HEALTH ASSESSMENT INTERVIEW ANALYSIS
In the medical field, interviewing is considered an art that encompasses practical skills which are only learned effectively through doing (Berg et al, 2015). Nurses and other, in general, require communication skills that are above checklists. When conducting an interview with a patient, the interview is part of a patient assessment and requires the interviewer (the nurse) to have a high level of skill in communication. This enables the nurse to obtain maximum valid information from the interviewee (the patient). A health assessment interview aimed at assessing the skills used in during patient assessment was recorded in a video (Haley et al 2017). Caregivers and nurses are expected to establish a connection with a patient which can only be achieved through communication. Good communication skills during a health assessment interview enable the patient to develop a sense of trust in the nurse and hence provide valid information. This interview analysis is aimed at analyzing the application of three communication skills in a patient assessment interview which are active listening skills, empathy, and therapeutic touch.
Active Listening Skills
Active listening can be described as a response that is usually in form of a statement that shows that the interviewer hears the patient out and is understanding his or her feelings at the moment (Haley et al 2017). When conducting an active assessment interview, it is necessary that nurses engage in more than simply listening. They are required to listen actively. Active listening generally encompasses grasping the patient’s verbal and non-verbal communication as well as his or her emotional state (Berg et al, 2015). During a nursing assessment, complete concentration is very crucial and this can be achieved by listening carefully patient, using both verbal and non-verbal prompts so as to entice the patient into speaking more about the symptoms he is experiencing.
Poor active listening in a patient assessment is characterized by; verbal interruptions and finishing of the patients’ sentences, preoccupation with other activities instead of listening to the patient among others. For instance, during the conducted health assessment interview a section of the interview reflected poor active listening.
Interviewer: ‘How are you feeling?’
Patient: ‘I have been very nauseated today… (Nurse interrupts)’
Interviewer: ‘you mean since morning. Those are the side effects of the pain injection administered.’
Patient: ‘I have also had been experiencing some pains in the back since yesterday.’
Interviewer: ‘(writing down). Is there any other problem?’ (5:35)
From the example above, the interviewer was a poor active listener. First, the interview was not patient-centred as the nurse interrupted the patient as he described his feelings of the day. The nurse did not wait for the patient to complete his statement which is very ineffective and could scare away the patient from revealing his true experiences. Also, the interviewer failed by withdrawing her concentration when the patient was talking and instead make notes as the patient is speaking. When an interviewer is preoccupied with activities other than listening to the patient, the patient is likely to get disinterested in the interview and could even withhold some important information about his health (Bredart et al 2014).
The interview can be improved through active engagement with the patient by maintaining eye contact and also listening to the patient without having to make notes. Also, the interviewer should avoid interrupting the patient or completing the sentences for him since it makes an impression to the patient that the nurse knows his experiences and so it’s unnecessary to share. Active listening should involve establishing a platform where the patient can talk freely. This interview should also be geared towards making it patient-centred and hence the patient should do more of the speaking.
Empathy.
Empathy can be described as the ability to share the feelings of other people (Puggina et al 2012). It involves understanding the patient’s worry, pain, anxiety, and fear and therefore facilitating a more caring treatment. It goes beyond the symptoms, signs or the medical history of the patient. Empathy is very crucial in health assessments since it is a key component in enhancing the patient’s encounter (Ambresin et al 2013). Health assessment interviews are usually characterized by expression of pain and anxiety hence even the smallest and seemingly the most insignificant empathy expressions can make long-lasting impressions on the patient.
Nurses can show empathy through verbal cues such as giving encouraging comments, charming the patient using non-medical topics of their lives and giving promises and hope (Montague et al, 2013). From the interview, the following example of poor empathy is deduced.
Interviewer: Have you had any medical tests conducted on you since morning?
Patient: No. but I was hoping that by the end of the day some samples would be taken from me.
Interviewer: From the symptoms you described, do you know that you could be suffering from Meningococcal Meningitis.
Patient: (Bursting out in tears). I think that means that I will die. (7:10)
From the above section of the interview, the nurse was not empathetic o the patient. First, the way in which she breaks the news about the possibility of the patient being diagnosed with meningitis was careless. The nurse did not give any hope to the patient that it could actually be signs of a mere infection but instead continued to insist on the severity of the patient’s condition. Also, the nurse is not seen to express empathy through simple gestures. For instance, when the patient burst out in tears, the nurse just stares at him without showing any empathetic gestures. Questioning during health assessment should show aspects of empathy.
This can be improved by avoiding speculative questioning about the patient’s condition. The nurse, for instance, should have avoided the part about the possibility of the patient suffering from the disease. The questions should be open-ended and should not leave the patient guessing about the condition he is suffering from (Bredart et al 2014). The nurse should give hope to the patient even when she suspects that his condition is severe. Also, as part of the assessment, the nurse should show concern of the patient’s emotional state for instance, in the interview the nurse should have given the patient a handkerchief when he burst out in tears. Such gestures show a sigh of concern and empathy.
Therapeutic Touch
Therapeutic touch is generally described as a process which is directly geared towards exchange of energy by use of hands (Ambresin et al 2013). This process is a form of therapy that is believed to facilitate the healing process either emotionally or physically, through balancing the individual’s spirit, mind, emotion, and body. Therapeutic touch is not only meant for therapists but also for nurses and other caregivers who interact with patients. It is effective in that it reduces anxiety, elicits relaxation feedback and also reduce emotional pain (Arif-Rahu &Grap, 2010). During health assessment interviews, therapeutic touch is very crucial especially when dealing with patients who are suffering from severe conditions. It is associated with giving a feeling of hope and restoration which could result in emotional healing.
If the process is not administered at the right time, the patients may end up feeling alone and broken in the moment of pain. It is shown in the form of nonverbal gestures which include tapping the patient’s back or on the shoulder and emotional facial expressions (Pollak et al, 2011). In the video, the nurse shows poor therapeutic touch when the patient breaks down in tears when he hears that he could be suffering from meningitis (7:10). She stares at the patient without a sign of emotion. This was insensitive to the patient and the nurse ought to have shared the emotions of the patient at the moment. This could have been done by changing the facial expression to show sympathy or by tapping the patient’s shoulder. This gives a sense of hope and relieves fear and anxiety.
It is important to note that therapeutic touch should be done in consideration to the patient’s space (Pollak et al, 2011). In some cases, when the nurse is too close to the patient, it may be considered an invasion. It is also necessary to be gentle for instance when tapping the shoulder of the patient or when holding his hand. Nurses should, therefore, ensure that during health assessment interviews, they are ready to give emotional care to the patient using therapeutic touch especially where the questions ask to lead to a dark medical past (Mai et al, 2014).
Conclusion
Health assessment interviews are meant to help the interviewer obtain information that can help treat the patient. However, if communication is poor, the interview may end up not being beneficial. The main issues in health assessment interviews are that sometimes nurses fail to fit in the patient’s position and be sensitive. As a result, the patients are prompted to withhold crucial information about their medical history which may affect their treatment. Nurses should be sensitive when conducting these assessments to enable them to give efficient care to the patient. They are required to be effective active listeners and empathetic so as to win the patient’s trust and also to establish a good nurse-patient relationship. Also, therapeutic touch is very crucial in comforting the patients and sympathizing with them. Patients are entitled to care which is not only physical but also emotional and mental.
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