Health Assessment And Physical Examination

Health Assessment And Physical Examination

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Health Assessment And Physical Examination

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Health Assessment And Physical Examination

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Question:

Discuss About The Health Assessment And Physical Examination.

 
Answer:
Introduction

Active listening is an important part of health assessment interview as it is the best method to build trust and interpret all issues of patient. In the video ‘Introduction to a patient’ (2018), the nurse showed excellent communication skills to build rapport with the patient. She started with introducing herself to the patient and greeting Ms. Felix. The video is a great example of active listening as patient was responding well and nurse was also taking vital information from patient while taking her blood pressure. For instance, she inquired about how the patient was and anything that she wanted to change during her stay at the hospital. Good non-verbal communication between the patient and nurse was also seen as the patient was smiling throughout the interview and both of them were making eye contacts. Such non-verbal cues can give nurse clear indication about patient’s current healthcare and feelings. Non-verbal cues are specially helpful when the patient is not responding, however in the video, assessment was easy for nurse because the patient was verbally and non-verbally responsive (Estes, 2013, p. 18).
Personal space and distance is also a necessary consideration during health assessment interview because patients do not like unauthorized invasion of their privacy and they like to maintain certain distance with people based on their cultural values too (Estes, 2013, p. 18). She maintained a distance of about 1.2-2 metres with patient and this allowed her to make good eye contact, observe non-verbal cues of patient and easily hear patient’s concern.
Effective communication techniques used in the video:
Nurses can engage in effective communication with patient by the use of various technique like use of open-ended questions, close-ended question, facilitation and using silence (Estes, 2013, pp. 19-26). In the video, the nurse utilized the technique of using open-ended question in an effective manner. Since, the nurse had the task of formally introducing herself to the patient and assessing blood pressure, her straategy to use open-ended questions for communication is found to be the best. Another advantage of using open-ended questions is that it gives patient freedom to express whatever they want (Wilson & Giddens, 2016). Hence, use of ‘how’ and when questions by the nurse in the video helped her to elicit patient’s information. For example, in the video, the nurse used questions like ‘How are you?’ and ‘How did you sleep last night?’. This helped her get general information about the patient’s health.
The value of open-ended questions as a communication technique between nurse and patient has been covered in recent evidence. Berman & Chutka, (2016, p. 243) showed that use of open ended questions favours taking patient-centered interview as it allows patient to respond as per their wish. By this technique, more accurate information related to patient sysmptoms can be obtained.. Therefore, considering the nurse’s task at hand, open-ended question is found to be effective. However this may not work when there is a need to conduct rapid health assessment and get some specific information from patient. In such situation, nurse may have to utilize other communication techniques like the use of close-ended questions.
 
Communication techniques to avoid:
A nurse or any other health care practitioner must also be mindful about communication techniques that must be avoided during health assessment interview with patient. Example of such ineffective communicaton techniques includes requesting an explanation from patient, probing, giving approval and defending, which disrpupts communication process (Estes, 2013, pp. 26-30). In the video, the nurse also displayed some form of these techniques. She was found to engage in giving approval during health assessment interview. She used terms like ‘That’s a shame’ when she asked the patient that she had a sleep last night or not. This comment might have blocked effective communication channels because by just giving this judgment, the nurse moved on to her task at hand and did not asked the patient for the reason for her sleeplessnes during night. By adopting such communication style, the nurse missed opportunity to extract more health information from patient. Hence, instead of giving such comments, the nurse in the video should have focused identifying the source because of which she could not sleep. Instead of giving the comment ‘That’s a shame’, she could have asked ‘Why could you not sleep last night?’. The things that a nurse should avoid during a clinical evaluation has also been explained by Defenbaugh and Chikotas, (2016, p 243) and through the research, the study showed that nurse have a role in creating a caring environment for patient and collecting health information from patient. However, they should avoid any form of behavior that disrupts the ccommunication process.
 
Reference:
Berman, A. C., & Chutka, D. S. (2016). Assessing effective physician-patient communication skills:”Are you listening to me, doc?”. Korean journal of nursing education, 28(2), 243.
Defenbaugh, N., & Chikotas, N. E. (2016). The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students. Nurse education in practice, psychology, 176-181.
Estes, M. E. Z. (2013). Health assessment and physical examination. Cengage Learning.
Introduction to patient 1. (2018). YouTube. Retrieved 18 March 2018, from https://www.youtube.com/watch?v=PoI_cJdtvoQ&feature=youtu.be
Wilson, S.F. & Giddens, J.F., 2016. Health Assessment for Nursing Practice-E-Book. Elsevier Health Sciences.

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