health needs of your command in a professional and expeditious manner. The sick call supervisor should  encourage  staff  personnel  to  share interesting or infrequently seen medical cases with the health care team and, if deemed significant, incorporate   those   cases   into   the   command’s inservice training programs. Sick call supervisors exercise  the  essential  responsibility  to  address patient complaints, and in this capacity, the sick call   supervisor   serves   as   the   patient   contact representative. Complaints need to be evaluated fairly  and  objectively  to  identify  the  cause  of problems  and  to  act  upon  resolutions.  Con- tinuing  education  in  the  area  of  patient  contact must  be  rigidly  and  aggressively  supported. The “right man for the job” keys the sick call supervisor  to  be  an  effective  manager.  In  this regard,   the   senior   hospital   corpsman   must understand the process of delegating authority to his staff and must maintain effective communica- tions  between  departments  and  individuals. Facilitating a good sick call can be one of the most challenging  assignments  facing  an  independent duty corpsman. Sound leadership skills combined with  effective  management  practices  will  result  in a  productive,  effective  sick  call  visit,  satisfying  the needs  of  the  patient  and  command. MEDICAL   DIAGNOSIS AND   TREATMENT The concerns of the hospital corpsman when confronted  with  a  patient  are  evaluation  and diagnosis. This is especially important for injuries, trauma, and severe pain. When a patient comes to sick call, it is a must to obtain a careful history first, followed by a careful physical examination, diagnosis, and appropriate treatment within the skills   of   the   hospital   corpsman.   An   effective corpsman  recognizes  the  limits  of  his  or  her expertise  and  obtains  additional  medical  help when necessary. The medical history plus the physical examina- tion form the basis for establishing the diagnosis and instituting a course of treatment. The medical history  makes  the  physical  examination  more meaningful  and  not  just  a  mechanical  routine, The  patient  may  be  confused,  nervous, fearful, insecure, resentful, and even argumenta- tive. To deal with these emotions and attitudes, you  will  need  a  professional  bedside  manner.  This can  be  achieved  by  cultivating  a  professional attitude,   sincerity,   understanding,   mental maturity,  and  compassion.  Corpsmen  should never  allow  themselves  to  take  a  moralistic attitude  or  to  condemn  or  condone  a  patient’s behavior. MEDICAL  HISTORY The  history  taking  begins  when  the  patient arrives in sick call. The patient should be observed for  any  overt  signs  and  symptoms,  reactions  to questions,  alertness,  attitude  toward  the  corpsman and  his  or  her  illness,  and  level  of  intelligence. Before  asking  the  patient  direct  questions,  the corpsman  should  let  the  patient  talk  freely  and listen  to  the  patient’s  story.  Remember  active listening is a valuable skill. When the patient has related the story in his or  her  own  words,  it  is  time  to  ask  specific questions. Keep the questions simple and on the patient’s  level.  Ask  the  patient  to  describe  the problem or pain including the duration, nature, location,  date  and  type  of  onset,  and  what  relieves or aggravates it. Remember that each history is an  individual  experience  and  should  not  be stereotyped,  but  rather  adjusted  to  each  indi- vidual’s   specific   problem.   Fear,   confusion, rambling,  exaggeration,  and  minimization  are obstacles  to  eliciting  a  good  medical  history.  They must  be  overcome  to  get  the  data  necessary  to establish a diagnosis. The following outline is a helpful guideline to use  in  obtaining  the  medical  history: .  Biographical  Data—Obtain  the  patient’s full name, age, sex, race, SSN, nationality, marital status,  and  occupation. .   Chief   Complaint—Main   reason   for coming  to  sick  call. .  History  of  Present  Illness—Phrase  ques- tions  so  that  the  patient  provides  the  needed information, and try to avoid leading questions. The  patient  should  describe  discomfort  or  un- pleasant sensations. Have the patient elaborate on the chief complaint, including the date, mode, course, and duration of onset. Find out how each symptom first made its appearance, whether it was abrupt or gradual, how long it lasted, and whether it was persistent or intermittent. Determine the location  and  whether  or  not  it  radiates  and  where it radiates to. Determine if there are any lesser symptoms that accompany the major complaint. Note any absences or cessations of the symptoms and any cycles they undergo. Elicit information regarding  any  previous  treatments,  or  self- treatment,  and  the  effect  of  such  treatment. 2-2