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Blog 3- Challenges in Communication in Clinical

In regard to my clinical experiences thus far, I have found two major challenges in trying to utilize therapeutic communication: how to communicate with and develop a therapeutic relationship with someone who is too lethargic and depressed to maintain a conversation and how to respond to and comfort a patient when they are genuinely and reasonably disturbed or stressed.
In the second week of clinical, I had an elderly male patient who was in his last day at the step-down unit since he was being transferred to a skilled- nursing facility that night. Whenever I tried to talk to him to establish trust and a connection, he would only sometimes acknowledge me or respond: either by opening his eyes and looking at me disapprovingly, or by quietly giving a one-word answer. The ‘me’ aspect to this that made this interaction especially difficult is that I am a talkative individual. I enjoy talking to others as a means of bonding but he wasn’t in the mood for talking. I was also excited to utilize what I had learned in communications class but I wasn’t able to since I never really got to analyze verbal responses. I can try to fix this through not going in with a set expectation of how an interaction will go. I can also try to use opportunities like this to build my nonverbal skills and awareness. I could have tried harder to communicate nonverbally that he knew that he had support- without accidentally getting on his nerves by continuously trying to start a conversation when he obviously wasn’t in the mood for one.
In that second clinical, I also found it hard to try to lighten the mood in the room. Even if the patient had been more conversational, I’m not sure how to comfort someone who is genuinely in a bad situation with no real positives, such as the patient who was being admitted to a skilled-nursing facility later that day and was in such a state that he needed a full feed, bed bath and more. I think the ‘me’ aspect of this situation that makes it difficult is that I know not to and find it morally wrong to try to make false promises of “it will get better!” if there isn’t a guarantee that it will. So, I’m simply not sure what to say. I also tend to get overly empathetic, and so I find it hard to try to be cheerful when the situation is dire and I feel equally ‘down’ about it. I am not sure how to improve the former issue, but I can work on the latter by trying to be more objective about patient cases. Through doing this, I can hopefully lose the blinds that emotions often carry with them so I can better focus on the objective facts of the situation- hopefully having a better stance then to find potential positives to share with the patient. Lastly, I can work on trying to not to always be a ‘fixer’ of situations. I wonder if sometimes when there isn’t anything positive to say, all you can do is offer support somehow.
In all, my greatest communication challenges that I have experienced in clinical thus far pertain to establishing a connection with patients through nonverbals, as well as trying to support a patient when they have a poor prognosis or circumstance.

Observation Exercise

Today, I had to complete an assignment where I had to disconnect from everything and just watch: specifically, watch the people around me and how they interact. I was looking for their communication styles, nonverbals, etc. This exercise left me with two feelings. The first, I felt like a creep. One of the groups I spied on was a small trio of doctors and I think that they noticed my frequent glances. The latter feeling, however, was a little more positive: one of accomplishment. For the last decade, I’ve been addicted to a show called Criminal Minds, one where FBI Profilers utilize everything from verbals, to nonverbals, to objects and habits to profile people and the offender. Through this exercise, I felt like a profiler: analyzing others with the smallest of details and trying to piece it together to figure out how they felt about each other, the topics they shared and the situation as a whole.
I started this exercise as seeing it as a perfect excuse to get Panera. I grabbed my food, found a seat in a corner where I had a few groups in view, then started documenting the assorted groups of people around me. I first wrote down what groups were where in relation to me, what the general demographics of each group were (with crude distinguishing factors occasionally), and what technology was openly visible with each person.
The first group: to the front and left of me was a small group of doctors, one white male, one black male and one white female. The two males sat on one side of the table and the female on the other. The majority of the conversation was run by the white male, with the black male usually responding a fair amount and the white female responding a little. The two males would laugh at jokes together while the female wouldn’t join. The white male had an open stance, the black male had his arms guarded in front of him, and the white female had her arms crossed in front of her as well. The two men would joke a lot, commonly with hand gestures, and the female would be on her phone a lot. Both the white male and white female had a computer open in front of them and to the side but each only used it a bit. When they left, they left ‘at the same time’, with the female taking the lead and walking a few steps ahead of the guys, followed by the white man letting the black male pass him so the white male could go last and hold up the rear. Due to this collection of information, I was able to assume that the white male has an alpha personality. He initiated most of the conversation, had the most comfortable stance, laughed heartily at most things he said yet at only a few of the jokes from the others, and was sure to walk last when everyone left (to keep an eye on everyone, either as a controlling or protective manner). The black male was the middle personality. His guarded stance yet frequent contribution to the conversation and ease of laughter leads me to assume that he was either around people that he wasn’t yet comfortable with but was trying to be, he was mildly uncomfortable with the conversation topic, etc. Lastly, I would assume that the female either has a submissive personality or wasn’t very comfortable with her company due to her guarded stance, occasional contribution to the conversation, frequent activity on her phone, and eagerness to leave first and quickly once they got up.
The second group: two white males, one balding and the other with red hair. They sat on opposite sides of the table so they could face each other. The redhead had a computer open and to the side, as well as a notebook and a pen in front of him. They seemed to be having a more serious conversation, potentially even a casual interview based on their positions and business casual dress. Most of the time when the balding guy talked, the redhead would stare at him, hands folded in his nap, nodding and giving occasional words of affirmation. One time though, he stared down at the notebook and scribbled while the balding guy talked and looked off to the side. I’m assuming from this intentional lack of eye contact that it was either a personal story or uncomfortable information being shared. They eventually got up and left together.
The last group: I didn’t know that this was a group until I later inquired. To my left was a female staring a computer screen doing homework with her computer in front of her. I assumed she was here alone until she eventually talked to the guy next to her, on the other side of the corner next to her. I then assumed that maybe she had lightly known him and just met him that day since he was charging his phone at the outlet between her and I (something I asked about and found out when I sat down). So, I assumed he had asked her, a random stranger, to plug in his phone. Then, he later started talking ot her since he had just finished an awkward 2 minute conversation with another girl that walked by- prompting him to turn and whisper his distresses to the stranger next to him that he mildly knew. I figured they might know each other a little though since, when they talked, she turned fully toward him to engage in the conversation. I still wasn’t sure, however, since they were on opposite sides of a corner and had a backpack between them, possible adding a barrier between strangers. Since he was around the corner, I wasn’t able to read his nonverbals to help decipher their relationship. Eventually, when she got up to leave I was curious. So, I explained my project and asked her if she did know him or if they were strangers. She laughed and explained that they did know each other, and that he sat around the corner because he was ‘weird and gets distracted easily’.
Overall, I thoroughly enjoyed this exercise. It was interesting to watch the world and people around me: utilizing small clues about their communications guess their personalities and relationships ot one another. In the end, it was enjoyable to do and I am excited to apply it to my own friend group soon.

Introduction

Hello! My name is Emma Murdock. I am hoping to utilize this post to share with you an introduction to my life: featuring everything from my school life, to my home life, to my aspirations that I have for the future.

In terms of school life, I am currently a sophomore at The Ohio State College of Nursing. I have a 4.0, which I have fought hard to have and will forever work hard to maintain. I have spent plenty of time considering all of the minors offered at OSU and, after careful deliberation, have settled on none of them. I was going to minor in Architecture, as it is a passion of mine and was my ‘back-up’ major in the event that I didn’t make it into the Nursing program, but I have recently discovered that the minor features one of the most intensive and difficult courses offered at Knowlton. So, I plan to take that course this semester so I can still learn the content, but I have made the decision to audit is so as to not hinder my GPA. Through auditing, I am losing my ability to have the class count toward the minor, and so I have decided to throw out the idea of obtaining a minor altogether, and instead plan on filling my schedule for the next two and a half years with classes that interest me that I hope to learn more in. This idea is likewise supported by the fact that it took me a year to sift through minors and to try to narrow it down to one, as I am highly interested in several fields. So, I am very excited to take assorted classes from an array of minors to learn more in the fields that I find intriguing. Overall, however, I do plan on having the main focus of my studies center primarily on my Nursing courses.

In terms of my personal life, I enjoy rock-climbing, knitting, writing songs, painting, drawing and more. I am also a part of two clubs at the moment: Fashion Production Association and Mountaineers at OSU. With FPA, I am charged with making a dress for the upcoming fashion show in April focussing on movements that we are inspired by. My group has decided to focus on the Amazon Rainforest fires, and so my dress will maintain both green and fiery elements. With the Mountaineers, I have gone on three trips in the last year: a backpacking trip to Dolly Sods (WV), a climbing/deep-water soloing trip to New River Gorge (WV) and a climbing trip to Moab (UT). In addition to clubs, I am currently in the process of applying for an SNA position at the WEX. I used to work as an Anatomy TA for the Anatomy 2300 course at OSU, and though I loved the job, I felt that it was time that I work in a position more pertinent to my future career.

Lastly, my future aspirations are still fairly variable, yet a few things remain constant. One of my greatest goals that I am aiming for is to become a Travel Labor and Delivery nurse. I plan on taking the first year out of college to gain experience in the field, then the following five years traveling in the position. While traveling, I hope to set up programs at assorted schools where I could go in and promote the significance of healthy habits and easy ways to implement them in children and young adults’ lives. After that, I plan on settling down, having a family, and returning to school to get a teaching license/PhD and (hopefully) becoming a professor at a nursing college.

Overall, I am a workaholic who has an array of interests, hobbies and ambitions.