Consultation 1

Consultation 1
Entire Consultation
Active Listening
Using the visual and audible reassurance the nurse is indicating she is listening.
Open Questions
If we watch this clip again this also shows the use of open questioning. These are questions that encourage someone to tell their story rather than expecting a yes or a no answer.
Reflection and summarising
In this clip the nurse tries to identify clearly what the problems are to ensure that she has understood the patient’s concerns. You can do this by reflecting back to the patient some of their key comments and checking with the patient that you have understood them correctly.
It is often helpful to summarise the discussion at intervals so that the patient and the health professional have a shared understanding.
Goal Setting
Patients are much more likely to achieve a goal that they have set themselves.
Jo has identified using her reliever frequently as being an immediate problem if the nurse plans around this concern Jo is likely to understand why using her preventer medication might be useful.
Forward planning / Safety netting
The best laid plans sometimes come adrift, it is vital to make sure that the patient knows what to do if things don’t work out.
This is sometimes called ‘safety netting’ the nurse has offered support if Jo’s asthma gets worse.
What features of Annie’s typical day might be a cause for concern?
- Frequent symptoms: early morning, throughout the day and 2-3 times at night
- Several clear triggers irritating her airways: cold air, exercise, cat dander, builder’s dust
- Using reliever 4-5 times daily
- Acceptance of these symptoms as a normal part of life and avoiding exercise routinely
A typical day
A useful technique for exploring the impact of asthma on a patient’s life is to ask them to go through a typical day from morning to evening, ‘painting a picture’ of how the condition affects daily activities.
The health professional may occasionally encourage them to provide important details.
This is also good for establishing rapport, particularly with patients who are experiencing difficulties.
Some Useful techniques to improve asthma consultations:
- Active listening
- Open questions
- Reflections
- Summarising
- Goal setting
- Forward planning/safety netting
- A typical day
If you are interested in further developing your consultation skills a new one day short course ‘Partners in Care: Five Steps to better Consultations’ is available from Education for Health. For details go to www.educationforhealth.org.uk
Recommended reading:
- Rollnick, Mason and Butler (1999) Health Behaviour Change A guide for practitioners. Churchill Livingstone: Edinburgh
- Hastings and Redsell (Eds) (2006) The Goof Consultations Guide for Nurses. Radcliffe Publishing: Oxford
- Education for Health (2007) Partners in Care: Five Steps to better Consultations. Direct Publishing Solutions Ltd. Cookham















