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Discussion

What is so difficult about this question?

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.

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I don't know. If it were me, I'd want the healthcare provider taking care of me to know all about my medical history. For example, I've had pneumonia 3 or 4 times in my life. I've had at least three concussions. None in the last 15 years, but still pretty important, I think. These are all things that I don't take medicine for every day, but they are something a provider would probably want to know if, for instance they were ruling out pneumonia, or a head injury.

...or how about "It's in my chart!".

Yeah I gave up trying a long time ago. I have asked 100 different ways and still "No nothing wrong" You take 23 medications. "Yeah so whats your point".

I just die inside a little each time.

HOw many times I ask for previous medical hx, "none." Then you see in MAR they have insulin. "So you have diabetes?"

Response...."No, not anymore. That's fixed now."

The layperson usually has little idea. I ask about meds they take regularly, if it's fairly obvious, such as insulin, amlodipine, sertraline, I say, "so, you take that for diabetes/depression/etc?" If it is something that could be for more than one condition, I ask "and why do you take that?"

Sometimes I get "well, don't you know? YOU'RE the nurse." Oh, well.

Sometimes they tell you they used to take "peanut butter balls" (phenobarbital) for seizures, but that's all gone now.

If they seem not to know, or have any clue what they take or for what, I usually ask if they have all the body parts they were born with (now you know chole, hyster, appy, prostatectomy, etc). Then I run down the list, is anything wrong with your heart? Lungs? Blood vessels? Kidneys?" Then "have you ever had cancer? Seizures? Stroke? Heart attack?

Usually works out fairly well.

Does anyone know where I can get HEDIS training in ny, I've heard some agencies offert the class.

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).

"I am a borderline diabetic controlled by diet only." Simple enough. If someone told me that I'd still get an order for a consistent carb diet and FS AC/HS.

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