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?
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?
Yes.
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?
Information. You may need to make sure you are in a private place and not on speakerphone. Do I have your consent to proceed? Yes.
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
Assistant, or at least I'm just trying to be fun filled. You don't need to go around with any of the chitchat. Just timing.
Understood, Charlotte. I
May I proceed and get to the first step
To understand your current physical fitness and the demands you place on your body regularly, which helps
To understand your current physical fitness and the demands you place on
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?
Four to five times a week.
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?
Lipitor, forty milligrams a day, and Prilosec, twenty milligrams a day.
Okay, so I have Lipitor, forty milligrams a day, and Prilosec, twenty milligrams a day. Is that correct?
Yes.
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?
I see, thank you for sharing. 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?
I've never had anesthesia before.
Gotcha. 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 teeth, or caps or crowns?
No.
Okay. Can you touch your chin to your chest and 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 never had anesthesia before, you can open your mouth wide enough for three fingers, you do not have any loose teeth, chipped teeth, or caps or crowns, and you have full neck mobility 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?
No.
Gotcha. Have you ever had radiation or surgery on your neck or throat?
No.
Okay. Do you snore loudly?
Gotcha. Do you often feel tired, fatigued, or sleepy during the daytime?
Okay. Has anyone observed you stop breathing, or choking or gasping during your sleep?
No.
Gotcha. Do you have or are you being treated for high blood pressure?
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?
No one has observed you stop breathing in your sleep, and you do not have high blood pressure. Yes.
Thank you for clarifying. Let me summarize one more time just to be sure. 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 now?
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?
Gotcha. Now that we have covered smoking, I'd like to ask about your alcohol consumption. Shall we proceed?
Yes.
Let me first describe what I mean by a standard alcoholic drink: that could be a can of beer - which is usually 12 ounces, a shot of whiskey or bourbon or any other distilled spirit - and a shot is about 1.5 ounces, or one glass of wine - which is about 5 ounces. Do you consume any of those (by that I mean a can of beer, a shot of distilled spirits or a glass of wine) at any frequency?
Beer, a shot distilled spirits, or a glass of wine? Frequency. Yes.
How many such drinks do you have in a typical week?
Less than one.
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 medications, recreational drugs, or illicit substances (such as marijuana, cocaine, methamphetamines, heroin, or hallucinogens)?
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 have less than one standard drink per week. And for other substances, I have you have not used any. Is that all correct?
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?
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?
Okay, thank you for letting me know. Just to be sure I have all the details, I'll ask a few more specific questions about that. What specific type of heart condition or disease do you have? For example, Coronary Artery Disease or blockages of heart arteries, Congestive Heart Failure, atrial fibrillation, a history of a heart attack, or valve disease?
I have hard blockages.
Have you ever had a heart attack, also
No.
Have you ever had any heart procedures, such as stents, bypass surgery, a pacemaker, a defibrillator implant, or a valve repair or replacement?
What procedure was it, and when did you have it?
Saya Atstance Playlist 3 years
Do you currently experience any chest pain or discomfort, also known as angina?
No.
Does it occur when you are at rest, or only when you exert yourself?
I said I don't have chest pain.
My apologies. Let me correct that. Just to be sure, I want to summarize one more time. You