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.
My assigned patient is a 38 year old native American pregnant female living on a reservation. According to the Federal Health Program for American Indians and Alaska Natives, an important style of communication for this community lies in the art of listening rather than speaking. It is important in this patient scenario to allow the patient to ask any questions they may have, especially related to pregnancy and navigating health issues that may arise. (Indian Health Service, 2019) The risk assessment tool that I believe would be most appropriate for this patient is the Pregnancy Risk Assessment Monitoring System that is completed with pregnancy and tracked by the Centers for Disease control. I believe this is important for this patient as pregnancy is a major component of her health status and assessment at this time. Another important component of the risk assessment for this patient would be a comprehensive family health history. A family health history is a vital step in any health assessment as it provides key data that may increase risk of mortality for the patient. (Wu, Orlando, 2015)
Important questions that I would ask this patient are
- Do you have any questions for me about your health?
- Are there any cultural considerations that I need to be aware of in obtaining your health history?
- During the 3 months before you got pregnant with your new baby did you have any fo the following health conditions, Diabetes, high blood pressure, or depression?
- Thinking back to just before you got pregnant with your new baby, how did you feel about becoming pregnant?
- How many weeks or months pregnant were you when you had your first visit for prenatal care?
Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health
history: Barriers and benefits. Postgraduate Medical Journal, 91(1079), 508. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1136/postgradmedj-2014-133195
“Indian Health Service (IHS).” Indian Health Service, 2019, www.ihs.gov/.
sample response
Thank you for your well thought out and well researched post. I especially liked that your first targeted question focused specifically on the patient and their needs. I believe that helps create trust between us, the practitioner, and the patient, especially if that patient is trepidations about seeing a medical professional. You also did a great job of asking open-ended questions that remained specific.
Research shows that Native American women are at higher risk for pregnancy complications due to a lack of pre-natal care due to multiple factors including poor communication with physicians and a lack of access to care. (Hanson, 2012). Because of that reason, a comprehensive first examination should attempt to obtain a detailed patient history including the specifics of their pre-natal care. Just because they are seeing us for the first time, does not mean that they are or that start of their pregnancy or that they have been seeing another practitioner.
When we go out into the world and treat these patients, we must remember that culture plays a large role in how medical care is both received and delivered. Culture reflects the whole of human behavior including specific attitudes, ideals, etiquette, manners of speaking, and ways of relating to others. (Ball, et. al, 2019). Sensitivity and awareness should always play a part in our practice as APRNs.
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.
Hanson J. D. (2012). Understanding prenatal health care for American Indian women in a Northern Plains tribe. Journal of transcultural nursing: official journal of the Transcultural Nursing Society, 23(1), 29–37. https://doi.org/10.1177/1043659611423826
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.
response 2
Thank you for your post! You have made some excellent points regarding the risk assessment and health history formation for this patient. I especially like how you are being culturally aware of this patient. Your questions are excellent and demonstrate transparency and thoughtfulness as a provider. I agree that with this patient, due to her Native American background, it is important to hear what she has to say regarding her health concerns.
Communication is key when building a health history with a patient. Effective communication improves our patient outcomes by increasing diagnostic accuracy as well as patient and family understanding of treatment. (Damm, Leiss, Habeler, & Ehrich, 2015). Research shows that many Native American patients feel stereotyped and ignored by health care providers (Roessel, n.d.). This is why effective communication and cultural awareness are so important in this scenario.
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
Roessel, M. H. (n.d.). Working with indigenous/Native American patients. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-competency/education/best-practice-highlights/working-with-native-american-patients