion and disease prevention; prevent future illness with balanced diet, clean space, hand washing, vaccines, seasonal doc visits, etc

When evaluating older adults, what must we consider concerning trust?

Autonomy of patient, they could feel like others are making decisions for them; Trust with health care providers, could have had a surgery in the past that resulted in their deflated trust in healthcare because of a negative experience

What is the name of Policy that protects patients information, ensure condifentiality?

HIPAAW

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

Verbal Communication

words you speak; vocalization; tone used in conversation; avoid using the word “why”

psychological privacy

involves safeguarding a patient’s emotional and mental well-being by respecting their person boundaries/autonomy

What is the significance of equal-status seating?

builds trust between the patient and the examiner because it shows that the examiner is on the same level as the patient. This shows empathy for the patient and does not intimidate them to answer questions because of intimidation, fear of embarrassment or fear of judgement.

What should nurse consider when using gowns with patients?

Proper fit, comfortable material, privacy, temperature, ease of use, hygiene, patient input

Why is it important to NOT to do notetaking while in the room with the patient?

the nurse could miss nonverbal cues that is essential to the patients diagnosis; also, could be intimidating to the patient, feel like they’re not getting personalized care

EHR

electronic health record that is mandated to improve quality of care and safety; used to keep tract of patients health record

why is false assurance bad?

the situation that the patient is in might not end up being ok

Why shouldn’t the nurse give unwanted advice?

seems judgmental, no patient wants to be told what to do

Why shouldn’t professional jargon be used?

makes the patient feel inferior

Why is engaging in distancing bad?

shying away from topics can give the patient the wrong idea about the severity of their situation

Why should a nurse use silence in an interview?

makes patient feel calm, active listening, pick up on nonverbal cues

Why is patience key when interviewing an older adult or patient with special needs?

Consider key elements that will address vulnerable populations; not going to give the most accurate/best answer

Use appropriate resources as they relate to the context of the situation

Be alert to “personal questions” as they may indicate ulterior motives; Provide appropriate responses based on personal ethics

Oral Teaching

provide simple, easy directions; use conversation structure, no medical jargon

Written materials

based on standard educational levels; use legible font, CAPS and bullet points

Teach Back

encourage verification of understanding, allow for questions

SBAR

USED WHEN YOU HAND OFF A PATIENT; Important for teamwork, reducing errors, ensuring patient confidentiality, and high-quality patient care.

What does the S in SBAR stand for?

Situation: provide a brief description of pertinent patient variables, demographics, clinical diagnostics, and location; Name, DOB, health status/diagnosis

What does the B in SBAR stand for?

Background: provide pertinent history as it directly relates to patient’s current health status; Past medical history

What does the A in SBAR stand for?

Assessment: state pertinent assessment findings obtained with interpretation of data; Vital signs, tests, labs

What does the R in SBAR stand for?

Recommendation or Request: state what you need or want for the patient in terms of medical treatment and/or assistance; Referral to PT, keep checking vitals