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From the very first clinical until our last in person clinical, I noticed a ton of improvements in my interactions with patients. When we first started we were paired up with a single patient. We were obviously nervous because it was our first few clinical and we honestly were very unsure as to what to expect. Even with my partner there, I was very nervous and lacked confidence when speaking with the patient. In the beginning of the semester I basically only went in the patients room to complete vitals, head to toe and hourly rounding but failed to make an effort to bond with the patient. I also was very focused on these tasks because I had yet to get in a good routine and was still learning how to work the equipment. I noticed that once I was on my own and had a little more experience I became a lot more confident. I was able to make more of an effort to build a relationship with the patient rather than solely focusing on the tasks. Towards the end of the semester it just felt easier to bond with patients. Each morning I was excited to meet my patient and get to know them better. I think building my communication skills and making stronger relationships with my patients definitely improved my overall quality of patient care. I believe that my communication improved partially because I felt more comfortable but also due to the numerous techniques we have learned in class.

Though I improved a lot this semester, there are still so many things I should be working on. The main growth I would like to see is gaining confidence. I know this is something that will come more with time, but I feel like it’s something I can actively strive for. There were times throughout clinical this semester where I found myself second guessing myself over things that I knew were correct. A lack of confidence in myself made some patient interactions uncomfortable. There is no way to avoid awkward or upsetting situations in the healthcare field, but being confident may help my response to these situations. I also think that gaining more confidence will help further improve my communication skills. Becoming more confident in my nursing skills will allow me to focus on bettering my relationships with patients.

The relationship between healthcare providers and patients is arguably the most important factor within the hospital setting. It is crucial that there is a trust and a mutual respect factor between the team and patient. For this assignment I chose to fuel my obsession and watch an episode of Grey’s Anatomy. I have watched the show several times and when I read the prompt for this assignment there was immediately a specific episode that came to mind. I went back and watched an episode at the end of season two. This episode had mostly bad patient and provider interactions but I did notice a few good communication skills. There was a patient that was extremely nervous for an upcoming procedure and one of the residents, George, sat down and explained the entire surgery. Making sure to answer any and all questions the patient had, George definitely helped to put the patients mind at ease. This interaction helped the patient build a positive bond with George and allowed the patient to trust him. As the episode continued, the patient consistently went to George with any concerns.

The main reason I chose this episode was because of all the bad communication. During the season, one of the residents, Izzy, began a romantic relationship with her patient. It began as just a friendly interaction but then progressed to a relationship with promises of continuing after leaving the hospital. Of course this alone is a major boundary crossing, but it goes even further than that. This patient was scheduled for a heart transplant that fell through. There was another heart available but it was assigned to a different patient. In order to for Izzy’s patient to receive the heart his condition had to rapidly deteriorate. Izzy decided that she was going to cut the patients LVAD and take labs to prove that he patient was more deserving. She discussed with him what was going to happen and he agreed to it all in hopes that he would get the heart and have a future with Izzy. When she finally cut the LVAD, she recruited her other resident friends to help her because the patients health was even worse than what she was expecting. In the end the patient ended up receiving the heart but due to Izzys lack of judgement all of the residents were in major trouble.

This example and episode is a very extreme example but it still demonstrates errors in communication and relationships between patients and their healthcare team. Izzy having a relationship with this patient while still caring for him put them both at risk. Since Izzy is his doctor, it is an unequal relationship in which she has more power. It could also result in favoritism of him and potentially lead to insufficient care of her other patients. Her love relationship for this patient also led to the unthinkable, cutting the LVAD. This is a breach of basically everything that a healthcare professional is taught all because of the inappropriate relationship the two had. It is so ethically incorrect but moral as well because she stole the heart from another deserving patient. I understand this is a very dramatic situation to analyze but nonetheless a great example to look at for patient and team relationships.

This semester we started our first clinical rotation. I was lucky enough to be placed on Ross floor 6. The floor is mainly for patients in congestive heart failure and those waiting for a heart transplant. For the first couple of weeks, everyone in my group was given a partner. It was super helpful to have these partners because it helped reduce stress and made me feel a lot more comfortable walking into the patients room. Though it was overall beneficial to have a partner, this was also where I noticed the biggest communication problems. There was an instance when we walked into the patients room and we didn’t fully discuss what each of our responsibilities were. After completing the head to toe assessment, my partner and I realized while charting that we had forgotten to check capillary refills and ask the patient about their most recent bowel movement. We also forgot to count the patients respiratory rate. If my partner and I had more clearly discussed each of our roles before interacting with the patient, we could have made less mistakes.

Though I felt like my partner and I communicated pretty well, there was definitely room for improvement. Going into the first week of clinical, I was very nervous. It was super nerve wrecking interacting with patients for the first time. I think my nerves did play a role in the communication errors my partner and I made. I feel like we were both overwhelmed by the responsibilities and figuring out how to work IHIS. We both should have realized that we were on edge and made a game plan before entering the room.

Going into the second week of patient interactions, my partner and I were my comfortable. We knew the routine and were able to execute our responsibilities well. We also prepared a lot more before we began our day. My partner and I both made a cheat sheet to follow throughout the day. We made it a point to communicate to one another what each of us would do in the room to ensure we didn’t forget anything. Moving forward there is several things I could do to improve my communication. I need to be more assertive and direct with my peers. The miscommunication my partner and I had was easily resolved by preparation and discussing our responsibilities before the day began. The profession of nursing is very team based and it is so important to communicate clearly. It is crucial for communication within the nursing field to reduce the risk of medical errors.

While studying in the library this week, I took the time to observe the interactions of people all around me. I sat in a very high traffic area to ensure that I could watch all different types of communication between individuals. It was very interesting to see how different everyone interacted with each other and all the forms of communication used. With such a big university, it is very common to walk through the library and not recognize anyone. I believe this is the reason for such a large percentage of the people I observed walking to be on their phones or listening to music. The distraction of their phones led to less observable exchanges of communication between individuals.

The most popular communication I saw was nonverbal. I witnessed so many people walk past, I assume, an acquaintance of theirs and simply smile or give a small wave. For some people who saw their close friends, they exchanged hugs or some even shook hands. It was also very popular for individuals to exchange a small head nod. I noticed that when people would sit down in an empty seat at a table that was already occupied by someone, that the person would usually give a soft smile and make eye contact. I believe that making eye contact with someone is the largest form of nonverbal communication. Our minds our programmed to look at someone eyes even if we aren’t directly speaking to them or know them. I know that when I walk around campus, I constantly find myself accidentally making eye contact with an individual walking past me. It is a very small form of communication but I believe it is one of the most powerful.

I also noticed some exchanges of verbal communication. I feel as though this was mostly exchanged between close friends. There were quite a few individuals who saw their friends and stopped to talk to them for a few minutes. A lot of people would talk with their friends sitting with them at the table. I noticed a few people that would ask an individual if it was okay that they sit at the table with them. Verbal communication seems like such an important form of interaction between people, but in a library full of people trying to study it was definitely less common to see.

Hi, my name is Sarena Graham and I am currently a second year nursing student at Ohio State. I have lived in Columbus my entire life and have always been a huge Buckeye fan. My family loves OSU so much that both of my pets names were picked because they related to Ohio State. My cat’s name is Scarlet and we also have a dog named Champ. We adopted him right after osu football won the national championship. I also have two sisters, one is three years older than me and the other is three years younger. My family has always been a big priority to me, so I love to spend as much time with them as I can over breaks. 

Though I love quality time with my family, there are also several other things that I love to do. My most recent obsession has been cooking. I really enjoyed finding new recipes over break and trying them out. I also am very passionate about animals especially dogs. I am a part of the 4 Paws for Ability organization which trains puppies to become service dogs. My first dog I trained was matched with a little girl and graduated as a service dog over the summer. Other than 4 paws I also am a part of Project sunshine which is an organization that volunteers at the Ronald McDonald house. 

I have always known that I wanted to work within the healthcare field, it wasn’t until my senior year in high school that I realized I wanted to be a nurse. I am most interested in working either as a pediatric nurse or in the NICU. I also am hoping to go back to school to become a nurse practitioner at some point.