Nursing and Communication Analysis

Communication Even Analysis
This report is to reflect on a particular event that occurred during my placement at a general hospital. The placement afforded me a firsthand experience of the importance of communication skills in nursing practice. Effective communication is an essential component of medical practice which improves the quality of treatment given to patients. It is an integral part of Hippocratic medicine, and it not only inspires a recovery-oriented medical practice but also establishes a trusting patient-care provider relationship. (Kourkota & Papathanasiou 2014 ). It is the best tool for calming an intense atmosphere in a healthcare environment, achieving the full cooperation of the patients, and aiding a rapid recovery. Such was my experience with a 43-year-old psychiatrist-patient at the hospital where I had my placement. Jane was a widow, a mother of two children, ages ten and eight. Jane had irritability, restlessness, and some other symptoms of clinical depression. She had spent about five weeks at the hospital, and her condition was getting back to normal. However, a few days to the night I had interaction with her, she had been showing some signs of relapse in her recovery process.
Suddenly, Jane stopped taking her medications, started displaying aggression at people around her and preferred to be all alone. I became interested in Jane’s case and was willing to help her the best possible way I could. To have a full understanding of her condition, I approached the resident nurse to know more about Jane’s health challenge. According to the information I gathered, Jane had a happy life with her husband and two children until she lost her husband in a car crash a few months before her admission at the hospital. The death came as a shock to her. Since then, the more she tried to move on and concentrate on raising her children, the more difficult it was for her. So, she resulted in alcohol to help her forget her sorrow. After a few weeks into her alcohol indulgence, Jane became addicted and would take several bottles of beer and became heavily drunk at nights. Soon after, her new lifestyle started affecting her performance at work and later made her lose her job. Being bereaved and experiencing a job loss in quick succession was too much for Jane to bear and the overall effects led to depression.
Having known the cause of her health condition, I became more determined to speak to her. I went into her ward and met her soliloquising as she always did. Then I moved close to her and sat on the chair beside her bed. At first, she attempted to snap at me and distance herself from me, but I gave her a reassuring look, which later made her become calm and was ready to listen to me. During our conversation, Jane told me she stopped taking her medications because she would rather remain in her depressive health state than to be out there without her beloved husband. She could not imagine the possibility of living a normal life again without her husband. In the beginning, Jane spoke like someone who had given up on living, but as we went further, I succeeded in convincing her that she still had so much to live for. While I was committed to helping Jane using interpersonal-engagement, I also realised that I had to uphold both legal and ethical rights of my patient, which include giving care on a voluntary basis (“Mental Health Legislation” 2017). So, I began my communication using open question; thus, "Jane, could you please tell me how you feel right now?"
The simple question led to about thirty minutes chat between us, which afforded me the opportunity to make her realise that everyone at the hospital sincerely cared for her, and are willing to help her. I was able to convince her on why she needed to take her medications, so she could be there for her two children whom she claimed to "love so much" during our conversation. After my interaction with her, Jane became friendly and was ready to take her medications. From that moment until my last day at the hospital, she started showing a rapid recovery.
Just like Jane, most depressed patients are usually given general treatment and barely listened to by health practitioners. The general assumption in Jane’s case was that she was only displaying the usual symptoms of depression. However, as a nurse student with the knowledge of person-centred care, I knew, there was a need for a clinical relevant intervention that is peculiar to each patient. Person-centred care is the concept of having empathy and respect for patients, and being ready to go extra length in helping them lead the life they desire (Levett-Jones and Bourgeois 2011, p.7). This effective medical practice initiative, among other things, helps in establishing an atmosphere of confidence and trust between the patient and the healthcare professional; creating a relaxing atmosphere; and removing every element of doubt and suspicion from the client. In person-centred care, the patient becomes the focus of the care, and all effort is geared towards understanding her personality and linking her past to the present in order to know the best way to help her.
With this in mind, I employed an interpersonal engagement approach in Jane’s case. As widely recommended in medical practice, one of the best ways to adequately care for a depression patient is to create time to engage her in a conversation about her current thoughts. Knowing the exact reason behind Jane's case really helped in having effective therapeutic communication with her. According to the Nursing and Midwifery Board of Australia’s 2018 Code for Nurses and Midwives, some of the required techniques for professional therapeutic communication are active listening, recognising the patient’s individuality without any value judgements, and the usage of open questions to “elicit more information” (Tollefson & Hillman 2019 p.11). As stated above, striking a conversation with Jane was difficult at first because she appeared to be both suspicious and apprehensive as she always did whenever any nurse comes into her ward. However, with the therapeutic communication initiative, she eventually cooperated.
Ruminating on the experience, I can recollect that Jane did more of the talking after I succeeded in creating a friendly atmosphere. Listening keenly to Jane helped me in reflecting on her words and interjecting when necessary to keep the conversation alive. At some point, I asked her to tell me about her children, which she did with enthusiasm written all over her face. For the first time during our conversation and my entire stay at the hospital, Jane put on a smiling face as she talked about her children. This made me realise that she had not completely given up on living, after all. Therefore, it presented me the opportunity of letting her see more reason while she should overcome her depressive state. Throughout our conversation, I made use of body language by keeping eyes contact to assure her that I was wholeheartedly listening, and periodically gesturing her with hand movement to encourage her to speak on anytime she appeared to be holding back midway in her speech.
The encounter with Jane enlightened me about the value of person-centred care and the efficacy of effective communication in medical practice. Through the experience, I practically learnt to avoid generalisation and treat every case differently in my nursing practice. Moreover, I have also discovered that professionals in medical practice should always be ready to influence an atmosphere of trust and regard at all times in their discharge of duty. The art of effective communication skills will always be one of the determinants of patient satisfaction in health service. (Chandra, Mohammadnezhad & Ward 2018, p.3). Empathy, respect, and compassion are, therefore, fundamental aspects of nursing practice which no healthcare provider should neglect when dealing with patients.


References
Chandra, S. Mohammadnezhad, M. and Ward, P. (2018). Trust and Communication in a DoctorPatient Relationship: A Literature Review. Journal of Healthcare Communications ISSN 2472-1654, 3, 1-6.
http://healthcare-communications.imedpub.com/trust-and-communication-in-a-doctorpatient-relationship-a-literature-review.pdf
Levett-Jones, T. & Bourgeois, S. (2011). The Clinical Placement: An Essential Guide for Nursing Student. Churchill Livingstone Elsevier. 2nd Edition.
“Mental health legislation” and psychiatrists: putting the principles into practice (2017). The Royal Australian & New Zealand College of Psychiatrists.
https://www.ranzcp.org/news-policy/policy-submissions-reports/document-library/mental-health-legislation-and-psychiatrists-putti
Kourkota & Papathanasiou (2014). Communication in Nursing Practice. Journal of the Academic of Medical Science of Bosnia and Herzegovina. doi: 10.5455/msm.2014.26.65-671, 65–67. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376/
Tollefson, J. & Hillman, E. (2019). Clinical Psychomotor Skills: Assessment Tools for Nurses. 3-Point Standard Assessment, Cengage Learning Australia Pty Limited. 7th edition.