Make a follow-up of a student’s weekly discussion and respond with your opinion regarding to her post

 

Theresa Keppard-Nelson

Hello professor and class, 

I work in the preadmission testing (PAT) department at my facility. The most significant part of my responsibility is to prepare patients for surgery by obtaining their medical histories before their procedures. Many of the patients that we serve are from the Hispanic population and do not speak English. We have access to an interpretation service. These assessments are done over the phone. Although the interpreters know medical terminology, they will occasionally ask for clarification or the meaning of a question. Our anesthesia protocol is the form we use to get the medical history. Unfortunately, the questions are closed-ended and require yes or no answers. Sometimes the answers that I get need further investigation. For example, if I ask a patient if they have high blood pressure and the answer is no, and the medication list includes blood pressure medication, I will question this. Some responses make me aware that the patient does not understand what I am asking. One of the questions on the form asks, “are you able to walk two blocks or two flights of stairs without getting chest pains or shortness of breath.” This is intended to assess for possible cardiac issues. Patients that answer yes to the question may require further testing by a cardiologist before proceeding with their procedure. Recently I had a patient answer no to the question. Meaning she could not walk without getting chest pains or shortness of breath. I questioned her through the interpreter for further clarification and realized she misunderstood that question. There were no adverse effects; however, this could have resulted in her surgery being delayed or canceled and requiring the patient to see a cardiologist unnecessarily. To avoid miscommunication in the future, we should use closed-ended questions. When communicating with patients who are Non-English speaking, I will use closed-ended questions and thoroughly explain the questions. Ideally, the form could be revised to change how the questions are asked. Meanwhile, I will be careful how I ask the questions.