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At the beginning of the semester, it was a goal of mine to become more proactive in my efforts to work on my communication in a healthcare setting. This involved working on my communication with my patient, my nurse, my PCA, and my clinical instructor. In terms of patient communication, this is where I felt the most comfortable. I generally have a very friendly demeanor and I knew that I had strong communication skills when it came to working with older adults. I was generally extremely comfortable talking with my patients since I would go into their room with a plan and was not shy about admitting that I would not be the best person to answer certain questions, but I was prompt with their requests and utilized a lot of skills from therapeutic communication when my patients would express concern or anxiety to me.

In terms of communicating with my PCA and nurse, this required a little more work. At the beginning of the semester, I lacked confidence that I now have. I wasn’t great about being proactive in asking them if they needed help and my verbal communication with the nurse about a patient’s condition would sometime be jumbled or confusing. As the semester went on and I learned some of these communication skills (SBAR, etc) and gained confidence, it became much easier to communicate with the nurses and PCAs that I used to find intimidating. By the end of the semester, I was asking people if they needed help with anything and communicating regularly with my nurses about changes in my patient or unusual vital signs.

In the future, I would like to continue to improve on my confidence. As I mentioned, when I get nervous sometimes my words come out very jumbled and I can’t get my point across. Seeing myself already improve regarding my verbal communication has shown me that I can continue to grow in this area. In terms of my nonverbal communication, I would like to present myself as more confident than I might be in front of my patients. Some of them would say things like, “oh, you seem a little nervous” and the last thing I want is for my patient to be concerned with whether or not I know what I’m doing. Taking deep breaths and continuing to enter my patients’ rooms with a plan will help me relax, trust my knowledge, and build on my nonverbal communication.

I’ll be the first to admit that I love reality TV- especially on the channel TLC. One of my guilty pleasures is a show called “My 600 Lb Life”, in which the producers follow the lives of morbidly obese patients through their journey to lose weight. The main doctor showed on the program is named Dr. Nowzaradan (AKA “Dr. Now”). Dr. Now is a bariatric surgeon who performs gastric bypass surgeries to help these patients control their eating habits in order to ultimately lose weight. Generally, he is a very supportive doctor, especially given the difficult population that he works with. His patients can be stubborn, self-neglecting, and impatient, and often take this out on him when he only has their best interests in mind.

I watched this clip of an argument Dr. Now had with a patient on one of the episodes of My 600Lb Life. While there were some examples of good communication here, I think overall Dr. Now could have done a better job using therapeutic techniques to encourage the patient who already was likely disheartened by his inability to lose weight. Dr. Now came into the room in a pretty confrontational manner and immediately began questioning the patient on why he skipped his last appointment and made some very accusatory statements about his lifestyle. The patient claimed that he must not be eating the right things since he had only lost nine pounds in two months, but Dr. Now brushed that excuse off and stated that it was the patient’s fault that and that they were making excuses for their poor dietary choices. I think Dr. Now could have at least entertained the notion that perhaps the patient really did not understand the resources he had been provided with, but I also understand that Dr. Now knows how this population operates and let his frustrations get the best of this conversation. The patient expressed that he had been throwing up a lot and without missing a beat or acknowledging that this is a hard surgery to recover from, Dr. Now just jumps into talking about how it’s the patients body trying to correct his overeating with a very stern tone. While this form of communication can be good to really drive a point home and work towards getting a patient to hold themselves accountable, I think Dr. Now does not fully realize how hard food addiction can be to overcome, even if a patient has had a bypass. Dr. Now did acknowledge that the “easy” part (the surgery) was over and that the changing of habits and diet is the hard part, but basically did so in a way that called the patient lazy and irresponsible when there may be other factors limiting the patient’s ability to stick to their healthcare plan.

I admire how Dr. Now is straight-forward and does not sugar-coat information, however. Some patients really just need to hear the truth, even if it hurts, in order to benefit them in the long run. He provided some education to the patient a few times in layman’s terms which is positive, but I think overall the exchange was very negative and Dr. Now spent very little time trying to work with the patient to improve rather than just pointing fingers and scolding.

So far in clinical, my biggest communication challenge this far has been communicating information to the nurse and my PCA. I have done well so far with communicating with patients, explaining what I’m doing and why I’m doing it, but I am still trying to figure out what has to be told to the nurse and the urgency of the information. My instructor has been working with me on this and of course always lets me know if there is something the nurse has to know right away, but I want to be more confident in what I know I’m supposed to be reporting.

In terms of what about “me” that contributes to this challenge, I think it’s just a general lack of confidence in my knowledge of normal vital and lab values. I know with experience and continued education the confidence will come, however in the mean time it’s a nerve-wracking thing because I want to make sure every important detail is told to the nurse because it affects a real patient who is experiencing some sort of discomfort or illness.

In order to overcome this challenge, I plan on continuing to work with my clinical instructor and asking her ahead of time what should be reported to the nurse. For example, if I’m about to take vitals on a patient with COPD, I can ask my instructor to help me figure out what values would be concerning and should be reported (e.g. a low O2sat). Going over this ahead of time will help build my confidence if I find a concerning value that I will automatically know to report to the nurse and in the future will have that in the back of my head for future patients with similar disease processes.

For this assignment, I chose to sit in the Berry Cafe at Thompson Library for 30 minutes. I was at Thompson doing homework on Wednesday afternoon, and while I was taking a break I decided to look around and observe the different types of communication on display. The first thing I noticed was that almost every single person at the cafe was on their phones, excluding the employees. People waiting in line, people eating at tables by themselves, or even with friends, and people who were studying were intently looking at their laptops. The few bits of verbal communication I noticed took place after a student would place an order at the cafe then talk with a friend while waiting to pick it up at the end counter. It was pretty busy seeing as I was there around lunchtime, so I did notice some people expressing impatience while waiting for their mobile order that they’d sent ahead of their arrival. I could tell they were impatient from crossed arms, visible sighing or eye rolls, and just general agitated mannerisms while they would look through the stacked orders waiting for other students on the shelf. They would restlessly pull around other orders to see if their’s had magically appeared behind the existing ones and then sigh in frustration when they discovered it wasn’t there. This was the most obvious form of nonverbal communication I observed.

While I did observe a lot of talking amongst friends and what I’m sure was people texting their friends or emailing their professors, it was clear to me within this 30 minute period that nonverbal communication can tell you a lot more about a person’s mood and attitude… even from a distance! Nonverbal communication- the crossed arms, the facial expressions, and the manner in which people would sort through the orders- has the ability to project someone’s emotions more loudly than verbal communication can in most cases. Honestly, I believe that it is much easier to show someone how you are feeling than to tell them. While I couldn’t hear many of the conversations that I observed at Berry Cafe, I would bet that I could walk up to a couple of people and be able to correctly identify the emotions behind their words if not the words themselves. It was a really interesting experience and I know that in the future I will be paying a lot more attention to nonverbal cues that I observe in everyday life.

My name is Ellie Wilson and I am currently a third-year at OSU, but it is my first year in the nursing program here! Before I applied to the nursing program, I was a psychology major but was not really sure as to what I wanted to do with that degree. I had considered becoming a genetic counselor or a psychiatrist, but never felt a very strong connection to either of those careers. All I knew is that I did NOT want a normal, 9-5 desk job in an office or cubicle and that I wanted to help people. Nursing seemed like the perfect option for me, especially since I have always heard about what a flexible career it is. I know many nurses who have been able to have families, active social lives, and interests outside of work and that is very appealing to me.

I am from a northern suburb of Chicago called Deerfield and came to Ohio State for the school spirit, strong academic programs, and atmosphere. I love the fact that our campus is so close to a city, and although Columbus is a bit smaller, being able to look down High Street and see tall buildings downtown reminds me of ~sweet home Chicago~ 🙂

In terms of my involvement on campus, I have explored a lot of what OSU has to offer! As a freshman I joined a few service organizations, mainly focused on working with the homeless population of Columbus to provide moral support, donated items, and food donations collected weekly from a local Panera. It has had an enormous impact on my time at Ohio State so far and I’m excited to continue working with these organizations for the remainder of my academic career here!

Another big part of my life on campus is my involvement in the sorority Alpha Chi Omega (AXO)! I joined a sorority because honestly I did not have a ton of friends on campus being from out-of-state and I was intrigued by the recruitment process and their involvement in philanthropies. I ended up joining AXO because of their philanthropy specifically (domestic violence awareness) and strong messaging of women empowerment. I’ve made some of my closest friends in the world through this organization and have become more deeply involved with leadership within AXO by becoming the service chair and participating on the Chapter Relations and Standards board!

My goals for nursing currently are to become a labor and delivery nurse or a women’s health nurse practitioner! I know that this goal is bound to change since almost everyone comes into nursing expecting to do one thing and ends up doing another. So far I feel like I’ve achieved a good balance between academics, social life, self-care by working out when I can, and maintaining a healthy relationship! I’m excited to see where nursing takes me and I am really looking forward to this class!