DISCUSSION: NURS 6512 Week 1 Building a Health History Post

DISCUSSION: NURS 6512 Week 1 Building a Health History Post

Patient Overview – 38-year-old Native American pregnant female living on a reservation

Interview Summary

My interview would begin with the basics:  introducing myself to the patient and any accompanying individuals. Afterwards, I would address the patient specifically and verify the manner in which they prefer to be referred, be it formally or informally.  I would also want to insure that the visit was not rushed so I would be sure to schedule an extended amount of time, given that it is the patient’s first time meeting with me Building a Health History NURS 6512 week 1 Discussion Post.

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As an APRN, I need to be aware of the factors that can effect both how I conduct myself during a visit and what the patient expects from me, their provider. Factors such as age, gender, race, ethnic group, cultural attitudes, regional differences, and socioeconomic status influence the way patients seek medical care and the way clinicians provide care. (Ball, et. al, 2010).  I believe that a knowledge of the patient and their background prior to their visit is an important piece of the puzzle. The patient’s cultural background and diversity will play a role in ensuring that I remain sensitive to her specific needs. Health beliefs and practices vary widely between cultures and ethnicities and can affect how the patient defines their current medical situation, how faith and spirituality plays a role in their care, and what level of support and input specific family members have.

In this case, the patient is a pregnant Native American woman. First, as the clinician, I would need to be aware of the specific cultural dynamics at play. For example, in the Native American culture, women play a large role in their communities because many communities are considered matrilineal. In these types of nation’s women are the decision makers and the matriarch should be included in all decisions. (Cerario, 2001).  Explanation of any procedures would be explained in detail and include all possible side effects, outcomes, and complications in an effort to build trust and show transparency Building a Health History NURS 6512 week 1 Discussion Post.

Additionally, I would ensure that I was aware of the specific practices regarding pregnancy in this population. Childbearing is viewed as part of the life cycle and therefore rhythmic. The pregnant woman’s focus at this time will be on the pregnancy and not on other issues or events that follow the pregnancy, such as child rearing or contraception. (Cerario, 2001).   The beliefs and values surrounding pregnancy, labor, delivery, postpartum, and newborn care vary from tribe to tribe and from individual to individual, and as the primary healthcare provider, it is my duty to be aware of some of the commonly practiced traditions of Native American families. (2001).

In addition to the above practices, completing a health risk assessment also plays a large part in ensuring the appropriateness of patient care. In its simplest terms, a health risk assessment (HRA) is the evaluation of an individual’s risk of developing certain conditions based on specific factors and the role preventative medicine plays in such assessments. (Wu, 2015). As an APRN, (and an individual diagnosed with a chronic/and most likely fatal disease), the importance of preventative medicine as opposed to reactive medicine is of great importance to me Building a Health History NURS 6512 week 1 Discussion Post.

When developing my targeted questions, I attempted to combine the patient’s cultural background and the concepts surrounding the benefit of an HRA.

 

Targeted Questions:

1. What Native American tribe do you belong to?
2. Have any family members had pregnancy complications and if so, what were they?
3. Is this your first pregnancy?
4. What is your personal vision for your birth-plan?
5. What support do you require/need from your medical staff?

 

For me, at the end of the day, the treatment of the patient comes down to a holistic approach and being inattentive to  any portion only serves as a detriment to the patient I am treating Building a Health History NURS 6512 week 1 Discussion Post.

References:

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Cerario, S. (2001). Care of the native American woman: Strategies for Practice, Education and Research. Scholarship for the Care of Women, Childbearing Families, and Newborns. (30), 13-19. DOI:https://doi.org/10.1111/j.1552-6909.2001.tb01517.x

Wu, R. R. & Orlando, L.A. (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal (1079), 508-513 Building a Health History NURS 6512 week 1 Discussion Post.

Response

Thank you for your fantastic and thorough post! You have made many fantastic points. I agree that being culturally aware is important in your scenario. It appears that you have gathered some extremely useful research regarding treating Native American patients.

Effective communication increases diagnostic accuracy, patient and family understanding of treatment, and improves patient outcomes (Damm, Leiss, Habeler, & Ehrich, 2015). In this scenario, your communication tactics will be extremely important. It is important to be open and sensitive in this scenario. Many Native American individuals and Indigenous patients feel stereotyped, ignored, and not respected by non-indigenous health care providers (Roessel, n.d.). Letting this particular patient know that they are respected and in control of their care will go a long way.

                                                                                                      References

Damm, L., Leiss, U., Habeler, U., & Ehrich, J. (2015). Improving care through better communication: Continuing the debate. EUROPEAN PAEDIATRIC ASSOCIATION, 167(2), 501-502. Retrieved from https://www.jpeds.com/article/S0022-3476(15)00547-8/pdf

Shannon, M., Best, D., Binns, H., Kim, J., Mazur, L., Weil, W., … Spire, P. (2005). Lead exposure in children: Prevention, detection, and management. AMERICAN ACADEMY OF PEDIATRICS, 116(4), 1036-1046. http://dx.doi.org/10.1542/peds.2005-1947 Building a Health History NURS 6512 week 1 Discussion Post

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Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history Building a Health History NURS 6512 week 1 Discussion Post.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

• Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
• Suggest additional health-related risks that might be considered.
• Validate an idea with your own experience and additional research.