TAKING A HEALTH HISTORY: BUILDING A HEALTH HISTORY: ASKING DIFFICULT QUESTIONS
Instructions
TAKING A HEALTH HISTORY: BUILDING A HEALTH HISTORY: ASKING DIFFICULT QUESTIONS
Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.
Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.
For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient.
To prepare:
· Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
· Review the media programs related to a vaginal exam, pap test, and breast exam.
· Review the health history guide presented in Chapter 6 of the Schuiling & Likis (2017) text and consider how you would create your own script for building a complete health history. (Note: You will also find the Health History Form in Chapter 6)
· Provide all the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.
· What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, shingles, etc.)?
· What questions would you consider in your patient’s complete health history? For example
o What is your patient’s living situation?
o Do they have stairs?
o Do they live by themselves?
o Do they have a working refrigerator?
· Develop your own script for building a complete health history and as you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. (Utilize chapter 6 of your Schuiling textbook to provide guidance). You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.
Reflection
· In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:
o A brief summary of your experiences in developing and implementing your script during your health history.
o Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.
SAMPLE ANSWER
Developing a script for building a complete health history requires careful consideration of the patient’s needs and concerns. A comprehensive health history includes aspects such as demographic information, current health status, past medical history, family history, social history, sexual history, gynecologic history, and psychosocial history. Therefore, your script should cover all these aspects and should be sensitive to the patient’s privacy and cultural background.
Considerations for special populations such as LGBTQ+ individuals should be included in the script. For example, questions about gender identity, sexual orientation, and sexual practices should be approached with sensitivity and respect. It is important to create an environment where the patient feels comfortable disclosing such information.
Health maintenance guidelines should be included in the script for initial and follow-up assessments. This includes recommendations for preventive screening tests such as mammography, Pap tests, bone density tests, and immunizations such as Gardasil vaccine and shingles vaccine.
Some difficult questions that may be included in the script for gynecologic history include questions about menstrual history, sexual activity, contraceptive use, and history of sexually transmitted infections. These questions should be approached with sensitivity and respect to avoid causing discomfort or embarrassment to the patient.
During the implementation of the script, the nurse practitioner may find it difficult to ask certain questions. For example, questions related to sexual history and sexual orientation may be challenging to ask. It is essential to use appropriate language and a non-judgmental attitude while asking such questions to create a comfortable environment for the patient. It may also be helpful to acknowledge any discomfort that the patient may feel and assure them that the information they provide will be kept confidential.
In conclusion, building a complete health history requires sensitivity, respect, and attention to the patient’s needs and concerns. Developing a script that covers all aspects of the health history and includes guidelines for preventive screening tests and health maintenance is essential. Difficult questions related to gynecologic history should be approached with sensitivity and respect, and the nurse practitioner should be prepared to handle any discomfort or embarrassment that the patient may experience. Reflection on the implementation of the script can help the nurse practitioner to identify areas for improvement and ensure that patient care is provided in a compassionate and professional manner.
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