Reflection on Nursing Communication Scenario

Reflection on Nursing Communication Scenario

This essay is a reflection on nursing communication scenario. Study it to acquire knowledge that you can use to create your own reflection essay on a nursing communication scenario.

Introduction to Reflection on Nursing Communication Scenario Essay

The nurse’s job requires a lot of communication. Therapeutic communication is emphasized as a core aspect of nursing and the main focus of nursing practice by theorists such as Peplau (1952), Rogers (1970), and King (1971). Long (1992) goes on to say that presence, listening, perception, caring, disclosure, acceptance, empathy, honesty, and respect are all important aspects of communication. While communication may help to form a therapeutic connection, it can also create barriers between clients and staff, according to Stuart and Sundeen (1991, p.127).

Communication in healthcare may be seen as a dynamic and ever-changing transitional process (Hargie, Saunders, and Dickenson, 1994, p.329). Communication between the nurse and the patient is the most important aspect of it. Information should be communicated if the encounter is to be meaningful; this requires the nurse to take a planned, comprehensive approach, which finally becomes the foundation of a therapeutic relationship.

Poor communication, according to Fielding and Llewelyn (1987), is the leading source of patient complaints. Young (1995) backs this up, stating that one-third of complaints to the Health Service Commissioner were about communication with nursing personnel. According to studies by Boore (1979) and Devine and Cook (1983), excellent communication really aided the pace of patient recovery, resulting in shorter hospital stay periods. This shows that having strong communication skills is a wise investment.

I’ve commented on incidents that occurred throughout my clinical work experience in this project. These experiences have aided in the development and application of my interpersonal abilities, as well as the maintenance of therapeutic connections with patients. Gibbs’ (1988) reflective cycle served as the context for my reflection in this case.

Gibbs’ (1988) reflective cycle in nursing practice and learning from experiences has six steps.

  1. Description of the situation that arose.
  2. Conclusion of what else would I could have done.
  3. Action plan is there so I can prepare if the situation rises again.
  4. Analysis of the feeling
  5. Evaluation of the experience
  6. Analysis to make sense of the experience

My Reflective Cycle

The value of reflective practice is shown by Baird and Winter (2005). They claim that reflecting will aid in the generation of knowledge and professional practice, as well as the capacity to adjust to new conditions, self-esteem, and work happiness. Siviter (2004), on the other hand, defines reflection as “gaining self-confidence, recognizing methods to develop, learning from one’s own errors and behavior, looking at other people’s viewpoints, being self-aware, and improving one’s future by learning from the past.”

I’ve realized that it’s critical for me to help my patients develop and create therapeutic connections with them by assisting them in establishing a rapport based on trust and mutual understanding, therefore forming the unique bond between patient and nurse defined by Harkreader and Hogan (2004). According to Peplau (1952), as referenced by Harkreader and Hogan (2004), effective contact in therapeutic interactions fosters trust and raises the patient’s self-esteem, which frequently leads to personal progress.

The goal of therapeutic communication, according to Ruesh (1961), as described by Arnold and Boggs (2007), is to increase the patient’s capacity to function. As a result, a nurse must exhibit particular attributes, such as compassion, honesty, empathy, and trustworthiness, in order to build a therapeutic nurse/patient contact (Kathol, 2003). (P.33). Interpersonal skills may be used to exhibit these attributes via creating good communication and relationships. Interpersonal skills, according to Johnson (2008), are the capacity to communicate successfully.

Communication, according to Chitty and Black (2007, p 218), is the simultaneous verbal and nonverbal exchange of information, thoughts, and ideas. They emphasize that, although verbal communication focuses on the spoken word, nonverbal communication, which includes gestures, postures, facial expressions, as well as the tone and volume of one’s voice, is just as significant. As a result, the formation of therapeutic connections between the nurse and the patient through interpersonal skills is the focus of my reflection in this project.

My perspective is on a specific patient, whom I will refer to as Mr. R in order to protect patient information confidentiality (NMC, 2004). It is about an incident that occurred when I was working on a surgical ward. Female and male surgery patients were encouraged to mix despite the fact that there were separate wards for them. I spotted one of the male patients sitting alone in his bed on this particular day. Mr. R., a 64-year-old man, had been diagnosed with pancreatic cancer that was incurable and had a life expectancy of 18-24 months.

Mr. R. was unable to regulate his agony, and although chemotherapy might give some respite, he had a thorough awareness of his disease and understood there was no solution. He was unable to walk alone and required aid simply to stand or sit. I volunteered to fetch him his cup of tea because of his mobility issues, and then I sat with him since he was lonely.

Now I’d like to talk about the sentiments and ideas I had at the moment. I approached Mr. R. in a polite way and introduced myself before giving him his cup of tea; I sought to develop a good relationship with him since I wanted him to feel at ease with me despite the fact that I was not a family member or related.

Mr. R. stared at me when I initially asked if I could bring him a cup of tea and said, “I have asked the girl for a cup of tea, but I don’t know where she is.” “Well, I’ll see where she is, and if I can’t locate her, I’ll happily fetch one for you, Mr. R,” I said. I displayed emphatic listening by doing so. Wold (2004, p 13) defines emphatic listening as a desire to comprehend the other person rather than evaluating them only on their appearance.

Then I put my hands on MrR.’s shoulders, continued chatting, and increased my tone somewhat since I wasn’t sure how he would respond. At the same time, I utilized my body language to convey the drinking movement. I took a breath and repeated my motions, but this time using some basic phrases that Mr. R. would comprehend. Mr. R. gave me a nod and glanced at me. I kept eye contact with him while bringing him his cup of tea since I didn’t want him to feel uncomfortable or ashamed.

Fortunately, I was able to communicate with this person by just body language. I was apprehensive at the time that he wouldn’t understand me since English wasn’t my first language, but I was able to communicate well with him utilizing both verbal and nonverbal techniques, as well as appropriate gestures and facial expressions. Nonverbal communication includes body language and facial emotions (Funnell et al. 2005 p.443). I kept thinking that I needed to work on my English so that he could understand and interpret my behaviors better. I considered the potential for a language barrier to prevent verbal communication.

The language barrier emerges when people come from different socioeconomic backgrounds or use slang or colloquial words in discussion, according to Castledine (2002, p.923). Fortunately, the specific movements and facial expressions I employed while interacting with Mr. R. helped him grasp that I was providing him support. I kept eye contact with him to demonstrate my eagerness to assist him; it reassured him and encouraged him to put his trust in me.

Direct eye contact shows a feeling of interest in the other person and gives another method of communication, according to Caris-Verhallen et al (1999). I attempted to speak in the best and most suitable manner possible with Mr. R. in order to make him feel at ease; as a consequence, he put his faith in me and was more cooperative.

Evaluation

In assessing my actions, I believe I acted appropriately since I offered Mr. R. both the support he need and some companionship. I was effective in establishing a nurse-patient connection. Despite the fact that McCabe (2004, p-44) would classify this as task-centered communication – one of the main components lacking in nurse communication – I believe the case contained both effective patient and task-centered communication.

Because Mr. R. was unable to do some chores owing to mobility issues and was now rejecting treatment, I believe I treated him with empathy. It was my responsibility to ensure that he was at ease and that he felt supported and comforted. My engagement in the nurse-patient interaction did not stop at task-centered communication; it also included a patient-centered approach that covered fundamental skills for providing warmth and empathy to the patient.

In my interactions with Mr. R, I discovered that I was able to increase my nonverbal communication abilities. He gave very little information when he initially mentioned getting chemotherapy, emphasizing the importance of nonverbal communication. Nonverbal communication becomes vital when talking with older persons who have terminal cancer, according to Caris-Verhallen et al (1999, p.809) (Hollman et al 2005, p.31)

There are several effective ways to maximize communication with people, such as attempting to gain the person’s attention before speaking – this makes one more visible and helps to prevent the person from feeling intimidated or under any kind of pressure; using sensitive touch can also help them feel more at ease. I believe that my engagement with Mr. R. was good to me since it taught me how to alter my verbal and nonverbal communication abilities.

Because communication with Mr.R. was difficult due to the language barrier, I employed body language to its best potential. To promote Mr. R.’s engagement, I selected basic language that he could comprehend. Gestures are a sort of nonverbal communication used to communicate thoughts, according to Wold (2004, p.76). They are important for persons who have poor verbal communication abilities.

I also utilized facial expressions to persuade him to undergo chemotherapy, which would not cure his issue but would provide him with some respite and make him feel better. Although facial expressions are the most expressive form of nonverbal communication, they are constrained by cultural and age boundaries (Wold 2004 p.76). My facial gestures were designed to persuade Mr. R. to rethink his chemotherapy treatment choice. While I couldn’t get into all of the specifics of his therapy, I was able to urge him to finish it in order to relieve his problems.

Analysis

In order to assess the scenario, I’d want to assess the critical communication skills that allowed me to offer Mr. R the greatest possible nursing care. Mr. R. and I had to deal with interpersonal communication, which is communication between two individuals (Funnell et al 2005, p-438). Even though Mr. R. could only comprehend a few of the things I was saying, I realized that nonverbal communication helped me a lot in providing him with adequate nursing care.

One of the issues I saw with this kind of communication was the language barrier, but I persevered by using suitable communication skills to help the discourse. Although it was tough at first, using nonverbal communication skills encouraged him to talk and enabled him to comprehend what I was saying.

Mr. R. was able to react when I asked him the question without making me wait for an answer he couldn’t provide. Communication, according to Funnell et al (2005, p 438), happens when a person reacts to a message and gives meaning to it. By nodding his head, Mr. R. had signaled his agreement. This channel is one of the major components of communication strategies and processes, according to Delaune and Ladner (2002, P-191). It is used as a medium to send out messages, according to Delaune and Ladner (2002, P-191).

Mr. R. also provided feedback by demonstrating that he was able to decipher the signals expressed via my body language, facial expression, and eye contact. As a result, the communication channels I employed may be classified as both visual and audible. The sender gets information when the receiver replies to the message, according to Delaune and Ladner (2002, p.191), however Chitty and Black (2007, p.218) describe feedback as a reaction to a message.

In this case, I was the sender who sent the message to Mr. R., and Mr. R. was the recipient who accepted to speak with me about his chemotherapy treatment and enabled me to help. Consequently, I believe that my contacts with Mr. R. comprised the 5 important components of communication stated by Delaune and Ladner (2002, p.191) i.e. senders, message, channel, receiver, and feedback.

Reflecting on this occurrence helped me to investigate how communication skills play a critical part in the nurse and patient interaction in the delivery of patient-focused care. While attempting to help Mr. R. in walking, I saw that he required time to adjust to the changes in his activities of daily life. I was also thinking about how to promote successful and effective communication in order to achieve a positive nursing result.

I came to the conclusion that building a connection with Mr. R. was critical in encouraging him to engage in the conversation both vocally and nonverbally. This may therefore give him the confidence to speak successfully with the other staff nurses, preventing him from being overlooked because of his age or incapacity to comprehend the information provided to him about his therapy and its advantages.

For future reference, I’ve created a clinical practice action plan. I would make sure I was well prepared to deal with patients who couldn’t communicate properly if they needed assistance with feeding or other procedures. This is because it is my responsibility as a nurse to guarantee that patients get the best possible care. To do so, I need to be able to successfully interact with patients in a variety of scenarios and with patients with varying requirements. I must communicate well since it is critical for me to understand what patients need the most throughout their time on the ward under my care.

Despite my extensive expertise in this sector, communication is still an important aspect of the nursing process that must be fostered in nurse-patient interactions. Communication, according to Wood (2006, p.13), is the key to unlocking the basis of relationships. If you want to learn about a patient’s specific health situation, good communication is crucial (Walsh, 2005, p.30). When dealing with patients, active learning may also assist in identifying communication hurdles.

Reflection on Nursing Communication Scenario
A nurse Communicating with a patient

Active learning implies listening without making judgments; I always strive to listen to patients’ thoughts or concerns because this offers me the chance to understand the patients’ viewpoint (Arnold, 2007, p.201) (Arnold, 2007, p.201). On the other hand, it is vital to prevent the hurdles that develop in communicating with the patients and be able to recognize linguistic difficulties.

This may be done by interviewing patients about their health and by asking them whether they need support in their everyday activities. I started about removing such impediments by asking open-ended questions and interrupting when required to acquire further data (Funnell et al, 2005, p.453) (Funnell et al, 2005, p.453).

Walsh (2005, p.31) also points out that stereotyping and making assumptions about patients, by forming judgments on first impressions and a lack of understanding of communication skills are the biggest hurdles to successful communication. I must not condemn patients by making assumptions on my initial impression but instead, go out of my way to make the patient feel respected as an individual. I should respect each patient’s underlying values, beliefs, culture, and unique modes of communication (Heath, 300, p.27).

I should be able to know how to establish a rapport with each patient. Cellini (1998, p.49) suggests a number of ways in which this can be achieved, including making oneself visible to the patient, anticipating patients’ needs, being reliable, listening effectively; all these factors will give me guidelines to improve my communication skills. Another important consideration in my action plan is the need to account for any disabilities that patients may have, such as hearing loss, vision impairment, or mental illness. This may help the patient regain control and make the best use of their body language.

Once I’ve established that a patient has a disability, I’ll be able to plan ahead of time, deciding on the most appropriate and effective means of communication. According to Heath (2000, p.28), communicating with patients who have disabilities necessitates a unique set of skills and considerations.

When talking with impaired persons or the hard of hearing, Nazarko (2004, p.9) proposes that instead of repeating oneself, one should attempt to paraphrase what one is saying in ways they can comprehend, such as speaking a bit more slowly. Due to the aging process, hearing loss is the most frequent impairment among adults (Schofield. 2002, p.21).

In a nutshell, my action plan will demonstrate how to develop a solid relationship with the patient by recognizing what influences the patient’s capacity to communicate effectively and how to minimize future communication hurdles.

Conclusion

Reflection on Nursing Communication Scenario
Gibbs Reflective Cycle

In conclusion, I have explored the value of reflection in nursing practice and the rationale for using Gibbs’ (1988) reflective cycle as the framework for my reflection. I believe I have covered each step of the cycle and shown my capacity to create therapeutic relationships via the use of interpersonal skills in my interactions with one specific patient.

The majority of the reflective cycle (Gibbs 1988) seems to apply to the circumstance on which I’ve reflected. I doubt I would have had the confidence to explore the problem in any detail without the paradigm of organized reflection (Graham referenced in Johns 1997 a, p.91-92), and I worry reflection would have stayed at a descriptive level.

As explained by Boud Keogh and Walker (1985, p.19), reflection in the context of learning is a general word for those intellectual and effective actions in which people engage to investigate their experiences in order to lead to greater knowledge and appreciation.

Reflective learning, according to Boyd & Fales (1983, p.100), is the act of inwardly investigating and addressing a concern triggered by an experience that produces and clarifies meaning in terms of self and leads to a shift in conceptual viewpoint. However, I think that the reflective process is solely determined by each person’s personality and beliefs, as well as their attitude and approach to life.

Appendix

Mr. R., a 64-year-old gentleman, was an inpatient in a surgical ward. Earlier that day his consultant had directly informed him that he had inoperable cancer of the pancreas with a life expectancy of 18-24 months. Some relief might be offered by chemotherapy, but there was no cure. Mr. R. was understandably shocked but had suspected the diagnosis. At that time he remained in the care of the specialist nurse. Later in the day, as I was passing through the ward, I notice Mr. R. alone on his bed.

1. Prescriptive

A prescriptive intervention seeks to direct the behavior of the client, usually behavior that is outside the client-practitioner relationship. My first intervention was to open the conversation and demonstrate warmth. I provided information myself and gave Mr. R. the choice of staying on his own or engaging with me. By shaking Mr. R.’s hands I was attempting to provide reassurance and support as well as communicating warmth in order to reduce his anxiety and promote an effective nurse-patient relationship.

Practitioner: Hello Mr. R, I am one of the nurses here this morning with Dr. M. Is there anything I can get you, or would you rather be on your own? (Shook hands).

Mr. R: NO, I remember you from this morning, come and sit down. I’ve asked the girl for a cup of tea, I don’t know where she’s got to.

Practitioner: Well give me a minute and I’ll bring you one in. Do you take sugar?

Mr. R: I suppose I shouldn’t, then why to worry. Two, please.

Practitioner: (Returning with a cup of tea) Here we are, don’t blame me if it’s horrible, I got it from the trolley. (I smiled at Mr.R. and tried to establish eye contact, then sat down in the chair next to him).

Mr. R: Thanks, that’s just what I need.

2. Informative

An informative intervention seeks to impart knowledge, information, and meaning to the patient. My intention was to reinforce the nurse-patient relationship by smiling and attempting to establish eye contact as well as using facial expressions to put the patient at ease and establish a good rapport. Making Mr. R a cup of tea it created a pleasant response in a time of crisis.

Practitioner: Jane (specialist nurse) was here this morning, what did you think about what she had to say?

Mr. R: Oh yes she was very nice, mind you, I’m an old hand at this, I looked after my wife when she had cancer.

Mr. R: She was riddled with cancer, but we kept her at home and looked after her. She could make a cracking cup of tea (Mr.R. smiles)

Practitioner: (smiles and nods) When did she pass away?

3. Confronting

A confronting intervention seeks to raise the client’s consciousness about limiting behavior or attitudes of which they are relatively unaware. By meeting the patients’ needs at that time I felt the urge to continue to show a display of warmth and develop the relationship further.

Mr. R: It will be two years next month that she died.

Practitioner: You must miss her.

Mr. R: There’s not a day goes by that I don’t talk to her. Goodness knows what she would make of all this, it’s brought it all back.

4. Cathartic

A cathartic intervention seeks to enable the client to discharge/react to a painful emotion – primarily grief, fear, and/or anger. Mr. R spoke emotively and angrily by using such words as ‘riddled’ and ‘cancer’. He spoke loudly and angrily with congruent non-verbal cues.

Practitioner: Has what you’ve been discussing with Jane reminded you of your wife’s death?

Mr. R: Yes, (patient covers his face with his hands).

Practitioner: What is it about what you’ve heard that is worrying you, do you think you can tell me?

5. Catalytic

A catalytic intervention seeks to elicit self-discovery, self-direct living, learning, and problem-solving in the client. Mr. R had a broad scope in which to discuss any concerns he may have had, but his response only concerned his wife, not him as his wife was the one who suffered from cancer.

Mr. R: (Pause) ..I’m an old hand at this and I don’t want any of that chemo.

Practitioner: What is it about the chemotherapy you don’t like?

Mr. R: My wife had it and we went through hell.

Practitioner: You went through hell

Mr. R: The doctors made her have the chemo and she still died in agony.

6. Supportive

A supportive intervention seeks to affirm the worth and value of the client’s personality, qualities, attitudes, and actions. It is done to encourage the client to say more and to explore the issue further. Support is provided by non-verbal means like giving warmth, supportive posture, and maintaining eye contact. I wanted to convince Mr. R that I was interested in what he had to say and help him believe that he was worth listening to – that his opinions really mattered.

Practitioner: Do you think the same thing will happen to you?

Mr. R: Yes, that’s the one thing I’m worried about.

Practitioner: em, if I’m honest with you chemotherapy treatment is not a subject I know a lot about. (Pause), would you like to see the specialist nurse again? She can go over things with you and explain your options.

Mr. R Well if she doesn’t mind, I’m just not sure the chemo will be worth it.

Learning outcomes

From this experience, I have learned the importance of:-

Practice in accordance with the NMC (2004) code of professional conduct, performance, when caring for adult patients including confidentially, informed consent, accountability, patient advocacy, and a safe environment.

Demonstrating fair and anti-discriminatory behavior, acknowledging differences in the beliefs, spiritual and cultural practices of individuals.

Understanding the rationale for undertaking and documenting, a comprehensive, systematic, and accurate nursing assessment of physical, psychological, social, and spiritual needs.

Interpreting assessment data to prioritize interventions in evidence-based plan of care.

Discussing factors that will influence the effective working relationships between health and social care teams.

Demonstrating the ability to critically reflect upon practice.

Frequently Asked Questions (FAQs)

1. What is reflective practice and why is it important in healthcare?

The value of reflective practice is shown by Baird and Winter (2005). They claim that reflecting will aid in the generation of knowledge and professional practice, as well as the capacity to adjust to new conditions, self-esteem, and work happiness. Siviter (2004), on the other hand, defines reflection as “gaining self-confidence, recognizing methods to develop, learning from one’s own errors and behavior, looking at other people’s viewpoints, being self-aware, and improving one’s future by learning from the past.”

2. What does communication mean in health?

Communication in healthcare may be seen of as a dynamic and ever-changing transitional process (Hargie, Saunders and Dickenson, 1994, p.329). Communication between the nurse and the patient is the most important aspect of it. Information should be communicated if the encounter is to be meaningful; this requires the nurse to take a planned, comprehensive approach, which finally becomes the foundation of a therapeutic relationship.

3. How is Gibbs reflective cycle used in nursing?

Gibbs’ (1988) reflective cycle in nursing practice and learning from experiences has six steps.

  1. Description of the situation that arose.
  2. Conclusion of what else would I could have done.
  3. Action plan is there so I can prepare if the situation rises again.
  4. Analysis of the feeling
  5. Evaluation of the experience
  6. Analysis to make sense of the experience

4. What is your idea of reflective learning?

Reflective learning, according to Boyd & Fales (1983, p.100), is the act of inwardly investigating and addressing a concern triggered by an experience that produces and clarifies meaning in terms of self and leads to a shift in conceptual viewpoint. However, I think that the reflective process is solely determined by each person’s personality and beliefs, as well as their attitude and approach to life.

Reflection on Nursing Communication Scenario

 

 

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