Lloyd H. $ Craig S a Journal Review Essay

I have found that by using active listening and communicating in an open and professional manner with both patients and colleagues has led to strong long term professional relationships. I have received positive feedback from facilitators on my communication, specifically on my bed side manner.

Note: Patients will tell you what you want to hear, so be careful how you ask your questions.

Nurse’s care for several patients in a day and it is important to understand the patient as a whole person to treat them effectively. The purpose of this assignment is to explore a patient’s disease to understand the nursing judgments and interventions involved, the medications for this diagnosis, and to understand the disease. The patient described in this paper will be referred to as Jonathan to ensure patient confidentiality.

I will stay calm and will not be nervous during the interaction. I will do this by focusing on the needs of my patient and by trying to understand how she is feeling in this situation. I will ask open ended questions. I will do this in order to foster a meaningful conversation and to allow my patient to answer questions in her own way. I will use silence throughout my interaction in order to give my patient time to think about what she wants to say. I will do this by waiting for her answers and by encouraging my patient to take part in our interaction.

This assignment provides an analysis of an observation of patient experience in a clinical area, following the assignment brief outlined in appendix A.

Mary, the patient the study focuses on (surname withheld to uphold confidentiality), was chosen due to the writers involvement throughout the duration of her stay in hospital. The writer met Mary prior to her operation in theatre and was present for the duration of her operation. When Mary was admitted to ward L4 the writer was directly involved in Mary's care and discharge.

Communicate Effectively: Explain a procedure or assessment prior to completing them: Give the patient a brief description of what you are going to do prior to completing the task. Patients do not like being startled, prodded, and poked. Refrain from using medical Jargon. Explain information to patients in laymen’s terms. Allow time for the patients to ask questions and answer questions appropriately.

A health assessment is an important part of the nursing process. The components of a comprehensive health assessment include the collection of both subjective and objective data from the patient to establish their overall level of health. It is important to develop a trusting nurse-patient relationship when interacting with all patients, especially with patients that have not had prior health care provider interactions. A patient who had never been seen by a healthcare provider may be nervous and apprehensive of what to expect in the situation. The nurse should use effective communications skills including eye contact and active listening and try to gain the trust of the patient. Systems used in the collection of data include, “active listening, restatement, reflection, elaboration, silence, focusing, clarification, and summarizing” in my verbal communication with this patient (Jensen, 2015, p. 19). The nurse needs to make clear any part of the history where there are questions.

The free text data and check box entry will appropriate for the purpose of obtaining chief complaint from patients in sense that only human intelligence can prioritized and determine what the chief complaint of patients really are, The free text data entry will allow clinicians to input narrative detail about the patient’s medical concerns, and due to the fact that complicated details are more easier to describe through imputed texts. Furthermore, free text data entry will capture robust information about patient’s medical condition and can be used to support and improve quality of care. Check box data can be used to gauge the severity of symptoms that will include duration of onset of symptoms, pain scale measurement. Also, patient’s age group, and race/ethnicity can used the check box data entry tool.

There are multiple dangers posed to clients when their provider has no access to their paper chart. It is always best practice to refer back to the patient’s medical history when making important medical decisions. In this real life story the patient happened to be a great historian however, this is not always the case. There are some circumstances in which the patient is unable to speak for themselves and there is no family to provide information. Critical details may be left out or overlooked when there is no access to the patient’s medical history. Thankfully this real-life story has a happy ending as the patient received appropriate treatment given the information provided. Not having access to a patient’s medical history could result in misdiagnosis, medication contraindications and

Using this example, we clearly see that the nurse asks the patient a direct and clear question so as to get information and in turn she gets a response. It is suggested that this is a good example of questioning and probing and it is recommended to be used again in future. To provide the most effective care possible, nurses must begin with clear and appropriate verbal skills such as being honest, being concise and keeping emotions out of the conversation (Apler, 2006).

The chief complaint is used to help document symptoms to determine the location of symptoms, and type of symptoms (pain, paresthesia, numbness, and weakness). It will also help determine what symptoms are interfering with the patient's function the most to help determine a plan of care. It’s important under the history of the complaint to have an understanding of previous “flare-ups” to determine if the previous “flare-up” is related to their current condition. In the healthcare systems, new episodes of symptoms are sometimes tied to a previous condition. However, sometimes the new episode is due to a new condition. Taking a detailed history of the patient chief complaint can help avoid this, and determine the best form of treatment for the

History of Present Illness-Gather more information about the present illness by asking questions such as: When did the symptoms start? Did it occur suddenly or gradually increased over time? How often does the problem occur? What is the intensity of the pain? Can you rate it from 0 to 10? How much sputum, vomit, or discharge came up or out? What color was it? Was it watery, thick, or bloody?

A guide to taking a patient’s health history is an article published in Nursing Standard in the August 2007 issue, written by Hiliary Lloyd and Stephen Craig. In this article Lloyd and Craig outlines the process and rationale for taking a health history. Also, this article provides different methods to taking a comprehensive history.

“A guide to taking a patient’s history,” is an article published in Nursing Standard in December 2007, written by Hillary Lloyd and Stephen Craig. The article provides an overview of the process involved in taking a patient history including factors such as; the environment, importance of following a logical order when taking the history, and communication skills.