3.7 Preparing for the Interview

You should review the client’s existing health record/chart (if applicable) so that you have a general overview of the client’s main health needs/reason for seeking care and health history. If the client is already admitted, this review will not only give you an overview of the health history, but also their last 24 hours. This is an important first step for several reasons:

  • It conveys your interest and competence as a provider.
  • It allows you to follow up on missing data.
  • It saves the client from repetition.
  • It allows you to identify any changes in the client’s health status.

You should also consider how to leverage the environment of the interview location and your position within the space. The client interview is often conducted in locations such as clinic rooms, hospital rooms, emergency rooms, and community spaces such as the client’s home. You should attend to the following principles:

  • Create a quiet location so that both you and the client can hear and communicate. Some possible strategies to reduce sound may include closing the room door, closing the curtains, and turning off radios and televisions.
  • Establish a welcoming environment, which may include offering the client a place to sit and avoiding physical barriers between you and the client such as a desk.
  • Attend to the client’s physical comfort, which may include offering them a drink of water and inviting them to take their coat off or have a place for them to put their bag/purse. Additionally, if they are in bed, you should ensure that they are comfortable and ask if they want to sit up, if they are permitted.
  • Create an inclusive space in which care partners are invited to be part of the interview based on the client’s wishes.
  • Ensure a private space so that the client feels comfortable to share personal information and that this information is kept confidential. Sometimes it will not be possible to ensure a completely private space, such as when a curtain is the only barrier. In this case, try to avoid using the client’s name and other client information loudly so that others can’t overhear.
  • Maintain professional boundaries, “mean[ing] that a nurse abstains from attaining personal gain at the patient’s expense and refrains from jeopardizing the therapeutic nurse–patient relationship. In order to maintain that trust and practice in a manner consistent with professional standards, nurses should be knowledgeable regarding professional boundaries and work to establish and maintain those boundaries” (National Council of State Boards of Nursing, 2018). In preparation for the client interview, you must first be aware of the legislation and nursing standards concerning privacy and confidentiality.

The HIPAA Privacy Rule “establishes national standards to protect individuals’ medical records and other individually identifiable health information (collectively defined as “protected health information”) and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of protected health information and sets limits and conditions on the uses and disclosures that may be made of such information without an individual’s authorization. The Rule also gives individuals rights over their protected health information, including rights to examine and obtain a copy of their health records, to direct a covered entity to transmit to a third party an electronic copy of their protected health information in an electronic health record, and to request corrections” (U.S. Department of Health and Human Services, 2024).


Point of Consideration: Abuse and Neglect

Physicians, hospital staff, dentists, chiropractors, coroners, social workers, registered nurses, and law enforcement officers are some of the professionals who are mandated to report the suspicion of abuse or neglect of a resident in a licensed nursing facility. Reports are to be made to the Illinois Department of Public Health’s Nursing Home Hotline at 1-800-252-4343. The reporter is encouraged to contact the Illinois Long-Term Care Ombudsman Program for information on how to make an effective abuse or neglect complaint to the Nursing Home Hotline, how to interpret the findings of a report, how to appeal the findings, and how to get other needed services for the alleged victim in the long-term care facility setting. The Ombudsman Program is a resident advocacy program and will work with the resident and his or her family to obtain the services desired from the facility or establishment. An Ombudsman contact list [PDF, 200 kb] can be downloaded from the Illinois Department on Aging’s website or by contacting the IDoA Senior HelpLine at 1-800-252-8966; 1-888-206-1327 (TTY) (Illinois Department on Aging, 2024).

References

Illinois Department on Aging. (2024). Reporting Abuse: What Professionals Need to Know. https://ilaging.illinois.gov/content/dam/soi/en/web/aging/resources/newsandpublications/publications/documents/what-pros-need-to-know.pdf

National Council for State Boards of Nursing. (2018). A nurse’s guide to professional boundaries. https://www.ncsbn.org/brochures-and-posters/a-nurses-guide-to-professional-boundaries

U.S. Department of Health and Human Services. (2024). The HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

Attribution

This chapter contains material taken from Introduction to Communication in Nursing by Jennifer Lapum, Oona St-Amant, Michelle Hughes, and Joy Garmaise-Yee and is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Nursing Physical Assessment Copyright © 2024 by Barbara Gawron and Meenu James is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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