6512-W1-D9

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Fazaia Degree College, M.R.F, Kamra, Attock *

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6512

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Nursing

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Nov 24, 2024

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docx

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Uploaded by maryamberlas

For this week’s discussion, we are examining the importance of effective communication between provider and patient and the role it plays in collecting an accurate and thorough health history. My new patient scenario includes an 80-year-old white male with angina that lives on a farm 80 miles from a healthcare center. According to Diamond-Fox, the use of appropriate examination techniques provides a deeper insight into the patient’s history and symptoms and further boosts the skills of the advanced practice nurse. What was once reserved for physicians only, has transitioned across the medical specialty to other professional roles making the patient interview and assessment an integral part of the advanced practice role (2021). Effective communication is crucial in establishing positive patient relationships. The communication technique that would be utilized in building this trusting relationship is referenced in our course text and is termed the “patient-centered approach” in building the patient’s health history. This communication technique requires a clinician to possess the ability to eliminate their own bias to ensure non-discriminatory care is delivered with every patient encounter (Ball et al., 2023). Another effective communication technique, especially when treating the elderly, is the practice of communicating with the purpose of showing courtesy, comfort, connection, and confirmation. This is crucial in establishing a positive relationship with the generation who values traditional respect. Things like knocking before entering, calling them by name, valuing their privacy, maintaining eye contact, and showing candor in practice are just some examples given to us in our text (Ball et al., 2023). An article by Barratt further supports that effective communication is a fundamental skill of clinicians in the advanced practice role. It is here that we learn that it is directly linked to higher levels of patient satisfaction, enhanced clinical reasoning, increased ability of patients to self-manage their diagnoses, and increased prevalence of shared decision making (2018). With all of this in mind, the five-targeted questions for my 80-year-old male patient with angina who lives 80 miles from a healthcare center are as follows: 1. Describe what your chest pain feels like to you? Is there a word that relates the pain like dull, achy, sharp, pressure, heaviness? Does the pain radiate anywhere? 2. . How are you coping with your pain? Do you find it is keeping you from your normal daily activities? 3. What does your emotional support system look like? Do you have close friends and family that live near you that would be able to drive you to the hospital if needed? 4. How much do you value your privacy? Does it bother you to discuss your pain with me? 5. Is there anything else you would like to discuss? Any other symptoms that may or may not be related to your chest pain? If you have a concern, I want to talk about it. The relevant risk assessment instrument in relation to my elderly patient ensures that the risk of falls has been addressed. There are many fall risk tools in practice today to help determine the likelihood of future falls. This is supported in an article by Chow et al., which reads that falls remain one of the 20 most expensive medical conditions. In 2015, Medicare costs for falls for those aged 65 and above totaled 31 billion dollars (2019). Some of these evaluation tools include the Dynamic Gait Index, Conley Scale, Five Times Sit-to-Stand Test, or the John Hopkins Fall Risk Assessment Tool. These assessment scales are all utilized within the USA, among others (Strini, Schiavolin, & Prendin, 2021). Personally, I have the most experience with the John Hopkins Fall Risk Assessment Tool because it is utilized at the healthcare organization where I have been a practicing registered nurse for eleven years.

Resources Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel's guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby Barratt, J. (2018). Developing clinical reasoning and effective communication skills in advanced practice. Nursing Standard (Royal College of Nursing (Great Britain) : 1987). https://doi.org/10.7748/ns.2018.e11109 Chow, R. B., Lee, A., Kane, B. G., Jacoby, J. L., Barraco, R. D., Dusza, S. W., Meyers, M. C., & Greenberg, M. R. (2019). Effectiveness of the “Timed Up and Go” (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED. American Journal of Emergency Medicine, 37(3), 457–460. https://doi.org/10.1016/j.ajem.2018.06.015 Diamond-Fox, S. (2021). Undertaking consultations and clinical assessments at advanced level. British Journal of Nursing, 30(4), 238–243. https://doi.org/10.12968/bjon.2021.30.4.238 Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall Risk Assessment Scales: A Systematic Literature Review. Nursing reports (Pavia, Italy), 11(2), 430–443. https://doi.org/10.3390/nursrep11020041

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