To enhance the establishment of rapport with a patient, the nurse should:
Share information with the patient about other patients and why they are hospitalized.
Share his own personal experiences so that the patient gets to know him as a friend.
Act in a trustworthy and reliable manner; respect the individuality of the patient.
Identify himself by name and title each time he introduces himself.
The Correct Answer is C
A. Share information with the patient about other patients and why they are hospitalized. Sharing information about other patients violates confidentiality and does not help establish trust. This is unprofessional and goes against HIPAA guidelines.
B. Share his own personal experiences so that the patient gets to know him as a friend. Although occasional sharing of personal experiences may enhance rapport, extensive sharing can shift focus from the patient to the nurse, which is unprofessional and can create boundary issues.
C. Act in a trustworthy and reliable manner; respect the individuality of the patient. Acting in a trustworthy, reliable manner and respecting the patient's individuality establishes rapport by building trust, ensuring the patient feels valued and respected. This is the most professional approach.
D. Identify himself by name and title each time he introduces himself. Introducing oneself by name and title is essential, but it alone does not fully establish rapport. It is part of a courteous approach, but rapport-building requires deeper engagement.
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Correct Answer is C
Explanation
A. Asking the patient, "Did you graduate from high school?" This question is not a direct way to assess reading or comprehension ability. A person’s educational level does not necessarily reflect literacy skills.
B. Giving the patient a printed instruction sheet and saying, "Some people have difficulty with written instructions. Others find them helpful. Would these be helpful to you?" This approach is indirect and does not confirm whether the patient can actually read or understand the instructions.
C. Giving the patient some printed materials and saying, "After you have read this, I'll ask you some questions about what's in them, to see if you've learned it." This option allows the nurse to assess both the patient's reading ability and understanding by following up with questions, ensuring comprehension.
D. Asking the patient, "Are you able to read?" While this question is direct, it may embarrass the patient, and it does not assess comprehension.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.