Part I
Communication:
The nurse did not use a polite tone as she was communicating to her patient.
The nurse used a hostile tone and it appears that she was yelling at the patient.
The nurse made the patient feel frightened and inhibited.
Rationale:
The patient will feel threatened and may become uncooperative if the patient if an impolite, hostile tone is used.
Treatment goals may be impaired if the patient feels frightened or intimidated.
Appropriate Action
The nurse should always act professionally
Cultural Competence
The nurse failed to greet everyone in the room
The nurse failed to introduce herself and ask for the patient and her relative’s name.
The nurse failed to acknowledge the presence of the patient’s relative.
Rationale:
Not greeting and acknowledging the presence of everyone in the room may be interpreted as a sign of disrespect in some cultures.
The nurse’s relationship with the patient’s relatives may contribute to the overall healing process of the patient because there are times wherein the nurse cannot take care of the patient. In those cases, the nurse should have left instructions to the family members regarding how they are supposed to take care of the patient.
Appropriate Action
The nurse should always acknowledge and be polite to the patient’s family.
Quality and Safety
The nurse rushes everything
The nurse failed to check for the patient’s vital sign before, during, and after the assessment.
Rationale:
Rushing the physical assessment and patient interviewing process may result to errors and gaps in the medical report.
The nurse will be unable to identify meaningful changes during a treatment or an assessment session if she failed to check for the patient’s vital signs.
Appropriate Action
The nurse should not rush the treatment or evaluation.
Body Language
The nurse acted as if she is disinterested with the patient or her condition.
The nurse kept on fidgeting around and is very lousy.
The nurse’s facial expression somewhat tells the patient that she is mad at her or that she does not want to be there to assess her (the patient).
Rationale:
If the nurse will show aloofness during the conversation, the patient may not cooperate.
The patient may get distracted if the nurse keeps on moving around and doing unnecessary motions.
The patient may misinterpret the facial expressions of the nurse.
Appropriate Action:
The nurse should not do any motion or gesture that is unnecessary to the treatment or evaluation.
Legal and Ethical Issues
The nurse failed to honor the patient’s right to privacy especially when she asked whether the patient was taking any form of birth-control pills.
The nurse informally informed the relative about the hospital’s policy regarding the use of cellular phones.
Rationale:
Failure to honor the patient’s right to privacy and confidentiality may lead to a lawsuit against the nurse and may also lead to the revocation of her professional license.
A patient complaint may result from the nurse’s informal enforcement of the hospital rules and regulations regarding the use of cellular phones.
Appropriate Action
The nurse should honor every patient’s right to privacy and confidentiality at all costs.
Part II
Communication
The nurse smiled as she was talking to the patient
The nurse introduced herself, and then greeted the patient and her relative before going to the assessment proper.
The communication between the nurse and the patient was a two-way communication. Both of them were talking and we could see how compliant the patient was.
Rationale:
Healthcare practitioners, especially a nurse, should know how to effectively communicate with patients, regardless of their case or condition (Weiten et al., 2009). Even though a patient has been diagnosed with a mental disorder, it is still a part of their job to make sure that that the patient gets what he is trying to say and he understands what the patient is trying to say (Driver, 2010). A nurse who does not know how to communicate to his patient effectively is considered an incompetent nurse. Nurses, especially in a public hospital setting, may get to interact with literally hundreds of patients every day (Castro, 2009) and if a nurse does not know how to communicate properly, he might as well find a new job because being the essence of being nurse not only lies on the level of practical skills but also on the ability to create and handle meaningful and goal-oriented conversations with the patient.
Appropriate Action:
Smiling while talking to the patient.
Avoiding the use of informal and hostile tone while talking with the patient.
Cultural Competence
The nurse did not forget to ask permission before trying something that might intimidate or disturb the patient.
Rationale:
Cultural competence is an important aspect to consider in every profession. What a nurse should try to avoid here is to be branded as a racist healthcare service provider. A cultural competent nurse should know how to deliver high quality healthcare services to his patients regardless of their age, their race, their place of origin, and cultural background (Castro, 2009). In some states, a medical professional can be sued by a patient, if it has been proven that the medical professional did not observe cultural competency during the treatment or evaluation. Being culturally competent can contribute a lot to the patient’s compliance and level of comfort.
Appropriate Action:
Acknowledging the presence of the patient’s relatives if there are any.
Imposing the rules of the hospitals regarding the use of cellphone in a formal manner.
Quality and Safety
The nurse did not fail to inform the patient and the parent that the treatment may still take some time even though every staff in the hospital was busy.
The nurse did not give any false promises to the patient’s mother even though she knows the mother wants everything to be finished as soon as possible because the nurse knows that an accurate and properly-done physical assessment will definitely take some time.
The nurse was able to make the patient open up and feel very comfortable despite the nature of the questions asked.
Rationale:
The reason why patients go to the hospital is to seek medical care and attention. However, if for some reason, they are not getting what they were expecting, then the particular hospital they visited may have some problems with regards to the quality or safety of their services (Polit & Beck, 2007). As long as there are patients who are complaining about the hospital’s quality and safety of healthcare services, the more hospital administrators and medical professionals should focus in doing the best that they can to deliver the type of service that their patients are expecting.
A competent nurse knows that a careful patient assessment and evaluation is necessary in the diagnosis and observation process (Benner et al., 2009). A medical professional who rushes things is more likely to commit errors versus a medical professional who does his job calmly and with perfect precision (Johnstone, 2009).
Body Language
The nurse looked professional because of her body language. She did not do any unnecessary motion during the entire treatment.
The nurse did not do any negative body language that may intimidate the patient.
Rationale:
A competent nurse should be able to make her patient feel comfortable at all times. However, in the video, the nurse’s body language can be considered intimidating for the patient. The crossing of the forearms can either be a sign that that person is angry or disinterested and the nurse in the video did that gesture in front of the patient (Joe, 2008). There are body languages that could show how open the speaker is to the one he is talking to and vice versa. It all depends on the speaker how he will use his body to say something to his patient. More often than not, body languages are expressed subconsciously and depend on the current emotion of the speaker (Ekman, 2008).
Appropriate Action:
Not doing any unnecessary motions while assessing the patient.
Legal and Ethical Issues
The nurse did not fail to preserve the patient’s privacy.
The nurse was able to professionally and ethically enforce the hospital’s policy regarding the use of cellular phones.
Rationale:
A nurse should definitely consider all the possible legal and ethical consequences of everything that he is doing to her patient. A nurse’s professional license may actually be revoked if proven guilty of neglecting her legal and ethical responsibilities as a medical professional, depending on the degree and the nature of the criminality or unethicality (Brown et al., 2008). One of the most common ethical issue among nurses and their patients is the issue about privacy. A patient reserves the right to confidentiality (Laschinger & Heather, 2008). Meaning, the nurse should automatically assume that every information that she was able to gather from the patient is to be kept secret even from family members and other relatives.
Appropriate Action:
Honoring the patient’s right to privacy and confidentiality.
Part III
Oral Health
1. How often do you brush your teeth?
2. When did you last see a dentist?
Development
1. How old are you?
2. How are you doing at school? Are you grades OK?
Speech
1. Can you read this sentence aloud? (The assessor will have the child read something)
2. Can you repeat the words that I just said? (The assessor will say or read a phrase and have the child repeat the phrase after him)
Speech
++++
Speech
++++
1. How are you today?
2. Can you tell me about yourself?
Speech
+++++*++
1. Since when did you get sick?
2. When was the last time you had a medical check-up?
Speech
++++++*
1. What time do you usually sleep?
2. What time do you usually wake up?
3. Do you experience any discomfort at night?
Speech
+++++++*+++
1. Do you have any sports? If yes, what sport do you play?
2. How often do you exercise?
Speech
+++
1. Do you eat vegetables?
2. How often do you eat meat?
3. Can you tell me what food your mom usually cooks at home?
Speech
++++++++
1. Do you have many friends? Can you name them?
2. How are you and your classmates?
Speech
++++++++
1. How are your mom and dad?
2. How often do you spend time with your parents and siblings?
Speech
+++++++++++*++
1. How do you spend time with your parents and siblings?
2. Can you describe to me the feeling whenever you spend time with your family?
Speech
++++++++
1. How do you spend time with your friends?
2. Describe to me the activities that you usually do with your friends.
3. Can you describe to me the feeling whenever you spend time with your friends?
Speech
+++++
Benner, P., Tanner, C., & Chesla, C. 2009. “Expertise in Nursing Practice: Caring, Clinical Judgment, and Ethics Second Edition.” Springer Publishing Company.
Blais, K., & Hayes, J. 2010. “Professional Nursing Practice 6th Edition.” Lavoisier S.A.S.
Brown, C., Wickline, M., Ecoff, L., & Glaser, D. 2008. “Nursing Practice, Knowledge, Attitudes, and perceived Barriers to Evidence-based practice at an Academic Medical Center.” Journal of Advanced Nursing.
Castro, E. 2009. “Facial Expression: The Effect of the Smile in the Treatment of Depression.Empirical Study with Portuguese Subjects.” The Brain and The Face 127-140.
Driver, J. 2010. “You say more than you think.” New York, NY: Crown Publishers.
Ekman, P. 2008. “Emotions Revealed: Recognizing faces and feelings to improve communication and emotional life.” New York: Times Books.
Joe, N. 2008. “What every body is saying.” New York: Harper Collins.
Johnstone, M. 2009. “Bioethics: A Nursing Perspective.” Chatswod, N.S.W.: Churchill Livingstone Elsevier.
Laschinger, S., & Heather, K. 2008. “Effect of Empowerment on Professional Practice Environments, Work Satisfaction, and Patient Care Quality: Further Testing the Nursing Worklife Model.” Journal of Nursing Care Quality.
Polit, D., & Beck, C. 2007. “Nursing Research: Generating and Assessing Nursing Practice.” Lippincott Williams & Wilkins.
Weiten, W., Dunn, D., & Hammer, E. 2009. “Psychology applied to modern life.” Belmont, CA: Wadsworth.
