For this discussion, you will reflect on the significance of becoming competent in therapeutic communication skills. The professional tone we set needs to be congruent with evidence-based practice. For your initial post, please address the following:
· Share a time that communication stalled for you.
· What were the results of poor communication?
· Did it result in a wrong diagnosis? Incorrect or unnecessary medication? Was there a loss of contact with a patient?
· Share how you were able to overcome the communication failure.
· What communications skills would you have liked to have better practiced changing the outcome for the patient?
POST # 1 AYME
Therapeutic Communication Skills
Communication during therapy sessions is a critical element because it enabled exploration of the patient’s feelings and the possible state of their social or family circle (Wheeler, 2014). In psychiatric nursing, adolescents and minors will be accompanied by their caregivers or parents. The nurse must seek to integrate the views of the patient and those of the caregiver/parent considering that each has a significant role in the care process. Adolescents especially in their late teenage years always feel a bit more entitled to greater independence. Such entitlement must be negotiated rather than cut off or dismissed. Further, it should not be used to curtail the role of the caregiver since such an approach would hinder desired communication (Carlat, 2016).
A time when communication stalled for me
From my encounter, a 17-year-old male presents to the clinic in the company of his mother for the follow-up and refill visit due to his depression diagnosed 18 months ago. The patient was not willing to talk, arguing the mother has been dictatorial and she has not allowed him to go out with friends for 6 weeks now. He says he decided not to take his medications two weeks ago to ‘show mom I have my rules too’. The mother interjects in between the discussions arguing ‘I’m not taking in being controlled by a child. That’s not rules. I requested the mother to allow some space I talk to the son privately, but the mother insists that she is the sole sponsor of her son’s healthcare and she has to know what is going on. The son angrily retorts “You see what I mean…she’s overbearing and owns everything and everyone”. The room turns chaotic with each party shouting its case. I found it difficult to control the situation and called my supervisor to help resolve the situation. I felt I had failed to sustain communication with my clients.
Results of poor communication
The mother informed my supervisor that I was siding with the son. She says she prefers that I am not involved in his son’s care. The son on the other hand feels that I was proceeding well. This partisanship would easily be interpreted as bias on my side. While I may have remained professional through the argument, I felt that I had failed to offer the two parties a common ground to resolve their issues and pursue the son’s health matters. I was not involved further in the management of the son to avoid conflicts (Wheeler, 2014).
Results from the wrong diagnosis
Luckily, there was not a case of misdiagnosis or wrong prescription since I was not involved further in the case. However, having seen myself as a trigger for conflict between the son and the mother, it was decided between me and my supervisor that future visits involving the family would not involve me (Meuter et al., 2015). Having successfully managed the son since he was diagnosed with depression, I had bad feelings that I would not be managing the patient anymore despite the viable progress since we started treatment.
How I overcame communication failure
Introducing my supervisor to take part in resolving the chaotic scene was the only way out in resolving the communication failure. My supervisor already understood the situation and provided a platform of neutrality seeking to reconcile the mother and the son without separating them in the room as I had tried to do (Yamashita et al., 2018).
Communication skills I rather have practiced more
Negotiation is the most important skill I should have practiced more. Had I sought negotiations with the mother and the son on whether to have separate talks with each of them, we would have reached an amicable solution. However, in this case, I appeared to be ordering the mother to exit the room so I could talk to the son. Patients and their family members are likely to interpret the tone and wording of the clinician wrongly such as in this case (Meuter et al., 2015). The best mechanism is to assume that all decision points must be negotiated to protect the emotions and feelings of the patients and family members (Olasoji et al., 2017).
References
Carlat D. J. (2016). The Psychiatric Interview (4th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming language barriers in healthcare: a protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC health services research, 15(1), 1-5.
Olasoji, M., Maude, P., & McCauley, K. (2017). Not sick enough: experiences of carers of people with mental illness negotiating care for their relatives with mental health services. Journal of psychiatric and mental health nursing, 24(6), 403-411.
Wheeler, K. (2014). Psychotherapy for the Advanced Practice Nurse Psychiatric Nurse: A How-to Guide for Evidence-Based Practice (2nd ed.). St. Louis, MO: Mosby.
Yamashita, N., Kuzuoka, H., Kudo, T., Hirata, K., Aramaki, E., & Hattori, K. (2018, April). How information sharing about care recipients by family caregivers impacts family communication. In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems (pp. 1-13).