Prompt 3: Exploring Communication

I have had the opportunity to communicate with a nurse.  Since I have known her for almost my entire life, the responses received from the questions asked seemed to be more in depth as opposed to speaking with someone I do not know.  The comfort level of questioning a close family friend allowed me to come up with a complex list of things I am interested in knowing.  A few of the questions discussed are listed below.

What are some common misconceptions in your field and what types of communication is used to work around them?

"One misconception is that Doctors do all of the work related to patient care plans and treatment plans. Communication around that would be that Nurses are with patients the whole day and we have to have strong communication across all fields to bring out the best patient care.  Nurses need to speak up to doctors about their assessments and though on plan of care because they see day to day differences among patients and would know if something felt wrong or off with their patient.  Same goes with PT or OT or Respiratory.  Communication is face to face, in the chart, and over the phone.  Another one is that the hospital is paid for every patient.  This is changing with Obama Care that we are now reimbursed based on patient satisfaction.  We have to transition to providing the best patient care and making sure the patient is happy so we get money form the government to pay for the patient stay.  We have to focus on teaching the patient and keeping them from coming back to the hospital as well.  Another is that men are not big in our field.  They are not the majority, but we have to work as a team.  We count on our men to help us lift and move patients as well as use teamwork to get all tasks done."

What forms of communication are the most effective and ineffective in the hospital and why? 

" Verbal communication face to face is most effective.  Not always practical and doesn't happen the most but it is what you get the most from your patient or doctor.  You read nonverbal cues and facial expressions. Example is during your assessment, you evaluate for pain.  Pain is what the patient says it is not matter what, but you can evaluate pain based on facial grimaces, guarding the area, facial expressions, and you get an idea without even asking them to rate pain.    Ineffective is reading through doctor notes.  You are unable to ask questions, verify or confirm.  You can call and get more details but it is least effective.  It is always best to talk either on the phone or face to face." 

What was difficult to first understand about communication in the hospital environment and how long did it take you to adjust? What steps did you take to assist you in being able to comprehend the terminology and communication used?

"Probably 6-8 months to fully be capable.  It was difficult t learn how and when to call doctors.  They are busy people and they don't want to be bothered with silly questions.  You have to judge when to call them, use your intuition and judgment and know all the things you want to know from the conversation before you call because if you get off and you don't have all the answers you have to call back and they usually aren't too happy about it. What helped was practicing calling with someone and just doing.  Also learning medical terminology.  What little acronyms used meant and understanding when people talk a mile a minute and use all of these big words.  Listening a lot helped and asking a lot of questions.  It is better to ask a question if you don't know than to hurt or kill your patient because you didn't ask a question.  Medical terminology came over time, learning, understanding the basics and roots of big words. Like gastritis- gastro is stomach, itis- is inflammation, appendicitis- inflammation of the appendix, colonoscopy- looking with a camera using a scope at the colon, and arthroscopy- looking with a camera in a joint.  Learning all of that in school is very important so you can keep up.  Learning how to give and get reports is another important thing.  Picking out that important things to tell the next nurse coming on.  You learn over time, with preceptors and the nurses help and when you forget something calling and following up so they aren't left missing information."

In emergency situations, how are you informed of what is happening and what is the most effective way to communicate and get help quickly?

"In an emergency you are paged overhead, called or given signals like codes. Code red, code blue, amber alert- all have meanings and you need to know what they mean and what to do if it is called out. Your next person with information is your manager. They are in command so you go to a post or where you are supposed to go and do what is assigned to you. During a code or when someone is CPR one person is in charge and calling orders. Then all people fill in doing the tasks. You need one person in charge so you get all tasks done and nothing is missed but it can all be done at the same time. Someone giving meds, someone doing chest compressions, someone charting and keeping a log, someone calling for help."

How do you communicate with patients?

"Nurses and patients communicate with talking, assessment, asking questions. Asking them to rate pain on a scale from 1-10, looking at nonverbals, coaching them through tough times. Patients give signals beyond just talking and describing problems or pain they guard the sore area, they have facial expressions or grimaces. They show caring with physical touch, holding a hand, rubbing a back or arm during a procedure. Patients communicate through a guardian or power of attorney at times when the patient is incapable of making decisions. They use the call light from their bed. Nurses answer all questions and provide communication to and from the doctor to patients. We are the gateway to the doctors and medical personnel. We have the ability to call and page doctors where he patient is depending on you to communicate for them."

What did I discover about the uses of communication in this field?

Through this email interview I discovered that verbal communication is the most effective way to get things done quickly and efficiently in this field.  After reading through her responses, she also touched on a few topics we have discussed in previous blog posts.  Some of these include the stereotypes of nurses, that males are not a big part of this field, and also that nurses do not do as much as a doctor does.  Going through this interview provided me with a more open mind to the field and understanding the strengths and difficulties when encountering certain situations and what works best to solve them.

-Samantha B.