Shamsa Amin Hussaini
NU 328: Reproductive Health
Faculty: Ms. Nimira Asif
The Aga Khan University School of Nursing and Midwifery
Date: 18 April 2013
A few words of kindness, a simple act of listening and a calm demeanor is just what it takes to care effectively for a patient. The first lesson taught to healthcare providers is of communication and its implications are evident in hospitals. Effective communication is the key to holistic care, aiding better assessment, better care plans and ultimately better care.
I practically learnt this on an incident during my first day of reproductive health clinical rotation to a private hospital where I encountered a twenty-five year old female patient who underwent caesarian section for the first time that led to multiple complications, therefore this fourth baby of hers was special. Since it was my first experience in dealing a patient with a reproductive eye, I was very anxious in taking history because reproductive health is a sensitive topic and not much talked about in our society. Yet, I managed to initiate the conversation but realized that my noticeable hesitation made the patient reluctant. Later, the doctor came for her rounds and patient complained about no milk ejection from her right breast. The doctor seemed disinterested and told her to continue feeding from another breast while walking towards another patient. The patient was not satisfied with the doctor’s response; she just lowered her head and remained silent.
Upon witnessing this, several questions bombarded me; couldn’t the doctor spend few minutes to answer the patient? What about patient’s confidentiality? What was I doing? I was her nurse for the day, she was my responsibility, and I should do something as there could be other unspoken problems. Hence, I gathered strength and confidence and went back to the patient. I realized that the increased sensitivity actually helped in building a stronger nurse-client relationship as she poured her heart out this time, it felt like she was waiting for someone to talk to her with an aim to help and not merely to fulfill their responsibilities. This made me believe that quality communication which is usually ignored and considered unimportant can bring significant improvement in patient’s care.
Throughout the incident there were numerous feelings. I felt anger and dismay by the despising attitude of the doctor. Even if the problem mentioned by the patient was minor, I felt the doctor could have consoled the patient rather than being impolite. I believe that patients wait the whole day for their doctors’ rounds, to share their concerns but lack of communication from the doctors’ end disappoints them. And such inattention by any healthcare provider becomes a barrier for the patient to express themselves. Patients may not question unless asked, as they may feel they are wasting the physician’s time therefore doctors are responsible to probe further queries before leaving, ensuring patient’s satisfaction (Yeh & Nagel, 2010). Moreover, the patient’s discomfort compelled me to advocate for the patient and enforce the doctor to satisfy her but being a student from another institute, I couldn’t assert an opinion. Besides, my hesitation towards discussing sexual health previously, hindered my communication. This all led to frustration and disappointment. I was disheartened to witness what happened, contrarily, I felt contended when I was able to guide the patient by identifying and correcting my flaws on time, thus improving the quality of care provided.
There could be many reasons for this incident to happen. Firstly, I think that the doctor’s unconcerned behavior was because of numerous patients to be cater in less time, however, effective communication requires time for assessing, explaining, and caring for the patient. Secondly, being a novice I wasn’t very comfortable in talking about reproductive issues that led to a bad start. Thirdly, as Beam, O’Brien & Neal (2010) suggest that reflection is critical for the improvement of clinical reasoning and clinical knowledge. Correspondingly, my reflection, that a proper communication aids effective patient care, helped me improve myself.
Looking back, though by the end of the incident the patient was able to vent out her feelings and her problems were catered, yet it would’ve been better if the patient’s concerns were responded earlier. Raine, Cartwright, Richens, Mahamed and Smith (2010) discussed maternity patient’s opinions that these women are not always spoken to clearly, treated respectfully, given required information or involved in self-care decisions, however they want relaxation and feeling of control. As an educator I could teach this to the healthcare providers in order to improve communication and achieve optimal care. Additionally, I could disseminate information and updates on regular basis. I could also educate staff on individual feedback and conduct regular trainings.
As a caregiver, I could’ve thought that lack of proper communication makes patient think that their healthcare provider is indifferent to them. To avoid this we need to enhance our communication skills and have confidence to cover sensitive topics. Saunamaki, Andersson and Engstrom (2010) concluded that if nurses do not pay attention to sexuality, patients’ sexual concerns may remain unresolved. Therefore, we should discuss patient’s sexual issues because if we aren’t comfortable ourselves, patients wouldn’t discuss their issues with us either. For that, as a student nurse I should have been more prepared to assess my patient’s concerns efficiently.
As communicators we shouldn’t adopt communication styles which leave a person feeling rushed, ignored or dismissed. Rather, we should remember that it’s a natural phenomenon that people who are compassionate, willingly engage in dialogue, and genuinely cater individual’s needs are the valued ones.
Furthermore, as a manager, I could have provided guidance, support, emphasis and help staff to integrate effective communication skills into their practice and to keep an eye on implementation which is very important. I could have best employee recognition to maintain staff’s enthusiasm and continually assure practice.
The incident suggests that certain improvements are required in communication techniques. I believe that we should analyze our practices including meaningful use of communication skills as it would ultimately help us fulfill our roles and direct us in becoming a competent nurse. Environment may be challenging, patients might be difficult but whatever happens, we as healthcare providers should not stop striving for effective communication.