Reviewing the client’s existing health record or chart (if applicable) provides a general overview of the client’s primary health needs, the reason for seeking care, and health history. If the client is admitted, this review will give you an overview of the health history and any events of the last 24 hours. This is an important first step for several reasons:

• conveys your interest and competence as a provider
• allows you to follow up on missing data
• saves the client from repetition
• allows you to identify any changes in the client’s health status.

You should also consider how to leverage the environment of the interview location and your position within the space. The client interview is often conducted in clinics, hospitals, emergency departments, and community spaces such as the client’s home. You should attend to the following principles:

• Create a quiet location so you and the client can hear and communicate. Some possible strategies to reduce sound may include closing the room door, closing the curtains, and turning off radios and televisions.
• Establish a welcoming environment, which may include offering the client a place to sit and avoiding physical barriers, such as a desk, between you and the client.
• Attend to the client’s physical comfort, including offering them a drink of water and inviting them to take their coat off or have a place to put their bag or purse. Additionally, if they are in bed, you should ensure that they are comfortable and ask if they want to sit up if they are permitted.
• Create an inclusive space in which care partners are invited to be part of the interview based on the client’s wishes.
• Ensure a private space so the client feels comfortable sharing personal information and knows this information is confidential. Sometimes it will not be possible to ensure a completely private space, such as when a curtain is the only barrier. In this case, try to avoid using the client’s name and other client information loudly so that others cannot overhear.
• Maintaining professional boundaries and standards of practice facilitates a trusting and therapeutic relationship between nurse and client
• You must understand your professional role and ensure that your relationship with the client does not become personal (e.g., meeting the client outside work hours, disclosing personal information, or accepting or exchanging gifts; Alberta College of Social Workers, 2019; College of Nurses of Ontario [CNO], 2019b).

In preparation for the client interview, you must first be aware of state or federal legislation and practice standards concerning privacy and confidentiality. Each legislative act includes statements about clients having the right to keep their health information private. Healthcare professionals are legally required to keep this information confidential. You must emphasise that client data is kept confidential and only shared with relevant healthcare team members directly involved in the client’s care. You may want to re-emphasise confidentiality when addressing sensitive interview topics such as trauma and violence, sexual health, and substance use. The client owns their personal health information; as a custodian of this information, you must request permission before the disclosure (Alberta Government, 2022; CNO, 2019a). However, there are certain situations where consent for disclosure is not required, for example, “to eliminate or reduce a significant risk of harm to a person” (CNO, 2019a, p. 7).

Activity: Check Your Understanding

References

Alberta College of Social Workers. (2019). Standards of practice. https://acsw.in1touch.org/uploaded/web/ACSW%20Council/DOC_FINALACSWStandardsOfPractice_V1_1_20200304.pdf

Alberta Government. (2022). The Personal Health Information Protection Act. https://open.alberta.ca/publications/h05

College of Nurses of Ontario. (2019a). Confidentiality and privacy–personal health information. https://www.cno.org/globalassets/docs/prac/41069_privacy.pdf

College of Nurses of Ontario. (2019b). Therapeutic nurse-client relationship, revised 2006. https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf

Community Legal Education Ontario. (2019). When does elder abuse have to be reported? https://www.cleo.on.ca/en/publications/elderab/why-elder-abuse-seldom-reported