NURBN2000 Transition into Nursing Studies - Assessment Reflection on Therapeutic Communication

• Description 

In the therapeutic communication video, Bronwyn was informed about the results of examination of her breast lump. The patient was informed by the doctor that she is diagnosed with metastatic breast cancer. Another significant player in discussion was nurse, who was trying to provide information of ongoing care and future treatment. 

It was identified that way of communication was direct and patient was not asked permission of whether she wants direct information or not. After hearing about the results of her examination, patient was distressed and uncomfortable, while she was not given time to get relaxed or to get control of her stress. The direct and open communication is although an essential need of therapeutic communication with patient, yet physician and nurse were continuing the information giving (Schwind et al. 2016), in spite of fact that patient was not able to believe her results. She was in state of denial and she might needed more empathic approach of communication. Moreover, in this situation, patient was not willing to hear about fatal nature of her disease and she might wanted to hear about the tools in tool box of physician, which can cure her disease or even control it. Moreover, when Bronwyn told about her back pain, she might wanted to discuss some other symptoms or issues she is experiencing. However, nurse has interrupted to provide information about breast cancer organization and active listening was seem missing in this situation. This scenario has highlighted the importance of active listening and empathetic communication.  

• Feelings

After watching the scenario, I think that importance of training in oncological practice is undermined, with regard to therapeutic communications. For instance, the aspect of continual feedback about communication is mainly missing during practice and colleagues or trainers offer core importance to effectiveness of procedures, rather than communication. As in the case, patient was not able to believe about her terminal diagnosis and she needed empathy. However, in this scenario of therapeutic communication, the relation building between physician, nurse and patient was not given primary importance and bad news was communicated without considering aspect of empathy (Fan & Taylor, 2016). Moreover, I feel that patient might have wanted to talk more about her diagnosis if she was given enough time to accept the news. This issue was also linked with lack of proper communication procedure, which demands to feel yourself in the shoes of patients (Cashin et al., 2017). Moreover, I feel that families also need as much empathy as patient does. As, their journey is just beginning and they need guidance, support, empathy and hope. I feel that in order to transit to role of registered nurse (RN), I need to bring lot of improvements in my way and approach of communication, such that I might offer needed assistance to patients with terminal diagnosis. 

• Evaluation 

It is not fair to say that each aspect of therapeutic communication was altogether ineffective. While analysing the given scenario, I had found that nurse was trying to offer consultation with inclusiveness. She was providing details of future treatment and she has informed the patient that she can be contacted any time, if patients face any issue. Likewise, she had tried to develop hope, which was much needed by Bronwyn at the revelation of her terminating disease. Additionally, aspect of open ended question was also evident in the scenario and nurse has tried to initiate discussion with both patient and her family members. However, they were in state of shock and were not in position to enter into a discussion, which has undermined the effectiveness of communication. 

On the other hand, scenario has lacked different aspects as well. Firstly, the formal permission seeking from patient was missing. Patient was not given time for accepting the results and information was injected without considering emotional and mental state of the patient at the moment. In addition to this, the evidence of active listening was also missing, which might have hindered the discussion with patient. Likewise, as noted by Boselli et al. (2018) therapeutic contact and relationship evolution is much need aspect of effective therapeutic communication and in the underlying scenario, this aspect seemed missing. During the research, I have discovered, that in order to be an effective communicator and a successful RN, reliance is needed to be maintained on suitable professional as well as communication practices.