This is a reflective journal about the clinical experience rotation. It does not have to be in big words I just want it simple but also making sure that the flow is well. Some of the vocab I used are not that great so please change that and grammar as well. if something needs to be added, I would appreciate you doing that. I do not need extra sources
Q10 : Discuss an event that was in sharp contrast to something that you learned in skills or nursing theory. What are your thoughts about this situation? What do you think your role could be in the future if you were to encounter this again.
Communication skill
I was accompanying a nurse on 10/29, and found that she did not communicate therapeutically possibly due to the fact that she was overwhelmed by the workload of that shift and did not have time to put the extra mile to talk to the patient.
It was not the direct patient I was caring for that day, but I was shadowing the nurse who was assigned to this patient. Patient is a 54 year old female who was post-op from brain tumor. As I entered the patient room to shadow a nurse administrate medication, the patient immediately began to lash out by saying “Is that BIOOH gone?! I don’t want to see her face ever again.” The nurse asked her who she is talking about, and she stated that her physical therapist was really pushy about her going for a walk and told her that she cannot be acting like that and that she is not the princess in this hospital. I thought the nurse would dig in further to validate her feeings, and possible investigate a little further whether what the physical therapist were saying is true or not.
Now it was time for the nurse to pass medication, but patient kept lashing out non stop about the poor quality she gets at the hospital. She stated that the food sucks in the hospital, she doesn’t like the fake weird looking bacon, she thinks that the CNA’s are not attentive etc The nurse was kind of begging her to take the meds, as she was taking a lot of her time., and I was able to feel that she was a bit irritated by it. Patient stated, “please don’t rush me to take this pill. These are huge and I went though a lot. I just had brain tumor surgery. Do you understand?! “ The nurse said she understands and informed her that she will come back in an hour to administer the meds. I think her judgement about coming back to give the patient meds in an hour was professional, as she never forced her to take it.
However, sharp contrast to what I saw in the textbook and reality is different because I thought it was lacking patient centered care and therapeutic aspects of nursing. In theory, we learned that communication in the nurse-patient relationship should focus on the patient’s needs, not on the nurse or an activity in which they engage in. Patient was communicating her concerns about the hospital cares and services, and although she appeared to be demanding and I honestly thought (she has some kind of behavioral issues due to all the bad languages she kept throwing ) when I started speaking to her, I knew that she was not just the “needy patient who is asking for so much” she stated that all she does in the hospital is eat or sleep like a pig, now I can’t even move like I used to, cant event walk to the restroom by myself. I have this huge ugly stitches on my forehead –which I had peed on my pants when I saw myself in the mirror. It seemed like the patient wanted someone to talk to and vent to. Especially during this time of covid, when visitation hours are limited, it seemed like needed that additional attention –just someone to talk to.
I have learned both the pain of the patient and the nurse because patient wants attention, and nurse cannot give that attention due to the limited time she has during the shift. However, as a student nurse, I should of informed the nurse about my opinion about the patient, and possible patient can get a social worker or psychologist to talk to. Since this was not my patient of that day, I kind of feared that my opinion would not be heard.
In the future, I should immediately talk to the nurse and state my concern, not to be a chicken. Also, it was a good learning opportunity , to once again to revisit the material I have learned in class about therapeutic communication, always reminding myself the best ways of communication techniques based on the patient. In this case, it appeared that patient just wanted to have someone listen to her, and sometimes silence is a way of communication, to let the patient gather her thought and let her explore