Brief description of the encounter I had with a client
In general, communication, especially the first contact with a patient, is essential; it determines the patient’s different relationship with the medical staff. In the context of the treatment process, the nurse acts as a partner, an intermediary between the patient and the treating physician. It is essential to establish a relationship of trust, so the nurse must make the patient feel at home. This situation happened in a day service center for people with intellectual disabilities where I was presented as a student nurse during my medical internship.
In my first days on the job, a woman in her sixties and her son in his thirties came to my first appointment. The young man explained that his mother had an intellectual disability due to progressive Alzheimer’s syndrome. Although the situation was complicated because the patient could not assess the situation soberly and thoroughly, so all communication mainly occurred with her son, the patient actively wanted to participate in the admission process. That is why I had to repeat the same information several times trying to avoid its mixing. This approach slightly impacted my efforts to build solid relationships between me and a patient on the basis of compassion, respect, and mutual trust.
What was my role in the encounter?
My role in this appointment was to provide an initial examination and admit the patient to the hospital.
Did I feel comfortable or uncomfortable? Why?
I felt a little uncomfortable with this situation as I had to switch my attention between the patient and her son constantly repeating the same information making sure it was not mixed or missed. This situation created tension and I was afraid to spoil relationship with my patient and her relative due to any error or negative emotions.
How did I convey or not convey my understanding to this client?
I had to use some patient communication skills, such as tolerance, respectful communication, and listening skills. I explained to the patient through phrases that showed my interest and involvement in the patient’s story. I also spoke in as friendly a tone of voice as possible and let the patient’s son know that I would understand and take as long as necessary to explain the essential information.
Were listening skills appropriate?
Communication is essential in a nurse’s work. Even if a nurse is naturally communicative, it is vital that she can analyze her contact with people and consciously use her skills to improve her professional performance. To reflect on this experience, it is necessary to evaluate my listening skills. I believe that my listening skills were appropriate to provide decent service to my patient and her son. The foundation of my communication for relationship building was participation, openness, listening, perception, concern, acceptance of others’ views, empathy, sincerity, and respect for the other person. In doing so, I also exhibited active listening skills. During the meeting, I asked follow-up questions and showed my interest in helping the patient. I feel that I could not have demonstrated better listening skills than I did in the meeting because I did everything I could to make the patient and her son feel comfortable.
How could I have improved my listening skills in this encounter?
I could learn a lot of helpful information from theoretical studies in psychology and nursing to improve my listening skills to convey understanding. For example, listening skills mean being open to the world, to the thoughts and feelings of others, explicitly expressed or implied. Listening skills require sensory understanding and refraining from making judgments about the other person. It does not involve influencing another person to change them or trying to do so. Listening skill is an active, conscious effort to form participation, not mere passive perception (Bramhall, 2014). It requires concentration, an absence of bias, and an interest in what is being said, in addition to a very understanding of what is being said. My experience during the meeting influenced my view of listening to convey understanding. I realized that I needed to focus more on the patient rather than the companion. The patient is the central figure of the appointment, and he should feel comfortable knowing that the nurse understands and accepts him.
What knowledge from theory and research (nursing and psychology) could I draw from in future to help me become more effective?
This encounter may be regarded as a stage of orientation according to Peplau’s theory of nursing as an interpersonal and therapeutic process. In general, it identifies three stages of the nursing process: orientation, working, and termination (Hagerty et al., 2017). Orientation may be regarded as the most important phase as it presupposes the formation of contact between a patient and a health care provider. From this situation, I have received an opportunity to learn more about orientation and practice it to improve my professional skills for the future. Any patient should be identified as a person with his or her unique preferences, priorities, and needs that should be considered (Hagerty et al., 2017). In addition, respect, courtesy, and positive interest to a patient should be kept through all stages of the nursing process.
How has my experience of the encounter changed my way of thinking about listening and to convey understanding to clients?
From the experience of this meeting, I learned a lot of new information about my behavior in an unusual situation as a future nurse. This meeting was unique for several reasons. Firstly, it was my first experience of communicating with a patient and her relative at the same time. Such a meeting involves the ability to correctly distribute attention so as not to leave any of the visitors unnoticed. Secondly, the patient could not fully explain her problems and needs, and her son did it for her. This created difficulties in the sense that no one except the patient knows for sure about his experiences, even his relatives. Therefore, it was essential to ask the patient’s son many clarifying questions to make sure that he was precisely thoroughly familiar with the situation. Sometimes children send their parents to help centers for people with intellectual disabilities without knowing exactly what disease they suffer from. This can have unpleasant consequences; for example, the patient may be assigned to the wrong department and not receive appropriate care for her illness.
Myself (my thinking, feelings and behaviour)
From this experience, I learned that I have a high concentration and pay equal attention to both visitors at once. In addition, I successfully apply communication skills to find out all the details about the patient that interest me. I was also surprised by the fact that in such an ambiguous situation, I did not feel confused or disoriented. This suggests that I can cope with stressful situations and successfully hold meetings even in unusual conditions for me.
My communication skills
This meeting also gave me the opportunity to assess my communication skills objectively. The primary skill I showed was active listening. I have successfully applied verbal and non-verbal attributes of active listening, such as specific phrases and gestures that show my understanding and involvement in the patient’s situation. I also managed to convey to the patient’s son that I am entirely on his side and believe his words about his mother. This provided my visitors with comfort during the meeting and collected the maximum amount of helpful information.
My knowledge understanding and application of psychological/ nursing knowledge to practice (verbal and non-verbal listening skills)
During this meeting, I also had the opportunity to demonstrate my knowledge of nursing psychology and its application. For example, I know that sincerity is an essential aspect of communicating with patients. Sincerity is a necessary condition for establishing a relationship of trust. Sincerity means that a person honestly shares his thoughts, feelings, and experiences (McKenna et al., 2020, p. 612). A sincere or harmonious person understands his inner feelings and thoughts and correctly expresses them verbally and in another form. This harmony is essential for meaningful communication. It contributes to the emergence and maintenance of trust in oneself and between oneself and others (Myers, 2020). This trust gradually develops into free and open communication. Therefore, I showed maximum sincerity in communicating with patients. For example, I explained to the patient’s son that his mother has a progressive disease that cannot be treated. It can be fixed and slowed down to the maximum, but it cannot be reversed by freedom.
This policy of frankness helped me to build a trusting relationship with the patient’s son and, therefore, with her. If the patient’s family trusts the nurse, then the patient himself feels more confident. The experience of receiving this patient and her son also showed me the communication skills that I need to improve. Among such skills is increased focus on the patient herself and not on her attendants. I need to focus more on the patient, even if he cannot fully explain his condition. The fact is that even the behavior of a patient who is in his thoughts and some sense disconnected from reality because of his illness can say a lot about his needs. That is why it is essential that the nurse considers all the signs that the patient gives and puts the information received from the patient at the forefront.
What knowledge and skills do I need to work on to further improve my communication skills for nursing?
First of all, I should improve my ability to analyze the situation to understand what communication method will be the most appropriate one. In some cases, active involvement in communication is more efficient, while in others, careful listening is necessary. In addition, I need to improve my confidence to know that my communication skills are suitable for nursing practice. Concerning this encounter, I felt that my actions could cause a patient’s dissatisfaction, however, in reality, I did my best and succeeded. Moreover, the improvement of my emotional stability will help me to control my emotions. In nursing, this personal quality is essential – all patients have unique needs and different communications skills, and a considerable number of them are affected by health-related issues that cause stress and anxiety. Thus, my emotional intelligence will help to establish comfortable relationships with any patient.
What was my overall learning from engaging in this reflective project?
Summing up, from participating in this reflection project, I have learned a lot of helpful information and knowledge. First of all, thanks to this project, I was able to analyze my experience to become better professionally in the future. I believe that such reflection is critical, especially for medical personnel who practice direct communication with people. Secondly, the experience of participating in a reflection project helped me analyze my main mistakes in an unusual situation for me to communicate with patients. This was important to me because initially, I considered my behavior to be as correct as possible in that situation. Now, I was able to evaluate my communication with the patient and her son more objectively and notice some shortcomings on my part. Thus, writing a reflection project gave me invaluable experience analyzing my behavior in a client situation. From now on, I will reflect on my experience more often because I find this procedure very useful and necessary for practicing nurses.
Reference List
Bramhall, E. (2014) ‘Effective communication skills in nursing practice,’ Nursing Standard, 29(14), pp. 53-59.
Hagerty, T. A., Samuels, W., Norcini-Pala, A., and Gigliotti, E. (2017) ‘Peplau’s theory of interpersonal relations: an alternate factor structure for patient experience data?’ Nursing Science Quarterly, 30(2), pp. 60-167.
McKenna, L., Brown, T., Williams, B., and Lau, R. (2020) ‘Empathic and listening styles of first year undergraduate nursing students: A cross-sectional study,’ Journal of Professional Nursing, 36(1), pp. 611-615.
Myers, S. (2000) ‘Empathic listening: Reports on the experience of being heard,’ Journal of Humanistic Psychology, 40(2), 148-173.