Become better at questioning during initial assessment

rhan101277

rhan101277

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I find myself nervous when asking questions, I don't know why. I sometimes feel that the patient may think I am asking stupid questions. I guess I just need to be more confident. Anyone have any tips.
 
Just relax. Be conversational. Listen to what they say rather than focusing on next question. You will find they and you will be more comfortable and you will actually get better and more accurate information.
 
Pretend you're talking to your mom or dad. Imagine they walked up to you and said "I don't feel well" or "I have pain" or sometihng along the lines, pretend you're having a casual conversation with them.

May not work for everyone, but that's how one preceptor told me to get comfortable with assesments, and it actually worked for me.
 
Sasha said:
Pretend you're talking to your mom or dad.
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DON'T DO THAT!!!

Makes asking about last menstrual period... weird....:wacko:







Joking aside, practice is what it takes to get better at it. Eventually you'll be able to sift through the junk and get to the pertinent info.
 
Linuss said:
DON'T DO THAT!!!

Makes asking about last menstrual period... weird....:wacko:
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Only if you are immature about a natural bodily function such as a woman's menses
 
Which I am.


I thought we established my immaturity already?
 
Sasha said:
Only if you are immature about a natural bodily function such as a woman's menses
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Point for our young EMT don't ask if Aunt Flo is visiting. Use proper simple terms. When was your last menstrual cycle? Then if confused say period.
 
medic417 said:
Point for our young EMT don't ask if Aunt Flo is visiting. Use proper simple terms. When was your last menstrual cycle? Then if confused say period.
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Thank you! I hate cutesy terms for a woman's cycle!
 
I was taught this a long time ago. If I fail or miss a diagnosis because of poor interview technique, I am then responsible for the error or misdiagnosis. Remember, in the medical examination, history, history, history is the foundation of the assessment where as trauma is usually quite obvious.

Although, quite much length and much in detail one can learn the proper way and then of course modify and abbreviate the interview and history portion. Yes, they are dry but listen to what is asked.


http://videos.med.wisc.edu/tag.php?tagid=1312


R/r 911
 
Yeah you can know all day about all the book stuff, all the indications and contraindications but when it comes down to it you just gotta ask questions.
 
Ridryder911 said:
I was taught this a long time ago. If I fail or miss a diagnosis because of poor interview technique, I am then responsible for the error or misdiagnosis. Remember, in the medical examination, history, history, history is the foundation of the assessment where as trauma is usually quite obvious.

Although, quite much length and much in detail one can learn the proper way and then of course modify and abbreviate the interview and history portion. Yes, they are dry but listen to what is asked.


http://videos.med.wisc.edu/tag.php?tagid=1312


R/r 911
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Thanks for the link.
 
Watch "The Dog Whisperer" but with the sound off.

See how he uses body language to take charge and establish his authority with pet owners while maintaining a "nice guy" image.

You can always fall back on "I know this might be pretty embarassing to anser but we (or "you and I") need it to take care of you". In MOST instances don't apologize; console, reassure, and use body language and voice. Apologize when you are wrong, not embarassed.
 
As demonstrated in the videos rid provided, doctors have come up with something called a review of systems. It is a part of the history designed so you will not miss anything.

Print this out and keep it in your clipboard, and ask about these symptoms right after your OPQRST/HPI. Use relevant body systems, do not spend all day on scene asking about urination habits on a chest pain.

http://medinfo.ufl.edu/year1/epc97/handouts/ros.html

If you do not know some of the terminology in the above document, look it up or buy a programmed medical terminology book at Barns and Noble. Do not ask a patient is she has polyuria, rather ask about frequency of urination. Record it as polyuria.
 
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daedalus said:
As demonstrated in the videos rid provided, doctors have come up with something called a review of systems. It is a part of the history designed so you will not miss anything.

Print this out and keep it in your clipboard, and ask about these symptoms right after your OPQRST/HPI. Use relevant body systems, do not spend all day on scene asking about urination habits on a chest pain.

http://medinfo.ufl.edu/year1/epc97/handouts/ros.html

If you do not know some of the terminology in the above document, look it up or buy a programmed medical terminology book at Barns and Noble. Do not ask a patient is she has polyuria, rather ask about frequency of urination. Record it as polyuria.
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Yeah I don't dumbfound patients with medical terminology. I usually just stick to questioning based upon chief complaint. Though sometimes after calls I felt I could have asked this or that as well. Oh well I will keep learning, hopefully during medic school I will get better at this.

I just worry about spending to much time on scene with a questionnaire. I think I do pretty good with scene times, sometimes I feel to much time has gone by while I ask questions. Some pts. who aren't critical but have a valid c/c will sit there and give me a term paper on stuff and I just feel like I don't want to interrupt them. Now if they were in bad shape I would just say lets talk about it on the way.

Also many of them like to comment on things un-related to why we are there or they will be trying to run the household while we are there attending to them.
 
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Polly Uria? Of the Uria Family Singers?

Polly, Oleg, and their married sister, Ms Uria-Heep?

Oh, man, don't step off the curb into the "problem oriented versus universal" history/exam argument. I'm with you, vitals and survey plus complaint should direct our short time together with the pt, not an endless round of 128 Questions.
 
mycrofft said:

You can always fall back on "I know this might be pretty embarassing to anser but we (or "you and I") need it to take care of you". In MOST instances don't apologize; console, reassure, and use body language and voice. Apologize when you are wrong, not embarassed.
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I don't know about this: by admitting that the pt might feel embarassed, you are assuming that there is embarassment to be felt. By asking in a matter-of-fact manner and being cool and clinical you can put the pt at ease, let them know that you aren't going to judge them, that they can tell you privately and that you need to know the info to help them.

As far as body position goes, specifically, putting yourself at or slightly below the pt's face level is reassuring for pts. Also, don't, I repeat DON'T apologize for anything, you just open yourself up to liability.
 
rhan101277 said:
Yeah I don't dumbfound patients with medical terminology.


Also many of them like to comment on things un-related to why we are there or they will be trying to run the household while we are there attending to them.
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You need to talk to every pt differently, some people are super educated and will understand the terminology that you are using "When was your last bowel movement" as opposed to hood rats who need is simpler "When was the last time you took a sh**". And if the call isn't going the way you want with people going every which way and running their household or whatever, just remember that you are in charge, don't be afraid to step in and tell them to sit down, listen and do as they are told..... nicely of course.
 
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