Role of Exemplary Communication in Clinical Scenario - Essay Example

Communication in Clinical Practice You’re Name University Communication in Clinical Practice Introduction Communication is a basic human process that is used in both interpersonal and intrapersonal level. Communication can be performed by following either verbal or non-verbal cues. Thus it may be defined as a process that is primarily dependent on interpretation of words, objects, facial expressions, gestures, tone of voice, eye contact, spatial arrangement – or simply, interpretation of symbols. In case of effective ‘therapeutic’ communication, which significantly differs from ordinary communication, a patient should be encouraged to build up a trustful relation enabled by the health care professionals to collect require information in a more sophisticated and effective manner. Effective therapeutic communication has long been recognized as a crucial aspect in nursing profession, especially in the case of patients suffering from mental disorder, with an addition to promoting the effective self-care practices along with more effective accumulation of relevant information from both non-verbal and verbal cues. It also promotes in developing a supportive and healing relationship among the family members of the patient as well as in community framework. Previous research has been illustrated the crucial aspect of nurse-patient communication in the case of a schizophrenic patient, and how exemplary communication affected the scenario and the onset of treatment policy. This paper discusses and analyzes how the role of effective therapeutic communication influences the overall treatment pattern of an individual suffering from schizophrenia and how the ethical points and societal points should be covered in the context of exemplary communication. Role of Exemplary Communication in Clinical Scenario The first and foremost important component of effective therapeutic communication involves the ability to listen and encourages the interaction in order to build up underlying meaning of that communication. In nursing profession, communication is at its basic level considered as a sharing of health-related information among patient and nurse with both of the participants as sources and receiver of information (Lisa Kennedy Sheldon, 2005). The complexity of effective communication pattern involves more than sharing between two persons as source and receiver of information, rather it occurs following two levels of communications, namely, the relationship level and the content level (Watzlawick, Beavin and Jackson, 1967). The relationship level defines the mode of the relation among both of the participants and how they are related to each other, whereas, the content level provides the informational aspect gathered through the verbal and non-verbal cues. Hence, it is evident that the content level is a dependable variable that depends on the quality of relationship level. The healthier the relationship among the both participants, the more effectively the content part will be relayed. The more the effectiveness in content, the more effective will be the diagnosis and hence the treatment. As it is said “Accurate diagnosis is an art of communication perfected by experience” (Hubert, 1998), thus the derivation of effective and accurate diagnosis depend on the crucial factor influencing client’s trust and faith on the carer concerned in question resulting a perceived safe environment for the client to disclose all relevant information necessary to the treatment. In the case of my cousin it is observed that the nurse never went in any kind of arguments or confrontations with my cousin in order to let him out from his imagination, rather she showed a great empathy to the situation he is in and tried to find out the internal conflict resulting the consequences. Carl Rogers (1951) illustrated how important the therapeutic relationship is in facilitating the healthy adjustment in the client, by promoting client-centered therapy employed as the client being the focus of interactions. The helper or assigned nurse may communicate with empathy, positive regard and congruence to make it possible for the patient to do the adjustments with the treatment procedures as well as with the environmental stress and progress towards health. The nurse, here in the case study discussed before, showed a great empathy followed by listening ability as well as respectful and effective interaction with the patient. She did not make any useless arguments or disrespectful comment even when my cousin showed great disturbance in his verbal behaviour with the nurse by saying “Can’t you see Punko? Are you blind? You have big, big eyes and you can’t even see Punko!”, rather the nurse used ‘I’ statements and affirmatively paid him positive regard by naming him ‘observant’. This style of communication promoted by the nurse to my cousin helped him to calm down and provided the relevant information required to the context of the situation. On the other hand, this is quite evident, if the situation handled by the nurse turned out into other direction, that is arguments, it would end up either by silence or aggression resulting futile outcome at the end. In effective therapeutic communication style, the empathy is important rather than any kind of aggression or confrontation with the patient, which eventually builds a trust and faith in the client with a reassurance of their productivity as a whole (Adler & Rodman 2003). The important aspect of effective therapeutic communication also involves the essential knowledge of conveying message on time and how the message has been delivered. This is not related to ‘what’ all the time – that is, the content part of the communication phase integrated among two parties is not only the important factor taken into account, but, ‘how’ the message is conveyed and its associated non-verbal clues along with the way it is perceived by the listener are also essential aspects here to be considered (Paul L. Wachtel, 1993). In case of my cousin, the nurse not only listen his story about ‘Punko’ but, at the same time, she came to understand a conflict developed within my cousin as a child about ‘caring someone’ and ‘hitting that person’. As the nurse effectively conducted and handled the interaction part with my cousin, she came to know about the pattern of his internal conflict and the origin of it. This effective communication helped her to perform a documentation related to this context which is eventually relevant to the treatment and successful intervention in his thinking pattern he developed as the symptoms of his disorder. According to Desmon, J., & Copeland, L 2000, the documentation in a treatment policy is an essential factor leading to the valuable contribution to the client’s care as well as other relevant necessities important to the conduction of the treatment. Here in this case, the nurse took a relevant note while my cousin reported about his internal conflict and her documentation of the relevant data would be helpful for other health workers and community members to carry out effective treatment including planning and recovery for the same. The relevance of accurate and instantaneous but logical documentation attributes to the effective treatment quite a length as well. To conduct an effective documentation the primary need is focusing meticulously to the problem and identifying the associated factors while interpreting both the verbal and non-verbal cues conveyed by the client. Here, in this case, the nurse successfully developed an understanding of the patient’s condition by employing her logical but empathetic exemplary communication style. In her communication, the nurse never drew any attention of my cousin to any sensitive issues like any kind of narration of parental relation from him; rather she put her focus on taking the systematic mental note of my cousin’s condition so that it can be passed out to collect all relevant family related information and possible future interaction with related family members by health care authorities associated to the treatment of my cousin. Likewise the other cases of mental health problems, documentations of schizophrenic cases are also considered from the ethical point of view in personal, communal and societal context regarding the level of confidentiality in concern. According to UK General Medical Council (GMC), one must not disclose any information provided by the client by showing the respects to the client in question, however, in case of exceptional extremities including perceived danger or potential harm to the patient or others as a result of non-disclosure of the information (Rosalind Ramsay et al, 2003). The nurse in question not only dealt logically with the documentation part, but also she performed responsibly when she left the room of my cousin by employing another nurse to take care of my cousin. At this point of time, she was basically concerned about two factors – one is the potential danger associated with the schizophrenic patient, as documented by Brammer 2006, that if in case of hallucination, specifically in the case of auditory hallucination, the patient must not leave alone especially when he or she reports any events involving any kind of harm to self or any other imaginary objects. Thus, the nurse in question assigned another nurse while leaving his room as my cousin reported about hurting ‘Punko’ or ‘making fight with Punko’ as well as ventilated his conflict with the ‘care person may be hurt’ by focusing on parental scenario. This implies that harm and hurt are within the focal range of my cousin’s hallucination, so the nurse did not allow him to stay alone with himself only. The second reason of course involves the arena of good care that may result from the nurse’s efficient nursing style and empathetic outlook, which compelled her to not to allow my cousin to stay alone concerning both of his safety and his sharing practices with the newly nurse employed. According to Stein-Parbury 2005, the effective care must include the active involvement of supervisors, family or community members, nurses and other care givers along with the patient and need to be consulted in order to find out the relevant measure to handle the patient in concern. This in due course involves the educational awareness among the family members and close relatives by employing positive interventions such as reduction of unfavourable family environment, interaction among members, reduction of expressed anger and frustrations towards any family members and encouraging empathetic interaction among family member consistent with the pertinent information about the disorder and coping skills (Caroline Moran, 2001). In the case of my cousin, the uncle needs to be informed and be considered as an important factor for assisting with relevant information in support of the treatment for my cousin. However, the primary reflection about the schizophrenia deals with the self and human subjectivity with the definition of its influence on human cognition, perception, social identity or functioning. This effectively leads the individual suffering from schizophrenic disorder to have been distortedly identified with various societal factors such as self-concepts, self-awareness, self-career and self-functioning, hence implying that the subjectivity and self is integrally related to the broader aspect influencing both the societal and cultural context (Fabrega H Jr). The cross-cultural studies suggested that the perceived personal experiences greatly vary in different cultures hence influencing the awareness among various cultures. Mentioned by Jagannathan Srinivasaraghavan, 2004, that the investigation factors relating to schizophrenia can be divided into four contexts such as central Javanese culture in Indonesia, in Bogota, Columbia, characterised by homeless mad people, in Bangladesh madness, and symptoms of colonialism in Southwest Nigeria defining the fallacy of cultural common sense, distorted subjective perception among the common mass and lack of proper education. Irrespective of other interpersonal and intrapersonal factors, continuity of care is an important issue in dealing with patients with critical mental health problems. As mentioned by Carol E. Adair et al., 2005 in the research study “Continuity of Care and Health Outcomes Among Persons With Severe Mental Illness” that “Continuity of care is considered to be essential to the effective treatment of persons with severe mental illness” and hence it should be encouraged. In the case of my cousin, the nurse showed a great enthusiasm by providing him an empathetic care and concern and a great deal of respect with a feelings of security encompassing all aspects of an exemplary communication. Conclusion Likewise any mental health career, nursing profession is an important area in handling patients, especially in the area of mental health, and is characterized by a good listening ability along with cultural sensitiveness and observation skill. Being a nurse, one must possess certain qualities involving the empathy, sensitive attitude with a good interpersonal communication skill. The important points encompassing the standard of effective communication such as acknowledgement and verification of data received from the patient, timeliness, completion of communication or logical termination of communication as well as maintaining standards of conveying message from the sender (nurse) to the receiver (patient). The nurse in question must understand the value of enhancing effective communication for the promotion of a culture pertaining to client’s safety by emphasizing the importance of systematic and consistent information relevant to the clinical status of the patient and treatment policy. References Bauke Koekkoek, Berno van Meijel, and Giel Hutschemaekers; "Difficult Patients" in Mental Health Care: A Review; Psychiatr Serv, Jun 2006; 57: 795 - 802. Carol E. Adair, Gerald M. McDougall, Craig R. Mitton, Anthony S. Joyce, T. Cameron Wild, Alan Gordon, Norman Costigan, Laura Kowalsky, Gloria Pasmeny, and Anora Beckie: Continuity of Care and Health Outcomes Among Persons With Severe Mental Illness; Psychiatr Serv, Sep 2005; 56: 1061 - 1069. Improving Therapeutic Communication: A Guide for Developing Effective Techniques edited by D. Corydon Hammond, Dean H. Hepworth, and Veon G. Smith; San Francisco, Jossey-Bass, 2002; Leslie Hartley Gise, M.D. Schizophrenia, Culture, and Subjectivity: The Edge of Experience; edited by Janis H. Jenkins and Robert J. Barrett; Cambridge, England, Cambridge University Press, 2004, Jagannathan Srinivasaraghavan, M.D. Thornicroft G; Susser E; 2001. Evidence-based psychotherapeutic interventions in the community care of schizophrenia. British Journal of Psychiatry 178:1 pp 2-4.Summarised by: Caroline Moran; Original report published: 2001; Published on Mental Health Care: 27th February 2003 The self and schizophrenia: a cultural perspective: Fabrega H Jr.; Dept. of Psychiatry, University of Pittsburgh, PA 15213. Stein-Parbury J: Patient and Person: developing interpersonal skills in nursing, ed 2, Melbourne, 2005, Harcourt. Extract from Mental Illness: A Handbook for Carers, Edited by Rosalind Ramsay, Claire Gerada, Sarah Mars and George Szmukler; Jessica Kingsley Publishers, 2001. ISBN: 1-85302-934-3 Communication for Nurses : Lisa Kennedy Sheldon ; Jones and Bartlett Publishers (February 2005) Adler, R & Rodman, G 2003, Understanding human communication, ed 8, Oxford University Press, New York, pp. 1-29 Desmon, J., & Copeland, L.:Communicating with today’s patient. San Francisco 2000: Jossey-Bass Therapeutic Communication: Knowing What to Say When : Paul L. Wachtel; The Guilford Press (January 1, 1993) Brammer Susan V., May/June 2006. “Facilitating a Connection with a Rehabilitation Patient Who Has Schizophrenia.” Rehabilitation Nursing, 31(3), 92-94 Read More