Self Reflection on Communication in Nursing

AMITA KHOWAJA

Introduction

Reflection is an organized and a planned way to think positively and make better decisions. Reflection allow person to learn from their mistakes and past experiences. This is more applicable to form the fundamentals of healing and therapeutic process in health care field. According to Parker (2006) Reflection in health care profession will enhances effective care and therapeutic process. In line with this thought I shall reflect on the change noticed in my communication style after analyzing the situation occurred few days back.

After the incident happened which I have discussed in my self-awareness piece of writing there are number of lessons I learned from the experience which includes inappropriate communication style. Initially I was following the passive style then turned into aggressive style which I feel worsen the problem rather than solving it. I identify that my poor communication style had created stress and bad feelings within relationship with my roommate so, I decided to follow the assertive communication style to solve the conflict going on between me and my roommate.

Assertive communication is a skill to express positive and negative thoughts and feelings in an open, calm and straight forward way. It recognizes our rights at the same time respecting the rights of others. It is a sense of taking responsibility for ourselves and our actions without judging or accusing other people.

I choose this style because I want to express to my roommate what I want, what I was thinking, my wishes, desires and feeling to make her understand that we both matter. Moreover, I want to learn to say no to request from others without having guilt feelings. In this way, mutually satisfying solutions will be drawn to avoid any future conflict and good relationship will be maintained between me and my roommate.

Before starting the conversation with my roommate, I had made my mind to be clear with some of the aspects of assertive communication such as when practicing assertive communication my body language should convey the message of openness and receptiveness. I must maintain upright, relaxed posture with clear voice tone and maintain good eye contact with her. I must show willingness to hear her point of view and accept feedback from her rather than denying and counter attacking her.

By keeping in mind all the skills, I went to her and start my conversation

“I am really worried about the conflict which had occurred between you and me. So, I want to ask you when is a good time for us to talk about things that has been bothering me.”

Response: “we can discuss it right now.”

“I feel frustrated and overwhelmed when you are not sharing with me the household responsibilities so, I want to discuss about the following points with you like sharing the responsibilities of monthly payments of internet, house rent, hydro, house cleanliness, cooking food and doing grocery etc. From the following tasks, I would appreciate if you could take the responsibility of doing monthly payments” (using I statements).

Response: “Before shifting over here I was living with my parents so they are taking care of all the house hold responsibilities of monthly payments and my mother cooking food for me”

“Let me see if I understand you are saying that sometime if I ask you to make monthly house payments or ask you to cook food is not the suitable job for you?” (Paraphrasing and active listening)

Response: “yes, I am not aware about the proper procedure of making the payments as well as I do not have expertise in cooking”.

“The steak which you had prepared was good in taste but it need little bit more cooking from inside so that the blood will not ooze.” (Encouraging).

Response: “I spent all afternoon preparing that meal and that’s the last time I cook for you.”

The best solution to this is that as I have more experience in cooking so I will look after the cooking. For monthly payments, could you please tell me more about how enough information you have about the payment process so that I will help you out for further steps?” (Open ended question, encouraging).

Few more examples that depict my assertive communication are:

“I hate it when you do not listen to me when I was discussing with you about the grocery items that need to purchase”.

Response: “You want to say that I was pretending to be alert while thinking about somewhat else. You are just saying based upon your pre-assumptions about me.”

“I think I hear and understand what you are saying, (encouraging) but I am in disagreement. I feel frustrated and annoyed when I have to get back with you about the conversation which we had already did related to grocery items. Moreover, I would appreciate it if I don’t have to remind you over and over to wash your left-over dishes and empty trash from your room”.

Response: “I will be careful about my dishes next time. When I hear rude words about me I feel very upset and they hurt my feelings”.

“I need to be careful about using alienating messages”. (Accepting criticism)

When I reflect upon the above conversation I can say that I had use effective interpersonal communication skills for example:

Right time and right place: I choosing the private place (our house) with proper time (when she is available) to do open dialogue for discussing the important issues and to respond with clarity.

Organize ideas in mind: when communicating with her I have some key points in mind to stick like about different house hold responsibilities to make my conversation clear, focus and directive. By using the ‘I’ statement for expressing my feelings I was making my roommate aware of the problematic situation without making any accusations. My purpose was to become crystal clear in informing her about the problems and for initiating actions.

Clear body language: I was using soft, gentle and aware facial expressions during the conversation and try to avoid negative facial expressions, such as frowns or raised eyebrows.

Be attentive when listening: By actively listening to her I could reflect on the content of the conversation, her feelings as well as trying to understand the nature of problem from her perspective. This can help me to recognize and correct mistaken views. I gave her opportunity to talk about her feelings without interruption and when she has finished talking I reflect back upon what I have heard.

Paraphrasing: Once I had absorbed what she has said, I use clarification skills of paraphrasing to make sure that I had understood accurately and let her know that I have heard her point and understand her side. Furthermore, by asking open ended questions I was allowing her to share her knowledge.

Accepting criticism: Accepting criticism always provide a room to improve, feel better about self and help to be the better person. I accept criticism with empathy and owning my personal contribution in a conflict to set good example and to shows the maturity.

I was able to practice interpersonal communication skills with my roommate and it make a huge difference in establishing healthy relationship with my roommate. It enables me to swap my old behavior patterns towards a more positive approach of life. It helps in diffusing the situation and draw a mutual agreement between both the parties (me and my roommate) hence, better decision making and problem-solving would be done. Furthermore, my stress will be managed better as I have learned to set boundaries earlier.

By adopting an assertive communication style my communication become greatly enhances with others and produce positive outcomes. My interpersonal relationships become strong. I am now able to reduce my feeling of anxiety, stress and helplessness and gain a better sense of control. In addition, I learn to treat people more respectfully to retrain self-respect thus my self-esteem will be enhanced.

Being a health care assistant assertive communication style help me in building effective team relationships with other health professionals. I will be more likely to provide patient with appropriate care hence, improving their quality of care. In addition, my appropriately delivering assertive stand to a possibly harmful situation will help in preventing medical errors and empower me become a better patient advocate. The use of assertive behavior constitute feeling of respect for both parties (me and my patient) and thus my confidence and self-esteem will be enhanced. Proper team communication will increase my moral as a worker and prevent me from high levels of stress, burnout and poor job satisfaction, overall my quality of life will be improved.

Effective interpersonal communication is necessary to negotiate the challenges of everyday living, whether in your personal or professional life. Because human beings are complex and each individual brings his or her own set of internal variables to every situation, the possibilities of interactional outcomes of any given communication can be exponential.

Although much has been written regarding workplace violence (e.g., bullying), practical strategies for addressing the mechanics of effective interpersonal communication are lacking. In order to address this, we need frank, open conversations regarding how our personal internal variables affect our interpretation of the world as we see it. This article has hopefully provided an opening dialogue in that direction with pragmatic discussion of common areas of concern. These recommendations are often ones that we, as nurses, offer to patients every day. Taking the time to consider them as they may apply in our professional and personal lives may go a long way to encourage healthy communication, and thus healthy nurses!

Communication problems often arise because we don’t say how we feel, what we think or what we want. People often avoid communicating because they are embarrassed or concerned about upsetting the other person. Sometimes we just assume that others should know what we think. The problem is that when you don’t say what you need to say, it increases the likelihood of feeling angry, resentful and frustrated. This leads to tension in relationships and, sometimes, to angry outbursts.

https://crana.org.au/uploads/pdfs/Other_48.pdf

https://justice.alberta.ca/programs_services/mediation/drn/Documents/AssertiveCommunicationPresentation.pdf

http://firstlanexperts.blogspot.ca/2013/10/interpersonal-communication-in.html

• Improve interpersonal relationships
• Reduce conflicts/anxiety
• Enhance self esteem
• Retrain self respect
• Minimize stress
• Treats others respectfully
• Reduce feelings of helplessness/depression
• Gives a sense of control    

REFERENCES

• Leonard, M., Graham, S.,Bonacum D. (2004). The human factor: The critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care, 13, 85-90

• Parker, M. (2006). Aesthetic ways in day-to-day nursing. London: Sage Publications.

• Wilk, J. M., Newmaster, R., Sorrentino, A.S., & Remmert, L. (2012). Mosby’s Canadian Textbook for the Support Worker (3^rd ed.). Canada.