Health Assessment Report: Importance of Rapport in Nursing

This report examines the critical role of health assessment in nursing, emphasizing the importance of establishing and maintaining rapport with patients to ensure quality care. The report details the process of building rapport through appropriate physical setups, suitable timing, and friendly communication, illustrated by a case study of a 53-year-old man with type 2 diabetes mellitus. It highlights techniques such as maintaining eye contact, showing empathy, active listening, and keeping commitments to foster trust and openness. The assessment includes gathering patient history, past medical history, mental health history, medication history, family history, and social and occupational history. The report concludes by stressing the significance of rapport for patient-centered care and recommends continuous medical education for healthcare staff to improve communication skills and healthcare outcomes. The provided references support the discussed concepts in the report.

Nursing
Student’s name:
Institutional:

Health assessment is a very important role is nursing and it provide the basis of a quality
nursing care (Potter et.al, 2016). As a nurse, one should perform a proper health assessment for a
client. This is to ensure that the client’s needs and clinical problems are well captured. It also
aids the nurse in formulating proper nursing diagnosing and evaluation of the client’s responses
to health needs and intervention. However, in order to perform a comprehensive and accurate
health assessment, the nurse should first establish a rapport with the patient (American Diabetes
Association, 2019). Building a rapport means establishing a connection or understanding with
someone. This thus helps a nurse to relate with the patients in a way that increases the level of
trust. The patients get to feel comfortable and more open hence revealing their health problems
without fear. This text will therefore discuss ways in which rapport can be established and
maintained and further discuss the health assessment of an adult client.
A case study of James a 53-year-old man with type 2 diabetes mellitus (DM) will be used for
this discussion. First, in order to establish a rapport with James I ensured that the physical set up
of the place was suitable. The set-up should allow for privacy and be comfortable for both of us.
The location had to be in a place where privacy was maintained, for example, where other staffs
could not easily disrupt us during the assessment. The health assessment was conducted at an
appropriate time to allow for full attention. The time that was most suitable for both me and
James. For example, doing the assessment when James want to sleep may be inappropriate.
James will most likely answer questions hastily so as to catch up with sleep. Most importantly, I
presented myself in a manner that was appealing to the client. I also ensured that I spoke in a
manner that was friendly and used friendly terms in my communication. This was to ensure that
James felt safe and secure being with me, which made the connection closer.

Some of the techniques that I used to build a rapport with my client include; maintaining eye
contact, showing empathy, active listening and ensuring that I kept my words. I maintained eye
contact in order to showed the patient that I cared and was interested with his situation. Eye
contact was also a way of showing empathy (Riess, & Kraft-Todd, 2014). Empathy implies to
the ability to comprehend the patient’s feelings, perspective and condition. It allows for more
patient-focused care. I also embraced the skill of active listening. This, for me, was a very
effective non-intrusive manner of sharing the client’s feeling and thoughts. Active listening
involved listening keenly to James, ensuring that my understanding of his statements was correct
and providing feedback. Moreover, I was honest with him. I kept every word that I told James,
for example, when he asked for pain medication, I promise to get them delivered to him and
ensured that indeed it was. I also manage to make the patient less anxious and scary since I
believed that comfort would make him more open with me throughout the assessment.
When taking James history, I began by asking him about his presenting complain and the
history of the presenting illness. This is important to elicit some valuable information concerning
his condition. Next, I questioned him concerning his past medical history. This included the
diagnosis, dates, sequence and the management. I prompted him with direct questions he has
ever had such as, whether tuberculosis, heart disease so as to make it easier for him. It is
recommended to prompt the patient with such direct questions while asking about common
major medical conditions (Sansoni, et al., 2015). Next, I assessed the patient’s mental health
history. NHS confederation highlighted that out of four people one is likely to experience mental
health issues (Webber, et al. 2014). This was challenging however I manage to ask him about his
current coping strategies on issues like anxiety.

I also inquired James about his medication history. This included his current prescriptions,
past medications, over the counter drugs, allergies and adherence status. This information is
significant in the future treatment of the client. Next, I assessed the family history of James.
Some disorders are familial and therefore, thus, family history can provide vital information that
can guide in the treatment of the patient (Silverman, et.al, 2016). I also assess the social and
occupational history. The social history included asking about smoking and alcohol
consumption. The social life of a patient may influence his ability to cop up with the change in
health (Silverman, et.al, 2016). Finally, I gathered information regarding other body systems that
was not covered in the presenting illness. This is important in order to ensure that there is no
history that have been omitted. I then gave James an opportunity to ask any question of concerns
and provided the feedback accordingly. I also could not forget to thank the patient for his time
and responses that he gave me during the assessment and reassured him that he will be attended
soon by one of the doctors looking after him.
In conclusion, the significance of rapport in nursing cannot be stressed enough. It is what
connects the nurse to his or her patients and improve the care of the patient. This is a skill that
every nurse should learn in order to effectively deliver care to the patients. Conducting a health
assessment is much better when a good rapport is established first. It is what leads to a very
comprehensive and genuine communication with the patient when getting the history. This is
what lead to a patient-centered care which is essential for better healthcare outcomes. The
hospital management should therefore ensure that there is continuous medical education on
better communication skills, not only to the nurses, but also to the other healthcare staffs. This is
to ensure better delivery of care to all patients by all healthcare staffs and hence better health
outcomes.

Reference
American Diabetes Association. (2019). 4. Comprehensive medical evaluation and assessment of
comorbidities: standards of medical care in diabetes—2019. Diabetes
care, 42(Supplement 1), S34-S45.
Bircher, J., & Kuruvilla, S. (2014). Defining health by addressing individual, social, and
environmental determinants: new opportunities for health care and public health. Journal
of public health policy, 35(3), 363-386.
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of Nursing-E-Book.
Elsevier health sciences.
Riess, H., & Kraft-Todd, G. (2014). EMPATHY: a tool to enhance nonverbal communication
between clinicians and their patients. Academic Medicine, 89(8), 1108-1112.
Sansoni, J. E., Grootemaat, P., & Duncan, C. (2015). Question prompt lists in health
consultations: a review. Patient education and counseling, 98(12), 1454-1464.
Silverman, J., Kurtz, S., & Draper, J. (2016). Skills for communicating with patients. crc press.
Webber, M., Treacy, S., Carr, S., Clark, M., & Parker, G. (2014). The effectiveness of personal
budgets for people with mental health problems: a systematic review. Journal of Mental
Health, 23(3), 146-155.