The healthcare industry today is in a hot seat with respect to how it is operated and what the future holds in store. Regardless of what is said about it, the industry still serves the patient’s needs in most cases in a timely and efficient manner. My last visit to a physician was a textbook example of what is right in the healthcare field today. The circumstances surrounding my visit started about a year before I made my initial decision to see a practitioner. Around the wintertime, which also included the time of finals and mid-terms, my tonsils swelled-up to the point of going beyond minor inconvenience. Moreover, the swelling also occurred during other parts of the year including the spring and in the summer. The pain associated with the swelling was unbearable and made it hard to concentrate on daily life. Me being an optimist, however, I would tell myself that this would all go away. It did. But soon the problem would return. Eating regular food became hard for me. Another symptom of the swelling, or what might have caused it, was constant sickness with flu-like and cold-like symptoms around the time of this occurring. For a while, to avoid unnecessary doctor’s visits, I tried to do all I could to prevent this from happening, including more sleep, more fruits and vegetables in the diet, as well as vitamin supplements. To backtrack for a bit, my parents and I had the option of removing my tonsils when I was much younger, however, a unanimous decision to keep them was made partly because of the fact that they are a part of the lymphatic system and removing them for prophylactic reasons might be detrimental to my health in the future. Eventually, however, the time came for me to see a physician and get his opinion.
A. The Assessment
There were differing opinions in my family on whether or not I should go see a doctor and to possibly have my tonsils removed. I finally made the decision to see a physician so he could ascertain as to what my next options would be. In the Physician’s office, I was greeted by a nurse who had an interview with me to see what my history was and how are the symptoms affecting me. I was referred to by my name very politely, and she had introduced herself by her name to make me feel that there is human on the other side of this process. She was going by the questionnaire that I had filled out earlier in the waiting room. An integral part of the health assessment process and the first part of it, the interview conducted gave the nurse a good picture of where I am and should be. The interview process was very polite from the nurse’s side and made me, the patient, feel very comofrtable and relaxed. The temperature in the room was at a comfortable level which made me not as tense about my problem for which I came to see them. Immediately folloing my entering the examination room with the nurse, she closed the door behind her so as to ensure my privacy during the interview and the taking of my vitals, as well as to reduce any noises coming from the outside that might also make me agitated. The distance between us was approximately two arm lenghts or 4 feet, which ensured that the nurse does not enter my comfort zone and make me more anxious. Unfortunately equal-status seating was not implemented by the nurse, because as I was being asked questions, she was taking my vitals including Blood Pressure, Body Temperature and Blood Oxygen Levels while standing. On one hand it was an efficient way to make good use of her time in order to process me faster, yet on the other it did communicate superiority on the part of the nurse, which did not bother me that much or make me uncomfortable, but it’s understandable how this might make the average patient feel. (Jarvis, 2004)
B. The Assessment
Personal questions were asked with neutral body language, facial expressions and tone of voice, so as not to make an impression of her judging me in any way, shape or form. She was an effective communiactor by going over the questionnaire with me and confirmed the questions by asking me direclty about family history of any diseases, risks, etc. Effective communication was an important tool to make me feel less anxiety and to properly ascertain my full medical background, as is stated my countless international authors. (Campos & Graveto, 2009) While going over the questions, some included: health history, while others focused on my lifestyle; where I work, where I live, how I eat, my excersise regiment, etc. Some of the questions were direct, as in “Do you excersise?” Whereas, others wre open-ended like: “How would you describe your health today?” It is no surprise then, that the way the nurse carried herself, and the small processes she went through, which I didn’t even notice are an artform. The subtle expressions she used to get the best perspective on what is going on with me to get the full picture was not the most easiest task. This is the art of science at its best becuause she used the tools available to her for the assessment. (Baxter, 2008)
C. Assessment Background
The information that is studied in psychology, sociology and communication is utilized in the health asessment process. For example, verbal and non-verbal cues could tell the nurse if there is something that is being omitted from the answers. For example, if one is asked whether or not he smokes, and says no, but scratches the side of his nose and turns to the side, a well-trained nurse might suspect that the patient is lying, and therefore either do a follow-up question or note how the question was answered. Non-verbal cues might be useful to the nurse when she is treating a victim of domestic violence. Subtle expressions in the face and body positioning by the patient while explaining the situation at home, for example, might give away that the victim is saying one thing, but is thinking of another, yet he/she is just too afraid to say anything, even in the comfort of a medical professional. Of course, physical cues like bruises on the face or hands will signal a red flag and the interview will turn into a search for why the patient might be bruised or have soars. This in turn might prove, abuse, neglect, physical harassment, etc. (Jill Fuller, 1990) From another perspective, cultural differences must be addressed in order to maintain a well-rounded rapport with the patient. Depending on the culture the patient is from, a nurse’s behavior can prove to be the straw that broke the camel’s back during the interview, thus rendering it not as successful as it could be, or it can prove to be a vital asset which will provide the nurse with valuable information. Depending on the culture, some patients might be uncomfortable shaking a woman’ or a man’s hand, or might find it disrespectful if someone across from the crosses their legs. In situations like these the art of nursing comes into play where a skilled nurse will be able to adjust her behavior accordingly so as not to make the patient feel uncomfortable or disrespected. In some cases, the best thing a nurse can do is to stay silent; case in point being after a nurse asks a question and only gets a partial answer, some silence might be useful in order to let the patient collect his or her thoughts and continue answering. As stressed earlier, however, the nurse’s communication never gave way. (Weber, 2009)
As the interview continued, she was monitoring my vitals, but as she was doing this, she would let me know what she is about to do, just so there won’t be any surprises. She wasn’t rought when doing this, again, so as not to cause stress or anxiety. The most important questions that she asked me, were regarding the reason why I came to the office that day in the first place. As I described to her the symptoms, each answered was followed by a follow-up question. For example, when I would say “my tonsils hurt,” she would follow by asking “do they always hurt and to they hurt right now?” She needed to know whether or not I have been exposed to any family members that are sick. I was also asked whether or not I smoke. When this was done, the nurse looked over and analyzed the information that was collected during the assessment. After looking over the data, she gave me a physical evaluation and checked my tonsils. She said that she had never seen them so inflamed before. She then left me in the room to give the results to the physician, who after looking at the results and my tonsils let me know that the only alternative was to extract them by surgical means. There was no clear diagnosis, but the physician said that because they bother me so much, and because they are so inflamed, a tonsilectomy was the best choice available. He explained to me what kind of procedure they will and how it will be done. I was asked whether or not I have any questions after after every bit of information that I was given. When all was done, the nurse returned to make a surgical appoint for me. She instructed me on what I should do before the surgery like eating, drinking, smoking, etc.
When it was all done, my recovery time was quick, and I came in for a follow-up appointment. The interview process started again, but this time, I was asked how I was feeling and what had changed for me after the surgery. The physician took a look at my throat and said that everything went very well.
Although the deciscion was made to remove the tonsils simply by inspecting them, the health assessment process proved vital for the health practitions to see whether or not I was healthy enough for such a procedure, and to see what lifestyle changes can be made in order to eliminate some symptoms. I was treated in a professional and courteous manner by the staff, which made me feel not like just another sick person, but like a human being.
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