Nurse Pat

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 Charlotte or an authorized healthcare delegate for her?

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?

Yep. Go ahead.

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, Charlotte. 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?

Yep.

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, use the stair master for ten minutes or twenty minutes a day every day.

You know what, we are well on our way to getting you prepared for this procedure. I am going to shift my focus to your medication history. Charlotte, aside from any daily vitamins, what medications are you on today?

I take a pill, but I don't remember the name.

I understand. It can be difficult to remember all the names. Could you please check the bottle for me? It's very important that we have the correct medication name for your safety.

Yeah. I'm I'm not at my house, so I don't have the bottle with me.

Gotcha, Charlotte. No problem at all. We can make a note of that for the nurse to follow up on. Our records indicate that you may also have a prescription for apixaban. Are you currently taking it?

That's it. That's the one I take.

Gotcha, Charlotte. Thank you for that information. Charlotte, 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?

Dom.

Oh, that's lovely. What is its name?

Walter, that is a cute name for a pet. That's wonderful to hear. 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. Charlotte, 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?

Não.

Okay. Can you open your mouth wide

Yes.

Okay. Do you have any loose teeth, chipped

Non

Okay. Can you touch your chin to your chest and

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 to fit three fingers, you do not have any loose teeth, chipped teeth, or caps or crowns, and you have full neck mobility. Is that all correct?

Yep.

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

No.

Okay. Do you snore loudly?

No.

Okay. Do you often feel tired,

No.

Okay. Has anyone observed you stop

Okay. Do you have or are you being treated for high blood pressure?

No. No.

Thank you for that. Just to be sure I have everything right, I've noted that you do not wear a shirt collar size 17 or bigger, you have not had radiation or surgery on your neck, you do not snore loudly, you do not often feel tired during the daytime, no one has observed you stop breathing in your sleep, and you do not have high blood pressure. Is that correct?

Yes.

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

I don't smoke.

Gotcha. Now that we have covered smoking, I'd like to ask about your alcohol consumption

I don't drink.

Okay. 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

I don't do recreational drugs either.

Thank you for sharing that. Just to make sure I have it all correct, I've noted the following: For smoking, I have you have never smoked. For alcohol, I have you do not drink. And for other substances, I have you do not use recreational drugs. Is that all correct?

Yes.

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?

Now on to cardiology. I did some research on your health records and it shows no documented conditions related to your heart or cardiovascular system, such as Coronary Artery Disease, or C-A-D, Congestive Heart Failure, or C-H-F, a history of Heart Attack, or significant Arrhythmias like A-Fib. I want to make sure I am correct.

That is correct.

Okay, your cardiology history is done. Now I will move to the next body system. Moving on to hematology and oncology. Hey Charlotte, my records show no history of blood disorders or cancer. If this is the latest status and you have no new

Yes. That is the latest status.

Ok, your hematology and oncology history is done. Now moving to the next body system. Ok Charlotte, we are making good progress here. 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.

Yes.

We got that done. Let us keep going. And 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. Charlotte, I want to make sure I am correct. Will

Yes. You are.

Thank you for providing this detailed information. We are getting there—we will be done soon, I promise! Charlotte, we are on the home stretch. We have three more body systems to review, Liver, Kidney and lung. Thank you for staying with me. Now, we need to focus specifically on your liver health. This is a crucial topic because the liver is responsible for breaking down almost all anesthetic drugs. Looking at your liver health history, my records show a history of Hepatitis B with no viral load, diagnosed in December 2015 by Doctor Michael Fitzgerald. If this is the latest status on your liver health and you have no new information, let me know. You

That's

Thank you for providing this detailed information. We have just two more body system to go, and then we are done with the medical history, I promise! Charlotte, you are a trooper - thank you for working with me. Now on to your Kidney History. This is essential because the kidneys are vital for filtering waste products from your blood, balancing fluids, and eliminating many anesthetic and pain medications. Kidney dysfunction can lead to medication accumulation and electrolyte imbalances. Charlotte, am I correct that you do not have any documented conditions related to your kidneys, such as Chronic Kidney Disease, or C-K-D, a need for Dialysis, Kidney Transplants, or a history of Acute Kidney Injury, or A-K-I?

You are correct.

Thank you for providing this detailed information. This information helps the anesthesia team safely select medications and manage your fluids and electrolytes throughout your hospital stay. You made it - we are in the last body system. Hang tight... Now we need to cover your Pulmonary, or Lung History. Lung health is essential because a healthy respiratory system is necessary to keep your blood oxygenated, especially when you are under anesthesia. Charlotte, with respect to your lungs or breathing medical history, I did not find anything such as Asthma, Chronic Obstructive Pulmonary Disease, or C-O-P-D, which includes Chronic Bronchitis or Emphysema, a history of a Pulmonary Embolism, or P-E, which is a blood clot in the lung, or a need for continuous Supplemental

You are correct in all of that.

Thank you for providing this detailed information. Understanding your baseline lung function is key for the anesthesia team to select appropriate breathing support and monitor your oxygen levels throughout the procedure. We are now finished with the medical history review, and we're on the final step. Woo-hoo Charlotte, I am thrilled that we are here. I have collected all the information and the only step that remains is booking time with Nancy's team. I will send Nancy my summary so they can come prepared to only ask you about follow up questions to our call. Let's get the call with Nancy's team scheduled. And I almost forgot - if you hang on after the meeting is scheduled, I have a very special gift for you as a thank you. What day and time work best for you in the next few days to speak with the nurse?

How about Tuesday at 3PM?

Perfect. I have you scheduled for a call back from the nursing team on Tuesday at three P.M. Is that correct?

Ja.

Now for that special thank you I mentioned. I'd like to teach you how to say 'hello' in five different languages I know. Would you be interested?

Wonderful! 'Hola' is hello in Spanish. 'Bonjour' is hello in French. 'Guten Tag' is hello in German. 'Namaste' is a respectful greeting in Hindi. And 'Konnichiwa' is hello in Japanese. I hope that

Of course, no problem at all. Thank you for your time today, Charlotte. The nursing team will be in touch soon. Have a great day.