Enhancing Clinical Communication – Analyzing, Strengthening, and Mastering Therapeutic Techniques
Summary of major theme(s):
The summary presented demonstrates caregiver-patient communication processes during patient assessment. It reveals areas with the potential to cause conflicts during patient-caregiver engagements and gives an insight into how these conflicts can be addressed. Conflicts in interpersonal engagements can be evidenced by the patient’s use of non-verbal cues suggestive of anger or disapproval (Del Giacco et al., 2020). In the case presented, an analysis of the verbal and non-verbal communication techniques revealed that the resident’s and nurse’s verbal and nonverbal cues were congruent, explaining the seamless flow of the communication process.
The geriatric population faces unique challenges. How do you feel your resident’s physical and psychosocial challenges influenced the communication exchange?
Physical: The resident interviewed did not have significant limitations in her mobility and, subsequently, activities of daily living. The communication processes between her and the nurses were, therefore, not influenced by physical challenges that otherwise affect the geriatric population.
Psychosocial: Psychosocial challenges affecting the elderly border on loneliness and activity dependence. The resident, in the case, presented with complaints of headache. However, she demonstrated a change in mood upon being asked if his complaints affected his ability to perform her daily activities. This may suggest her discomfort when discussing her functional ability.
How did your own personal feelings identified in the table above influence the interaction?
My feelings had a predilection on the interaction. They determined how I responded to the resident and the questions asked therein.
Therapeutic Process Recording: TEAM MEMBER
Pre-Interaction (5 points):
Briefly describe the environment where the communication took place & note if others were present: The communication took place within the clinical setup, at the point of care. The people present included a resident with complaints of headaches, the nurse, and the team member.
Give a brief summary of events leading up to the therapeutic conversation: The team member is working alongside the attending nurse to assess a resident presenting with complaints of headache.
DOCUMENTATION & ANALYSIS OF EXCHANGE WITH TEAM MEMBER (10 points):
| What I said and did
a) Verbal Communication b) Non-verbal Communication |
What team members said and did
a) Verbal Communication b) Non-verbal communication |
My feelings & thoughts experienced during the exchange (minimum of 2)
a) Feeling/thought b) Feeling/thought |
Inference of communication Student’s inference of team member’s communication based on verbal and non-verbal cues i.e. what is behind communication – happy, frustrated, angry, etc. | Analysis of communication
a- Communication technique used b- Did communication improve client care/safety? c- Principles of professional communication observed. (see document in assignment module) |
| a- How do you assess headaches in geriatric patients with cognitive decline?
b- Eye contact |
a- There are no differences in the assessment process for headaches. Just perform it as you would for other populations.
c- Nodding the head. |
a- I feel the team member is affirming the nurse’s assessment of headaches.
b- I feel the nodding demonstrates the team member’s approval. |
The communication begins positively but is stirred by the disapproving remarks from the team members. | a- Asking open-ended question (T)
b- Restating (T) c-Disapproving (NT)
|
| a- So you are saying asking similar questions as I would to a 12-year-old will give me insight into the likely cause of the headache.
b-Seeming surprised |
a- Yes. The only challenge would be how to frame the questions so that she understands them. I had once used the same technique and got an accurate diagnosis.
b- Nodding |
a- There seems to be some understanding between the nurse and the team member.
b- The team member utilized the comparison strategy to affirm her point. |
The communication regains some sanity as the nurse and the team members converse effectively with the nurses. | a- Giving general leads (T)
b- Rephrasing (T) c- Encouraging comparisons (T).
|
| a- Okay. So framing the questions to make them better understandable to the client is key.
b-Frowned face |
a- But you must also recognize that personal characteristics differ; older adults are also sometimes confused.
b- Laughing |
a- There was a notable disagreement during the course of the conversation.
b- The team member is stereotypical. She links the elderly with confusion. |
The communication, once again, crumbles as the team member interrupts the nurse while she is making her remarks. | a-Summarizing (T)
b- Interruptions (NT) c- Stating generalization (NT)
|
| a-I have not finished yet. You need to be patient when engaging your peers.
b-Crossing arm on the chest |
a- Why didn’t you know that? You should consider bolstering your knowledge of healthcare communications.
b-Laughing sarcastically. |
a- The nurse seems angered by the interruptive behavior of the team member.
b-The communication crumbles due to gross misunderstanding between the nurse and the team member. |
The communication finally fails due to poor communication behaviors from the communicating parties. Crossing arms is a nonverbal cue that reveals resentment. Laughing sarcastically is also a nontherapeutic communication technique. | a- Aruguing (NT)
b- Asking why questions (NT) c- Disapproving (NT)
|
SUMMARY & REFLECTION of RESIDENT COMMUNICATION (5 points):
Was the goal of the communication exchange met at the conclusion of the interaction? Why or why not?
No. The goal was not met. The team member demonstrated non-therapeutic techniques during the interaction processes that jeopardized the communication processes. Non-therapeutic techniques impede the development of nurturing relationships between caregivers. The team members were interruptive, disapproving, and generalizations.
The healthcare environment can be stressful. How do you feel your own personal feelings and past experiences influenced the communication exchange?
There may be some signs of influence from personal feelings and past experiences during the communication exchange. Personal feelings may have interplayed when the team member disrupted or gave disapproving remarks. This further contributed to the communication breakdown.
Discuss strategies you will implement to improve your verbal and non-verbal communication prior to moving forward into ADNG 2100 Clinical II.
Verbal Strategy: The strategies that will be used to improve verbal communication include maintaining the awareness of the audience, asking for feedback during communication processes, and engaging the audience by asking leading questions. These strategies can help enhance my communication skills enabling me to communicate verbally effectively.
Nonverbal Strategy: Several strategies can be used to enhance nonverbal communication. Understanding various nonverbal cues and their interpretations across populations, rehearsing by filming myself and identifying areas that require improvements, and watching videos and tutorials to understand how different persons utilize nonverbal cues can help enhance my nonverbal cues.
References
Del Giacco, L., Anguera, M. T., & Salcuni, S. (2020). The action of verbal and non-verbal communication in the Therapeutic Alliance Construction: A mixed methods approach to assess the initial interactions with depressed patients. Frontiers in Psychology, 11. https://doi.org/10.3389/
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Question 
Analyze communication with residents and team members in clinical settings to identify communication patterns
Utilize analysis to identify strengths and areas for improvement of therapeutic and professional communication
Develop skills in the identification of therapeutic communication techniques
Enhancing Clinical Communication – Analyzing, Strengthening, and Mastering Therapeutic Techniques
Introduce awareness of the impact of thoughts/feelings on communication
Introduce the ability to make accurate inferences based on both verbal and nonverbal communication
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