Health Care Observation

Me: Today we did height, weight and blood. I am checking our records, and the last time that we have blood from the Health Care Provider was in 2014, I would like to know if no blood was require for the 2016 physical.
Participant: My son had a physical in December 2016, I requested a medical referral form for WIC, but I need to schedule and appointment, because the information is old.
Me: Ok, I am asking, because we to keep this information on file and if it is not up to date we need to know the reasons.
While the participant was listening to me, I kept eye contact. I requested permission for her to take my notes. I asked all the pertinent questions in a way that the participant did not feel that I was following a format. For instance, she

HNU's are updated after six-months of certification. For HNU's the participant is assessed depends on the risk, it would be anything. For instance, the most common one are low levels of hemoglobin, overweight and underweight. This, day even though I was so busy, I created a better rapport with the participants. For instance, I had a four-day postpartum mother and I helped her to latch-on the baby to breast. She was overwhelmed and I after I asked opened-ended questions she told me that, the day before she had a fever. I referred her to the Doctor, she was not engorged, because she was breastfeeding on demand and her breast were soft.
On March 21, 2017 was class day; we provide nutritional counseling in-group. I like group classes, because there are more interactions with the participants. March is the nutrition month and, we did a cooking demonstration, while I was preparing a salad one of the participants said, “I want to lose weight and learn to cook.” I asked probing questions. After a few basic questions I assessed her and I provided nutritional educational according to her needs. She did not want to learn to cook, she wanted to learn how to measure the food, and control the food portion

While I putted the data in the computing I made eye contact and she was looking at me differently. After, I finished, she received nutritional counseling, and she asked me, where did I study to become a Nutritionist? I said, “ I did my first two years at Bronx Community College and my last two years at Lehman College. She said, “I am a LPN and I am not working now.” I think I did something different, because if we had that kind of conversation meaning the participant creates a bond with me. I checked the participant record, and I did the certification, six months ago, probably I already saw the participant more than once, and she felt confident during our conversation. According to Shapley et al., (2000). He states that in an interview or in this case an assessment it is important the elements of bond, goals and tasks should be present. The lack of one of these elements is a failure of the counseling process. On way of creating a strong bond is by building rapport. Shapley states that building rapport is not easy, because if the health professional only follows the theory that learns in school and does not make strategies to engage the patients, sometimes counseling is not successful. Patients tend to lose the interest and trust. There are two types of communication that would be effective, verbal and non-verbal communication. With this participant I meet these