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Communication Improvements Throughout The Semester

Throughout clinical this semester, I have improved not only in the assessment aspect, but also in communicating with my patient. Looking back at past blog assignments, I remember writing about my biggest communication barrier thus far. On February 3rd, I wrote that my biggest obstacle in communication was “conveying information completely”. I still think this is something I have to work on and will continuously have to work on throughout my nursing career; however, I have improved on it since then. I tried to become more knowledgeable on common conditions seen on the clinical floor I was working on. This allowed me to become more familiar with these diseases and as a result I was able to answer more questions or concerns the patient had. In addition, I would make an effort to thoroughly look at my patients chart before entering the room. This allowed me to learn as much as I could about the patient and their condition before talking to them. I was also able to look up anything in their chart I was unfamiliar with and learn about it or do further research on items I was already familiar with. I also think I have improved on just the comfort aspect of being in a room alone with the patient. During the first couple of clinicals I was so uncomfortable talking to, assessing and being alone with a patient. However, after the 3rd or 4th clinical, I became much more comfortable and everything I was doing seemed natural. At the beginning, I didn’t really know what I could and couldn’t say to a patient, but now I know my boundaries and topics I can talk to them about. In the future, I would love to continue learning about therapeutic communication techniques I could implement into the care I provide. Once I am on a specific unit or floor for a set amount of time, I plan to learn as much as I can about the conditions commonly seen, so I can answer as many patient questions and concerns as possible.

Communication Techniques Used in Grey’s Anatomy

I decided I would use this assignment as an opportunity to watch a Grey’s Anatomy episode.  Throughout the episode I noticed some of the different forms of communication techniques used and observed relationships between healthcare providers and other colleagues and patients.  I also looked for areas of boundary crossings and potential barriers to communication. In general, the physicians demonstrate the correct use of verbal communication fairly well. They refer to the patient by their desired name, are concise and make sure to involve the patient in the conversation.  However, because this is a drama, their use of non verbal communication is sometimes not always therapeutic. I noticed that some of the physicians would come to work looking disheveled, like they haven’t slept or showered in days. Some non therapeutic gestures I noticed while physicians were in the patient’s room were an irritated sounding tone of voice, facial expressions, eye rolls, avoiding eye contact with the patient when talking to them and poor body language.  If the patient was able to pick up on these unfavorable non verbal cues, this could negatively impact their desire to have this physician work with them. They might feel like a burden and begin to not trust the provider. Again, because this is a television show, humor was used to entertain the viewers. Humor invites interaction between the physician and the patient and allows the patient to feel more at ease and cope with stress or fear. The physicians did a great job at expressing empathy towards their patients.  They were able to listen to the patient, put themselves in their position and provide constructive feedback. Empathy is extremely important to use and be aware of when providing care for a patient, as it makes the patient feel like they can trust you. As for team communication, hand off reports were completed face to face and were detailed so the next provider knew the patient’s current status, background and any new or pending labs. Mid shift reports were much less detailed; they were more or less a quick synopsis on what has recently been going on with the patient and anything specific to look out for or monitor.  Throughout the episode, there were some communication barriers. There were a couple of times where there were distractions and a lack of coordination, follow ups, time and role clarity. Distractions came from the physicians life outside of work such as marriage, friends or family stress. Distractions could potentially be very harmful to the patient, as the physicians mind is not solely on the patient. However, in this episode the physicians did an excellent job at not letting outside distractions interfere with the care they provided. Creating the feeling of a lack of coordination and time is done mainly for the drama, so the viewer stays intrigued in the show.  If everything was perfectly going to plan and without chaos, the show would be boring and no one would watch. I was quite impressed with how Grey’s Anatomy, although not realistic in the slightest, was able to display many aspects of good and bad communication.

My biggest communication challenge

Personally, I think my biggest communication challenge thus far has been conveying information completely.  This also goes hand and hand with my lack of information verification. Often when patients have asked me questions about their personal condition, I do not have clear answers for them.  I try and respond with a general response such as, “I’ll ask the nurse about that and get back to you.”  My lack of information verification may lead me to become apprehensive and timid.  This is not ideal, as I may come off to the patient as not skillful or capable, causing them to not trust me with their care.  I think the fact that I am a new nursing student definitely contributes to my lack of knowledge on answering specific, detailed medical concerns or questions.  I am also quite inexperienced when it comes to communicating with patients, as I have not had any one of one patient contact experience so far.  However, once we start working with patients one and one and we start to see the same patients over and over with similar conditions, I hope I will be able to give more precise responses to their questions.  Right now, I can improve this by becoming more knowledgeable about certain conditions constantly seen on my clinical floor so I become more familiar with them and may be able to answer some more of the general questions a patient may have. Also, during clinical I can try and look at my patient’s chart more thoroughly before entering the room so I have as much information on them as possible.  This will allow me to look up anything in their chart I am unfamiliar with and learn about it or do further research on items I am already familiar with.    

People Watching

I am a people watcher for sure, and today was no different.  While I was sitting in Thompson library, clearly easily distracted, I figured it would be the perfect time to actively note my observations of the different forms of communication I saw.  I spent about 30 minutes on and off trying to look at (but not stare for too long at) peoples’ communication behaviors. I saw many people verbally communicate through physically talking or whispering to someone nearby, as well as speaking to someone on the phone.  The most common type of communication I saw was nonverbally through technology. Whether it was texting on phones or communicating on their laptops with one another, people were constantly viewed communicating through technology. Other forms of nonverbal communication I witnessed were gestures such as waving to one another, hugging, eye contact, poking and a couple people actually snapped to get another person’s attention.  Throughout my time student staring, I was also able to notice body language differences between people. Some were very hunched over, their arms and legs crossed and head down. These people you could tell were giving off a “closed” vibe; in their own mind and not very willing to talk to you or open up. However, I also witnessed the opposite; others walking confidently, with their hands by their side, good posture and head up.  I always find any exercise involving watching people do certain things so interesting because you never notice what different people are doing until you are specifically looking for it.  

Get to know me!

Hi!!  My name is Katie Graham and I am from Whippany, NJ (a small town in north jersey).  My favorite things to do are cook, bake, ski, listen to podcasts, watch youtube and talk about anything medical or nutrition based.  Growing up, I was always pretty good at science so immediately everyone assumed I would eventually go to college and study to be a doctor.  That was the plan for a little bit, but then I thought about how much school it really was and finally settled on the idea of becoming a pediatric nurse practitioner.  I have always loved kids and have babysat for multiple families, including my own brothers.  Besides being busy with nursing, I am also in a sorority on campus, Delta Gamma.  I am seriously obsessed with my sorority and always encourage anyone who is on the fence about joining one to do it.  I have met so many more people and friends not only in Delta Gamma, but in greek life as a whole.  There is never a dull moment, especially due to the fact I live in the house with 52 other girls!  There is always something going on whether its a social event, philanthropy event, or just hanging out, watching a movie at the house.  I am super excited to finally begin clinical this semester, and hope to have a successful, fun, hardworking year!