I interviewed a 64-year-old male patient who had suffered from a stroke. The patient was in a nursing home that takes care of elderly stroke patients. During the initial minutes of the interview, I actively created an environment for effective interaction with the patient. This was important because the meeting was between two strangers, the patient and I, therefore, introductions were crucial. Although I was nervous, I made sure to show the patient that he is a unique individual. I was anxious and worried that I would say something that would upset the patient. I was not sure of my role or what exactly I would say even though we had learned those skills in class. Being a first-year student, I also lacked enough clinical knowledge or even the understanding of various diseases.
My opening statement read, “Hello Mr. R, My name is (Please insert your name). I am a first-year student at the nursing school. I will do a short interview with you that will take around 30 minutes of your time. I would like to learn more about your health and particularly the kind of health problems that you are having. Will you allow me please?I needed to make sure that the patient was comfortable even though I was nervous on my end. Also, I tried not to shake or show my anxiety in front of the patient by reminding myself that I had a role and a purpose to fulfill.
After acquiring the patient’s consent and establishing a good rapport, I started questioning and listening to the patient. I inquired about the patient’s condition, including when he got the stroke and how he was progressing. I asked the patient about the problems that had led him to go to the nursing home and the kind of problems he is currently experiencing. Mr. R looked sickly even though he was well oriented in space and time. He told me that he had got the stroke a week before the interview. I had not even started asking about his social life when Mr. R started narrating about his life and how.. Mr. R is a driver and he lives alone at his home in Hong Kong. His wife passed on in 2019 while his two sons are married and live in a different city. He does not have anyone to take care of him. He felt sorry about his condition. He said, “I am a lonely old man with no one to take care of me”. I sincerely empathized with the patient and wished that I would contact one of his sons but then I was in no position to do that.
The patient lacked a social life and did not have any friends around him. After inquiring about his nutrition, he explained that he usually takes instant noodles for breakfast, mostly skips lunch, and takes fries for supper at least three times a week. Mr. R did not take fruits or drink water frequently unless when he felt thirsty. The patient did not understand the implications of his diet on his health. He did not engage in any physical exercise and he said that the only form of exercise he performed was driving his customers to their destinations. He kept asking me to review some of the drugs that he was taking and if I could assure him that he was going to be okay. I did not have sufficient knowledge about drugs or stroke conditions. I was embarrassed and needed to ask my supervisor to check the patient’s drugs.
Expectations
Before the interview, I knew that would get nervous because of insufficient clinical knowledge as a first-year. Also, I expected that I would be fluent during the interview and that I would get a direct answer from the patient. I did not know that the language barrier, that is, the inability of the patient to understand medical terms would be a big hindrance. Our instructors had always told us that we needed to use the simplest terms possible for the patient, but for a first-timer that was not very possible. I expected that I would be able to interpret and explain any unfamiliar word to the patient but I also struggled to simply the terms. Additionally, I also expected that the patient would have a basic understanding of a healthy diet given that he was hypertensive. I thought that most hypertensive patients were more cautious about their health and only followed doctors’ and nutritionists’ instructions.
Reflection of the visit
The visit transformed my view about nursing and patients. Even though I had been taught that it is important to assure the patient that he/she is unique, I had not encountered the uniqueness of the patient in a clinical setting. I kept wondering about the extent of health education that is given to the patient or even the general public. I also wondered whether it could be a lack of adherence to the clinician’s instructions on the patient’s side or the inability of nurses to educate the patients during treatment. I empathized deeply with the patient as he did not have anyone who could take good care of him. I marveled at how the patient showed little concern for his health since he was more concerned about his work. He kept insisting that he needed to be discharged so that he could go back to work. Working kept him busy and never made him feel lonely. He said that he loved interacting with his clients; thus, contributing to his love for work.
Additionally, I wondered how patients, especially, stroke patients would be urged to take good care of themselves and how a nurse would ensure that these patients are following instructions. I believe that even the most reluctant patients can be persuaded to take care of themselves. With consistency, I think nurses and other healthcare workers can create enough awareness about healthy eating, exercise, as well as, the advantages of having social interactions among the public. This way, some notorious patients might accept to take care of their health even if it means quitting their jobs.
Moreover, some of my expectations before the visit differed from reality. I expected that the patient would be able to understand most medical terms and even be familiar with some of the hypertensive drugs he was taking. However, this was not the case. I also expected that I would be able to explain some of the medical terms fluently but I struggled. Also, before the visit, I had always assumed that patients with chronic health conditions such as hypertension paid more attention to their health including eating a healthy diet and engaging in physical exercises. This was not the case with Mr.R. he did not comprehend the implications of unhealthy eating on his condition and also did not seem to want to change his habits. However, I tried to explain to the patient as much as I could and I believe that he apply the instructions in the future. The best thing about the experience is that I got to interact one-on-one with a stroke patient. I understood that the health information has not reached every individual and learned that it was my duty to spread it.
What I learned
The experience taught me the uniqueness of patients. every patient has his/her unique needs and therefore they should be treated individually. For example, other stroke patients might be willing to change their habits but this was not the case with Mr. R. He needed to be persuaded and shown that his health was more important than his job. Additionally, I learned the significance of establishing a good interaction with the patient by introducing yourself. Some patients may choose to disclose information based on the clinician’s first impression. I ensured that I established a good first impression to give the patient a comfortable space where he could answer all my questions. The experience taught me the importance of being patient even when the patient seems to be difficult. Nurses are carers who provide care to all patients regardless of their nature or background. They meet different patients every day. Individuals with different personalities, social backgrounds, and economic abilities visit the hospital. Therefore, it is crucial for health care practitioners to practice patience with all kinds of patients to ensure that they receive a good healing environment.
I plan to apply these lessons in the future when interacting with patients. in the future, I should not assume that a patient understands the implications of their habits on their health but I will be repeating the instructions and health education during every visit. The importance of having good communication skills also became more vivid during the visit. I need to strengthen my conversation skills and understand the language that I should use with the patient. This is important because many patients do not understand several medical terms presented to them.
