Even with working at the James as a SNA, when it came time for clinicals I was so excited but so nervous. When I started clinicals I had challenged myself with gaining confidence in the little things like introducing myself to the patient, taking vitals, and doing a head to toe assessment in an organized manner that keeps the patient at ease. I have seen a huge difference in my therapeutic communication skills with the patients and their families throughout my clinical shift. I even had a clinical experience where at the end of the day, the patient thanked me for helping get her through the stress test without having an anxiety attack like she normally has had. Hearing that made my whole day, I was so happy that I could help someone in that way! Something just as simple as keeping someone distracted with conversation during a treadmill portion of a stress test can help the patient so much and I learned that firsthand. I have also gained a lot more confidence with taking their vitals and communicating with nurse in a comfortable and professional manner. I became comfortable in the setting and often towards the end of in hospital clinicals found myself helping people find things they needed as I had finally figured out where certain things were. I also became better at finding education materials that fit the patient’s needs and then be able to sit down with them and discuss those things. I even helped one patient download a health app on her phone as she wanted something on her phone to help that had accurate information for her disease. It feels great to be able to see improvement in myself and see how it is helping my overall work in clinicals.

Although I have seen a lot of improvement in my skills throughout clinical, there are still many areas where I want to continue to improve my skills. I often find it hard to figure out when is a good time to use silence and which aren’t good times to use it in a therapeutic way. I also want to improve my skills in my head to toe assessment because if I forget something and have to go back to it during the assessment, I tend to get a little flustered with myself and don’t want to become so flustered as that can show sometimes to the patient and that isn’t therapeutic in any way for them. I also want to be able to become more confident when doing actions and speaking to the patient when in front of the family as sometimes it can feel like they are questioning me and I start to become less confident in what I am doing as I do it. There will always be areas that I want to improve in, but I think for the first clinical experience of nursing school that I did pretty good and have goals set to help make me successful in the future. I was sad to see clinicals cancelled in person for the semester, and I cannot wait to go back next semester and get to work in pediatrics as that experience will help teach me more therapeutic communication techniques for that population.

Grey’s Anatomy is a popular TV medical drama, but when looking closer there are many positive and negative patient and caretaker communication interactions. In this episode that I watched, there were many great therapeutic communication skills used. When a patient was refusing to do physical therapy, the doctor instead of saying they were stubborn or unmotivated, found something that motivated the patient and used that to help with physical therapy. The patient wanted to hang out with his siblings and so the doctor set up a tennis video game that he could play with his siblings to help with PT. Another patient was starting to feel lonely and as if she wasn’t going to be like the others her age and the doctor disclosed personal information about his struggle to success so that they could relate so that it could benefit her. During this situation the doctors also used silence and active listening to help the patient open up about her feelings regarding the present situation. When there was a scene in the ED, a person reported what had happened to the patient and the doctors repeated this statement with paraphrasing so that they could confirm what had been said.  Instead of telling the patient they are proud of them, the doctors said that this is a very difficult situation and they are doing well at taking one step at a time and thinking it all through. When the patient’s parents were overcome with emotion, the doctors sat down with them and allowed them to let out the emotions and continued the conversation with different cues to allow the patient to continue speaking. Lastly, when a patient wanted to know what each doctor did, the chief of surgery used plain language to explain the positions.

While the previous paragraph showed many positive examples of therapeutic communication, there were some negative examples also. When dealing with patients, the doctors often got over involved, and another doctor would step in as the patient story would start to become very personal. When one patient was ready to be discharged, the doctor refused to let him go as he was homeless and she walked him around the hospital so he could learn different jobs. She later asked him to go home with her as she had an extra room for him, this is a perfect example of a role boundary violation. Another negative was when a patient was venting to the doctor, the doctor stood over the patient and had their arms crossed showing a power difference and continually looked away from the patient speaking to look at distracting noises which shows a lack of active listening. Also when listening to a patient give their ideas on what is next for them a doctor stated their own opinions as a “mother” rather than advocating for the patient’s opinions and decisions showing a boundary crossing. Another therapeutic communication error was when the doctor gave the patient false reassurance that they would get a liver that day without having the liver ready or in the hospital as many things went wrong afterwards that prevented them from getting the liver. Overall the episode showed many positives and negatives that were interesting to notice and good to see and find what needed fixed so that it could help me learn what to do in certain situations even when emotions might run high.

Clinicals this semester has been eye-opening; I am a SNA at The James but clinicals combines a little bit of that work in with a lot of new material to think about while working with the care team and patient. My biggest communication challenge so far has been schedule workload with the staff. The staff have their own ways of going about morning rounds, etc. and being a student nurse, we must wait for the nurses and PCA’s to come around before we can begin on our single patient. It makes it difficult to plan and organize the day when sometimes I am not able to get vitals until almost 8am because the staff hasn’t been around to do handoffs. I tend to be a very organized person so not being able to schedule anything can make it stressful and hard to make sure I accomplish what is needed at the right time. I have started to see a pattern with how the timing of things goes with this group of nurses and so I will hopefully continue to adjust and get better at planning when to do what with when the nurse needs or has time for things. I contribute to this based off just how I am programmed to try and plan out the things I need to do throughout the shift.

I need to continue to push myself to become better at working off other people’s schedules because a lot of times in this profession that’s what happens. To help myself overcome this challenge, I try to just be prepared and have a positive outlook on the day ahead. If something can’t happen at a certain point or if I know it’ll be awhile before the nurses will be around and I’ll be able to take vitals then I can pick something else off my to-do list to do in that moment. But I also need to help remind myself to allow myself to be in the moment sometimes rather than thinking of the to-do list in my head. For example, the last clinical we had, my partner and I waited until the nurse could be around which ended up being close to 8:00a.m. and then our patient had a stress test that ended up taking 3 hours due to certain circumstances and while we still had our clinical worksheets to complete, we took the time to just be in the moment with the patient and talked with her about anything that she wanted. It helped her to not be so anxious for the test and we were reminded of why we wanted to be nurses because while it seemed so small while we had so much to do still, the patient thanked us afterwards and told us that due to their anxiety they never thought they would be able to get through that but she made it through because we were by her side throughout the test. It was so rewarding and in that moment I wasn’t stressed about the to-do list or how the stress test took longer than expected so it screwed up our schedule, I was in the moment with a patient and it was a good reminder for how I want to challenge myself to always be like that.

I often find myself at Starbucks, studying for the upcoming classes and finishing up homework. Sometimes while I am working on school stuff, I find myself looking up from my laptop and watching the interactions around me. My family used to play a game where we would try to guess their “story” as we observed people. While sitting in Starbucks, I observed many verbal and nonverbal communications as well as a dependence on technological communication. There were many people using verbal communication to their advantage as they worked in a group for their project, and some that seemed to use it to ask for help from others which showed how jargon can get in the way of clear communication when people ask a question with very specific wording. Some people when seeing someone they knew would say “Hey!” but without using their name, the other person walked off without realizing what was happening. I saw how people used nonverbal communication as they ordered their drinks they made eye contact with the barista and when their order was ready they smiled as the coffee was there to save their day. When working with group members, I saw people huddled together but then when a stranger sat down at a table the people already sitting there moved farther away from the new person. With today’s technology advancements though, verbal and nonverbal are not the only types of communication I saw.

With technology at every person’s fingertips that was sitting at Starbucks, I would look up and find many people texting others and sometimes you could even tell they were texting people who were sitting at the same table as them based off of the nonverbal reactions to one another. I could also find myself looking around and finding people taking selfies for snapchats that they would be sending to friends. It is very interesting to see the communication that happens at a cafe and how social norms help dictate the communication you see. Everyone looks up when someone walks in the door, but then they go back to studying instead of smiling at the person or saying hello and often sit down at the same table as others and don’t say anything to each other during the time at the table. But at the same time, you can see how nervous a person looks as they bite their lip and have their body shrugged as they ask the stranger sitting beside them if they could watch their stuff while they go to the bathroom.

It is very intriguing to see how people interact in these cafe settings. Some sit by themselves and use technology to communicate while others sit in groups using verbal and non verbal communication with each other. Then you have the communication interactions that are with the cafe workers. The workers often use verbal and nonverbal communication to put off a very happy vibe towards the customers. They smile and say hello and ask how your day is, and by watching the interactions at the counter, it makes a huge difference in how the customer walks away acting. By looking up for just a few minutes throughout your day, you can see how much communication matters to the world we live in and how we live.

Hello!

My name is Morgan McCutcheon. I am a second year at Ohio State University and am currently in the Nursing program here. I am originally from a small rural town east of Columbus, called Saint Louisville. I live there with my parents, my brother Sean, and my pets: Lizzy (cat) and Bailey (dog). I have always been very active growing up with sports, church activities, and clubs at my high school. Along with all those wonderful activities I participated in, I was most deeply involved with 4-H. I was in 4-H from the age of 5 to the age of 18. I showed market lambs, breeding sheep, market goats, and did various leadership and foods projects as well. In 4-H, I held various leadership positions including being a camp counselor, junior fair board member for our fair, lamb commodity royalty, State 4-H Ambassador, and then in my last two years I was blessed to be the 2017 Hartford Fair Queen, and then compete at the state level with all the other county fair queens to become the 2018 Ohio Fairs’ Queen. Being the Ohio Fairs’ Queen, I traveled the state speaking at various events, and advocating for the agriculture industry and our youth in 4-H and FFA. I would love if in the future I could become a 4-H advisor/volunteer and give back to the organizations that gave me so much throughout my years involved.

My parents both work for Ohio State as Extension Educators, so I always knew I wanted to go to OSU for college. Growing up, I always wanted to be a nurse because with having food allergies I had been around a lot of nurses who always made me feel better and I wanted to do the same for others. Last year I was in the Pre-Nursing program, until this spring when I was accepted into the nursing program. At OSU, I have been a part of the nursing club NSPIRE which I am currently on the Executive Board as a Social Officer, BuckeyeThon, and the Health Science Scholars. I have loved being involved with the organizations here at OSU, and they brought me some of my best friends and roommates. I also work at the James in the float pool as a student nursing assistant which has been eye-opening thus far. With the degree I am pursuing I hope to become a pediatric nurse with the option to go back to school to get my practitioner licensure, and I would love if I could someday work at Nationwide Children’s Hospital.