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NURS 2460 Blog 5

Ian McGraw

NURS 2460

13 April 2020

Blog 5

So far, this school year has been a rollercoaster experience for not only me but so many other college students. I do not think anyone prepares for a pandemic to cut their time at school short and cause virtual learning (and clinical) from home for the rest of the semester. With this unfortunate reality, my first nursing clinical semester was cut short, but that does not take away from all the extraordinary information and knowledge I have been able to apply into my student practice.

When speaking about therapeutic communication specifically, I have progressed much more than I could have ever expected from the start of this semester. To be honest, one of my biggest fears starting clinical was interacting with patients, nurses, PCA’s, and hopefully not to make major mistakes that would upset them. I know many people feel like this and instructors say that it gets better throughout the semester, then eventually you reach the end and feel like a completely different person. I was skeptical about this concept, until I have taken the last few weeks to reflect about how much I have changed in a short 10 weeks and it is incredible. My interaction with patients got so much better; I was able to ask them some open ended questions to help gain more insight on how they were feeling (emotionally, mentally, physically), I was able to establish professional relationships with them even if I was there for 6 hours, and I tried to make them feel as comfortable and safe as I could since they were not where they wanted to be… in a hospital. To accomplish these tasks, I have combined verbal and nonverbal communication techniques and made them congruent. For example, I have learned to speak in a slow, soothing tone, I have learned to avoid medical jargon, ask open-ended questions, and also how to talk “with” a patient not “at” them. Some nonverbal communication techniques include maintaining eye contact, communicating at patient’s level, having appropriate emotional facial expressions, and professional mannerisms. These techniques have helped me progress in my therapeutic communication skills.

Although there have been many positive practice techniques I have applied, there is always room for improvement in the clinical setting. One thing I am looking to improve is interacting with the nurses and PCA’s more; I have been more comfortable with the one on the floor, but I believe developing that relationship can become beneficial throughout my clinical time, and that communication can help benefit patients as well. Another technique is making a better transition when first interacting with my patients. This is something that is hard for me because I feel somewhat awkward when doing this, but after I do that everything is fine, so having a better first interaction is vital for me because that can make or break if a patient will be willing to develop a communicative relationship with me or not sometimes. The last thing I really want to focus on is my posture. Sometimes I tend to slouch or cross my arms; this can indicate me feeling uncomfortable in a certain situation (even though I usually am not), but I do not want to give off mixed signals, because that could cause stress to the patient or other nurses on the floor. These are three specific techniques I believe are my biggest points of improvement for upcoming clinical.

Like stated earlier, this semester has been anything but standard/ordinary. Having the last three hospital clinical taken away is not fun because I could really see my improvement and actually felt like a nurse. With that being said, I cannot take away from how much I have learned throughout the semester and this is definitely where I believe the start of my nursing career has begun.

NURS 2460 Blog 4

Ian McGraw

NURS 2460

2 March 2020

Blog 4

The television show I decided to watch for a healthcare to patient relationship was “Royal Pains.” This show is about two brothers starting up their own private medical practice in the Hamptons and taking on their patients to start a new life outside of New York City. In the episode I decided to watch, Hank (the doctor and older brother) was treating a patient who had recently suffered from a heart attack. During their communication at the patient’s bedside, Hank was able to use some great technique, but also there were some situations were it could have been better.

For his positive technique, he was able to demonstrate active listening; while employing this technique, the patient was able to let out all of his questions regarding what happened and how nervous he was and what he needed to do to maintain better health. I was able to observe Hank making direct eye contact during all communication, he was slightly leaning towards the patient to show that he had interest, and he was relaxed. This allowed the patient to not hold anything back, and allow the health care provider receive as much information as he could. Another positive technique I observed was Hank’s use of providing information to the patient and his family. After the patient was in stable condition, Hank was able to let the family know his diagnosis of a heart attack (mainly due to the patient’s uncontrolled high blood pressure) and that he was in stable condition resting. This provided information to the patient’s family showed signs of relief, especially knowing that the medical team was able to determine the diagnosis and find out that he was in stable condition. The final positive technique I was able to observe was asking relevant questions. Hank’s ability to ask open-ended question in a timely manner allowed him to be able to find the patient’s diagnosis at an early time period so it could be treated. Also, these questions allowed Hank to realize that the patient was not properly taking his blood pressure medication, so this provided information at a possible underlying cause.

Although Hank did show many positive techniques when communicating with his patient, there were some negative points, especially when discussing about health literacy. The patient did understand a few medical terms like blood pressure and heart attack, but not enough to connect all the dots to why he had experienced a heart attack in the first place. Hank came to the conclusion that it was caused due to his uncontrolled blood pressure, and the patient did understand that, but he just was not able to make the connection. So, Hank was not able to use plain language during his patient education; this in turn would leave the patient even more confused, and a big misconception made by the health care provider that the patient should be taught about his medication for his blood pressure. Another negative was that he did not ask the necessary questions about the patient’s medication list. He did not ask anything about the route, benefits, side effects, or even what the medication is for. For a patient that obviously has problems with taking medication, this would be one of the first topics to discuss and make sure the patient is educated in this specific field, because instances like these may lead to possible death.

Even though this television show is fiction, it was nice to be able to apply some of the communication techniques I learned in class and identify when they are being used in a healthcare environment as well. Watching medical shows now, a lot of them make more sense and I am able to pick up on the benefits and negatives between communication techniques and see how they could be better, almost as a way for me to practice for events in a  real healthcare environment.

NURS 2460 Blog 3

Ian McGraw

NURS 2460

10 February 2020

Blog 3

After looking back at my short time in the clinical setting, my communication with my patients has been interesting and something I do look forward to. I still am a little nervous and uncomfortable in the morning right after nurse huddle to talk to my new patient. I believe that my first communication with each patient has been my biggest challenge so far. I am not a very outgoing person, but I am sociable and able to continue and start a conversation with someone, but it usually takes a decent amount of time for me to reach that comfort level with my peer. As I have been learning in nursing school through my brief time here, I grow based on uncomfortable situations and how I am able to handle them, whether that is in life or in the real clinical setting. These are skills I need to apply into the work area.

So with that being said, I need to learn and practice how to quickly become adjusted to my surroundings in the hospital setting, and learn how to become an excellent communicator to not only my patient, but also my colleagues. In the morning, I do not always feel comfortable, it is not like the nurses, PCA’s. or physicians scare me or intimidate me, but it is more that I do not know always know how to start a conversation that will get me the information I need about what I need to do that day or more importantly what I need to know about my patient. So, the past few times I have been in the hospital, I have just waited after huddle  and almost looked lost in the early morning waiting to receive information about my patient, and waiting until my nurse introduces herself to me before I do, and then waiting for her to enter the patient’s room before me as well. To me, this may be perceived as being scared, shy, and uncomfortable which are skills no nurse should have in the hospital setting.

With that, I understand that it is a slow, progressive process that does take time, and I am not expected to have these communication and social skills done perfectly. There are techniques that I can apply to the hospital setting that can make this process go much smoother, though. First, I have to take initiative and maintain a steady level of confidence. I need to make it a point to start conversations with my colleagues as well as my nurse to develop that relationship early in the shift, and make sure they know that they can rely on me to serve our patient. This way, I will be able to gain a brief understanding of my patient and my job for the day without waiting around. By gaining this relationship, it will help me take that confidence into introducing myself and communicating with my patient for the first time that day. I also need to learn how to better control my emotions; I tend to be one that can stress out easily, and I do not ever want that the carry over into my job or choices during clinical practice. So, with the techniques applied in class, I will take deep breaths before entering my patient’s room as well as understand that I am capable to apply what I have been taught. This will help me carry over that confidence and stress-free energy to my patient to make them feel better as well. These are a few simple techniques that I need to apply in the clinical setting.

Like I state earlier, I understand that nothing is ever perfect in the profession and every nurse is learning something new each shift about themselves. Uncomfortable situations occur daily, and overcoming them shows a great deal of each nurse’s skills. Nursing takes time and a lot of practice, especially in communication with patients.

NURS 2460 Blog 2

Ian McGraw

NURS 2460

27 January 2020

Blog 2

Earlier this week, I was able to take some time just to people watch– or in a more professional form-observe. With such a busy schedule this semester, it was nice to be able to employ some of my free time into this exercise and see what others around me do when faced with a vast amount of ways to communicate with their peers. So, I went to the Ohio Union to observed a wide range of individuals from college students, staff, adults, children, and even animals to see how they communicate and interact with each other.

After spending over thirty minutes in the Union observing people, the most common sight that I saw was college students independently sitting in a chair on their phones with headphones in. I am not shocked by this result as I myself do the same thing; for me it counts as a mid-day break between classes just to relax and catch up on things through social media and such. But with this result, it shows how so much communication takes place with texting instead of face-to-face in society today. The next type of communication I saw was a group of two or three college students that were verbally communicating, but with very poor nonverbal communication techniques. Rather than putting down their phones, actually listening to one another talk and creating good discussion, it looked as if when any of them talked no one was interested. That was one scenario that made me realize how important nonverbal communication is. With the addition of eye contact, facial expression, and overall consideration of the person talking, those girls could have made whoever was talking feel more important about what they had to say. I myself am guilty of this habit as well; even when I go out to dinner I will sometimes feel the need to go on my phone when communication is occurring in the group itself. I realize that it is extremely disrespectful but I do it anyways, but my goal is to work on this in the future as it will not only help my communication skills, but also my way of therapeutical communication in the clinical setting.

The best type of communication I saw in my time at the Union dealt with great nonverbal communication and a small amount of verbal. As stated in class, 90% of communication deals with nonverbal as the top priority in society and the hospital setting, and the scenario I observed perfectly fit that description. There was a father and his little son that stopped to take a picture with the infamous Brutus bench statue, as do most people when it is their first time visiting the campus. The kid was so happy and excited to sit next to Brutus, and his father was too; they both had huge smiles on each other’s faces and both just looked so happy to be there, in the present with each other and it seemed that they did not need and technology to help support their happiness. After they took the picture, the only verbal communication I heard was, “Dad, thank you for bringing me hear!” It honestly was one of the highlights of my day to be able to see their interaction, even if it dealt with very little verbal communication.

After completing this exercise, I was able to reflect on myself and see how technology has made college students (myself included) forget their ability to communicate on a standard level. It shows that there is so much to learn still with how to better society’s skills in the verbal and nonverbal communication sector, and the ability to balance technology with those skills.

NURS 2460 Blog 1

Ian McGraw

NURS 2460

13 January 2020

Blog 1

     My name is Ian McGraw and I am currently a sophomore nursing student in Ohio State’s BSN program. In this blog, I will give incite on a little bit about myself and how I was influenced and the path I took to want to become a nursing major.

I am originally from Youngstown, Ohio, and this is actually my first year at Ohio State. I am a transfer student from Youngstown State University and that is where I started my pre-nursing curriculum and career. I was originally accepted to Ohio State as an incoming freshman and was planning on attending, but I decided it would be best for me to stay home. After almost half a year at school, I felt like I missed out on a great opportunity, so I decided to re-apply to Ohio State, but this time directly to their BSN program. It was a long process, but in the end it all worked out.

So a little bit about myself. I attended Canfield High School and played both basketball and baseball; I love any type of sport honestly. I like to exercise because it helps keep my stress at minimal levels, and hanging out with friends and family as much as I can. I have two sisters, one is currently in her fourth year of medical school and ready to start her residency this upcoming summer, and the other is in graduate school for genetic counseling. My dad is a pharmaceutical representative and my mom is an oncology nurse at our local hospital. So as you can see, my family is circulating around science and the medical field; this is one reason why I wanted to become a nurse.

Being a part of a family in which each job has some connection or relevance to each other at all times acts as a comfort for me because they can understand what we go through. This applies especially to my mom, her ability to care for others, her amount of responsibility that she can take on, as well has her fun/social skills can really relate to me. She is another reason why I want to become a nurse. My dream job is to become a nurse anesthetist (CRNA). For the longest time I did not really know what I wanted to do, but before my freshman year of college I looked into the career and was able to meet a few in my local area and felt that not only is it a successful field, but I can relate to them from a wholistic approach.

With that being said, I am excited to continue my education to become the best possible nurse and hopefully nurse anesthetist that I can be. Also, I was glad to be able to share a little about my story and personal life on how I got to this position.