HEALTH ASSESSEMENT

SEM: 2 / AY: 2023-2024

===============================================================================================

RELEVANT ETHICO-LEGAL GUIDELINES IN CON- Incompetence

DUCTING HEALTH ASSESSMENT An incompetent person is unable to: evidence a
PRINCIPLE OF FREE AND INFORMED CONSENT preference or choice,
• A person's basic rights are established on
– understand one’s situation or relevantly similar
recognition of his human status, the inviolabil-
situations,
ity of his life and the fact that he was born, and
– understand disclosed information,
will always be, free.
– give a rational reason,
• Respect for the values and wishes of the indi-
– give risk/benefit-related reasons,
vidual is a duty which becomes even stronger
– reach a reasonable decision.
if the individual becomes vulnerable.
Consent by Proxy is permitted when the patient is
• Since the autonomy and responsibility of every
incompetent
person, including those who need health care,
• INFORMATION
are accepted as important values, reaching or
Disclosure – the patient is given information
participating in decisions concerning one's
concerning:
own body or health must be universally recog-
– the diagnosis,
nized as a right.
– the nature and purpose of the proposed treat-
• No physical or psychological therapy may be
ment or procedure,
administered without the free and informed
– the known risks and consequences of the
consent of the patient.
treatment,
INFORMED CONSENT
– the expected benefits,
• In order to be fully legal, the patient's consent
– alternative treatments/procedures with their
must be informed.
risks and benefits,
• Being informed implies cognition, willingness,
– the prognosis of the treatment or nontreat-
consideration, intention and understanding.
ment.
• Opinion and choice cannot be final and ac-
– all costs.
ceptable unless they are based on knowledge.
Understanding
No consent will be valid which does not de-
– To actually communicate and not merely to
pend on willingness and voluntariness.
blabber out words or present facts.
FREE AND INFORMED CONSENT
– Use a language that is understood by the pa-
ELEMENTS
tient. – Do not use medical terms; use commonly
• THRESHOLD
understood terms by non-healthcare workers.
Competence
• The competent patient has to understand the
A competent person is able to:
consequences of his decision to reject or ac-
– understand the diagnosis,
cept a procedure or treatment.
– understand the therapy or procedure,
• The fact that the patient makes a decision
– deliberate regarding risks and benefits,
contrary to that recommended by the MD,
– make a decision in light of this deliberation.

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

does not prove that he is incompetent because – Reasonable discretion must be used in the
of lack of understanding. manner and extent of the disclosure.
• In general, the assumption is that adults are EMERGENCY
competent unless there is clear evidence to the • Treatment without informed consent is justified
contrary. in emergency situations.
• CONSENT • 3 Conditions:
Voluntariness – freedom from: – The patient must be incompetent, and no
– Coercion lawful surrogate is available to give consent
– Undue manipulation and the wishes of the patient are unknown.
– Persuasion – There is danger to life or danger of a serious
– Natural reactions to illness impairment of health.
– Influence of drugs or alcohol – Immediate treatment is necessary to avert
AUTHORIZATION those dangers.
– This is obtained when the patient gives his/her INFORMED CONSENT
free and informed consent. • The right not to know
– The physician acts according to what has been • Patients have the right not to be informed on
communicated and decided upon. their explicit request. The right not to know
EXCEPTIONS FROM INFORMED CONSENT provides an instrument to prevent the receipt
THERAPEUTIC PRIVILEGE of unwanted information.
• The withholding of information from the pa- • On the other hand, this right not to know is not
tient when the physician believes that the dis- applicable when a person should be given in-
closure will have an adverse effect on the pa- formation allowing him/her to protect other
tient’s condition or health. people by an adapted behavior.
• Information may be withheld from patients in • For instance, the positive result of a sexually
exceptional cases only when there is good rea- transmitted disease investigation should not
son to believe that the disclosure of certain in- be held back from a patient. The possible re-
formation would endanger the patient's life or sult of the investigation and the consequences
detrimentally affect his physical or mental of this result should be anticipated with the
health. person before they are performed.
• 3 Conditions on the use of the privilege: OBLIGATIONS OF THE HOSPITAL
– The actual use must be on a case-to-case • To ensure that informed consent has been ob-
basis. – The physician must have a founded tained for diagnostic and therapeutic proce-
belief based on an intimate knowledge of the dures performed in the hospital.
person that the full disclosure will have a sig- • To develop educational programs that teach
nificantly adverse effect on the patient. effective ways of getting ethically and legally
acceptable informed consent.

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

• To make certain that patients are aware of problems related to recuperation, and proba-
their right to consent or reject proposed proce- bility of success and reasonable risks involved
dures and treatments. • Provided, That the patient will not be subjected
PATIENT’S BILL OF RIGHTS to any procedure without his written informed
• Right to Appropriate Medical Care and Hu- consent, except in the following cases:
mane Treatment. • a) in emergency cases, when the patient is at
• Right to Informed Consent. imminent risk of physical injury, decline of
• Right to Privacy and Confidentiality. death if treatment is withheld or postponed. In
• Right to Information. such cases, the physician can perform any di-
• The Right to Choose Health Care Provider and agnostic or treatment procedure as good
Facility. practice of medicine dictates without such
• Right to Self-Determination. consent;
• Right to Religious Belief. • b) when the health of the population is de-
• Right to Medical Records pendent on the adoption of a mass health pro-
RIGHT TO APPROPRIATE MEDICAL CARE AND HU- gram to control epidemic;
MANE TREATMENT • c) when the law makes it compulsory for eve-
• Every person has a right to health and medical
ryone to submit a procedure;
care corresponding to his state of health, with-
• d) When the patient is either a minor, or legally
out any discrimination and within the limits of
incompetent, in which case. a third-party con-
the resources, manpower and competence
sent Is required;
available for health and medical care at the
• e) when disclosure of material information to
relevant time.
patient will jeopardize the success of treat-
• Patient has the right to appropriate health and
ment, in which case, third party disclosure and
medical care of good quality.
consent shall be in order;
• His human dignity, convictions, integrity, indi-
• f) When the patient waives his right in writing.
vidual needs and culture shall be respected
• Informed consent shall be obtained from a pa-
RIGHT TO INFORMED CONSENT
tient concerned if he is of legal age and of
• Patient has a right to a clear, truthful and sub-
sound mind. In case the patient is incapable of
stantial explanation, in a manner and lan-
giving consent and a third-party consent is re-
guage understandable to the patient, of all
quired. the following persons, in the order of
proposed procedures, whether diagnostic,
priority stated hereunder, may give consent:
preventive, curative, rehabilitative or thera-
– spouse;
peutic, wherein the person who will perform
– son or daughter of legal age;
the said procedure shall provide his name and
– either parent;
credentials to the patient, possibilities of any
– brother or sister of legal age, or
risk of mortality or serious side effects,
– guardian

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

• If a patient is a minor, consent shall be ob- – c) when the patients waive in writing the
tained from his parents or legal guardian. If confidential nature of such information;
next of kin, parents or legal guardians refuse to – d) when it is needed for continued medical
give consent to a medical or surgical proce- treatment or advancement of medical science
dure necessary to save the life or limb of a mi- subject to de-identification of patient and
nor or a patient incapable of giving consent, shared medical confidentiality for those who
courts, upon the petition of the physician or have access to the information.
any person interested in the welfare of the pa- • Informing the spouse or the family to the first
tient, in a summary proceeding, may issue an degree of the patient's medical condition may
order giving consent. be allowed; Provided that the patient of legal
RIGHT TO PRIVACY AND CONFIDENTIALITY age shall have the right to choose on whom to
• Privacy of the patients must be assured at all inform. In case the patient is not of legal age or
stages of his treatment is mentally incapacitated, such information
• Patient has the right to be free from unwar- shall be given to the parents, legal guardian or
ranted public exposure, except in the following his next of kin.
cases: RIGHT TO INFORMATION
– when his mental or physical condition is in • In the course of his/her treatment and hospital
controversy and the appropriate court, in its care, the patient or his/her legal guardian has
discretion, order him to submit to a physical or a right to be informed of the result of the eval-
mental examination by a physician; uation of the nature and extent of his/her dis-
– when the public health and safety so de- ease, any other additional or further contem-
mand; and plated medical treatment on surgical proce-
– when the patient waives this right in writing. dure or procedures, including any other addi-
• Patient has the right to demand that all infor- tional medicines to be administered and their
mation, communication and records pertain- generic counterpart including the possible
ing to his care be treated as confidential. complications and other pertinent facts, statis-
• Any health care provider or practitioner in- tics or studies, regarding his/her illness, any
volved in the treatment of a patient and all change in the plan of care before the change is
those who have legitimate access to the pa- made, the person's participation in the plan of
tient's record is not authorized to divulge any care and necessary changes before its imple-
information to a third party who has no con- mentation, the extent to which payment
cern with the care and welfare of the patient maybe expected from Philhealth or any payor
without his consent, except: – a) when such and any charges for which the patient may be
disclosure will benefit public health and safety; liable, the disciplines of health care practition-
– b) when it is in the interest of justice and ers who will fumish the care and the frequency
upon the order of a competent court; and of services that are proposed to be furnished.

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

• Patient or his legal guardian has the right to RIGHT TO SELF-DETERMINATION

examine and be given an itemized bill of the • Patient has the right to avail himself/herself of
hospital and medical services rendered in the any recommended diagnostic and treatment
facility or by his/her physician and other health procedures. Any person of legal age and of
care providers, regardless of the manner and sound mind may make an advance written di-
source of payment. He is entitled to a thorough rective for physicians to administer terminal
explanation of such bill. care when he/she suffers from the terminal
• Patient or his\her legal guardian has the right phase of a terminal illness: Provided That
to be informed by the physician or his/her del- – a) he is informed of the medical conse-
egate of his\her continuing health care re- quences of his choice;
quirements following discharge, including in- – b) he releases those involved in his care from
structions about home medications, diet, any obligation relative to the consequences of
physical activity and all other pertinent infor- his decision;
mation to promote health and well-being. – c) his decision will not prejudice public health
• At the end of his/her confinement, the patient and safety.
is entitled to a brief, written summary of the RIGHT TO RELIGIOUS BELIEF
course of his/her illness which shall include at • Patient has the right to refuse medical treat-
least the history, physical examination, diag- ment or procedures which may be contrary to
nosis, medications, surgical procedure, ancil- his religious beliefs, subject to the limitations
lary and laboratory procedures, and the plan described in the preceding subsection: Pro-
of further treatment, and which shall be pro- vided, that such a right shall not be imposed
vided by the attending physician. by parents upon their children who have not
RIGHT TO CHOOSE HEALTH CARE PROVIDER AND reached the legal age in a lifethreatening situ-
FACILITY ation as determined by the attending physi-
• Patient is free to choose the health care pro- cian or the medical director of the facility.
vider to serve him as well as the facility except RIGHT TO MEDICAL RECORDS
when he is under the care of a service facility • Patient is entitled to a summary of his medical
or when public health and safety so demands history and condition. He has the right to view
or when the patient expressly waives this right the contents of his medical records, except
in writing. psychiatric notes and other incriminatory in-
• Patient has the right to discuss his condition formation obtained about third parties, with
with a consultant specialist, at the patient's re- the attending physician explaining contents
quest and expense. He also has the right to thereof.
seek for a second opinion and subsequent • At his expense and upon discharge of the pa-
opinions, if appropriate, from another health tient, he may obtain from the health care insti-
care provider/practitioner. tution a reproduction of the same record

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

whether or not he has fully settled his financial • Provided that, an institutional review board or
obligation with the physician or institution con- ethical review board in accordance with the
cerned. guidelines set in the Declaration of Helsinki be
RIGHT TO LEAVE established for research involving human ex-
• Patient has the right to leave hospital or any perimentation:
other health care institution regardless of his • Provided, further. That the Department of
physical condition: Provided. That Health shall safeguard the continuing training
– a) he/she is informed of the medical conse- and education of future health care pro-
quences of his/her decision vider/practitioner to ensure the development
– b) he/she releases those involved in his/her of the health care delivery in the country:
care from any obligation relative to the conse- • Provided, furthermore, That the patient in-
quences of his decision; volved in the human experimentation shall be
– c) his/her decision will not prejudice public made aware of the provisions of the Declara-
health and safety. tion of Helsinki and its respective guidelines.
• No patient should be detained against his/her RIGHT TO CORRESPONDENCE AND TO RECEIVE
will in any health care institution on the sole VISITORS
basis of his failure to fully settle his financial • Patient has the right to communicate with rel-
obligations. atives and other persons and to receive visi-
• However, he/she shall only be allowed to leave tors subject to reasonable limits prescribed by
the hospital provided appropriate arrange- the rules and regulations of the health care in-
ments have been made to settle the unpaid stitution.
bills: RIGHT TO EXPRESS GRIEVANCES
• Provided, further. That unpaid bills of patients • Patient has the right to express complaints
shall be considered as loss income by the hos- and grievances about the care and services
pital and health care provider/practitioner and received without fear of discrimination or re-
shall be deducted from gross income as in- prisal and to know about the disposition of
come loss only on that particular year. such complaints.
RIGHT TO REFUSE PARTICIPATION IN MEDICAL RE- • Such a system shall afford all parties con-
SEARCH cerned with the opportunity to settle amicably
• The patient has the right to be advised if the all grievances.
health care provider plans to involve him in RIGHT TO BE INFORMED OF HIS RIGHTS AND OBLI-
medical research, including but not limited to GATIONS AS A PATIENT
human experimentation which may be per- • Every person has the right to be informed of
formed only with the written informed consent his rights and obligations as a patient.
of the patient: • It shall be the duty of health care institutions to
inform of their rights as well as of the

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

institution's rules and regulations that apply to • Example: A medical doctor in a private hospi-
the conduct of the patient while in the care of tal in Manila recorded a conversation with his
such institution. lady patient without the patient’s knowledge
and prior consent. Upon realizing what was
DATA PRIVACY ACT happening, the patient immediately con-
• Republic Act No. 10173, otherwise known as the fronted the doctor and expressed her strong
Data Privacy Act is a law that seeks to protect dismay, pointing out the physician’s lack of
all forms of information, be it private, personal, professionalism in recognizing his personal
or sensitive. right to privacy. She said she could have given
• It is meant to cover both natural and juridical her consent anyway if only she was asked po-
persons involved in the processing of personal litely.
information. • In recording a conversation or interview with
DATA PRIVACY RIGHTS someone, it is enough to verbally ask for a di-
• Right to be Informed rect consent from an individual data subject.
• The right to access • If the subject yields, it would be useful to also
• The right to object mention as part of the recorded conversation
• The right to erasure or blocking that the subject knows the conversation is be-
• The right to damages ing recorded and that you asked and were
• The right to file a complaint given the consent.
• The right to rectify • It would even be better if you could get the
• The right to data portability subject to verbally confirm his consent.
RIGHT TO BE INFORMED RIGHT TO ACCESS
• Under R.A. 10173, your personal data is treated • This is your right to find out whether an organi-
almost literally in the same way as your own zation holds any personal data about you and
personal property. if so, gain “reasonable access” to them.
• Thus, it should never be collected, processed • Through this right, you may also ask them to
and stored by any organization without your provide you with a written description of the
explicit consent, unless otherwise provided by kind of information they have about you as
law. well as their purpose/s for holding them.
• Information controllers usually solicit your con- • You may demand to access the following:
sent through a consent form. – The contents of your personal data that were
• Aside from protecting you against unfair processed.
means of personal data collection, this right – The sources from which they were obtained.
also requires personal information controllers – Names and addresses of the recipients of
(PICs) to notify you if your data have been your data.
compromised, in a timely manner. – Manner by which they were processed.

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

– Reasons for disclosure to recipients, if there without your consent for the following pur-
were any. poses:
– Information on automated systems where – Direct marketing purposes - When business
your data is or may be available, and how it organizations give you sales materials about
may affect you. products and services, they must explicitly in-
– Date when your data was last accessed and form or remind you of your right to object
modified – Profiling purposes - Businesses customarily
– The identity and address of the personal in- resort to profiling, or the creation of profiles of
formation controller. individual customers and clients without their
• Example: An individual had been involved in consent. This is done either for marketing or
an incident inside and outside a Manila res- customer care purposes.
taurant where his wallet was stolen. He also – Automated processing purposes
suffered minor injuries in the incident. He re- RIGHT TO ERASURE OR BLOCKING
quested access to the restaurant CCTV foot- • Under the law, you have the right to suspend,
age relating to himself, saying he wants to see withdraw or order the blocking, removal or de-
all details surrounding the incident and possi- struction of your personal data.
bly figure out a way to recover his wallet. He • You can exercise this right upon discovery and
tried to personally speak to the manager but substantial proof of the following:
was referred to the security guard. After a few 1. Your personal data is incomplete, outdated,
days of following up on his request, he was fi- false, or unlawfully obtained.
nally informed that the establishment would 2. It is being used for purposes you did not au-
not provide him any data. thorize.
RIGHT TO OBJECT 3. The data is no longer necessary for the pur-
• You can exercise your right to object if the per- poses for which they were collected.
sonal data processing involved is based on 4. You decided to withdraw consent, or you
consent or on legitimate interest. object to its processing and there is no over-
• When you object or withhold your consent, the riding legal ground for its processing.
PIC should no longer process the personal
data, unless the processing is pursuant to a 1. The data concerns information prejudicial to
subppoena, for obvious purposes (contract, the data subject — unless justified by freedom
employer-employee relationship, etc.) or a re- of speech, of expression, or of the press; or
sult of a legal obligation. otherwise, authorized (by court of law)
• The right to object is most specifically applica- 2. The processing is unlawful.
ble when organizations or personal infor- 3. The personal information controller, or the
mation controllers are processing your data personal information processor, violated your
rights as data subject.

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

RIGHT TO DAMAGES on the GSIS record, and in 2012 if based on her

• You may claim compensation if you suffered birth certificate. She, thus, invoked her right to
damages due to inaccurate, incomplete, out- rectify her personal data under the Data Pri-
dated, false, unlawfully obtained or unauthor- vacy Act of 2012.
ized use of personal data, considering any vio- RIGHT TO DATA PORTABILITY
lation of your rights and freedoms as data • This right assures that YOU remain in full con-
subject. trol of YOUR data.
RIGHT TO FILE A COMPLAINT • Data portability allows you to obtain and elec-
• If you feel that your personal information has tronically move, copy or transfer your data in
been misused, maliciously disclosed, or im- a secure manner, for further use.
properly disposed, or that any of your data • It enables the free flow of your personal infor-
privacy rights have been violated, you have a mation across the internet and organizations,
right to file a complaint with the NPC. according to your preference.
RIGHT TO RECTIFY • This is important especially now that several
• You have the right to dispute and have cor- organizations and services can reuse the same
rected any inaccuracy or error in the data a data.
personal information controller (PIC) hold • Data portability allows you to manage your
about you. personal data in your private device, and to
• The PIC should act on it immediately and ac- transmit your data from one personal infor-
cordingly, unless the request is vexatious or mation controller to another.
unreasonable. • As such, it promotes competition that fosters
• Once corrected, the PIC should ensure that better services for the public.
your access and receipt of both new and re- • Example: In case you want to close your Face-
tracted information. book account and leave the service, or simply
• PICs should also furnish third parties with said feel like you’ve shared a lot of information
information, should you request it. about your life and want a backup of all your
• Example: A government employee resigned Facebook data, you may exercise your right to
from her agency with a period with premium data portability.
payments of 20.49 years. The employee’s
birthdate indicated in her Government Service
Insurance System (GSIS) records is 30 June
1959. However, her National Statistics Office
(NSO) authenticated Certificate of Live Birth
shows 30 June 1952 as her birthdate. Her
birthdate will determine when she will start re-
ceiving her monthly pension – in 2019 if based

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

GUIDELINES OF AN EFFECTIVE INTERVIEW AND “Is the pain dull, cutting, sharp, throbbing, ach-
HEALTH HISTORY ing, piercing?”
INTERVIEWING “Does the pain occur every hour, every day,
TWO FOCUSES OF AN INTERVIEW
every month, every year?”
• Establishing rapport and a trusting relationship
- Rephrasing
with the client to elicit accurate and meaning-
- Well-phased phrases
ful information
- Interfering
• Gathering information on the client’s develop-
- Providing information
mental, psychological, physiologic, sociocul-
SPECIAL CONSIDERATIONS DURING THE INTER-
tural, and spiritual statuses to identify devia- VIEW
tions that can be treated with nursing and col- • Gerontologic
laborative interventions or strengths that can • Cultural
be enhanced through nurse–client collabora- • Emotional
tion. GERONTOLOGIC VARIATIONS IN COMMUNICA-
• PHASES OF THE INTERVIEW TION
- Pre-introductory Phase • Do not assume there is an existing health prob-
- Introductory Phase lem
- Working Phase • Assess patient’s hearing acuity first
- Summary and Closing Phase • If you detect hearing loss, speak slowly, face the
• Non-verbal and Verbal Communication client at all times during the interview, and posi-
NON-VERBAL COMMUNICATION tion yourself so that you are speaking on yell at the
- Appearance client.
- Demeanor • Speak clearly and use straightforward language
- Facial Expression during the interview with the older adult client.
- Attitude • Ask questions in simple terms. Avoid medical
- Silence jargon and modern slang.
- Listening • However, do mean that the client is slower men-
WHAT TO AVOID tally. Showing respect is very important.
- Excessive Or Insufficient Eye Contact • However, if the older client is mentally confused
- Distraction Or Distance or forgetful, it is important to have a significant
- Standing other (e.g., spouse, child, close friend) present dur-
VERBAL COMMUNICATION ing the interview to provide or clarify the data.
- Open-ended questions
CULTURAL VARIATIONS IN COMMUNICATION
- Closed-ended questions:
• Be aware of possible variations in your commu-
“When did your headache start?”
nication style and the client’s. If misunderstanding
- Laundry list
or difficulty in communicating is evident, seek help

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

from an expert, what some professionals call a • Avoid arguing and facilitate personal space so
“CULTURE BROKER”. that the client does not feel threatened or cor-
• This is someone who is thoroughly familiar not nered.
only with the client’s language, culture, and re- WHEN INTERACTING WITH A DEPRESSED CLIENT
lated health care practices but also with the health • Express interest in and understanding of the
care setting and system of the dominant culture. client and respond in a neutral manner.
EMOTIONAL VARIATIONS IN COMMUNICATION • Do not try to communicate in an upbeat, en-
• Not every client you encounter will be calm, couraging manner. This will not help the de-
friendly, and eager to participate in the interview pressed client.
process. Clients’ emotions vary for a number of WHEN INTERACTING WITH A MANIPULATIVE CLI-
reasons. They may be scared or anxious about ENT
their health or about disclosing personal infor- • Provide structure and set limits.
mation, angry that they are sick or about having • Differentiate between manipulation and a rea-
to have an examination, depressed about their sonable request.
health or other life events, or they may have an ul- • If you are not sure whether you are being ma-
terior motive for having an assessment performed. nipulated, obtain an objective opinion from
INTERACTING WITH CLIENTS WITH VARIOUS EMO- other nursing colleagues.
TIONAL STATES WHEN INTERACTING WITH A SEDUCTIVE CLIENT
WHEN INTERACTING WITH AN ANXIOUS CLIENT • Set firm limits on overt sexual client behavior
• Provide the client with simple, organized infor- and avoid responding to subtle seductive be-
mation in a structured format. haviors Encourage client to use more appro-
• Explain who you are, along with your role and priate methods of coping in relating to others.
purpose. WHEN DISCUSSING SENSITIVE ISSUES (E.G., SEXU-
• Ask simple, concise questions. ALITY, DYING, SPIRITUALITY)
• Avoid becoming anxious like the client. • First, be aware of your own thoughts and feel-
• Do not hurry, and decrease any external stim- ings regarding dying, spirituality, and sexuality,
uli. then recognize that these factors may affect
WHEN INTERACTING WITH AN ANGRY CLIENT the client's health and may need to be dis-
• Approach this client in a calm, reassuring, in- cussed with someone.
control manner. • Ask simple questions in a nonjudgmental
• Allow him to ventilate feelings. However, if the manner.
client is out of control, do not argue with or • Allow time for ventilation of client's feelings as
touch the client. Obtain help from other health needed.
care professionals as needed. • If you do not feel comfortable or competent
discussing personal, sensitive topics, you may
make referrals as appropriate, for example, to

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

a pastoral counselor for spiritual concerns or - The goal of tertiary care is to achieve the highest
other specialists as needed. level of functioning possible while managing the
HEALTH CARE TEAM IN HEALTH ASSESSMENT chronic illness.
HEALTH CARE SETTINGS - For example, a patient who falls and fractures
There are several levels of health care including their hip will need secondary care to set the bro-
primary, secondary, and tertiary care. Each of ken bones but may need tertiary care to regain
these levels focuses on different aspects of health their strength and ability to walk even after the
care and is typically provided in different settings. bones have healed.
PRIMARY CARE - Patients with incurable diseases, such as demen-
- Promotes wellness and prevents disease. This
tia, may need specialized tertiary care to provide
care includes health promotion, education, pro-
support they need for daily functioning.
tection (such as immunizations), early disease
- Settings include rehabilitation units, assisted liv-
screening, and environmental considerations.
ing facilities, adult day care, skilled nursing units,
- Settings providing this type of health care include
home care, and hospice centers.
physician offices, public health clinics, school nurs-
HEALTH CARE TEAM
ing, and community health nursing. - No matter the setting, quality health care re-
SECONDARY CARE quires a team of health care professionals collabo-
- Occurs when a person has contracted an illness
ratively working together to deliver holistic, indi-
or injury and requires medical care.
vidualized care.
- Often referred to as acute care. Secondary care
- Nursing students must be aware of the roles and
can range from uncomplicated care to repair a
contributions of various health care team mem-
small laceration or treat a strep throat infection to
bers.
more complicated emergent care such as treating
- Consists of health care providers, nurses (li-
a head injury sustained in an automobile accident.
censed practical nurses, registered nurses, and
- Whatever the problem, the patient needs medi-
advanced registered nurses), unlicensed assistive
cal and nursing attention to return to a state of
personnel, and a variety of interprofessional team
health and wellness.
members.
- Provided in settings such as physician offices,
HEALTH CARE PROVIDERS
clinics, urgent care facilities, or hospitals. Special- PHYSICIANS
ized units include areas such as burn care, neuro- - In the hospital setting, the physician is responsi-
surgery, cardiac surgery, and transplant services ble for the medical diagnosis and for determining
TERTIARY CARE the therapy required by person who is ill or in-
- Addresses the long-term effects from chronic ill- jured.
nesses or conditions with the purpose to restore a - Person who is legally authorized to practice
patient’s maximum physical and mental function. medicine in a particular jurisdiction
PRIMARY CARE DOCTORS

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

- When patients need medical care, they first go to - Holistic care for the patient
primary care doctors. - Proper health history and physical examination
- They focus on preventive health care. This in- NUTRITIONIST
cludes regular checkups, disease screening tests, - Person who helps people form healthy eating
immunizations, and health counseling. habits to improve health and prevent disease.
- Primary care doctors may be family practition- - May provide nutritional counselling, meal plan-
ers, internal medicine, or osteopathic doctors. Pe- ning, and nutrition education programs.
diatricians also provide primary care for babies, SOCIAL WORKER
children, and teenagers. - Are professionals who aim to enhance overall

SPECIALISTS well-being and help meet basic and complex

- Diagnose and treat conditions that require a needs of communities and people.
special area of knowledge. - They work with many different populations and
- Patients may see a specialist to diagnose or treat types of people, particularly focusing on those who
a specific short-term condition. If patients have a are vulnerable, oppressed, and living in poverty.
chronic disease, they may see a specialist on an PHYSICAL THERAPIST
ongoing basis. - Help patients when they have an injury, disabil-

- Examples of specialties include endocrinology, ity, or medical condition that limits their ability to

dermatology, and obstetrics move or function

TYPES OF NURSES - Physical therapists test a patient's strengths and

REGISTERED NURSES - they are required to pass a ability to move and create a treatment plan
written examination and should be a holder of a - The goal of treatment is to improve mobility, re-
bachelor’s degree in nursing from a college or uni- duce pain, restore function, or prevent further dis-
versity that complies with the standards of nursing ability
education duly recognized by the proper govern- OCCUPATIONAL THERAPIST
ment agency - Help patients perform tasks needed for everyday

ADVANCED PRACTICE NURSES - these are nurses living or working

who have more education and experience than - They work with patients who have physical, men-

registered nurses. Examples of advanced practice tal, or developmental disabilities this includes

nurses are clinical nurse specialists, nurse anes- stroke patients who have lost function on one side

thetist, nurse midwife and nurse practitioner of their body, heart or lung disease, patients with

LICENSED PRACTICAL NURSES - they're also called activity or breathing limitations, or diabetes pa-

licensed vocation nurses they train for about one tients who have had a limb amputated

year at a community or vocational college or - Help patients or clients find new ways to dress,

school and are licensed by their state nurses are cook, eat, or work.

instrumental in the care of patients SPEECH THERAPISTS

- Also called speech language pathologists
ROLES OF NURSES IN HEALTH ASSESSMENT

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

- They work with patients who have problems re- - The role of the pharmacists in monitoring and
lated to speech, communication, or swallowing. evaluating the actions of medications on patients
DENTIST is becoming increasingly prominent.
- Diagnose and treat problems with teeth mouth RESPIRATORY THERAPISTS
along with giving advice and administering care to - They are skilled in therapeutic measures used in
help prevent future problems care of patients with respiratory problems
DIETITIAN - They help improve the outcomes for people with
- Supervise the preparation of meals according to asthma, pneumonia, emphysema, lung trauma
the doctor's prescription. - Therapists can assess your breathing, recom-
- They also assess the patient's nutritional, and hy- mend exercises and monitor your progress.
dration needs and monitors the patient's response PSYCHOLOGIST
to those needs. - Is a person who studies normal and abnormal
MEDICAL SOCIAL WORKER mental states perceptual cognitive, emotional,
- Responsible for offering the support and re- and social processes and behavior by experiment-
sources that patients need in order to fully recover ing with and observing, interpreting and recording
from a medical illness or injury as well as the re- how individuals relate to one another and to their
sulting emotional, physical, or psychological con- environments.
cerns after performing a comprehensive assess- CLERGY
ment of a patient's support needs - The spiritual dimension of a person or patient
LABORATORY TECHNOLOGIST comes into play more during a person's illness.
- Is a person who performs the practical hands-on - Patients who draw their spiritual strength from
work in laboratories God are the ones who successfully cope with ill-
- Lab techs work in diverse settings which include nesses. The role of a clergy is therefore, very im-
healthcare industry, research, and educational in- portant.
stitutions. CORE VALUES IN NURSING
RADIOLOGISTS EMPATHY AND CARING
- Medical doctors that specialize in diagnosing - Empathy is a nurse’s ability to understand, be
and treating injuries and diseases using medical aware of, be sensitive to, and vicariously experi-
imaging (radiology) procedures (exams/tests) ence the feelings, thoughts, and experiences of the
such as X-rays, computed tomography (CT), mag- patient and their family.
netic resonance imaging (MRI), nuclear medicine, - Caring involves knowing and trusting the patient,
positron emission tomography (PET) and ultra- an interest in their growth and well-being, honesty,
sound. courage, and humility.
PHARMACIST - A caring nurse knows that he or she does not
- Prepares and dispenses pharmaceuticals in hos- know all there is to know about the patient, and
pitals and community settings projects the confidence and patience to help them
maintain hope or the sense of continued possibility

KRISTINE ALVAREZ | EAC-C

 HEALTH ASSESSEMENT
SEM: 2 / AY: 2023-2024

===============================================================================================

for growth and change. Caring involves the plan- - Nurses never stop learning! Nurses should be
ning and provision of culturally sensitive and ap- naturally curious and are encouraged to ask ques-
propriate care. tions on the job to learn more about the role and
- Empathy is an incredibly important value in responsibilities.
nursing as it helps you build trust with your pa-
tients and enables you to focus on their point of
view. Naturally, this strengthens your ability to ef-
fectively communicate with them and provide bet-
ter care.
PROFESSIONALISM
- Professionalism involves the characteristics of a
nurse that reflects his or her professional status.
- These characteristics involve behaviors about
self, patients, others, and the public as they reflect
the values of the nursing profession.
- Professional personas are knowledgeable in their
subject matter, conscientious in their actions, and
responsible for themselves and others.
AUTONOMY
- As a nurse, it is important to recognise a pa-
tient’s right to accept or refuse care provision.
Medical autonomy is an ethical nursing value
where nurses should aim not to influence a pa-
tient’s decisions but instead to make them feel at
ease whilst educating them without bias on their
choices.
ALTRUISM
- An important part of altruism is to not expect
something in return for the care that you provide
and advocating for fair treatment for all.
ACCOUNTABILITY
- Accountability is another important value in
nursing as you will need to demonstrate an ability
to acknowledge responsibility for your actions and
learn from mistakes.
CURIOSITY

KRISTINE ALVAREZ | EAC-C