Question

Anita Alvarez, a nurse, is providing care to Mark Walton, a 27-year old man who has just been diagnosed with irritable bowel syn. drome (IBS). Anita is teaching Mr. Walton about the dietary changes that he will need to make to manage his condition. Anita asks a series of questions quickly, changing the subject rapidly and not allowing Mr. Walton to provide answers or ask clarifying questions. During the session, she reads directly off a computer screen. When Mr. Walton does get a chance to ask questions, Anita takes several seconds to respond because she is busy look ing at her phone. She focuses on herself for several minutes when Mr. Walton asks one question about her work. When Mr. Walton leaves, Anita says, "Everything's going to be all right" as she slams the door.

Critical Thinking Questions

1. Which mistakes or barriers to communication did Anita engage in?

2. What could Anita have done better or differently to ensure that Mr. Walton retained the information and to promote the therapeutic relationship?

Answer 1

1)There are many barriers to communication and these may occur at any stage in the communication process. Barriers may lead to your message becoming distorted and you therefore risk wasting both time and/or money by causing confusion and misunderstanding.

Here the nurse shows inability to listen the patient. And lack of interest in listening the patient and his needs.

This is also a type of negligence.

Even good listeners are often guilty of critically evaluating what is being said before fully understanding the message that the speaker is trying to communicate. The result is that assumptions are made and conclusions reached about the speaker's meaning, that might be inaccurate. This and other types of ineffective listening lead to misunderstandings and a breakdown in communication

Q2

• Listen without interrupting the sender.

• Show empathy at all times and try to understand.

• Try to stay focused on the conversation. Do not however, force the patient to continue if he/she becomes anxious or seems to wish to change the subject.

• Use the body language that indicates your interest and concern. Touch the patient if it seems appropriate. Lean forward, listen intently and maintain eye contact if it culturally acceptable.

• Offer factual information. This relieves anxiety. Do not offer your personal opinion. Assure the patient that you have professional discretion.

• Try to reflect the feelings and thoughts the patient is expressing by rephrasing questions and comments using their own words.

• Avoid unclear or misleading messages.

• Avoid giving long explanations.

• Give your co-workers your full attention when communicating with them.

• Ask questions to clarify unclear messages.

• Do not interrupt until the sender has completed the message.

• Provide a quiet environment without distractions.

Be open, respectful and gracious in all your interactions with the patient and keep his/her cultural preferences in mind.

1. Answer nurses’ bells promptly.

2. Make sure you have the patients’ attention when communicating.

3.Use words that are non-threatening – explain what you would like to do and do not give orders to the patient.

4.Use simple, understandable phrases, not medical terms as most patients do not understand these terms.

5.Speak clearly and courteously.

6.Use a pleasant and normal tone of voice to the hard of hearing.

7.Always stand so that the patient can see the nurse’s face when communicating, as lip reading is part of all normal hearing.

8.Use body language that is appropriate.

9 Explain facts and procedures before donning a mask that covers the wearer’s mouth and lower face.