What is so difficult about this question?

  1. As an ED nurse who works triage a lot, I find it incredibly frustrating that when I ask most patients if they have had any medical problems in the past they give me a blank stare, and sometimes ask "What do you mean?" Most then proceed to give me their surgical history.

    Sometimes after I get the blank stare, and then the surgical history I ask if they have any problems that they take medication for every day, but that doesn't cover everything, like they could have had an MI in the past, but not necessarily be on any meds related to it.

    Is there some other way to ask people that would make it more clear what I'm looking for? I work in a busy ED, and see probably 50 patients a day come through triage, so I guess that's why it's bothering me so much lately.
  2. Visit 86toronado profile page

    About 86toronado

    Joined: May '07; Posts: 525; Likes: 659
    RN-emergency; from US
    Specialty: 5 year(s) of experience in neurology, cardiology, ED

    19 Comments

  3. by   nurseEsteve
    Try "have you been in a hospital due to a medical condition before?" Or where you admitted to a hospital due to unresolved medical condition? Coz the point here is they will remember their hospitalization and then when they do you can start dig deeper info. It works for me


    nurse.Esteve
  4. by   nurse2033
    Start with, "do you take any medications?" and that may get the ball rolling. Or, "do you have any medical problems like; HTN, diabetes, acorporal disassociation, psychogenic polydypsia, Web MD induced palpitations, you know...." If you offer up some diagnoses it gives them an example of what a medical problem is, so they can process it.
  5. by   emtb2rn
    I ask "do you see a doctor or take medications for anything like asthma, diabetes, high blood pressure, cholesterol, your heart, anything?

    And they still leave things out.
  6. by   ♪♫ in my ♥
    "Do you have any medical problems?"

    "No"

    "So you don't take any medicines?"

    "Yeah, I take metformin, hydrochlorothiazide, and atorvastatin."
  7. by   JBudd
    Since they are on meds and the problem is under control, they don't consider it a current problem.

    I just ask, "do you have any other medical problems, such as....." and offer a list based on age and what they look like.

    "asthma, diabetes, high blood pressure" being the three most common I use.
  8. by   Cobweb
    Lol, as a chronic patient, I have the other problem. The intake person says, "What's your medical history?" and I start rambling it off...after about 2 minutes, they are like, "Well, that's enough of that." I actually made a printed history that I take with me now, let them read what they will.
  9. by   ♪♫ in my ♥
    "So what brings you in to see us tonight?"

    "Well, in 1997..."

    "OK, let's keep it within this millennium, shall we?"
  10. by   llg
    I am 59 years old. I have had lots of medical problems in the past - most of them totally irrelevant to a current visit to the doctor. Do you really want the whole list since childhood? (E.g. When I was about 5 years old I got hit in the head with a croquette mallet. I had scarletina when I was 7. I used to get poison ivy every summer when I was a kid. etc.) I can understand why your patients are confused and/or hesitant to answer. They are trying to read your mind to figure out how detailed you want them to be.

    I think the posters above have given you some good advice. I like the "Are you currently taking any medications?" question but encourage you to follow it up with something like "Are there any other health issues you are currently dealing with?" and "Have there been any significant illnesses or injuries in the past, such as ...." as others have suggested.

    Personally, I never know what to say about my insulin resistance. A few years ago I was diagnosed with Diabetes Type II, but I never took any meds for it. I was borderline and my doc gave me a chance to manage it with diet and exercise. 45 pounds lighter now, exercising regularly, and keeping my carb consumption low keeps my labs OK -- so no meds -- and my diagnosis has been downgraded to insulin resistence. It wouldn't show up on my med list ... but I would want any health care provider to know I needed a low-carb diet and my blood glucoses monitored a couple of times per day (especially if hospitalized).
  11. by   canigraduate
    When I'm doing an admit I tell people "Tell me yes or no if you currently have or have had any of the following in the past:" and read off a list. At the end, I ask them if there is anything I didn't cover. I probably get a 90-95% accurate list.

    The yes or no format lets people answer quickly without having to think too hard, so it usually only takes 5 minutes. It also jogs their memory for other weird things they may have and they blurt those out as we go.

    Asking people "do you have any medical problems?" puts them on the spot and makes them uncomfortable with you because it is such a vague question. And since it is so open-ended, it takes forever for patients to answer fully.

    Sometimes, asking questions about their current medications helps, but some people are so health illiterate they honestly have no idea why they are taking something.
  12. by   brillohead
    My dad is one who doesn't know what meds he's on, but at least he KNOWS he doesn't know what he takes. Mom and I make sure he keeps an updated, typed (handwriting sucks!) list in his wallet at all times... he even uses it to set up his daily medicine compartments every week.

    I always recommend to everyone (friends, family, neighbors, strangers! LOL) who has any prescriptions to keep a list in their wallet (or at least on their phone) so they don't have to try to remember which meds and which doses every time.

    You also have to use the local vernacular sometimes....

    Do you have diabetes? "no" Why do you take metformin? "I gots the sugah."
    Do you have hypertension? "no" Why do you take Lasix? "That's for my blood pressure."

  13. by   brillohead
    This is an informative video that was shown in my nursing school program a few years ago, and it was very eye-opening for me.... I just never realized just how common these issues really are among our patient base.

    https://www.youtube.com/watch?v=cGtTZ_vxjyA
  14. by   BiotoBSNtoFNP
    I often find that people (young and old!) get confused by the "what medical conditions do you have?" Question. I've also learned to start out asking if they take any medication and then go from there. Sometimes if they are unsure, I'll ask something general like do you take any medication for your heart? And people will remember like oh yeah i take metoprolol or whatever.
    I think it's even more frustrating when people don't know the name of their drug allergies! I see that a lot:
    "Do you have any allergies to medication?" " oh yes I had a horrible rash and couldnt breathe after taking an antibiotic for an infection." "Ok what was the name of the drug?" "Ohhh...i dont know..." ..??!!!😵😵

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