we will discuss your plan of care. This afternoon will be
busy for you—some blood tests and a chest X-ray have been
ordered. Your evening will probably be quiet. Do you have
any questions? Is there anything else I can do for you before
I leave?’
Physical health assessment
Physical health assessment
is the examination of the
person for objective data that may better define the person’s
condition and help in planning care. The physical assess-
ment normally follows the health history and interview, and
may verify data gathered during the history or yield new
data. Doctors traditionally have performed the initial phys-
ical assessment, which commonly is the mechanism of
entry into the healthcare delivery system as well as the
basis for medical treatment. Some nurses and midwives in
Termination
The successful interview is concluded carefully. The person
should be advised that the interview is coming to an end. It
is helpful to summarise the interview, highlighting key
points. All parties involved in the interview should be satis-
fied that the important data are recorded. A helpful strategy
is to ask the person after the summary: ‘Is there anything
else you would like us to know that will help to plan your
care?’ This gives the person an opportunity to add data you
did not think to include.
Before terminating the interview, it is helpful to alert the
person to what to expect. The person should also know
when you will re-establish contact; for example, ‘Thank you
for answering these questions, Miss Jones. Please feel free
to keep us informed of anything you think we should know.
I’ll be leaving soon, but when I return tomorrow morning,
Unit III Thoughtful practice and the process of care
280
High anxiety
TABLE 15-3 Personal variables that can negatively influence an interview and suggested responses
Personal variables
Effect on interview
Nursing and midwifery response
The person may speak rapidly or
incoherently and may jump from
one topic to another; the person
may deny or misrepresent what
they are experiencing.
Normalise anxiety: ‘Many people find it difficult
to talk about their health and become anxious’;
approach the person gently, speak slowly and
softly; underscore the importance of the person
sharing what they are experiencing so you can
be of help.
Pain
The person offers clipped
responses and ‘yes’ or ‘no’
answers whenever possible;
overriding concern is pain relief.
Do everything possible to make the person
comfortable before the interview, including
obtaining an order for, and administering, pain
medication; if pain persists, obtain only vital data
and defer the remainder of the interview until the
person is more comfortable.
Language difficulty (the
person is not fluent in the
interviewer’s language
because the person speaks
a different language, has
limited education or fears
saying the ‘wrong thing’)
Vital personal data will not be
communicated; the person may
mistakenly be labelled ‘indifferent’
or ‘non-communicative’
Speak clearly (do not raise your voice) using
simple language; whenever possible, obtain the
assistance of an interpreter (a family member
may help, but it is preferable to have a healthcare
interpreter, especially if the personal data are
confidential)
Previous negative
experience with
healthcare professionals
or healthcare delivery
system
The person is aloof, unwilling to
participate in the interview and
has the general attitude: ‘Why
should I waste my time telling you
anything … it won’t do me any
good.’
‘I know other people who have had a tough time
with healthcare professionals or the system …
life isn’t perfect … but how about giving us a
chance this time to show you what you can do?’
Communicate competence and respect for the
person.
Unrealistic expectations
of health professionals
The person expects healthcare
professionals to magically know
everything about them and to
‘take care’ of them; ‘surrenders’
themselves to the system—‘you
know best’ attitude.
Communicate clearly that no-one knows or
understands the person as well as they know
and understand themselves, and invite them to
become involved in their own care: ‘No two
people are alike, and unless you tell me a little
more about yourself and how you are feeling,
there is no way we’ll be able to plan good care.’
