6.5 Preparing for the Interview
Learning Objectives
- Explain why health professionals review client charts or histories.
- Describe the environmental principles of a client interview.
Reviewing the client’s existing health record or chart (if applicable) provides a general overview of the client’s primary health needs, the reason for seeking care, and health history. If the client is admitted, this review will give you an overview of the health history and any events of the last 24 hours. This is an important first step for several reasons:
- conveys your interest and competence as a provider,
- allows you to follow up on missing data,
- saves the client from repetition,
- allows you to identify any changes in the client’s health status
You should also consider how to leverage the environment of the interview location and your position within the space. The client interview is often conducted in clinics, hospitals, emergency departments, and community spaces such as the client’s home. You should attend to the following principles:
- Create a quiet location so you and the client can hear and communicate. Some possible strategies to reduce sound may include closing the room door, closing the curtains, and turning off radios and televisions.
- Establish a welcoming environment, which may include offering the client a place to sit and avoiding physical barriers, such as a desk, between you and the client.
- Attend to the client’s physical comfort, including offering them a drink of water and inviting them to take their coat off or have a place to put their bag or purse. Additionally, if they are in bed, you should ensure that they are comfortable and ask if they want to sit up if they are permitted.
- Create an inclusive space in which care partners are invited to be part of the interview based on the client’s wishes.
- Ensure a private space so the client feels comfortable sharing personal information and knows this information is confidential. Sometimes it will not be possible to ensure a completely private space, such as when a curtain is the only barrier. In this case, try to avoid using the client’s name and other client information loudly so that others cannot overhear.
- Maintaining professional boundaries and standards of practice facilitates a trusting and therapeutic relationship between nurse and client
- You must understand your professional role and ensure that your relationship with the client does not become personal (e.g., meeting the client outside work hours, disclosing personal information, or accepting or exchanging gifts) (Alberta College of Social Workers, 2019; College of Nurses of Ontario [CNO], 2019b).
In preparation for the client interview, you must first be aware of provincial or federal legislation and provincial practice standards concerning privacy and confidentiality. Each province’s Personal Health Information Protection Act includes statements about clients having the right to keep their health information private. Healthcare professionals are legally required to keep this information confidential. You must emphasize that client data is kept confidential and only shared with relevant healthcare team members directly involved in the client’s care. You may want to re-emphasize confidentiality when addressing sensitive interview topics such as trauma and violence, sexual health, and substance use. The client owns their personal health information; as a custodian of this information, you must request permission before the disclosure (Alberta Government, 2022b; CNO, 2019a). However, there are certain situations where consent for disclosure is not required, for example, “to eliminate or reduce a significant risk of harm to a person” (CNO, 2019a, p. 7).
Activity: Check Your Understanding
Points of Consideration
Abuse and Neglect
In certain conditions, health professionals must disclose personal health information. You are legally required to report suspected child abuse or neglect and elder abuse when the person lives in a retirement or long-term care home in Canada. Each province has agencies through which child abuse is to be reported. In Alberta, the Child, Youth, and Family Enhancement Act requires individuals to report a concern if they believe a child is at risk (Alberta Government, 2022a). In Ontario, for a resident in a retirement home, you must report to the Registrar of the Retirement Homes Regulatory Authority. A resident in a long-term care home reports to the Director at the Ministry of Health and Long-Term Care (Community Legal Education Ontario, 2019).
In all provinces and territories, the relevant Protection of Persons in Care Act applies (for example, Alberta Government, 2022b). Each profession, province, and territory has a standard for reporting if a client discloses or you observe a “health professional who poses a serious risk of harm to patients” (sexual abuse, incompetent care, physical or mental incapacity to provide safe care or professional misconduct). Review the standard for your profession, province, or territory to know your legal responsibilities.
Key Takeaways
- The health history is an essential first step in understanding your client.
- It is important to consider the environment before conducting a client interview.
- Confidentiality of information is essential to a client interview, but in the case of suspected abuse or neglect, health professionals must report these offences.
Exercises
- Reflect on how you will prepare for your next client interview.
References
Alberta College of Social Workers. (2019). Standards of practice. https://acsw.in1touch.org/uploaded/web/ACSW%20Council/DOC_FINALACSWStandardsOfPractice_V1_1_20200304.pdf (archived version)
Alberta Government. (2022a). Protection of persons in care. https://www.alberta.ca/protection-for-persons-in-care.aspx
Alberta Government. (2022b). The Personal Health Information Protection Act. https://kings-printer.alberta.ca/570.cfm?frm_isbn=9780779839650&search_by=link
College of Nurses of Ontario. (2019a). Confidentiality and privacy–personal health information. https://www.cno.org/globalassets/docs/prac/41069_privacy.pdf
College of Nurses of Ontario. (2019b). Therapeutic nurse-client relationship, revised 2006. https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf
Community Legal Education Ontario. (2019). When does elder abuse have to be reported? https://www.cleo.on.ca/en/publications/elderab/why-elder-abuse-seldom-reported
Attribution Statement
Content adapted, with editorial changes, from:
Lapum, J., St.-Amant, O., Hughes, M., & Garmaise-Yee, J. (Eds.)(2020). Introduction to communication in nursing. Toronto Metropolitan University Pressbooks. https://pressbooks.library.ryerson.ca/communicationnursing/
Licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
