[Sharon]

Think of an example of a circumstance where communication did not go as planned. How would you approach the situation differently after having learned about communication styles and crucial conversations?

[Emma-Leigh]

I had a patient refuse my care and call me out as a student. The patient had a recent yet fast progressing ALS diagnosis. The communication was limited with barriers to her speech ability. It is crucial to put patient centered care at the top of the priorities. Spending more time and trying new ways to effectively understand the patient is of upmost importance.

[Antoinette]

Communication is important between nurse and patient but also just as important between nurse to nurse. For example, one situation happened where a nurse was covering me for break. She gave a pain medication to a patient but the documentation did not record on the eMAR. I wasn’t aware on return to the floor that this med had been removed and so I almost gave the patient another dose of the narcotic. Even though the nurse should have mentioned on report that she gave the pain med. I have learned to writer down anything I have done on my sheet so I don’t forget when giving report back to my buddy nurse.

[Patrice]

As a nursing student, during my clinical practice in the long-term care setting; I had a resident who did not speak English when communicating, however, the resident understood what was spoken in English. Oftentimes medication was refused, displaying a communication style of raising one hand at me, which was a clear indication that I should go away. My approach was to express my understanding and re-approach the resident several times. Whenever there was continuous, I would involve my preceptor to help to address the situation. Another approach was to respect the resident’s autonomy whenever there was continuous refusal, then I would document the refusal and report it to my preceptor for further assessment.

[Brittany]

I began my career as a PSW working in long term care. I absolutely loved to form a good rapport with my patients and did so by being attentive and always ready to help or lend a hand. There was one resident that never took to me and I often wondered why. One day while providing care she said to me I’m not a baby, I can do things on my own. This made me reevaluate my care in this setting. Alot of independence is being taken away at this stage of life and me being extra attentive made her feel as if I thought she wasn’t capable of simple tasks. From that moment I assessed from my first interaction, I asked questions and I allowed patients to take part in as much or as little of their care as they want.

[Ayotunde]

i was to assist a resident in a long-term home where i was having my placement with feeding as he cannot see, hear not speak but he can make sounds that you can know he is trying to pass a message but don’t know what. Everything I did to assist was frustrating the resident as he kept making sounds and the sound got louder. i had to bring out a pen and paper , placed in is hands and he wrote WHY?
Apparently, he was asking why I needed to feed him because he only need guidiance with reaching his cutleries and he could feed himself.

I explained to my preceptor and we documented this in the nursing note so other people can see and use the approach.

[Omono]

I needed to explain a new procedure to an elderly patient, who has language barrier. I used complex medical terms, assuming she would understand. However, looks confused and becomes anxious, indicating a breakdown in communication.
Seeing her facial expression, I realized the importance of clear and simple language. Explaining in layman’s terms, using every day words. I also utilize visual aids such as diagrams or pamphlets to explain better. Visual aids can enhance understanding, especially for elderly individuals who may benefit from visual reinforcement of information

[Amber]

During my placement, I was at a hospice and a family member was concerned about the lack of fluid their family member was consuming. Fluid and food are typically a point of contention for families, during end-of-life care because they view the lack of eating or drinking as starvation and dehydration. I explained the situation about this being a natural progression for end-of-life, and I also provided pamphlets. As I finished, the family appreciated what I was saying but, in respect to their religion, water is seen as the “food of life.” They needed to continue to try to administer water to their family member because of how important water is to their religion. I made an assumption about the family based on my previous experiences rather than asking the right questions to have an understanding of their concerns. By asking more questions, I was able to explain the end-of-life process, while being respectful of the family and their religion.

[Judith]

As a nursing student, during my clinical practice, I used therapeutic communication during every care I gave eg. Bathing, during medication or refusal of medication. for instance, At the hospital, when a client refused his food, meds, and even his bed bath because he felt tired of staying at the hospital. looks confused and becomes anxious, indicating a breakdown in communication. I had to explain why he was still there and make him comfortable by reading a pamphlet for him.

[Adeola]

While working in a Long-term care home, there was this particular resident who was always refusing care from staff related to her dementia. I provided care to this resident using therapeutic communication skills, being there with the patient by enforcing whatever she says she is instead of correcting her, which makes her feel frustrated. She would also participate in her ADLs

[Coleen]

In a previous scenario, I hurriedly delegated tasks to a healthcare assistant without considering their workload or providing clear instructions. Reflecting on communication styles and crucial conversations, I would now prioritize dedicated time for effective communication. I would actively listen to the assistant’s concerns, express expectations clearly, and offer support. By fostering open dialogue and mutual understanding, I aim to create a collaborative environment conducive to safe and efficient patient care.

[Shannon]

During my consolidation at a long term care facility, i found communication was a difficult task at times. During shift change/report, we would be asked to pass some information onto the night shift. the firs time this was required, my nurse and i made a note of it, and then communicated it at night shift change/report. the nurse coming on, wouldn’t accept report from me because i was “just a student|”. my preceptor stepped in and explained that i needed to be treated the same as her. once the staff member had it explained what my position was things improved. i think with more communication about what students are there to do, it would be beneficial

[Rose]

Hi Shannon, thank you for sharing your experience! I can definitely relate to how challenging communication can be in such situations. It’s unfortunate that the nurse didn’t initially recognize your role, but it’s great that your preceptor stepped in to clarify things. I agree that clear communication about the role of students would be so beneficial in helping everyone understand their responsibilities and ensure smoother interactions. By fostering respect and clear expectations, it would make transitions like shift changes much more efficient and supportive for everyone involved!
Thanks for a great discussion!
Rose

[Rahmatu]

Effective communication is essential in delivering patient-centered care to a patient. It enhances nursing assessment and enables the patient achieve optimal health outcome. Working in a long term care I have had situations where residents refuse care from other staff but would agree to nursing care from me. This is usually because I often approach the resident using a therapeutic form of communication, such as squatting down especially when the patient is in a wheelchair so I can maintain eye contact during communication. This posture helps show the resident that you empathize and validate their feelings.

[Adriana]

I was on my consolidation semester while a patient with stroke was being feed by family members while the patient was on NPO. The nurse charge have a talk with the family members while they said they did not knew it about it. The patient has an extended number of family member and some of them were communicated about pt’s condition and other were not. In this case the problem of communication between them for different factors could cause an incident in this patient. Communication has to be open at all times regarding patient’s safety.

[Racheal]

communication is very important when caring for patients. I had an experience recently when caring for an indigenous old lady who has always refused care from other people. I always use the GPA to communicate with her and that has helped me to impact and give her good care.

[Kerisha]

I was a member of a group for a graded assignment and there was a break down in communication as to who was responsible for proofreading, editing and submitting the final draft of the assignment. This breakdown in communication led to a disagreement with another group member which ended in the other group member leaving the group 3 days before the assignment was due. Using a thinker’s communication style I would approach the situation differently by communicating clearly what roles are required by each group member, asking for everyone’s input on the plan of action for completing the group work and communicating a clear and logical plan to get the assignment completed and submitted. I believe that ironing out every single detail about group member responsibilities and having a clear plan of action could have avoided the disagreement that occurred.

[Nicole]

Communication is an important part of nursing practice. Through self-reflection, I am aware that I am a doer. This means that I can be result orientated at times. Therefore, I clash most with feelers. I know that I need to work on communicating in an empathetic way when I work alongside feelers. In the past, I have completed a group project with a feeler. The feeler was emotional about an aspect of the assignment based on their personal experiences. Instead of being empathetic, I feel that I judged the classmate for their emotional response. In the future, I will allow the feeler to vent and help trouble shoot issues as the occur to ensure crucial conversations are had and conflict resolution can occur.

[Ngan]

In reflection of a circumstance where communication did not go as planned I would approach the situation more patiently, after having learned about communication styles and crucial conversation. The four classic communication style allows the ability to determine and understand who one is communicating with and how to carry on communicating with this person should be approached. For example, when communicating with someone who is a “feeler” style it is understood that this person is connected by and to emotions. In the re-approach of this “feeler” communicator, emphasis on the “c” of the crucial conversations ABC would be placed. Understanding that when views differ it should not be a point to yourself right and the other wrong but to know that there are two views regardless of accuracy.

[Yanique]

PSW might not be aware of an important update to a resident’s care plan, such as a change in medication or mobility restrictions. This could lead to the PSW unintentionally providing care that is not aligned with the updated plan, potentially resulting in a safety concern for the resident.
I would approach the situation by, If there’s resistance or misunderstanding, I would approach the situation as a crucial conversation, where emotions might run high due to the potential impact on patient safety. I would focus on creating a safe space where the PSW feels comfortable expressing their concerns, while also clearly communicating the importance of the changes.

[Janecia]

During one of my practicum placement, I gave verbal instructions to a PSW about repositioning a resident every two hours to prevent pressure ulcers. Later, I noticed the task wasn’t completed, and the PSW seemed defensive when I addressed it.

A communication breakdown occurred when a PSW didn’t follow repositioning instructions, leading to defensiveness. The issue stemmed from unclear expectations and lack of confirmation. In the future, I would ensure clarity by confirming understanding, adapting to communication styles, and using a collaborative approach. Instead of assuming resistance, I would ask open-ended questions to identify barriers and focus on shared goals, fostering teamwork and problem-solving.

[Gagandeep]

I once had a miscommunication with a PSW about a resident’s care plan—she misunderstood my instructions, leading to a delay in care. Looking back, I realize I wasn’t clear enough and didn’t check for understanding. Now, after learning about communication styles and crucial conversations, I’d approach it differently by using clear, direct language, confirming understanding, and creating an open space for questions.

[Nancy]

I disagreed with a coworker regarding the best approach for a resident who usually refused medication. I insisted that the medication was essential as the resident had behavioural concerns, but the other nurse pushed back, saying she did not want to force the resident. The conversation became tense, and we both walked away frustrated. Thinking back, I should have expressed my concerns that if the resident did not receive the medication, the resident would have behavioural issues in the next shift. I should have given her my approach to the resident that had helped me give the medication without much resistance.

[Rose]

Hello,
One example of a situation where communication didn’t go as planned was during a shift change when I was working as a nursing intern. I was supposed to hand over important information about a patient’s care to the oncoming nurse, but I rushed through it because of the pressure to finish on time. As a result, some crucial details were missed, and the oncoming nurse had to clarify things later on, causing confusion and frustration. After learning about communication styles and crucial conversations, I would approach this situation differently by taking a moment to ensure that both my communication style and the listener’s style align. For example, if I know that the other nurse is a thinker (who values details and structure), I would provide a more thorough, organized handover, focusing on specifics. I would also pay attention to non-verbal cues to make sure the nurse understood and ask if they had any questions. If necessary, I’d suggest a more formal approach, like written notes, to ensure that everything is documented and there’s no room for miscommunication. Recognizing the importance of these strategies would allow me to improve communication, minimize errors, and maintain patient safety.
Thanks for reading my post.
Rose

[Wafaa]

As a nursing student, one day I asked a PSW to help a patient change into clothes so they could go out with their family. However, when I returned, I found the patient had been changed into a hospital gown instead. I quickly pointed it out, and the PSW seemed confused. I realized that I had not been specific enough in my request and had not clarified that the patient should be dressed in regular clothes, not a gown. Reflecting on this, I would now approach the situation differently by being more clear in my communication. I would say, “Please help the patient change into casual clothes for the outing with their family,” and double-check to ensure the PSW understood the task. By being more precise and open to questions, I can prevent misunderstandings and ensure smoother teamwork.

[Sheryl]

One day I was speaking to my preceptor and she assumes that she knew what I was thinking without listening first to my concerns with regards to patients safety and care. So i changed the way i communicated with her, instead of giving information I am already assuming even when it’s not that she knew the situation, so when I talked i say this way ” let me just confirm that Mr. —–is not eating all his meals as observed and you already make a not”? then she started asking more information about it…..

[Author]

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