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This was the first semester that I had clinical in the hospital. I learned so much from this experience even though it was cut short and can’t wait for next semester clinical to come around. We were in the Ross Heart Hospital where I learned a lot related to cardiac problems, such as heart failure, hypertension, LVADs, cardiac medications, cardiac monitoring, and other disorders created/or occured from cardiac problems. I had an amazing clinical instructor that had so much knowledge about the cardiac unit and how to care for those patients. I appreciated how she gave us guidance along the way, but also pushed us out of our comfort zones in clinicals to better prepare us for next semester. 

I have seen multiple improvements in my ability to communicate to patients. At the beginning of clinical I was scared to even go into the patient’s room, afraid to wake them up in the morning to check their vitals. I have now grown to where I do not hesitate to knock on the patient’s door in the morning to introduce myself because they understand that it is necessary to wake them for vitals and medications. I have also grown in my ability to ask patient’s questions. One patient I had, had a very specific disease that isn’t common and is mostly diagnosed in autopsies since it is very hard to identify the signs and symptoms. I sat down with him and he explained everything about it, and it was amazing to be able to learn first hand from the patient who had it because he understood how uncommon it was. Another improvement that I have had in communication, is communication with the nurses on the floor. Since the nurse and I were both helping take care of the patient I was assigned, I became better at communicating the patient’s condition. It was hard at first since I did not want to feel like I was in the way or bothering them, but it is important to collaborate and work together. 

Growth that I would like to see is getting better at communicating with the family of the patients. I did not get to meet too many family members, but when I did I didn’t talk to them too much except when they asked questions. I utilize the tools learned in this class, Therapeutic Communication, to apply the techniques of how to talk to family members. I should also relay information about the labs and vitals when applicable/appropriate so that they do not feel in the dark about their family members. Another aspect that I can work on is educating a patient. Since we have not touched too much on educating patients, I was not able to apply it in clinical. But, in the future I want to able to master it because I believe education is one of the most important parts of a nurses job because if the patient does not understand their medication or what is going on then they will not be able to participate in their care as they might want to to be able to get better. Overall I still have plenty to work on when it comes to clinicals since this was only my first semester of them and can’t wait for what comes next. 

I watched Grey’s Anatomy Episode “Begin the Begin,” for this blog which was about one of the healthcare providers that shares feelings with a patient awaiting a heart transplant and a healthcare provider treating an intersex teenager. The patient awaiting a heart transplant’s name is Denny, the first thing he says when he sees Dr. Stevens (one of the resident’s working there) is that he is a Capricorn and single. The actual doctor tells him to be quiet as she knows him well, but Dr. Stevens seems flattered by it. When he said that, there should have been a reminder and boundary put up that she is just his healthcare provider and that what he says is inappropriate.  They end up flirting and he asks her personal questions about her dating history to which she responds. This is a major boundary crossing because personal information should not be shared with a patient.

The second part of the show showed a resident, Dr. O’Malley, who is assigned to a teenager Rebecca. When first addressing the teenager he calls her by her name and does not ask before what she would be preferred to be called. This offends her as she goes by Becks instead. A positive part of the communication is that he did address her and use the correct name after words. He also tried to understand her more by asking about her interests. Since he is a resident he is still trying to figure out how to talk to patient’s as you can see from the fact that the other doctor, who has more experience, Dr. Shepard gives reassurance and talks through everything the patient. When Dr. O’Malley is drawing blood from the patient he sees marks on her wrist that are from self harm. He reacts by starting at the marks and making a surprised facial expression. That is a negative form of non verbal communication because it can offend a patient as it is a sensitive subject. They end up finding out that she is having health problems due to taking excessive amounts of birth control pills. Dr.O’Malley handles this well by talking to the patient and asking her why she is doings and and why she feels that way about her body. He showed to her that he cares and wants to help her out therefore it allows her to open up. He ends showing empathy by sharing how he had a hard time of high school too, this is great form of communication to help a patient feel they are not alone but also not sharing too much.

I think my biggest communication challenge has been communicating with the patients. The first time going into a patient’s room I was very anxious since this was a new situation to me. I felt awkward because I am in the early clinical and the patients are still sleeping at this time. I know from my own preference that I hate being woken up in the morning, so I was afraid that the patient would just tell me to leave. I am learning that they understand that the nurse needs to come in and take vitals in the morning, so while they may be grumpy from just waking up they won’t stop you. When I do take the patient’s vitals, I need to explain what I am doing because I forget that they might not know the reasons why I put something on their finger or arm. I would want someone to let me know what is going on because it can be scary in the hospital with a stranger touching you. Later when the patient is up and I go do my full head-to-toe assessment I don’t always engage in conversation. After talking with one patient and using communication just to talk to him, I realized that the patients at the hospital can get lonely especially if their family and friends can not visit during the day. Conversation can be used as a sort of therapy to make the patient feel less alone and talk about things they like to get their mind off of their diagnosis.

The reason I think it has been hard for me to communicate with patients in more than just a greeting, is that sometimes new experiences can be hard for me. I have been getting better about putting myself out there, but it can be hard to do as I am more of an introverted person. I feel awkward in some situations, but I am realizing that nursing is about doing what is needed and not worrying about what others think about you. The patient is the main priority, and they understand what the role of a nurse is. To bridge the gap between lack of communication to the patient and full communication I need to explain what I am doing before and while I am performing a task. It will put the patient more at ease and myself. Along with that, since I am a student right now and am only taking care of one patient then I can talk to the patient a little longer so they are not as lonely. I can use tactics we talked about in class, such as, asking about their hobbies or shows they like to watch. It might make their day just to know that someone wants to talk to them. Overall great patient communication is one of the most important things I need to achieve while in clinical this semester. Confidence in practice results over time.

Today I was studying with my friend at the library. As she was talking to me, I noticed the different forms of communication she uses. When she explained to me the her stomach was hurting, she used her hands to explain where. After, her tone of voice changed to prove how serious she was about the pain. After discussing I turned to look around the room and I noticed the people around me and their forms of communication. Many people around would make eye contact to the person they were talking too. This shows a sign of respect and trustworthiness, as it shows the person in genuine in their remarks, I see its prevalence a lot in our culture. However, I noticed a student and what seemed to be a their tutor were doing some math problems and the student keep their head down with eyes darting across the room. It seemed like they were in a panic as they do not know the problems they are working on, it was conveyed to the tutor as he kept helping and talking it through. Other students who seemed to not be doing homework, were chatting casually and I noticed one would reach her hand out towards the other and put it on her shoulder. This gesture can be assumed as a meaningful gesture, since she feels comfortable with the person. It was also shown in her facial expression as she had a warm smile that was inviting. After talking for 5 minutes, another student went to join them and they greeted her with hugs and joy. It proves they enjoy her company and welcome their friend into conversation with them rather than looking absent when she came over.

Since I was in a library, most people had their laptops and phones out. Those working on projects, I saw moved closer to each other looking at one laptop screen to show the other. They showed concentration with their eyes focused solely on the laptop to figure out what they were doing. The other person of the group was on their phone, with posture slouched which showed their disinterest in what they had to do. Those individuals around the room who were in that same position but looked to be alone did not seem as friendly as others who were sat up straight and focused. Another thing I noticed is people using their hands and head a lot to emphasize their convictions. Some would shake their head if they strongly believed yes or no to a degree or others would point to people or things. In a way it was interesting to view how people communicate around me and makes myself more aware of my communication to others.