Читать книгу The Nursing Associate's Handbook of Clinical Skills - Группа авторов - Страница 153

When the nursing associates gather information regarding the needs of the patient, they need to observe and take note of how the patient is engaging in conversation, determine if the patient is focused or is there and expression of concern or worry? Take note of words expressed, silences as well as the strength of the patient’s voice.

The nurse–patient interactions and conversations should serve to help the nursing associate identify and address any of the patient’s needs. The nursing associates should draw on the knowledge they obtain of the patients’ feelings of nervousness/anxiety and their desire to maintain aspects of control. Because using this knowledge as a starting point may help them to foresee, understand and read patients’ reactions and responses to the situation, it can also help them to individualise nursing care (Bundgaard et al. 2012). If open to it, the patient’s response may instantly guide the nursing associate’s course of action.

In every encounter, the nursing associate continuously responds to the patient’s reactions and decides which course of action will best help guide the patient. These decisions are built on the nursing associate’s general knowledge of typical reactions of patients who have undergone similar medical procedures and on knowledge of the individual patient in each situation (see Table 6.2).

Within the clinical setting, nursing associates have several key information sources that they can use to support knowing the patient (Pearson 2013). In addition to verbal interactions with the patient and family, nursing associates also obtain information through verbal interactions with other members of the healthcare team. Components of the patient’s medical record are also sources of patient information, and nursing associates use nursing documentation as the primary mechanism to collect and communicate patient information. Interestingly, Olsen et al. (2013) discussed the importance of medical record documents for knowing the patient but found that nurses had limited time to refer back to the documents for information, indicating this was a barrier to gathering clinical information.