Reflection is important for reviewing an individual performance, and identify their strength and weakness to improve practice. Nursing students improve their learning by reflecting on a condition involving nursing care (Esterhuizen & Howatson-Jones, 2019). In relation to nursing practice, in this assessment I would reflect my experience about the difficulties faced with my communication skills during a patient encounter. Practice and evaluation are necessary to build effect effective communication with an individual. To provide deep intellectual and interpersonal abilities to patients, nurses must possess more than the general clinical information. To gain the best communication and interaction with patients, nurses must learn various aspects of communication and apply it in their nursing practice. (Machiels et al., 2017). This reflection is designed to self-reflect my communication experience in order to develop communication skills. I am writing my reflection based on Rolfe’s model of reflective practice. The patient who will be cited in this reflection will kept anonymous to respect his confidentiality. He will be cited simply by pseudonym, Mr. A.
Mr. A is 80-years-old patient admitted in nursing home as he was diagnosed with dementia. Dementia is a brain disorder that cause loss in memory, thinking and communication. This is a common disorder occur from mid to old age people. Cognitive and daily working deterioration are the key symptoms of dementia. Complications related to communication shows the earliest symptoms of dementia (Banovic et al., 2018). Initially, my mentor provides him nursing care and then I was assigned to continue the nursing care delivery. The rationale behind the fact that my mentor chooses me to provide care for Mr. A is to improve my communication skills. Whenever I interact with Mr. A, I tried to be calm, and spoke in short sentences with simple words and low voice. Although, sometimes I repeat what I said because I was not sure that he understood my statements.
Initially while interacting with the patient, I got bit nervous and hesitant. I was in dilemma about how to communicate with the patient, as he was suffering from dementia which is a kind of mental illness. This situation made me realize the importance of communication and healthy therapeutic relationship in nursing practice. If a nurse does not know how to interact or communicate with the patients, then all the understanding of complicated nursing interventions or routine task are in vain. According to (Feo et al., 2017), good communication is important to provide effective nursing care to patients and build healthy therapeutic relationship with them. Moreover, effective communication acts as a tool for nurses that allow them to encourage the patient and keep them motivated and empowered (Bramhall, 2014). While dealing with this patient, I realised that communicating with dementia patient is not such an easy task as I have predicted earlier. His mental illness becomes barrier for me to communicate effectively. Although I spoke easy language and short sentence still there was instances when Mr. A was unable to understand what I want to tell him. Maybe he was just pretending that he did not understand about the conversation. Moreover, I felt that during these circumstances, effective counter has to be established and while going through the therapeutic conversation with patients, genuine rapport must be maintained. Rapport demand the patient’s confidence and trust towards nurses. In absence of this rapport, it is difficult to convince the patient to follow nurse advice and their instructions. This experience has also made me understand the value of non-verbal communication. The patients that I had deal with in my past had no mental issues or cognitive impairments, so I have no idea about non-verbal communication. But in this case due to the mental condition of patient, verbal communication becomes less reliable. Patient’s feelings, mood, and their attitude towards caretaker or nurse during interventions, can all be interpreted by facial expression of patient’s, their behaviour, body gestures, and way of eye contact (Lorié et al., 2017). Observing theses non-verbal clues given by patient to communicate is a crucial task for nurse. From this, I have learnt that the duty of true nurse is to handle patient and able to communicate in both verbal and non-verbal ways. This may lead the nurse to deeply understand the patient feelings and needs.
The experience I got while communicating with Mr. A, makes me realize the importance of verbal as well as non-verbal communication. Nurses must be able to analyse patient communications during stressful situations and understand non-verbal cues to ensure patient safety. So, I need to work on my communication skills and sharpen them to fulfil my duties as an aspiring nurse. As in future also it might be possible that I shall interact with patients like this or may be of more varied complexities. To establish rapport and effective communication, I have to learn these techniques for interaction with them. Moreover, by learning and maximizing communication with patients, I will be able to empower, motivate and educate them with better understanding.
Overall, I want to conclude from my reflection that communication is an important skill in nursing practice and it must be mandatory to learn by all nurses. Moreover, reflecting on an experience will help determine diverse significant learning. It will help in learning own strength and weakness, and enhance self-knowledge. Effective communication acts as key to maintain healthy therapeutic relationship with patients and build rapport with them. Nurses communication skills are most important for improvement of patient, other nurses and healthcare organization by providing correct skills and technology. To attain these goals and patient satisfaction, effective communication skills are required to understand the patients’ emotional needs and health requirements. A nurse should always enhance his/her communication skills for providing best nursing care to their patient.
Banovic, S., Zunic, L. J., & Sinanovic, O. (2018). Communication difficulties as a result of dementia. Materia socio-medica, 30(3), 221–224. https://doi.org/10.5455/msm.2018.30.221-224
Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard,29(14), 53-59. doi:10.7748/ns.29.14.53.e9355
Esterhuizen, P., & Howatson-Jones, L. (2019). Reflective practice in nursing. London: Learning Matters, an imprint of SAGE Publications.
Feo, R., Rasmussen, P., Wiechula, R., Conroy, T., & Kitson, A. (2017). Developing effective and caring nurse-patient relationships. Nursing Standard,31(28), 54-63. doi:10.7748/ns.2017.e10735
Lorié, Á, Reinero, D. A., Phillips, M., Zhang, L., & Riess, H. (2017). Culture and nonverbal expressions of empathy in clinical settings: A systematic review. Patient Education and Counseling,100(3), 411-424. doi:10.1016/j.pec.2016.09.018
Machiels, M., Metzelthin, S. F., Hamers, J. P., & Zwakhalen, S. M. (2017). Interventions to improve communication between people with dementia and nursing staff during daily nursing care: A systematic review. International Journal of Nursing Studies,66, 37-46. doi:10.1016/j.ijnurstu.2016.11.017
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