The assessment that I will be focusing on is the first phase of the nursing process in the form of the initial assessment interview. The patient involved in the assessment is a 28 year old male who was admitted to a medical ward after an over dose. Within a few days it was established that the patient had mental health problems so he was referred to the community psychiatric nurse by his consultant and social worker, in order to continue his care in the community, after his discharge from the medical ward. I was introduced to the client, and his permission was given for me to use this assessment for the purpose of my study. The client in this assignment will be referred to as 'Fred'. This ...view middle of the document...
On entering the room the nurse introduced herself to Fred who in turn introduced himself to her. Good communication skills is an important part of the nurse client relationship, in as much as when two people are offering their names to each other they are respectively also offering themselves, which indicates an openness and readiness to talk and share with each other (Sundeen et al 1998). However Northouse & Northouse (1998) state that communication is the process of information sharing, through using common rules, where as Glover & Radcliffe (2000) describe communication as any interaction with another person.The nurse presented as being pleasant, smiling and relaxed. She sat slightly forward with her hands placed palm down on her lap. As she spoke to Fred, she made appropriate eye contact with him. These gestures of non-verbal behaviour, all indicate to the client that the nurse is interested in what is being said. Thomas et al (1997) states that non-verbal behaviour says a great deal without words, and posture also transmits a straight forward message. Egan (1998) created the SOLAR acronym to help improve nurse client communications. This being, sit square on, open posture, lean forward, eye contact, and relax. But Rowe (1999) states that inherent inequalities exist in the nurse client relationship and that the nurse will always have a degree of power over the patient to some extent. This may have been that case with Fred, as although he appeared relaxed, his eye contact with the nurse was not regular.The nurse began by explaining the assessment interview to Fred, she told him that the information was being collated in order to finalise an appropriate plan of care for him. She also made it clear that he was free to ask any question on issues which he was unsure of.The assessment commenced with the nurse asking Fred how he was feeling, she spoke in clear, simple terms. Heron (2001) identifies the importance of pitching language appropriately and according to the client's background. This is because a client with limited knowledge may find it difficult to understand highly academic language, which could result in inaccurate information being gained. However Morcombe (1999) suggests that clear explanations lie in the patient perception as to whether the nurse' language is appropriate. Morrison & Burnard (1991) suggests that complaints or disputes escalate if one person misperceives or misunderstands what another person has said or done regardless of patient background or academics.The questions used during the assessment were a mixture of closed and open ended questions. Stuart & Laraia (1998) states that closed questions are questions which only required a one worded response, usually 'yes' or 'no'. These questions are useful for gaining objective data i.e. name, address, health problems etc. Open-ended questions allow the interview to proceed in a natural sequence. Tamparo and Lindh (2002) describe how open ended questions ...
