Communication: standard nurse-patient situation
The equipment and personnel required to perform this skill:
This skill is developed by practising nursing skills and manipulation skills when the nurse is working with a patient (standardised patient)
Description of the clinical situation:
You are a nurse carrying out appointments in a specially designated room (polyclinic, hospital, antenatal clinic, sanatorium, etc.). You must provide medical care for the patient or perform medical manipulation as prescribed by the doctor (injections, taking tests, etc.). Middle-aged patient. This is the first time you have contact with the patient. The patient is neutral (friendly).
The order in which the skill is performed:
Preliminary stage
Set the mobile phone to silent mode.
Finish the work related to the previous patient.
Main stage
- Invite the patient to enter the room
- Make eye contact with the patient's eyes for 3 seconds. Thereafter, repeat this contact periodically for a total duration of 30-60% of the entire conversation.
- Say hello to the patient first, introduce yourself and offer to sit down:
‘My name is Olga Ivanovna. I am a medical nurse...’.
- Identify the patient:
ask for name, first name, patronymic, room number, check the appointment sheet
- Obtain patient's consent to perform manipulation (conduct care), collect history, identify medication with prescription sheet (if necessary):
- inform the patient about the forthcoming drug administration (care): ‘...For effective treatment, your doctor has prescribed intramuscular injections of a medicinal product ...’;
- explain to the patient the content and sequence of the manipulation (care) in an accessible form;
- ask whether the patient has been administered the prescribed drug before and whether there has been no allergic reaction to it (whether care has been given before): ‘.. Do you have any allergic reactions to this medication...’;
- obtain the patient's consent to perform the manipulation (care): ‘...Do you agree to subcutaneous injection...’, “Do you agree to tracheostomy care...”.
- Explain to the patient how to prepare for the manipulation (care):
- ask the patient to take the appropriate position (according to the manipulation or care), clarify with the patient about the need for assistance;
- invite the patient to remove clothing elements (expose body parts) to the extent sufficient for the manipulation (care), ensuring confidentiality of conditions (screen, inability to enter the room), clarify the patient's need for assistance: ‘...Release your right hand from your clothes...’, “...Please remove clothes below the waist...”;
- Perform the manipulation (care), during which you invite the patient to perform the actions you require, using phrases of polite address:
- ‘...Would you be so kind, Pyotr Ivanovich, turn your back to me...’;
- ‘...Would you, Pyotr Ivanovich, please open your mouth wider...’;
- thank the patient for his/her efforts:
-- ‘...Thank you, I've finished, I haven't bored you too much...?’
-- ‘...Thank you, I've finished, you can get dressed, Pyotr Ivanovich...’
- Ask the patient how he or she is feeling:
- say, ‘How do you feel...?’;
- Inform the patient of his/her next steps:
- inform the patient about the need for hygienic maintenance of the place of manipulation (care), possible reactions or the need to stay under observation for a certain period of time:
-- ‘...please protect the injection site from mechanical irritation for 1-2 days...’;
-- ‘...after the injection you should lie down for 5 minutes...’.
-- ‘...a local vaccination reaction develops at the vaccine injection site within a certain period of time, for its evaluation and registration in the medical records, you should visit a doctor on a monthly basis...’;
-- ‘...you need to be observed for 30 minutes, please stay near the vaccination room...’;
Final stage
- End the contact
- ‘...Goodbye. I shall be expecting you, Pyotr Ivanovich, in three days‘ time...’;
- ‘...Goodbye, Pyotr Ivanovich. Don't forget about...’;
- ‘...Goodbye, get well, Pyotr Ivanovich...’.