Early last month, I rushed a neighbor who was also a friend to the hospital for emergency treatment. I found the neighbor lying unconscious on the kitchen floor when I visited. On arrival at the hospital, I met a male nurse at the hospital entrance who seemingly was in a hurry to attend to other emergency cases. Fortunately, I managed to get his attention and explained what had happened. I started the communication with hello, sir but immediately fixed in the nurse’s name after I read it from the tag on his uniform. I noticed that he became more engaging when I called him by his name. I introduced myself, and after briefly stating what had happened, he called in for a stretcher which immediately took the patient in. As I followed them, he began asking questions about the patient. As I explained further, I noticed that he wrote down the information, remained silent, but kept nodding and reassuring me that he was actively engaged in the communication.
The nurse looked me in the eyes every time he asked a question and used other cues like spreading his hand to give me room to expand my explanation. After the assessment, he asked if I could wait until they attended to the patient since she did not have any relatives. After an hour, the nurse returned and apologized for the long wait. He informed me that the patient would be admitted. He courteously asked if I could step in as the patient’s family and bring her some of the necessities required for admission. Throughout the conversation, I noted that the nurse would switch between verbal and non-verbal communication. He would also interrupt me asking me to explain further or clarify something he missed. For a better part of the conversation, he would listen as I communicated and only spoke after I was done unless I said something he did not clearly understand.
The nonverbal communication techniques, such as head nodding, staring me directly in the face, and spreading hands, kept me in the loop. Hand spreading frequently guided me through the conversation, letting me know what I needed to explain or expand. Deliberate pauses between the conversations signaled that I needed to give the nurse crucial information to guide the patient’s treatment. He accompanied verbal communication with appropriate tonal variation and gestures. The nurse often asked open-ended questions to allow me to explain the situation better. He actively listened as I spoke, assuring me he was concerned and taking the situation seriously. The nurse also asked for clarification whenever I said something he did not understand. At the end of the conversation, he assured me that I had given them quality information to guide their treatment plan.
Nature of the Interaction
The interaction between the nurse and me was positive. The nurse valued my role in bringing in the patient for treatment. He also treated the conversation respectfully, reassuring me each time that every piece of information I had was crucial to the patient’s treatment. Salehe and Njine (2016) note that a positive interaction between the patient and nurse focuses on identifying the patient’s needs. The communication aims at achieving patient-centered care. Therefore, the interaction is respectful, engaging for both parties, empathic, and observes confidentiality. The nurse ensured that I only disclosed information relevant to the patient’s medical case. He remained attentive and sensitive when I mentioned the patient’s religious values.
Therapeutic Communication Techniques
Active Listening
Active listening is an essential component of any effective communication. Active listening manifested as a significant form of communication in my interaction with the nurse (Živanović & Ćirić, 2017). The nurse would listen as I talked but kept nodding his head to reassure me that he was still part of the conversation. He kept moderate eye contact as he switched between looking into my eyes and noting down the information I provided.
Silence
Silence occurs when the patient and nurse engage in an observation where they sort and speak out their feelings. The patient and nurse may be contemplating how to say something (Abdolrahimi, Ghiyasvandian, Zakerimoghadam, & Ebadi, 2017). During our conversation, there were moments when I did not know what to say, so I would go silent. The nurse would also go silent for some time to allow me to think. He would then break the silence with a question or ask if it was okay with the task.
Focusing
Focusing involves paying critical attention to a particular statement a patient or patient’s family member makes that could be crucial to the treatment. The nurse takes notice of specific ideas the patient expresses for clarity (Duggleby & Astkle, 2019). While I made countless statements, I realized the nurse would pause when I made a particular statement he found interesting or critical. For instance, when I mentioned the patient’s religious values, he paused, sought clarification, and wrote down every detail I provided.
Non-therapeutic Communication Techniques
There were no noted non-therapeutic techniques
Minimizing
Minimizing involves stereotyping the patient with no intention of listening to the patient. In this case, the nurse communicates with the patient from a predetermined perception that clouds their judgment (Duggleby & Astkle, 2019). This technique prevents effective listening as the nurse approaches the patient’s case with a negative attitude. The nurse may exhibit behaviors such as performing a different task when the patient is talking to them, avoiding eye contact, shifting between subjects, and using clichés. This technique creates an uncomfortable space which may force the patient to refrain from divulging important information that can be crucial to their treatment.
Pressuring
Nurses may pressure the patient into revealing certain information against the patient’s will. Pressuring may also involve asking leading questions and cornering the patient in a space with no alternative (Duggleby & Astkle, 2019). Nurses can also try to talk and lure the patient into taking a treatment. Patients are supposed to consent to treatment without being coerced. This form of communication may result in a patient taking part in a treatment that fails to respect their values and beliefs. In this case, the healthcare delivery fails to meet all patients’ needs.
Interrogating
Interrogation can manifest in the form of the nurse asking excessively too many questions. The nurse may begin to ask the why questions, making the patient uncomfortable. Interrogation can result in the nurse demanding answers to inappropriate questions and probing sensitive issues that the patient is unwilling to reveal (Duggleby & Astkle, 2019). This communication technique causes discomfort, forcing the patient to withhold vital information. The patient may feel judged or stereotyped in the process.
Changes
In my case, the nurse employed most therapeutic communication techniques. These techniques made it easy for me to trust the facility and step in for the friend as a family member. I felt safe and trusted that my friend would be okay after the constant reassurance by the nurse that they would do their best to save my friend’s life. However, I would eliminate silence as a technique in this case since it was an emergency. I felt anxious during the silent moment we shared. I did not know how to break it off. Secondly, I would share some humor to break the tension that comes with patients’ health challenges that take away their sense of humor. I would let the patient or family member take control in a more tensionless space. Therefore, the patient or family member would be the one to break the silence.
References
Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M., & Ebadi, A. (2017). Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician, 4968–4977. doi:10.19082/4968
Duggleby, W., & Astkle, B. J. (2019). Canadian Fundamentals of Nursing. Elsevier Can.
Salehe, B., & Njine, D. (2016). Good quality interaction between the registered nurse and the patient. Retrieved from https://www.theseus.fi/bitstream/handle/10024/120381/Njine_Doreen.pdf?sequence=1&isAllowed=y
Živanović, D., & Ćirić, Z. (2017). Therapeutic Communication in Health Care. SciFed Nursing and Healthcare Journal. Retrieved from https://www.researchgate.net/publication/320245946_Therapeutic_Communication_in_Health_Care
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