Personal development plan for student nurses

In this commentary I am going to discuss one episode that occurred during one of my practice days on placement. This will be specifically related to learning outcome number 3: demonstrate an understanding of the professional role of the nurse and the core values and principles underpinning ethical health and social care practice. I am going to discuss this episode and show evidence of reflection by giving my opinion of how this episode could have been dealt with better. I will also identify any areas that require further development and discuss how this is going to be achieved.

A definition of communication is The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Definition from online medical dictionary.

During my 35day clinical placement I attended a ward round. I have chosen this particular occasion as I feel the communication between the healthcare professionals and the patient that attended the ward round was poor. I will now give a brief description of who attended the meeting, where it was held and a account of what happened during the meeting.

The following Multi-disciplinary team members attended. The consultant, SHO, registered mental health nurse that worked on the ward and myself a student nurse. It took place in a visitors room located within the ward. The healthcare professionals sat opposite the patient. Whilst the patient entered the room greeting the healthcare professionals the consultant was documenting notes and never acknowledged the patients greeting and also put up her hand asking the client to “be quite” while not making any eye contact and continued writing. Eye contact plays a pivotal role in our non verbal communication. Without true eye contact you will not have the feeling to get “in touch” with the person you are talking to. It’s awkward to have a conversation with someone who never looks at you. This was my first concern. Some of the common signs that the person you are speaking with maybe giving poor communication include:

Hand/arm gestures are small and close to his or her body.. Facial expressions are minimal. Body is physically turned away from you. Arms are crossed in front of body. Eyes contact is minimal or not present.

Minutes later the consultant started asking the patient questions. One question that was asked and the patient became particularly distressed was “would the patient be willing to try clozipine as a part of there treatment?”. The patient replied and expressed that they have had that conversation with the consultant on numerous occasions. As the patient was on that medication before and the side effects were “horrific” there answer was still no. As the patient was speaking I noticed that the consultant was still writing and looked as if they were not listening. The consultant told the patient that they had to take it because it would help them and many patients have benefited from taking clozipine. The patient then became extremely frustrated and agitated shouting at the consultant that they don’t have respect for them and don’t listen to there point of view.

The benefits of good communication are avoiding confusion and misunderstanding reducing frustration, stress and sickness levels, capturing new ideas and initiatives facilitating change, gaining an understanding of others perspectives and meeting clients needs

Good listening skills include Empathy – listening for feelings, absorbing unpalatable messages, appreciation of the other person’s point of view , listening, not just hearing. Again I felt that these key areas of communication were absent in this scenario.

The consultant then asked the nurse to escort the patient out of the room. The nurse did so holding the door open pointing outside it at the patient. The patient left upset and feeling let down by the healthcare professionals.

I feel that one the important roles all of the healthcare professionals that were involved here is to be a theraputic agent. The health care professionals should of used core skills used in the humanistic approach which as Carl Rogers (1983) states is conductive to building positive therapeutic relationships.

Relationships between mental health nurses and client are established through communication and interaction

Communication skills such as actively listening to a client and demonstrating this by reflection (mirroring), paraphrasing, clarifying and summarising, expressing empathy by conveying your understanding of how the client feels from there point o view, and from where they are coming from. Unconditional positive regard, not making value judgements about a clients self worth, congruence, is the message sent the message received and honesty, openness and trust (Egan 1982).

Regardless of the situation it is important to remember that interaction with a client is a part of your professional role and therefore must be respectful of the client and his or her needs.

A number of communication skills or techniques wound of been effective in the scenario to promote a good therapeutic interactions with the client.

Firstly introduce yourself and your role and invite the client to sit down. The Health care professionals should of made eye contact. This gives the client a feeling that they are being acknowledged . Listening to the client is also important. This gives an understanding of what the client is trying to portray . Verbally an non verbally. I think in this occasion this was bad practice. When researching what should be done differently for future practice I feel that mostly everything that was done in this situation was not good practice except the environment. From doing this research I have learned the different was in which people communicate and what types are especially important within a nurse and patient relationship.

In conclusion, I understand what is expected of me as a professional nurse in relation to communication. Throughout this commentary I have expressed my thoughts and concerns in relation to the scenario. With the same scenario, I have given an example of good practice and one example of bad practice. This reflection has given me a greater understanding of the importance of communication within a healthcare environment.

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