Communication is essential in the nurses’ practice. It can facilitate therapeutic relationships or creates barriers between colleagues and clients (Blake, 2019). It also has components that include listening, presence, perception, disclosure, acceptance, caring, empathy, and respect. It is a primary and significant focus in nursing practice.
In health care, communication is transitional and continually challenging. It mostly involves interaction between patients and nurses; thus, for it to be meaningful, there should be passing of information that involves the nurse applying a planned and holistic approach that forms the foundation of therapeutic relationships. According to Blake (2019), the primary reason for patients’ complaints is poor communication. Further studies have shown that effective and fair communication increases patients’ recovery rate (Bello, 2017). It shows how cost-effective and essential communication is in nursing practice. In my reflection, I use Gibbs reflective cycle as my framework (Li et al., 2020).
Case Description
During my practice at the cancer ward for female cancer patients, I interacted with several patients, some with cancer at its early stages, others in late stages. However, there is this particular day that I was doing ward rounds that I encountered a communication challenge with a patient. The patient whom I will not reveal her real identity following the NMC code of conduct (Dean, 2017) challenged not only communication but also my critical thinking skills. For confidentiality reasons, I will nickname her Tina. She is a 40 years old patient diagnosed with stage two throat cancer, which has a life expectancy of 5 years. On this day, I noted that Tina was seated lonely in her bed, looking stressed and somewhat restless. She had been admitted for an operation which was to take place the next day. Tina was unable to move her neck or head due to pain, thus could not walk without help. Due to her mobility challenges, I offered to get her a porridge cup, which she asked for and then seated with her since she seemed lonely.
Before getting the cup of porridge, I approached her in a calm and friendly way. I introduced myself as her caregiver and that I was there for her if she needed to talk to somebody. I spoke slowly and calmly with short sentences while using simple words. However, I am not sure if she got me since she could sometimes pardon me many times as her mind seemed to drift often during the conversation. All of a sudden she turned to me and said “I feel hungry get me some porridge please. However I am worried whether my kids at home have eaten today. I am a mother with very young children and every time I think about them I feel depressed.” she continued to narrate about her problems and challenges. I listened to her patiently and empathetically as she complained about her illness and how it had costed her family, which was now languishing in poverty due to her illness.
According to Bello (2017), listening goes hand in hand with understanding the other person. However, after bringing her the porridge, Tina refused to take it. She claimed that she had given up and that there was no need to eat. As a nurse, I explained to her the importance of eating as she needed energy and nutrients from food to survive and having a terminal illness was not the end; she could still live everyday life as usual while treating the illness. However, she could not get any of it. At this point, I felt frustrated remorseful at the same time that I was not able as a caregiver to convince her. Running out of patience, I shouted at her and pushed the cup of porridge into her mouth. Knowing that this was against the NMC code of conduct, I recollected myself, apologized. I, later on, reported the case to the nurse in charge, who advised accordingly. My communication skills as a nurse were challenged. Fortunately, in the process of talking to her, I made a call to her husband, who talked to assured her that the children at home were okay and that the insurance had agreed to cater for her hospital bills. After the conversation, she agreed to take their porridge, and her mood lightened up a bit. In this scenario, I used my critical thinking skills to communicate with Tina, which is an essential aspect of nursing practice.
Evaluation
I feel that I did not do the right thing since I shouted at the patient, but I managed to help Tina with the assistance and reassurance that she needed at that time. I successfully developed a therapeutic nurse-patient relationship with her, which is an essential aspect in the nursing roles, according to Blake (2019). I regret my aggressive actions towards her, but I am grateful that I apologized, handled and communicated with her with empathy since I helped her perform tasks that she could not and also gave her reassurance and hope. My actions were part of my duty as a nurse to ensure that she was reassured and supported. I was able to improve my critical thinking skills during the communication challenge.
I think my interaction with Tina was beneficial as it helped me use critical thinking skills during our communication. I also used non-verbal skills such as facial expression and moving my hands when giving explanations to her. Gestures express ideas and are valuable to people whose communication is limited and more expressive to influencing decisions (Bello, 2017). I was also able to advise her about her treatment and the importance of adhering to drugs to elevate her symptoms.
Analysis
From the encounter, I realized that nurses should hold their ethics and conduct in high regard even when the situation is out of control. Good communication skills and critical thinking helped to provide care for patients by allaying her anxiety. Critical thinking and communication should be used by nurses during decision-making and solving patients’ problems with creativity to enhance results (Bello, 2017). I also ascertained that nonverbal communication helped a lot in providing Tina with nursing care since my facial expressions were able to reassure and make her cool down more than speaking to her. Touching and patting her back also allayed her anxiety. I realized that using patients’ family members to communicate to them positively impacts their well-being, quality, and results of nursing care, as indicated by Terezam et al. (2017). Further, I feel that my encounter with Tina helped me exercise the five communication components: sender, message, channel, receiver, and feedback. Thus reflecting on the event helped me realize how communication skills are essential in the nurse-patient relationship.
Conclusion
In conclusion, reflecting on experiences helps one realize the importance of learning communication as a process. Using Gibbs’s reflective cycle framework helps organize thoughts and ideas systematically during a reflection. It also plays a crucial role in adding knowledge and identifying one’s weaknesses and strengths. Communication is vital in nursing, as it helps build reports and therapeutic nurse-patient relationships. Nurses should always strive to better their communication skills to deliver effective nursing care.
Recommendations
I will continuously improve my communication and critical thinking skills, since I will interact with more varied patients every day. I will ensure that I can handle complicated cases through proper communication with patients and critical thinking. Good communication is essential in unlocking the foundation of patient-nurse relationships. Further, it is essential to remove communication barriers that may thwart service delivery to patients.
