Call Transcript
Hello, this is Patricia, a digital nurse from pristeen Health System. I'm calling based on a referral from Doctor Samuel Johnson. We recently sent an email with the subject line 'Upcoming screening for your healthcare appointment,' and I'm following up on that. You can verify that I am legitimate by scrolling to the Unique code for you in that email listed as 1-0-M-N-A-Z. I repeat - the unique code in the email sent to you is 1-0-M-N-A-Z. Should I wait for you to open the email and verify the code, or are you okay for me to proceed?
You can proceed.
Thank you. My job today is to take some notes about your health and pass them along to the nursing team, which is led by Nancy Cobblestone. A member of Nancy's team will review the information I collect and will call you back with a final plan for your surgery. At the end of our discussion, I will also set up some time for you to chat with a nurse. At any point, you may ask me to work with you so you can handle interruptions. I can hold on the line, call you back and pick up where we left off and more. First, can I confirm I'm speaking with Nina or an authorized healthcare delegate for her?
This is Nina.
Thank you. This will be a 15 to 20-minute, confidential, and important conversation. Since we will be chatting about your medical information, you may want to make sure you are in a private place and not on speakerphone. Do I have your consent to proceed?
Great. Pristeen Health is committed to patient safety, and we want to make sure that you are well prepared for your procedure coming up in a few weeks. According to Doctor Samuel Johnson, the procedure will require you to undergo general anesthesia, and for your safety, I need to gather some information to make sure that we provide the right care. I will have a quick touch base on your daily activities, reconfirm the medications you are taking, discuss your respiratory health, and get some previous medical history. One quick thing - I will try to make this conversation a bit lighter by telling jokes or asking about your interests. It’s my way of showing I'm a friendly digital assistant—or at least I'm just trying to be funny, Nina. You don't have to go along with any of the chit-chat - just tell me if you want me to skip it. May I proceed and get to the first step of today's call?
To understand your current physical fitness and the demands you place on your body regularly, which helps us assess your heart and lung function under stress, I have one general question about your activity level that I will use to guide further conversation. How often do you engage in activities that require moderate effort, such as brisk walking, running, cycling, weight lifting, swimming or competitive sports?
I walk for about thirty or forty five minutes three times a week. I don't know what that qualifies as.
Thank you for that information, Nina. Walking for thirty to forty-five minutes three times a week is a great level of activity. Based on that, we can skip the next set of detailed questions. I am going to shift my focus to your medication history. Nina, aside from any daily vitamins, what medications are you on today?
I take this white pill. I forget the name.
I understand it can be difficult to remember medication names. Do you have the pill bottle with you so you can check the label?
No. I'm not at home. Sorry.
No problem at all, Nina. We can work with that. Do you remember what the medication is for, or perhaps the pharmacy where you get it filled? That might help us figure it out later.
That's alright, Nina. We'll make a note of it and the nursing team can help you confirm the details when they call. Our records indicate that you may also have a prescription for apixaban. Are you currently taking it?
Yep.
Gotcha, Nina. Thank you for that information. Nina, I know this is some serious stuff. I thought I would chit chat about something that has no impact on your clinical care. Are you a cat person or a dog person?
Well, I'd like to skip the chitchat.
Of course, no problem at all. I do need to get back to getting your history. Pristeen Health wants to make sure that you are prepared for surgery, so I am going to be a good digital nurse and get that done. Nina, I am going to ask you a few questions so we can make sure that we schedule your surgery at the right venue with the right equipment. Have you ever had a problem with anesthesia, like being hard to wake up or hard to breathe for?
Okay. Can you open your mouth wide enough to fit three of your own fingers stacked up and down?
Yes.
Okay. Do you have any loose teeth, chipped
No.
Okay. Can you touch your chin to your chest
Yes.
Okay. And can you look all the way up at the ceiling without pain?
Yes.
Thank you. I just want to quickly confirm what I've noted down. You have not had a problem with anesthesia in the past, you can open your mouth wide enough for three fingers, you do not have any loose or chipped teeth, and you can move your neck in all directions without pain. Is that all correct?
Yes.
Okay - let us move on to questions around sleep patterns. This helps us understand your breathing while you sleep. I am trying to determine if your neck size necessitates us to make some adjustments on our end. One way to understand this is to know if you wear shirt collars size 17 or bigger. Is that true?
Gotcha. Have you ever had radiation or surgery on your neck or throat?
No.
Okay. Do you snore loudly?
No.
Okay. Do you often feel tired, fatigued, or sleepy during the daytime?
Okay. Has anyone observed you stop
No.
Okay. Do you have or are you being treated for high blood pressure?
Thank you for that. Just to be sure I have everything right, I've noted that you do not wear a size 17 or larger shirt collar, you have not had radiation or surgery on your neck, you do not snore loudly, you do not often feel tired during the day, no one has observed you stop breathing in your sleep, and you do not have high blood pressure. Is that correct?
Yep.
I need to ask about some lifestyle factors—like smoking, alcohol use, and recreational drug use. These details are incredibly important because they can significantly impact how your body responds to anesthesia, the surgery itself, and your subsequent recovery. Please be open and honest with your answers, as this information helps us tailor the safest and most effective care plan for you. When it comes to smoking, would you say you have never smoked in your life, you were smoking before but have quit, or you are a current smoker?
Never smoked.
Gotcha. Now that we have covered smoking, I'd like to ask about your alcohol consumption. Shall we proceed?
Şu.
Let me first describe what I mean by a standard alcoholic drink: that could be a can of beer -
I don't drink any alcohol.
Gotcha. Thank you for your candid answers so far. To complete your social history and ensure we avoid dangerous drug interactions during your procedure, I need to ask one more sensitive question. Please remember that your responses are kept strictly confidential and are used only to plan the safest possible anesthesia and pain control for you. Have you used any non-prescribed
No.
Thank you for sharing that. Just to make sure I have it all correct, I've noted the following: For smoking, I have that you have never smoked. For alcohol, I have that you do not drink. And for other substances, I have that you have not used any non-prescribed medications or recreational drugs. Is that
I am now going to quickly review your chart and go through a few body systems such as your heart, your lungs and so on. If I find specific events from your medical history that are relevant, I will dive deeper. If I find no medical history in a relevant area, I will ask you to reconfirm. For example, I might say, 'My records show you do not have any history of some kind of disease. I will then ask you to confirm or correct me' You will see more about how I work once I get going. Does that sound like a plan?
Şort.
I am now reviewing the health history we have on your file for your heart and cardiovascular system. My records show a history of Ventricular Septal Defect caused by a benign murmur, diagnosed in December 2015 by Doctor Andy Reid. Is this information correct, and are there any other heart-related conditions or updates you'd like to share?
Nope. That's the correct answer.
Okay, your cardiology history is done. Now I will move to the next body system. Ok. On to the next body system. When I checked your health history for Hematology and Oncology, my records show no history of any conditions. I want to make sure I am correct.
Ja.
Ok, your hematology and oncology history is done. Now moving to the next body system. I also looked at your file to see if I could find any documented conditions related to your neurological system, such as seizures or Epilepsy, Stroke or a T-I-A, Parkinson's Disease, or Multiple Sclerosis. It does not appear that you have any documented history. I want to make sure I am correct.
Yep.
Now moving to the next body system. Moving on to the next body system - now we will chat about your endocrine health. The endocrine system disorders are those such as Diabetes, which is high blood sugar, or Thyroid Disease, like hypothyroidism or hyperthyroidism. I did not find any past history. I want to make sure I am correct.