Recall some of your most challenging patients for gathering a health history. If you include a crying young child with a distracted parent, a moody adolescent, or an older adult with perhaps something to hide—or maybe all three—get ready to revisit those patients for this Assessment. The setting is Neighborhood Clinic, a fictional community health center. The avatar clinic director, Asha Gill, will introduce and conclude each scenario. You will engage with the following avatar patients:
• Archie, age 7, and Gabriel Moore, his father, who are making a first visit to the clinic because a very miserable Archie is sick
• Jasmine Walker, age 14, at the clinic for a high school physical but without her mother, who has previously accompanied her to appointments
• Colleen Hart, age 76, whose stepson may join the appointment, much to her resistance
Each scenario presents a distinct situation for the professional nurse and involves applying emotional intelligence and knowledge of health history information to gather for each patient.
To prepare:
• Access the Health History Challenges template document and review the requirements of this Assessment.
• View the video of each scenario as many times as you need. You are encouraged to take notes for details to support your analysis of each scenario. Keep these questions in mind as you view and analyze each scenario:
o What health history information is needed?
o What questions would you ask to obtain it?
o How would you demonstrate emotional intelligence to win trust?
o What may be presenting as a specific problem or need?
When Taking a Health History Is a Challenge
Full Answer Section
-
Crying Child:
- Distract the Child: Try to distract the child with toys, books, or other age-appropriate activities.
- Involve the Parent: Ask the parent to help calm the child down.
- Focus on Positive Reinforcement: Praise the child for cooperating and providing information.
-
Moody Adolescent:
- Respect Autonomy: Allow the adolescent to make their own decisions whenever possible.
- Validate Feelings: Acknowledge and validate the adolescent's emotions.
- Offer Choices: Provide options to give the adolescent a sense of control.
-
Older Adult:
- Respect Privacy: Ensure that the older adult feels comfortable discussing sensitive topics.
- Use Clear and Concise Language: Avoid using medical jargon that may be confusing.
- Involve Caregivers: If appropriate, involve caregivers to assist with obtaining information.
By applying these strategies, healthcare professionals can establish trust, gather accurate health history information, and provide effective care for patients of all ages and backgrounds.
Sample Answer
General Approach to Gathering Health Histories in Challenging Situations
1. Establish Rapport:
- Active Listening: Pay close attention to the patient's words and nonverbal cues.
- Empathy: Show understanding and compassion for the patient's feelings and experiences.
- Non-judgmental Attitude: Avoid making assumptions or judgments about the patient's situation.
2. Tailor Communication:
- Age-Appropriate Language: Use language that is appropriate for the patient's age and developmental level.
- Consider Cultural Factors: Be mindful of cultural differences and adjust your communication style accordingly.
- Respect Privacy: Ensure that the patient feels comfortable discussing sensitive topics.
3. Ask Open-Ended Questions:
- Encourage Elaboration: Open-ended questions allow patients to provide more detailed information.
- Avoid Leading Questions: Avoid asking questions that suggest a particular answer.
4. Use Visual Aids:
- Simplify Information: Visual aids, such as diagrams or charts, can help patients understand complex concepts.
- Address Language Barriers: Visual aids can be helpful for patients with limited language skills.
5. Address Concerns and Fears:
- Validate Emotions: Acknowledge and validate the patient's feelings.
- Provide Reassurance: Offer reassurance and support as needed.