taking a Health History: Building a Health History: Asking Difficult Questions
Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.
Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations.
More importantly in today’s society, the possible Social Determinants of Health for each of our patient’s also needs to be taken into consideration
For this Assignment, you will develop a make-believe script to be used when you first encounter a patient for a well woman appointment.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
- Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
- Review the media programs related to a vaginal exam, pap test, and breast exam.
- Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a complete health history. (Note: You will also find the Health History Form in Chapter 7)
- Provide all the components of a complete gynecologic health history. Include considerations for special populations such as LGBTQ+ individuals.
- What health maintenance guidelines should be included for initial and follow up might be needed for follow-up assessments? (i.e., bone density test, Gardasil vaccine, pap smear, Mammorgram, etc.)?
- Using the 5 areas of the Social Determinants of Health:
(Examples of SDOH include but not limited to)
-
- Safe housing, transportation, and neighborhoods
- Racism, discrimination, and violence
- Education, job opportunities, and income
- Access to nutritious foods and physical activity opportunities
- Polluted air and water
- Language and literacy skills
- SDOH also contribute to wide health disparities and inequities.
- What questions would you consider in your patient’s complete health history?
- Develop your own script for building a complete health history and as you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. (Utilize chapter 7 of your Schuiling textbook to provide guidance). You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.
Assignment: (1- to 2-page reflection)
- In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:
- A brief summary of your experiences in developing and implementing your script during your health history.
- Explanations of what you might find difficult when asking these questions. What you found insightful and what would you say or do differently.
- As a NP, what could you implement in your community to provide resources/assistance of the Social Determinants of Health.
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