Tina jones Health History shadow health Education & Empathy
Education & Empathy: 10 of 11 (90.9%)
During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.
Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient
1 Expression of pain
Description: Tina expresses frustration about her level of pain.
Why are you here today?
12:13 PM EDT
I got this scrape on my foot a while ago, and I thought it would heal up on its own, but now it’s looking pretty nasty. And the pain is killing me!
Am sorry to hear that?
12:13 PM EDT
I appreciate you saying that.
Do you have problems moving around after the accident? (Clarified to: Are you having trouble getting around?)
12:36 PM EDT
Yes! I mean, I literally can’t put weight on my foot, the pain is so sharp. (Clarified to: if I have mobility problems)
Am sorry to hear that
12:37 PM EDT
Model Statement: “I’m sorry to hear that your pain is returning. We want you to be in as little pain as possible. Together we can figure out the best way to reduce your pain quickly.”
2 Impact of injury on daily life
3 Gaps in health literacy around diabetic diet
Description: Tina describes controlling her diabetes by avoiding “sweets.”
How did you manage diabetes now?
01:13 PM EDT
I just watch what I eat and try to stay away from sweets.
Great, that’s a good way to control diabetes?
01:13 PM EDT
Alright, thanks for letting me know.
Model Statement: “Staying away from sugar is a great start. I can give you some more information on what a balanced diet looks like for someone with diabetes. For example, many starchy foods break down into glucose in the body, like pasta, and so you can eat those in moderation, too. Most people with diabetes feel better when they limit all starches, eat protein, and take regular medication.”
4 Lack of treatment with diabetes medication
5 Lack of blood glucose monitoring
6 Gaps in health literacy around asthma control
Not Followed Up
Description: Tina describes increased inhaler use and decreased effectiveness, indicating that her asthma is uncontrolled.
how many times do you use the inhaler?
12:49 PM EDT
I don’t use it every day. Maybe two or three times a week. Although I guess lately, once I have to use it once, sometimes I need it again that day.
have you been been hospitalized for asthma?
12:50 PM EDT
I went a bunch of times when I was little, for asthma attacks.
What else have you used for the asthma?
12:51 PM EDT
Model Statement: “It sounds like your asthma is giving you some problems, and you’re not getting full relief from your inhaler. I would like to talk with you about changing your medication and your regimen, to reduce your frequent breathing problems, so that you feel better day-to-day. Most patients find that using a daily inhaler is an easy way to reduce your asthma symptoms even more.”
7 Loss of a family member
8 Counseling around past drug use
9 Gap in sexual health literacy
Description: Tina reveals that she doesn’t fully understand the importance of testing for STIs.
did you use condoms?
02:16 PM EDT
I was on the pill so we didn’t need them.
Condom use is important to prevent STDS
02:17 PM EDT
OK, I understand.
Have you been tested for STDs with your boyfriend? (Clarified to: Has your friend been checked for sexually transmitted infections?)
02:55 PM EDT
When we were together, he told me he didn’t have any STDs, and I believed him. I don’t know if he was ever tested. (Clarified to: if my sexual partner has been tested for STIs)
It is good to be tested for STDs to be sure
02:56 PM EDT
Sure, I think I understand what you mean.
Model Statement: “There are many sexually transmitted infections that don’t necessarily present symptoms, for either men or women, and can persist for years if left untreated. The only way to be certain you and your partners are free of STIs is for both of you to get tested. This can be done as a part of a typical gynecological exam. Because your past partner was not tested, I would recommend that you get tested during your next annual pap smear.”
10 Risk for hypertension
11 Describes problematic menstrual cycle and symptoms
Description: Tina describes her periods as painful, long, and heavy.
How are your periods?
02:23 PM EDT
My periods are always the same–they’re bad. Cramps. Lots of bleeding for more than a week.
Seems your periods are heavier than normal, maybe we should discuss a way to make them less heavy, such as hormonal pills
02:25 PM EDT
Thanks for telling me.
What do you take for cramps?
02:25 PM EDT
I take Advil. I try a heating pad sometimes and that only helps a little.
Sorry for the discomforts
02:27 PM EDT
Thanks for understanding.
Model Statement: “Those periods sound painful and difficult to deal with. I’m sorry you have so many challenging symptoms. If you are interested, we can talk about hormonal birth control options that can make your periods less painful, or even lighter.”