Respiratory Shadow health assessment Education and Empathy

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Education & Empathy : 

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

  • Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
  • Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
  • Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient
 1 Symptoms
Not Followed Up

 Description: Tina describes the symptoms that have been bothering her.
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what brings you in to the clinic today?

Question
11:33 AM PDT
Tina Jones

I came in because I’ve been having breathing problems, and my inhaler just isn’t working the way it normally does.
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what made you seek medical treatment ms. jones?

Question
11:34 AM PDT
Tina Jones

I came in because I’ve been having breathing problems, and my inhaler just isn’t working the way it normally does.
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im sorry to hear you are having breathing problems (Clarified to: Are you having difficulty breathing right now?)

Question
11:34 AM PDT
Tina Jones

My breathing feels okay right this second, but I’ve definitely been having problems recently with it. (Clarified to: if I am having difficulty breathing now)
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im sorry to hear you have been having breathing problems

Question
11:35 AM PDT
Tina Jones

Yeah, my breathing’s been a lot worse the past couple days.
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describe how you feel when this happens (Clarified to: How is your breathing now?)

Question
11:36 AM PDT
Tina Jones

My breathing feels okay right this second, but I’ve definitely been having problems recently with it. (Clarified to: how my breathing is now)
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what other medical conditions do you have?

Question
11:37 AM PDT
Tina Jones

Other than my asthma problems, there’s just my diabetes.
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when were you diagnosed with diabetes?

Question
11:38 AM PDT
Tina Jones

I was diagnosed when I was 24.

 Model Statement: “Breathing problems can be scary and uncomfortable. I’m sorry you’ve been experiencing these symptoms. Let me learn a little more about your breathing problems, and we will be able to find ways to improve your breathing.”
 2 Asthma Triggers
Not Followed Up

 Description: Tina describes her perceived asthma triggers.
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does lying on your back make the asthma worse? (Clarified to: Does lying down make your asthma worse?)

Question
11:52 AM PDT
Tina Jones

Just recently lying on my back has definitely made my breathing worse. (Clarified to: if lying down makes my asthma worse)
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what asthma symptoms have experienced

Question
11:58 AM PDT

 Model Statement: “It’s important that I learn about what things may be triggering your asthma, so that we can figure out what you can avoid to improve your breathing.”
 3 Medications
Not Followed Up

 Description: Tina describes her inhaler use and medication regimen.
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what medications do you take for your diabetes?

Question
11:38 AM PDT
Tina Jones

I don’t take medicine for it anymore.
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what made you stop taking diabetes medications?

Question
11:39 AM PDT
Tina Jones

I guess I just got sick of feeling sick and gassy all the time, and it was overwhelming, remembering to take pills and check my sugar. I feel a lot better now that I’m just eating healthier than I did when I was taking the pills.
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do you monitor your blood sugar?

Question
11:39 AM PDT
Tina Jones

Um, no. I haven’t been checking it.
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what medication do you use for asthma?

Question
11:41 AM PDT
Tina Jones

It’s just a regular Proventil inhaler.
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how often do you take your proventil inhaler?

Question
11:41 AM PDT
Tina Jones

I’ve been using it probably every. . . four hours or so, I’d say.
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when did you start the symptoms?

Question
11:42 AM PDT

 Model Statement: “Thank you for letting me know that you’re using your inhaler pretty often. It’s important for me to know how you’re using all of your medications.”
 4 Inhalants
Not Followed Up

 Description: Tina describes her lack of exposure to cigarette smoke, secondhand smoke, and other inhalants.
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does any one smoke in your house (Clarified to: Does anyone in your house smoke?)

Question
12:29 PM PDT
Tina Jones

No, nobody at home smokes. (Clarified to: if anyone at home smokes)
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if exposed to second smoke it triggers your asthma

Question
12:29 PM PDT
Tina Jones

Some of my friends smoke when we go out drinking. But I don’t smoke, and nobody at home smokes.
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do you have history of sinus problems

Question
12:30 PM PDT
Tina Jones

I don’t really have a problem with my sinuses.
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have you ever been diagnosed with COPD

Question
12:31 PM PDT
Tina Jones

No.

 Model Statement: “I’m glad to hear that you don’t smoke and avoid smoke in your life. Your lungs are better off for it!”