I would easily say that my first clinical experience was my worst, and that my most recent had to be my best. At my very first clinical, back in the beginning of January, I had an older adult male patient who had a habit of ignoring staff. I was extremely nervous, despite having a partner to work with. I remember being too anxious to even want to perform duties as simple as vitals, or talk with the patient for that matter. I tried casually diverting every duty to my partner. In terms of communicating with the patient, it was a mess of trying to rely on textbook lines from classes and hoping for the best. There was no genuine connection or any therapeutic relationship established.
My third clinical, however, seemed to be the turning point. It was the first time where I had a patient who enjoyed conversations, and so I was sufficiently able to practice therapeutic communication techniques and grow more comfortable with patient interactions. Whenever I had free time, I was sitting next to the patient- joking around with him and really lightening the mood in the room. This connection I established with the patient made me more confident in performing my nursing duties: I was able to do more than the ‘checklist’ expected of us, I tried to act proactively- noticing and helping things that I otherwise wouldn’t have.
My favorite most impactful clinical experience in terms of communication, however, had to be my second to last clinical. I had an older woman who was having a neural issue. As such, she was sitting up, rocking slightly, eyes open and nearly completely unresponsive to any prompts we asked of her. The other staff talked to each other in front of her- discussing theories of negative diagnosis- without talking to her. I made sure to talk to her, keep her company, and treat her with the same respect and dignity that I would any patient who was more alert.
My last in-hospital clinical had to be my favorite clinical of the entire semester. For the clinicals leading up to it, I would always forget something that I either needed to do in clinical or to write down for my post-clincal worksheet. At the last clinical, however, I was sincerely proud of how I was able to finally time manage: I finally got everything done that was needed and was able to go beyond the expected in several aspects as well. I joked with the patient, had a solid report to give to the nurse at the end of the shift, and more. Simply said, as cheesy as it is, I felt like a nurse.
The areas of communication where I could still improve applies to both my personal and professional lives. Primarily, I still need to work on improving my confidence in myself in conversations. I need to be able to trust myself with what I have to say, to be able to maintain eye contact, and more. Secondly, I need to be able to improve how I handle constructive criticism. My last patient had snapped at me for something small and I kept it together only because I knew that she was frustrated at the situation, not me. Still, I wondered that day if I would be able to compose myself. properly had it been an extended heckling that was more personal in nature.
Overall, I am proud of the growth in communication skills that I have experienced over the course of this semester. I have grown to a level of comfort with patient interactions that I never originally could have dreamed of achieving, and I hope to see that momentum continue forward.

The Tv show that I chose to watch is one that I surprisingly haven’t seen before: Grey’s Anatomy. I wanted to start near the beginning but not the pilot since I figured there would be more of a focus on character introduction than patient/provider interaction. As such, I went with Season 1, Episode 2 “The First Cut is the Deepest”. In this episode alone, I have seen stark incidences of both apathy and cultural incompetence.
The moments of apathy in the episode bothered me the most. In this episode, there were two interns charged with informing patients of their conditions. The two interns were bored, so they turned their job into a game of ‘who could inform 10 patients the fastest’. The show then cut to a montage of both of the interns speaking rapidly in medical jargon to obviously confused patients- eventually ending with a bored and quick ‘you’re gonna be fine’ statement to the patients. The interns, no matter how ‘bored’ they could have been, should not have lost sight of the fact that what they were saying to the patients were huge and potentially life-changing moments for them. The patients were scared, confused, and worried yet the interns couldn’t be bothered to try to have sympathy and deliver their message with more emotion and layman terms. The effect on the provider will be that they only will grow in their apathy and lose touch with interpersonal communication. This is dangerous since the patient may not want to share potentially important information with a doctor in the future who they think will be apathetic in return. Sympathy is needed to build trust and understanding, as well as to improve patient satisfaction and experience.
The second incidence of patient/provider communication that could be improved is when one intern was in charge of sutures in the ED. A Chinese patient came in only able to speak Chinese. The intern was flustered and yelled to the room- filled with other patients among the HCP’s- “does anyone speak Chinese?” This was concerning as the patient didn’t speak English, and so could have been very worried that the doctor who came to check on her started yelling to the room- thinking that something could be wrong. The intern should have already been aware of what resources were available to help her in the event that she had a patient with limited English and not acted rashly- potentially worrying the patient in addition to sharing patient information with the room. Throughout the episode, this provider is continuously annoyed with the patient’s lack of English and that the patient ‘won’t let [the intern] see her arm’ that needed stitches. The provider should have phoned translator services and, while on hold for a translator to come down, maybe look for an educational video in Chinese to explain the process of stitches so the patient could understand what the provider was aiming to do with her arm. The negative effect of the way the provider handled this situation was that the patient wasn’t getting the help she needed and was only becoming more desperate. This negatively impacted the provider as well as they didn’t think with a clear head to look for a solution, and only elevated their own stress in the process.
Overall, healthcare professionals are certainly busy, but they should still remember to slow down, have sympathy, recognize how their patient feels and try to find the best way to help. Both of these situations would have been fine had the providers slowed down, recognized the feelings of the patient and adjusted their communication strategies accordingly.

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.

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.

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.

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