MR. NICHOLSON
I just made a cup of tea. Can I get one for you?

WANDA
No thank you, sir. Okay, let's see here. If we move along, I can get a lot of this answered. Let's see, we have your correct address, doctor's name…want to hand me that Medicare card again, please?

MR. NICHOLSON
I'm so glad that you could come…

WANDA
I see your daughter's phone is listed on your information. Does she help you out?

MR. NICHOLSON
Sure.

WANDA
It looks like she lives nearby.

MR. NICHOLSON
She's really just a few blocks away.

WANDA
How often would you say she comes over? She doesn't help you with the bathing, does she?

MR. NICHOLSON
She's awfully busy. She has a very good job. You know, a lot of people are losing their jobs these days. Oh, I don't need much help. I can get my bath okay. She'll probably bring me a few things from the store today.

WANDA
Good. That's nice. Good.

WANDA
Let's see, about your vision, I see you have glasses on. Read okay? Can you see my fingers if I hold them up? Can you see them now?

WANDA
Okay, Mr. Nicholson, I just want to watch you do a few things. How about first we try and go ahead and let's get you into bed and let's see how easy it is for you to get out of bed. And, um, we'll go from there. Well, that doesn't appear to be but so difficult for you.

MR. NICHOLSON
No. No problem, as long as I go slow.

WANDA
Great. Just a second. You said something a few minutes ago that I'd like to follow up on. You said you get kind of anxious at times. Would that be less than daily, daily but not constantly, all of the time maybe?

NARRATOR
How does this interview sound to you? Is Wanda letting the actual OASIS items guide the visit? What's happening? Is the form controlling the interaction? Is she missing some important information? What else might you have asked? How would you say it? Would you need to see more? What would you like to observe? When might be best to observe? It's true Wanda can mark responses on certain OASIS items. But would they be accurate and reflect a full picture of Mr. Nicholson's needs?

WANDA
Now, can you take these at the correct times, or do you need daily reminders for these?

MR. NICHOLSON
No, I'm just fine. See my list here? It tells me the times.

WANDA
All right, got that down. Now, in a minute I need to watch you walk to the bathroom. Do you ever have periods of incontinence? You know, can't quite make it to the bathroom? And if so, would that be the night only, or the day and the night?

MR. NICHOLSON
Ahhh, I don't want to talk about this, okay?

WANDA
Sir, please bear with me.

NARRATOR
Direct questioning makes patients feel like they're being categorized. They're likely to feel like they're being overlooked and just as likely to give one or two word answers. Guided conversation is more comfortable and lets you concentrate on functional categories. Focused conversation is even more precise and follows guided conversation as the visit progresses, especially in places where what you are seeing just doesn't match what the patient is telling you. In this lesson you are taking a serious look at your own assessment skills, what works and doesn't work, and what affects how you conduct an assessment. In the lessons that follow, specific scenarios will reinforce these assessment techniques.

WANDA
Works for me.