Elderly Interview Paper

Katie, a fellow nursing student, and I interviewed J. W. at the Inn at Sprucewood and we discussed about the pressing issue in healthcare today and Medicare part D. The main goal of this interview was for us to experience nurse to patient situations and use the different communication skill that we learned in Nursing 501 class. The interview illustrated the importance for a nurse to have competent communication skills because without communication, nurses cannot take care of their patients well. A nurse’s main role is to understand their patient’s problems and aid in their recovery. During the interview, we used at least three therapeutic communication techniques, active listening, open focused questioning and silence. As a group of two people, Kate and I worked together very well. We alternated questioning and responding, along with supporting each other. As a result, the conversation was smooth and relaxed.

Elder’s Background

On November 7 2008, I interviewed J. W., who is an 80 year old a woman. She went to college in Delaware, and she was married two times with two children. Her son lives in Maine and her daughter in Delaware. Although she cannot do much due to her lung problems, she still keeps herself busy by reading. When she came down the stairs, her breathing was heavy and she had to ketch her breath before she could speak. This prevents her from working out and doing anything that is fast pace that limits her from many activities that could be fun for her J. W. was a literature and art professor in Delaware and then moved to New Hampshire to support her critically ill son. Her second husband was in the military during World War II and the Vietnam War. Before he died, J. W. said that they traveled a lot to see the places that he had been. Although she is one of the successful women from her time period, at the end of her life, she expressed loneliness and unhappiness. J.W. (personal communication, Nov. 7, 2008).

Most Pressing Issue in Healthcare Today

J. W. believes that the most pressing issue in today’s healthcare is the cost. The cost of healthcare is so high that average citizens cannot afford it. Due to her inability to work and her need of healthcare assistance, J. W. feels that she cannot afford the medications that she needs even with the help of Medicare. Just as in J. W.’s case, 47 million or 16 % of Americans are uninsured because insurance is too expensive. The uninsured rate has increased as its cost has become too expensive for the middle class and lower class’ ability to pay for it. About 1.3 million of full- time workers have lost their work health insurance in 2006, and this number is increasing rapidly (Healthcare Insurance Coverage, 2008). Most of the self-funded employers, who have insurance for their employees, get an insurance that help them from their business being bankrupt. American Healthcare system is unsatisfying to J. W. because most of the expenses come out her pocket.

Medicare Part D

Medicare Part D is a federal program that subsidizes the cost of prescription drugs for those who have Medicare. Medicare part D is part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Act was implemented on January 1, 2006. To be eligible, one must be 65 years old and apply for Medicare part D before or after three month. One can also apply for it after being disabled for 25 months. Those eligible have to renew or sign up every November 15 through December 31 (Medicare, 2008). J. W. is eligible for Medicare part D, and she believes that having the Medicare part D is a good thing. However, her premiums have gone up. She used to pay $30 per month for her drugs, but now she pays about $100 per month. She says this increase is hard to manage. She hopes that the premium payment will go down again in January and looks forward to this happening.

Therapeutic skills

Active Listening

When the receptionist at The Inn at Spruce Wood called J. W., she slowly came down the stairs. The first thing that Kate and I did was introduce ourselves and stated where we came from. I asked her where she would like to sit and talk since I was unfamiliar with The Inn at Spruce Wood. We chose a dining room, which was quiet enable to have some privacy. I again restated that I was a nursing student from University of New Hampshire, and I explained the purpose of my visit. Quickly, I described what my assignment was. I sat in front of her with my arms placed on the table, so I can maintain eye contact. I sat upright, and I began to ask her about her background information. Slowly she started telling Kate and I. We listened attentively and continued with our discussion. (Charry & Jacob, 2008, p. 382).

Open Focused Questions

Most of the time, I asked open focused questions such as inquiring how she ended up in New Hampshire from Delaware and what her occupation was before she moved in to The Inn at Spruce Wood. I did not have to redirect her because she was well focused and understood us. She always came back to the topics quickly. I used open focused questions during the interview with J. W. to help direct her to the topic that we were discussing and also give her time and space to answer the question. It was more like the flow of a normal conversation, rather than an interview because we sporadically talked on and off the subject of healthcare issue and Medicare part D. The reason for this was I did not want to over whelm her with asking too many question. It seemed that she wanted to chat with us than deal with stress from thinking about healthcare payments.

Silence

J. W. was not angry at her situation, but seemed lonely. At one point, all of us were silent. Previously, we were chatting about her children and her husband, and she stated that she was divorced from her first husband, the father of her two children. She later remarried, but her second husband died few years ago. She said that she loves him very much and misses him greatly. Her son being unable to see her adds to her loneliness and that her daughter comes only once a year. Every time her friends’ grandchildren and children come, she feels lonely and does not like how her life has turned out to be. This was the moment where Kate and I went silent, as we did not know what to say. I kept quiet and tried to put myself in her shoes while watching her expression and body language. I tried to reassure her that it is not her fault that it ended up this way and asked her if I can help in anyway which made her smile. I used silence to let her know that I empathized and to give her some time to cope with her feelings. I also kept quiet because I did not know what would make her feel better. I used the silence to process the things that I was going to say (Kimmel, 2007).

Group Process

I went to The Inn at Spruce Wood to be assigned an elderly person for an individual interview. However, a fellow nursing student Kate was not assigned; therefore, she asked me if she could do it with me. As a group of two, we jumped from forming to performing because we did not have a lot of time to go through all of the processes. We took turns asking questions, and we supported each other’s questions and answers. When one of us did not know how to continue the conversation, the other took leadership and continued it, so there would not be awkward silences in the discussion. After the interview, Kate and I went over what we have discussed with J. W. and how we thought we did. We both understood the procedure for the interview and we felt that it enhanced our performance.

Reflection

I was very nervous when I was on my way to The Inn at Spruce Wood. Even though I had done some research on pressing healthcare issues and Medicare Part D, I knew these were complicated issues and unsure of how well I had retained that information. However, she did not ask many questions about the two topics, although I was prepared with some basic information in case she inquired or if I had to explain it to her. My comfort level was good but I did not know how to show my expression. I did not want to be smiling too much because some of the things that J. W. telling us is not funny, but I did not want to be a lump of rock sitting there. If I would change anything, it would be to do more research and to do group discussion or practice for the interview. I also would try to anticipate what the interview might look like.

In relation to our discussion, I was competent and was able to answer the questions that she asked. The interview went very fluently, and Kate and I worked well together. We used communication techniques smoothly. At first, I was nervous about how the interview was going to be. However, after meeting J.W., seeing how nice she was, and using some of the therapeutic communication skills, the nervousness faded, and the interview went great.

References

Benfield, R. (1999). Communication. Retrieved Nov. 12, 2008 from

http://faculty.mc3.edu/rbenfiel/NUR109/NUR109Communication/index.htm

Cherry, B. & Jacob, S. R.. (2008). Contemporary Nursing: Issues, Trends, and Management (4th

Ed). Effective Communication and Conflict Resolution (pp. 75-402). St. Louis, Missouri: Mosby, Inc.

Crawford, S. (2007, May). Clinical research and healthcare insurance. Critical Care Alert, 15(2),

14-16. Retrieved November 14, 2008, from CINAHL Plus with Full Text database.

Healthcare Insurance Coverage. (2008). Nov.11, 2008. National Coalition on Healthcare.

<http://www.nchc.org/facts/coverage.shtml.>

Kimmel, N. (2007, June 5). Therapeutic Communication in the Nursing Profession. Retrieved

November 14, 2008, from http://ezinearticles.com/?Therapeutic-Communication-In-The-Nursing-Profession&id=594747

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