Help with interviewing the Pt.

[Kitty Hawk, ADN, RN]

Hi...

We have to complete 14 page questionaires when we interview the patient. I am having the hardest time with this mostly b/c I feel bad for their situation and feel like I should say something!

I know I'm "supposed" to be the professional and remain objective..but from the beginning q of "what brings you to the hospital" even if we have the info in a pt care summary we still have to ask. My last pt was a diabetic and lost both his legs earlier in the year and now lost 3 finger of the R hand and I felt SO bad for him...he was the sweetest wtih a really decent dispostion of it all but still I feel like I should say something, but all the therapeutic comm skills we learned do not seem to help!

Also, we have to ask "what do you like most about yourself?" and "what do you like least?" I dread these q's b/c they're in the hospital...I feel like they feel they are being judged!

Any tips on how to ask the "if they're sexually active" would be helpful too...I have to add that to the things we ask this week.

I guess this really just feels fake at this point b/c the patient that I interview is not the same one I provide care for, so when I go in and introduce myself and say I'm the student nurse assigned to you today...basically I'm only "harrassing" them with questions and then leaving to provide pt care on someone else!

TIA (still feeling overwhelmed, but plugging at this day by day)

[traumaRUs, MSN, APRN]

Oh boy - when I was in school for my APN, we still had this darn 14 page assessment thingie too. If you have to do a physical assesement, I try to do both at the same time - it helps minimize the stress for the pt. For the really personal stuff; how do you feel about yourself, I phrase it as, "In your position, how do you cope with your disability/illness/trauma?" As to the sexual history: "Many people are sexually active despite barriers. How do you deal with the barriers?"

And...I"ll be honest, I'm always upfront with the pts and tell them this is an assignment from school and they are free to disclose or not disclose what they want. Then...I just write "pt refused to answer" by that question.

I do want to add that in my current practice, I do ask personal and sometimes confrontational questions. However, I have an established provider/pt relationship which allows me more leeway than a student/pt relationship.

[RheatherN, ASN, RN, EMT-P]

Heck yeah, use the student card now while you can!! i dont know what i am going to do when i graduate! lol..i am pretty good about not feeling bad or whatever, not that i am cold, but also have a job to do as well as school.

pull the student card for sure though.. most ppl understand that and will cooperate and heck, usually even like you more because you are honest. i tell them it is an assignment, but also that it is helping me care for them better because i know more about them than just what is in the chart on paper..

GL!!

-H-

[MB37]

I don't know if my method is the best, but it's worked so far: I start by looking over the chart, and making sure I know the major medical diagnoses, medications, past surgeries, etc. That way I don't sound like an idiot. Then (after introducing myself, getting am vitals, etc.) I'll ask if they mind helping me out with an assignment. I explain that I'm supposed to practice interviewing skills and do a physical assessment of whatever we've learned so far. I thank them in advance, and say something about how it never hurts to get a free checkup while they're already here. I ask if they're in pain or uncomfortable, and tell them they can refuse to answer any questions that are too personal, and that if they get too tired, need water, etc. to let me know. I warn them that it will take a "little while." I apologize if I have to interrupt the interview (my instructors have pulled me out to go over assignment, etc. - they only spend maybe 20 minutes on each of our floors). So far this has worked for me to build a pretty good rapport. Also, I use the information I've gotten from the chart, "So, I see here that you had 'stomach surgery'" in 2002, can you tell me what that was for?" so they know I'm not coming in unprepared. Last week, my devout Jehovah's Witness was comfortable enough to tell me that she tried drugs in college, and her actual number of past sexual partners. I start as early as I can - hopefully their visitors aren't there 24/7 so I can get some alone time.

One thing I need help with is how to ask the sexual/drug/etc. questions with family/SO in the room - do I ask someone's spouse, or kid who flew in from wherever, to leave to room just so I can do my homework? And will anyone answer those honestly with family in earshot? It takes so long, and our clinical time is so short this semester, that it doesn't seem right to ask someone's family to leave when maybe they only have the morning off from work (and we're off the floor at 12).