Term
| the role of the nurse in the patient interview |
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Definition
*the nurse frequently assumes the role of intermediary for the pt in the larger health care system.
*A critical role of the nurse is to assist the pt in effectively utilizing the system.
*The nurse is the facilitator of the interview of the interview and thus collaborates with the pt in establishing a mutually respectful dialogue.
*bc the primary purpose of the interview is to collect accurate data, the pt must feel comfortable and safe enough to provide info, ask ?s, and express concerns.
*the nurse can foster an atmosphere of comfort by approaching the pt with an accepting, respectful, nonjudgmental attitude. |
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Term
| how to begin an interview |
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Definition
begin the interview with an introduction that includes your name and title.
initially call the pt by his formal name and ask how the pt prefers to be addressed.
simple communication using appropriate names is respectful and helps identify pts as unique individuals. giving recognition helps lower pt anxiety and increase pt comfort level |
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Term
| Confidentiality and exceptions |
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Definition
confidentiality is essential in developing trust b/t nurse and pt.
your verbal assurance of confidentiality often eases the pt's concerns and fosters trust in the relationship.
in practice, there are exceptions to absolute confidentiality.
one example is a teaching institution where a team approach is used and information must be shared. another reason for sharing confidential information is when a pt is a danger to self or others. |
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Term
| working stage of the interview |
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Definition
| the working stage of the interview is where the bulk of the pt data is collected. it is a nursing responsibility to keep the interview goal-directed, including refocusing the pt and redefining the goals established in the joining stage. information is summarized and validated in the termination stage. progress toward goals is evaluated in the evaluation stage. |
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Term
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Definition
| active listening is the act of perceiving what is said both verbally and nonverbally; it is a critical factor in conducting a successful health assessment interview. the primary goal of active listening is to decode pt messages in order to understand the situation or problem as the other person sees it. the nurse needs to pay careful attention to all sensory data to make sense of the pt's message and formulate an appropriate response |
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Term
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Definition
| encourage the pt to provide general rather than more focused information. open ended ?s that begin with the words who, what, where, when, and how are usually for effective in eliciting the maximum amt of information; these ?s indicate respect for the pt's ability to articulate important or pressing health concerns, and therefore help set priorities. |
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Term
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Definition
| open ended ?s that begin with how, what, where, when, who are usually more effective. why ?s can cause pts to become defensive and feel the need to somehow explain or defend their ideas and behaviors, which sets up an adversarial relationship bt the nurse and pt |
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Term
| verbal and nonverbal communication |
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Definition
| a variety of verbal and nonverbal means can be used to encourage pts to continue talking. phrases like "go on" or "uh huh", the simple repetition of the words a pt has spoken, or even head nods or a touch on the hand prompt the pt to resume speaking and also indicate the nurse's continued interest and attn |
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Term
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Definition
| pt silence may indicate feelings of anxiety, confusion, embarrassment, a lack of understanding of the ? asked, or a lack of proficiency in English |
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Term
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Definition
| attempts made by the nurse to accurately receive, process, and then respond to pt messages. they provide one way for the nurse to communicate empathy, concern, and attentiveness. in order to "listen" to what the pt says, the nurse must not only process words spoken by pt, but also understand the context of the pt's experience |
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Term
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Definition
| focuses on the content of the pt's message as well as the pt's feelings. in reflecting, the nurse directs the pt's own questions, feelings, and ideas back to the pt and provides an opportunity for the pt to reconsider or expand what was just said |
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Term
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Definition
2nd group of effective interviewing or communication techniques.
these responses stimulate pts to make some change in their thinking and behavior. action responses include techniques such as focusing, exploring, presenting reality, confronting, informing, collaborating, limit setting, and normalizing |
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Term
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Definition
| type of action response where the pt is offered a relationship in which both nurse and pt work together, rather than 1 in which the nurse is in total control. this technique provides a respectful way for the nurse to encourage pt's active involvement in his own health care, in setting goals, in gathering info, and in problem solving |
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Term
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Definition
| technique that allows the nurse to reassure the pt that the response is quite common given the situation. this helps decrease pt anxiety and encourages the pt to share thoughts and feelings that might otherwise be kept private for fear of being judged or misunderstood |
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Term
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Definition
| a nontherapeutic interviewing technique; repeated or persistent questioning of the pt about a statement or a behavior increases pt anxiety and can cause confusion, hostility, and a tendency to withdraw from the interaction. a helpful rule for nurses is to pay attn to their own behavior and feelings. if in gathering info, nurses feel irritated, feel they are pursuing pt, or have become involved in a verbal tug of war, they are most likely probing |
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Term
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Definition
| *originates in nurse's own feeling of helplessness. it is an attempt by the nurse to relieve personal feelings of anxiety. this behavior often inc pt anxiety. a better response would be to 1st acknowledge personal feelings of anxiety then acknowledge pt anxiety |
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Term
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Definition
| a nontherapeutic interviewing technique; repeated or persistent questioning of the pt about a statement or a behavior increases pt anxiety and can cause confusion, hostility, and a tendency to withdraw from the interaction. a helpful rule for nurses is to pay attn to their own behavior and feelings. if in gathering info, nurses feel irritated, feel they are pursuing pt, or have become involved in a verbal tug of war, they are most likely probing |
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Term
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Definition
| a nontherapeutic interviewing technique; repeated or persistent questioning of the pt about a statement or a behavior increases pt anxiety and can cause confusion, hostility, and a tendency to withdraw from the interaction. a helpful rule for nurses is to pay attn to their own behavior and feelings. if in gathering info, nurses feel irritated, feel they are pursuing pt, or have become involved in a verbal tug of war, they are most likely probing |
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Term
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Definition
| *originates in nurse's own feeling of helplessness. it is an attempt by the nurse to relieve personal feelings of anxiety. this behavior often inc pt anxiety. a better response would be to 1st acknowledge personal feelings of anxiety then acknowledge pt anxiety |
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Term
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Definition
| implies that the pt has neither the right to hold bad feelings, or to express them |
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Term
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Definition
| can be seen by pt as unwillingness to share or attempt to hide info |
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Term
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Definition
*often read lips, so remain within sight and face pt
*tone and inflection of voice are lost to hearing-impaired pt
*speaking loudly can hinder communication and be insulting
*touch is especially important, however the nurse should ask permission |
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Term
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Definition
*always look directly at them
*voice intonation, volume, and inflection are important.
*speaking loudly can hinder communication and be insulting.
*touch impt, but should ask permission |
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Term
| speech impaired or aphasic pts |
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Definition
*all ?s directed to pt
*ask simple ?s w/ yes or no answers
*allow additional time for answers
*allow pt opportunity to contribute info |
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Term
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Definition
| it is important to show empathy and allow pt to cry. offering tissues indicates to the pt that it is okay to cry and conveys thoughtfulness. proceed w/ interview when pt has regained composure |
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Term
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Definition
*minimize risk by limit setting and refocusing
*position self near exit
*don't turn back
*never allow pt to walk behind u or b/t u and exit
*consider leaving door open and informing colleague your location |
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Term
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Definition
*may require additional time for ? interpretation and pt responses
*may need to schedule more time bc pt may have multisystem changes or complaints, a weakened physical condition, or a cognitive impairment.
*may be necessary for family or caregiver to assess pt's past and present health or illness status.
*speaking loudly and slowly is NOT helpful |
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Term
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Definition
| involves repeating or rephrasing the main idea expressed by the pt and lets the pt know that you are paying attn. it promotes further dialogue and provides pt with an opportunity to explain or elaborate |
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