Sally attends the practice nurse for her annual diabetic review. After checking and finding an irregular pulse, the practice nurse has a chat with how Sally has been feeling.
Nurse – It’s lovely to see you, Sally. How have you been keeping?
Sally – I”ve not been at my best the past few weeks.
Nurse – What do you mean you”ve “not been feeling at your best the past few weeks”?
Sally – I”ve noticed I”m more breathless when I”m pottering around the house, things just take more effort than normal.
Nurse – Can you tell me more about this breathlessness?
Sally – When I”m sitting in the chair or lying in my bed, I feel fine. As soon as I start to do something such as walk about the house, I feel breathless. I even felt breathless getting washed and dresssed to come here today.
Nurse – Other than the breathlessness, have you noticed any other changes to your health?
Sally – I feel a bit more tired and my daughter thinks I can”t be bothered with doing things as much.
Nurse – Can I ask you a final couple of questions before I examine you – Are you ever aware of your heart beating or have chest pain or do you ever feel dizzy?
Sally – No, it’s only the breathlessness and the tiredness that bothers me.
Pulse point
Developing rapport, gently asking permission to explore and asking open ended questions, will facilitate your assessment and help the patient to feel at ease. You can learn more about effective communication and consultation techniques in HEARTe: Applying Hearte in Practice and consider up-skilling yourself in health behaviour change (HBC) techniques to support patient engagement by visiting the Public Health Scotland: Health Behaviour Change e-modules.
Page last reviewed: 29 Jul 2020
