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Clinical was one of the biggest challenges that I had to face this semester. This is because it is something that was completely out of my comfort zone. I did not have any experience working in a healthcare setting before this. In addition, I had been lucky enough not to have to be in an inpatient healthcare setting for any reason at all throughout my life. This was all new to me so I have seen a lot of improvement from where I started which was the very bottom. The improvement that I have seen has mostly centered around my confidence when walking into the clinical setting. I think that confidence is the basis for the other skills that are necessary in the healthcare field. In my communication, I know I have improved simply by the fact that I can walk into a patients room ready to introduce myself with little nervousness now. At the beginning of the semester this simple task made my stomach turn and my mind race. I also have improved my communication skills with other healthcare professionals. I have always been a person to ask questions when I was unsure, but it can be intimidating when the person is not there to answer your questions. For example, in a classroom it is quite literally the professors job to teach you, where as when you are on the unit, the nurse you’re working with has a lot of other responsibilities that have nothing to do with answering your questions. I have found that almost all the nurses I have worked with have been very open and forthcoming with anything I asked, but sometimes it is bust and hectic and something go unanswered or unasked. I think a lot of it has to do with reading the situation and knowing when is the appropriate time to ask certain questions and when it is best to find the answer later. I also have improved in my knowledge of the way things work on the unit and some of the resources available. There are so many different specialties and healthcare workers that often go overlooked that play a vital role in the care of patients within a hospital. Active listening is something that I have definitely improved on, but I still have a long way to go. I have always been a problem solver and so when I am speaking with someone my mind always seems to be thinking about what I am going to say next or what might be something to help them. I have come to realize that this is usually not what patients, and people in general, need from a good listener. They need just that, someone to listen and really focus on and validate what they are saying. Remembering to validate someone’s feelings without bringing in anything about yourself also seems to be something that I didn’t really notice before this class. I hear myself doing it, or I will catch myself before I do and I will think of a different way to answer the person I am speaking to, hoping to give them a more therapeutic experience. Recently, we have been learning about the different ways that different patients need communicated with. This could be due to age, developmental stage, or diagnosis. I think this is another challenge that I am sure to face in my career because it seems that it can be a daunting thing to navigate. I think that I will be able to do it effectively but it is definitely something that I will have to work on, especially I think with the older population because sometimes I think it is easy to forget how much these patients have been through and how much you probably do not know about their life. In my future practice these will be the things that I focus on the most when communicating with my patients. Sometimes making someone feel better can be as easy as sitting there and listening to them talk for just a few minutes.

I chose to watch an episode of the show Grey’s Anatomy. In this show the communication depicted is mainly between the surgeons and the patients. Generally, the surgeons seem to have a good relationship with their patients. They have established trust, but keep the boundaries firm. The surgical residents also are shown when they are communicating and establishing a relationship with the patient. In this particular episode there was an interesting situation. A husband and wife had been attacked by a bear. The husband jumped in front of the wife to save her and so he was more severely injured. When the wife was stable and in her room, her lover ran into the room, very concerned for her. The surgeon, Jo, was very confused at first because as far as she knew the patients husband was in a different hospital room. Jo did not ask but the patient explained that she loved her husband but she wasn’t in love with him anymore so she had an affair with this man. She had planned to tell him on the camping trip they were on, when the bear attacked and her husband jumped in front of her to save her. The surgeon was struggling with how to handle this situation because the husband was begging to see his wife, but they didn’t want that to happen because the stress that information would cause would be detrimental to his condition. This would put any health professional in a unique situation. There are confidentially issues, along with moral issues. It could be hard for her to care for the wife knowing that she has betrayed her husband. In addition, she can’t counsel the patient on how to control her love life. In the end, the husband ended up dying without ever knowing that his wife was cheating on him and his wife grew angry at her lover. The communication did shift a little bit between the wife and Jo once the lover was in the room. I think that Jo had some personal moral issues with what she was doing, but the wife explained and the tension dissipated. In this situation, the wife explained, but that won’t be how it always is. I think that one thing about this is that sometimes there will be times in my nursing career where I personally do not morally agree with something I know my patient is doing but as long as it is not interfering with his care or the care that I need to give, I have to put my personal beliefs aside and give the best care possible. In addition, being put in that difficult position really comes down to confidentially and the best interest of each patient. The impact that this might have had on the patient would be that a little bit of judgement or shame was felt which could deteriorate some of the trust that Jo and the wife had before. This would also impact Jo because a level is trust is a big part of providing the best care possible.

The biggest communication challenge I have experienced in clinical so far is active listening. My mind is always racing with what to say, what is wrong, or wanting to relate it back to something in my life. I think this is because I want to solve the problem and try to help the patient, even when what they probably need is for me to just listen. I think the biggest step to try and overcome this is being self aware. I noticed it the most in my most recent clinical. I constantly was thinking about my answer and stopping myself from relating what my patient was saying to an aspect of my life. It helped me to recognize I was doing it because I would refocus and try to just listen to what the patient was saying. Another way to overcome this is to just focus on my responses being about the patients feelings and how things must be for them. This will be a tough thing to adjust to because it is something I feel is a deep habit of mine. I think trying to do it all the time too, not just when I am in the clinical setting would be beneficial as well.  Something else that I find can be challenging is communicating with a patient who openly does not want you to be in there. I think that this is difficult because it is challenging to realize that their emotions and attitude are probably not a reflection of anything you’ve done, but most likely their situation. Not many people are happy that they are in the hospital, and this is a very frustrating time for them. I think that the most important thing to remember when communicating with people who are in this emotional state is validation because I think that is one of the most therapeutic ways to communicate that you are there to help them. Remembering that they are in a very vulnerable state and allowing them to get some of their emotions and frustrations out is important.

I took 30 minutes and observed what was happening around me at a Starbucks here in Columbus. The first thing I noticed was that almost everyone had a laptop out and earphones in. Everyone was working independently except for 2 people who seemed to be working together on something. These two men were communicating verbally, both seemed relaxed, but one of the men also seemed frustrated because he kept running his hands down his face and sighing. There was only one person that had an actual print book in front of him, which he seemed to be enthralled in, not looking up from the pages very often. Surprisingly, those with laptops did not have their phones out very often. I know it is a challenge for many in my generation to put down our social media apps and really focus on school work, but everyone around me really seemed to be honing in on what they were doing. It was a pretty calm, quiet environment. The employees were talking the most, getting to know each other and having small banter, I’m sure to keep the shift entertaining. None of the employees seemed to be stressed out or feeling any pressure though I assume it can get stressful during peak times. While one man was trying to get to his seat he hit his head on the sign hanging on the window and he looked around to see if anyone had saw and then started laughing to himself. Another interesting thing that I noted was the nonverbal communication most people had towards strangers. Almost every person that walked in looked around for a table without making eye contact with anyone else and picked a spot that offered them the most space between someone else. In one instance, a girl got up and left from a large table and one other girl that was sitting there moved over, so that she would be further away from the other person left sitting there. I think this is interesting because it really shows how society tells us that when in public you stick to yourself and those around you that you know. A person that seemed to be a higher up with Starbucks came in and the attitude of the employees shifted slightly to being a little bit more polite and attentive. A family walked in, including a man, woman, and a small child. The child made eye contact with anyone looking at her while she walked through the store, which is interesting because she hasn’t learned yet that this isn’t considered a social norm, and she seemingly felt nothing awkward about it. While waiting for their coffee the woman sat on the mans lap, while the child took the other empty seat, which showed the affection the couple has. In addition the smile in both of their eyes as they watched the little girl talk to them and drink her hot chocolate really showed the immense love that both of them have for her. I think all of the things that I observed was in line with societal norms about communication. Most of what I saw was nonverbal communication indicating a few different emotions and feelings.

My name is Maria Hermann and this is my third year here at Ohio State. I graduated from a very small high school, so coming to OSU was quite a change but I have been in love with it ever since my first visit. I was a pre-nursing student for my first two years here. I did not get into the program my first time applying, but I stayed with it for a second year, finished my general education courses, a minor in HDFS and finally was accepted into the program. I am on my way to earning the new primary care certificate that the college is offering. I took the first course this past semester and have mapped my way for the rest of my time here. I love to read novels, travel to new places, and occasionally play volleyball. In the free time that I have I like to spend time with my friends and just relax in my bed with a good tv show or a good book. I am an active member and treasurer for the Buckeye Student Nurses Association student organization. I have attended a few National Student Nursing Association conferences though the group that furthered my passion for nursing. I am not completely sure what area of nursing I want to practice in yet, but right now I see myself in the NICU, labor & delivery, women’s health, or pediatric oncology. It is quite a few different areas, but I am hoping to find love for something during my time in the nursing program. Eventually I would like to go back to school for my masters to be a nurse practitioner. I have thought about being a clinical instructor as well. I think that I would really love helping new nurses discover their love for the profession and their confidence in their skills to take care of someone when they are at their most vulnerable. That is what I am hoping to gain from my clinical time. I am originally from a small town just outside of Kent, Ohio called Atwater. It is located about 2 hours north from here, so I do miss my family often, but I take advantage of the times that I do get to spend time with them.

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