Chamberlain College of Nursing NR 305
Professor Joanne Pearce
Journal Article Review #1
‘Taking a patient history: the role of the nurse’ is an article published on February 15 in Nursing Standard Volume 26, Issue 24, pages 41-46, written by Tonks Fawcett, and Sarah Rhynas. In this article, Fawcett and Rhynas illustrate the development of nurses taking medical histories on patients since the 1970’s. Change has evolved to create a higher level of quality care and outcomes for patients.
Summary of Article
The focus of this article is to exert how nurses utilize their critical thinking skills to assess family members as well as their family support units to create a foundation for building an accurate diagnosis. These skills are the crucial elements for the evaluation of an individual’s physiological, biographical, and psychological systems.
There are several components that are addressed in the article to evaluate areas of importance. They include the patient’s computational framework, protocols for physical and mental evaluations, compiling pertinent data of life events, and generating effects of excellence for diagnosis and skills of improvement that can be utilized for the future.
One of the first components that are looked at is the importance of accurate assessments. In previous generations informational data was only based on doctoral standardized observations to create a diagnosis for medical care. The neglect here is the absence of individualization. Other factors are needed to compile complete evaluation as social, cultural, and psychological data. “Effective communication is key to elicit an accurate and detailed patient history and models such as Calgary-Cambridge framework can be used to achieve this.”(Fawcett & Rhaynas, 2012) The specific model of this care is addressed as the focus for patient care; entitled person-centered approach to care.
Such a framework developed aides in the completion of precise material. Calgary-Cambridge’s basis of communication entails six areas; initiating the session; describe grounds for the meeting, gathering information, building the relationship, providing structure to the interview, explanation and planning, and closing the session.’ (Fawcett & Rhynas, 2012) In using this model a bond can be created between the nurse and patient to formulate a composite from the areas of interest, the pathological sector, and subjective experiences. Guidelines are presented by Lloyd and Craig within the article to structure the initial interview of the patient to obtain a complete report; “establish a rapport with the patient and family, gather health status, current concern, management of symptoms, medical history, emotional health and current medications, family and social history, activities of daily living, patient’s perception of illness, family’s perspective and finish with closure of both parties.”(Fawcett & Rhaynas, 2012)
The style of attaining information to create appropriate evaluations for diagnosis is necessary. The nursing perspective entails a more intimate connection through informal conversations. The effects of informal conversations with the patient is crucial in building a broader spectrum of information for insights leading to better care. Nurses have more contact with the patient to build trust. “Communication from a nursing perspective should encompass getting to know the patient better to understand problems and needs.” (Fawcett & Rhynas, 2012) In these moments of interaction nurses gain insight to the patient’s views, feelings, life events, and fears which in turn gives opportunities to support and educate the patient. This type of communication that nurses achieve are presented as person-centred care. Fawcett and Rhynas depict person-centred care, “as being essential to optimize the success of any intervention, thorough history taking is a component of this.” (Fawcett &