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Clinical Experience Reflection

As we are coming up on the end of the semester, I think that I can speak for most nursing students when I say that I wish we had more clinical experience this semester. I think that for this being our first semester incorporating clinical into our curriculum, it is a shame that it had to be cut short and moved to virtual clinical. As I reflect on my clinical experience this semester, the in-person clinicals have been the most beneficial to me and I have an easier time reflecting on my communication skills in the hospital rather than online. As I think about myself on the very first day of clinical compared to our most recent in-person clinical, I can see and feel a difference in the way I communicate with my patient, peers, and staff on the unit. I feel more comfortable introducing myself to the patient and being confident in being a student nurse. In the beginning, I had a lot of self-doubt and uneasiness about how the patients were going to respond to having a student nurse. I did not want to feel like I was bothering the patient because I had to practice new skills on them or feel incompetent because I was “just a student nurse”. I quickly realized that all of the nurses on my clinical unit were in the same spot as I am at some point during their careers too, and I became more comfortable and confident in being a student nurse. All nurses have to start somewhere! Knowing that I was just starting out, I have felt myself become more confident as I gained more clinical experience in asking questions which is a good skill to have because I will always have questions, even when I am a nurse. I also felt that I was more prepared to answer some of the patient’s questions, even when they were unexpected or slightly inappropriate. I have used a lot of the techniques that I have learned in Therapeutic Communications to direct a conversation toward a better direction if I felt uncomfortable or if I felt that a patient needed guidance in having a therapeutic conversation with me. I have excelled in making the conversation primarily about them and allowing the patient to disclose whatever information they feel comfortable sharing with me without fear of judgement from me. In terms of patient communication, I feel as if I am finally starting to get it right and will continue to work on my communication skills in order to provide therapeutic care to patients.

As for areas of growth, I struggle the most with communicating with staff on the unit. Talking to experienced nurses and doctors about a patient can sometimes make me nervous and I have a harder time answering questions coming from nurses or doctors compared to my clinical instructor. I could improve in my confidence when I talk to staff and use assertive language when expressing a concern about my patient that I think needs to be addressed in a timely manner. I know that this will come with experience and time, but I know that there is room for growth in this area of communication. Overall, I am impressed with the growth in communication that I have already observed in myself during clinical and am ready to continue to improve upon these communication skills in the upcoming semesters as a nursing student!

Communication in Healthcare TV Shows

In my many, many hours of binge-watching Grey’s Anatomy on Netflix, I have observed many forms of communication in healthcare settings that are not very reflective of real life situations. A lot of the show takes place in a surgery room, and it is easy to see the power struggle between the healthcare team. For example, the disrespect to the interns from the chief of surgery during a surgery is prevalent. The “higher-up” surgeons tend to not teach the interns and do not let them practice if they don’t answer a question about the patient right. I also have seen disrespect from the interns to the heads of surgery, when they preform procedures without permission from their teacher because they think that they know what is right. The other thing I see that hinders communication in the surgery setting is the discussion of personal information and gossip. Although the patient is under anesthesia during these conversations, it still is not appropriate to use that time to discuss personal issues. This gossip also sways the surgeons towards favoritism when it comes to performing procedures. The head surgeons pick and choose who gets to scrub in on surgeries based on how much they like them that day. Sometimes they let their spouses in on a surgery because they are their spouse, instead of letting others gain experience as they earn it. This favoritism is unfair and unprofessional, and has no place in the healthcare field. This can put the patient at risk and can also create inappropriate relationships between coworkers that can upset other surgeons.
The way that the surgeons communicate with each other in general is hostile, loud, and degrading. They are not good at communicating calmly and efficiently, which can lead to many mistakes and miscommunication in patient care. The surgeons are not active listeners and are overall very selfish in communicating with each other. They speak out of fear, anger, and uncertainty which leads them to make irrational decisions and mistakes. This type of communication makes it hard to work as a team, and encourages each surgeon to act selfishly.
The good communication that I see in Grey’s Anatomy generally tends to take place out side of the OR. It happens after a tough patient, or an unexpected outcome during surgery. Coworkers seem to be more supportive of each other when they are not competing in the OR. They listen to one another and provide advice when another surgeon is upset or mourning a loss of a patient. They engage in positive talk and allow each other as much time as they need to talk or heal. The other communication technique that I think is professional is when they speak to patient families. The surgeons are very professional, thorough, and empathetic when explaining a surgery or the outcome of a surgery to a patient family. They don’t tend to use medical jargon and they are patient with the families needs. These are communication techniques that we expect outside of TV dramas and strive to adhere to these techniques in the healthcare field.
As a side note, I have also noticed in this show that the nurses are very rarely involved in any of the care given to patients, which is obviously inaccurate! The nurses are not involved in codes, surgeries, or routine care in pre and post-op. As a nursing student, I wish to see more of the nurses in Grey’s Anatomy so I can observe more of how they are portrayed in the TV drama.

Communication Challenge

During my time at clinical, I have not run into many difficult communication issues with patients specifically, but I am sure that that is coming soon! The one big problem that I have noticed on my unit personally, and it may relate to the timing of my clinical, is the communication between myself and the nurse on the floor regarding the patient we are taking care of. This may be because I am on the floor in the afternoons and miss the main shift report given by all of the nurses at 7am, but either way I think there is some disconnect between the student nurses and the nurses during these first few weeks of my clinical. I am rarely given a version of a report on the patient I am assigned to by the nurse I am practicing with each day, which then leaves me to get a report from their chart. Charting is still fairly new to me and making sure I am reading the important parts of the chart is still slightly difficult. Looking at the chart may be useful, but it is not as efficient as having a nurse tell you face to face about your patient and allowing time for questions and comments. There are some things about a patient that are hard to put in their chart and easier understood when talking to someone in person about it. I am encouraged to interact with my nurse on the floor but many times they are busy tending to other patients and sometimes may not have time to answer any questions I may have about a report. I understand that as a student nurse I could be more proactive and assertive in asking the nurse for a more detailed report on the patient I am assigned to, even when a formal shift report is not being given. I do not think I am to that point of assertiveness on the floor yet, which I am sure contributes to this lack of communication between the nurses and myself. I need to be more confident and willing to get more information on my patient, even if that means catching the nurses on a busy shift. In order to overcome this challenge, I need to realize the importance of even a short rundown of a patient face to face in order to give adequate patient care and make the effort to get one. The importance of some kind of report from the nurse is worth the nervousness that may come with being assertive as a student nurse. 

People Watching

I sat in Thompson Library, the place where thousands of people pass through and utilize each day, for thirty minutes and quietly observed those around me. As odd as I felt sitting and watching all of these students pass by, I picked up on quite a few trends in light of human communication. I sat and watched most people coming into and out of the library on the oval side, and noticed that some people kept their voices down while walking with peers and respectfully walked through the library, careful not to let their voices travel up to the 4th floor to disturb anyone and some did the opposite. Some students walked through the echoey library without changing the tone or volume of their voices and continued the conversation with their peers quite disruptively, maybe this happened because they just did not notice, or they just did not care. The ones that seemed to be louder throughout the hallway seemed to be either happier and laughing in light-hearted conversation, or in an intent, more serious conversation with the person next to them. Either way, it seemed as if it was not bothersome that the whole library could hear exactly what they were discussing. People looked up either with disgust or with curiosity, but went back to what they were doing after only about 5 seconds. Enough time to recognize that it was not a threat or alarming, but instead people innocently chatting. I noticed a few other things as well, such as the use of cell phones and AirPods and how they hindered communication while walking through Thompson. People were approached by others more often when they were off of their phones while they were walking and even more when they were off of their phones without their headphones in. It seemed to me that those who were not looking down on their phones or had their headphones in were more alert and observant, and even somewhat happier. Friends waved to them passing by and some even stopped to chat for a quick second. I wonder how many people passed by someone they knew but neglected to reach out and say hi because that person was on their phone or blankly staring in front of them with tunnel vision while listening to music. I noticed that most of the people using their phones and headphones were younger people, while the older people were not. The last piece of information I observed from sitting in the library and observing was the difference in the way people presented themselves and made conversation with someone behind a desk. I am sitting next to the circulation and reserves desk in the library and this is where people can check out books or ask for directions and help. Immediately people take out their headphones and put down their phones and most of the people I witnessed, asked kindly and politely for what they were looking for. They were very clear about their inquiries in order to get the answer that they wished for. Some people’s voices even raised a few octaves while they were asking for help, and I know that I am guilty of that too! On the contrary, the people behind the desk did not tend to do the same. They kept their poor postures and were not extra polite or kind, but did give adequate answers to the people asking. I am curious if this is because they know that they are the only ones that can help out this person and are superior to them in a way. I also wonder if the employees behind the desk are this way because that is their job, and regardless of if they give someone the right answer or not, they are still getting paid whereas the people asking for help have to be extra kind in order to get the best help available. It was interesting and educational to watch people communicate while walking through the library or stopping at the help desk, and it certainly made me aware of good communication skills that I already have, or ones that I might need to work on based on how I interpreted some of the skills I saw while being extra observant.

About Me!

Hi!

My name is Kaylee and I am in my third year here at Ohio State. I am originally from Toledo, Ohio which is about two hours North of Columbus. I come from a fairly large family as I have 5 siblings! I am the oldest of them all and my youngest sibling is eight. I have a dog at home named Piper, she is a “bernadoodle” which is a St. Bernard and Poodle mix. Outside of my studies, I love to stay active specifically by going to barre classes. Barre is a workout that consists of Pilates, ballet, and yoga. I go to the Barre3 studio in Upper Arlington and absolutely adore how I have grown there. I love watching and re-watching Grey’s Anatomy and my favorite movie is How to Lose a Guy in 10 Days. I love to hang out with my friends, and we enjoy exploring all of the restaurants in the Short North area of Columbus. My favorite restaurant is Condado, by far! I also am a big fan of Jeni’s ice cream; the brown butter almond brittle flavor is to die for!

As for campus involvement, I am in a sorority here called Kappa Alpha Theta and I love to stay involved with my chapter. I was the service director of the chapter last year, so I loved planning all of the volunteer events around Columbus for the girls in my sorority. One of my favorite events that we did was volunteer for a Franklin County CASA breakfast this past October because CASA is our sorority’s philanthropy that we support. Giving back to the community is a large part of why I decided to join a sorority and why I decided to major in nursing. As for my nursing career, I am not exactly sure what I would like to pursue. I have been working at Nationwide Children’s Hospital in the Emergency Department as a PCA since October of 2018 and that has confirmed for me that I want to work in pediatrics. I also have a large interest in neonatal care and labor and delivery nursing, but I have not decided yet. I know that I do want to pursue my master’s degree in order to be a nurse practitioner in one of those three areas. I hope to stay in the Columbus area after graduation to start my nursing career but am open to whatever life may throw at me. I am more than happy to be in this phenomenal nursing program at Ohio State and am so grateful that I ended up here. I am looking forward to all of the challenges that nursing school entails and am excited to see how I grow and succeed in this program these next couple of years.