Patient Assessment and Communication in Imaging Chapter 2
As Radiographers, we must learn to asses the needs of the patient and formulate a plan of care that best fits the individual.
The Health-Illness Continuum
All persons seek to maintain a high level of well-being. Health can be defined as the status of an organism functioning without any evidence of disease or disfigurement. Unfortunately a perfect state of health is rarely achieved; therefore, health is seen as on a “continuum.”
Basic Human Needs
1. Physiological needs
2. Safety and security
3. Love and belonging
4. Self-esteem and esteem of others
5. Self actualization
The hallmark of an excellent radiographer is the ability to achieve a positive diagnostic or treatment result in a timely, efficient manner while meeting the unique needs of the individual patient.
Learning requires cognitive, affective and psychomotor skills.
Critical Thinking Requires
The ability to interpret
Modes of Thinking
Knowledge of scientific facts that you can recall at a moment’s notice while with patients
You will develop habits that make for the efficient practice of learned skills
Using the skills of recall and habit along with higher mode of thinking
It is used to solve individual problems and to prevent causing the patient discomfort or pain
Problem Solving and Patient Assessment
Every patient and every diagnostic procedure presents problems ranging from simple to complex.
The student radiographer must decide how to perform the assignment quickly, efficiently, and as comfortable as possible for the patient.
There are 2 types:
Subjective: Anything that the patient or significant other who accompanies the patient say in regards to their care.
Objective: Anything you see, hear, feel, or read on the patient’s chart; or, information given by another health care worker.
This part of assessment integrates all segments of critical thinking.
Once all the data has been collected, you must decide how will you achieve your goal to perform this exam with quality images, patient comfort, and efficiency.
This method requires demand recall.
Planning and Implementation
Planning requires the use of all modes of thinking.
Theoretical concepts learned from classroom instruction are recalled.
Implementation of the plan depends on the patient’s problems and the need for assistance to achieve the desired goal safely.
Each patient care situation differs in some way or another. As a student you will observe many approaches to a successful exam.
One must never cease learning from the patient regardless of how many years of experience he or she possesses.
Each patient care situation differs in some ways from all others encountered; therefore, all patient care experiences are learning experiences.
Cultural Diversity in Patient Care
Culture is defined as: “The socially inherited characteristics of a group of people that are transmitted from one generation to the next” (Fejos, 1959).
The patient’s culture and ethnicity will play a major role in assessing the patient.
Physiological and Biological
Cultural and ethnic diversity are a part of the radiographer’s assessment and plan of care.
The patient also has expectations of health care professionals.
The patient expects professionals to be:
Deliver quality patient care
All members of the health care team must learn to communicate clearly and therapeutically with the patients.
Any problem of communication, whether major or minor, has an impact on the patient’s health care.
To become a successful communicator you must develop skills:
Non Verbal Communication
There is more to communicate than the spoken word.
The unspoken or nonverbal aspects of communication can be defined as all stimuli other than the spoken word involved in communication.
Non-Verbal communication functions in the following ways:
It may repeat or stress the spoken messages
It may accent the spoken word
It may regulate the spoken word
It may substitute for verbal communication
The radiographer must be aware that the manner of communication will vary depending upon the sex of the patient.
The possibility of a patient requesting a technologist of the opposite gender.
The radiographer must also be sensitive to the issue of gender in his or her professional interactions with co-workers.
Avoid sexual innuendoes.
Other Factors that Affect Communication
Paralanguage – has to do with the sounds of the speech, rather than the content.
A patient who has difficulty standing, sit the patient and make them comfortable.
If the patient has difficulty hearing, speak louder.
Speak to the patient.
Establishing Communication Guidelines
Many relationships between the radiographer and patient are brief and it is essential to make the best use of the time.
Establishing guidelines for interaction is essential.
Introducing oneself to the patient
Give an explanation of the exam
Give an explanation of what is expected of the patient and what the patient can expect from the imaging staff
Obtaining a Patient History
The goal of a patient history is to obtain necessary information to perform a safe and comfortable examination.
Obtaining the information accurately demands sensitivity and critical thinking on the radiographer’s part.
During the history taking process, the radiographer must convey a professional image to ensure the patient’s confidence.
A patient who comes to the imaging department has a right to expect that he or she will be instructed as to the exam.
A detailed description of the procedure.
A description of the purpose of the exam.
Approximate amount of time.
An explanation of any unusual equipment.
Follow up care/results after procedure is complete.
If the patient questions the exam, do not begin until the problem is resolved.
Loss and Grief
Phase I – Denial
Phase II – Anger
Phase III – Bargaining
Phase IV – Depression
Phase V – Acceptance
Patients Rights Related to End of Life Issues
The public’s wishes to make their own determination in this matter was resolved when the PATIENT SELF DETERMINATION ACT (PSDA) was made law in 1990.
They are legal documents that are formulated by a competent person that provides written information concerning the patient’s desire if they are unable to make the decision on their own.