NRSG139 - Assessment in Health

The reflection is based on a video recorded at the beginning of the semester, in which I demonstrated therapeutic communication (TC) during a simulated clinical scenario in class. The purpose of this assignment is to critically reflect on my understanding and practice of therapeutic communication, focusing on the strengths and areas for improvement observed in the video. Using the modified Gibbs’ Reflective Cycle as a framework.

What was done well?

In my simulation lab experience, I demonstrated the important qualities required to build a trusting therapeutic relationship. I communicated empathetically, accurately, and in a timely manner. I maintained eye contact and practiced active listening, both of which are key components of effective therapeutic communication.

Maintaining eye contact indicated to the patient that I was fully engaged and actively participating in the conversation. It helped to build trust and made the interaction feel more meaningful and respectful. Eye contact is a crucial non-verbal cue that communicates attentiveness and empathy in nurse–patient interactions.

Therapeutic communication, as described in the literature, is a professional skill grounded in empathy and the maintenance of clear boundaries to promote understanding and reduce patient stress. I ensured that these principles were reflected throughout my practice.

 I used open-ended questions such as “Can you tell me more about how you’re feeling today?” to encourage the patient to share their thoughts and emotions more effectively. This approach encouraged open conversation and helped establish a connection built on trust and mutual respect. An effective therapeutic relationship is characterized by care, support, acceptance, and respect.

I also ensured that I included the key communication techniques and strategies outlined in the literature to enhance the quality of the interaction and uphold the principles of person-centred care (Rosenberg & Gallo-Silver, 2011).

Area for Improvement

During the simulation lab, I became aware of several key areas where I need to improve my therapeutic communication, especially facial expressions, managing nervousness, and enhancing cultural awareness. I noticed that my facial expressions were quite limited when interacting with peers acting as patients, which may have made me appear less engaged or empathetic, which could affect patient trust and comfort.

I also found that nervousness during communication, which affected my confidence and made it harder to fully focus or concentrate on the interaction. Managing my nervousness better will help me communicate more clearly and effectively and build strong rapport with patients.

Another important insight was the need to be culturally sensitive in all patient interactions. Every patient has different values and ways of expressing themselves, so I need to be respectful and adaptable in my communication. It is important to develop cultural competence by listening actively, working on these areas will help me to improve my overall therapeutic communication and provide better clinical practice and more positive patient experiences (Rosenberg & Gallo-Silver, 2011).

Implication for patient

The video reflection highlighted my strengths in active listening and using open-ended questions to build rapport. However, improving facial expressions and managing nervousness will enhance my therapeutic communication further. Therapeutic communication plays a key role in patient outcomes, and safety. One of the key implications of therapeutic communication is developing rapport with patients, their families and caregivers to promote person- centred care and communication and create a safe environment where the patient feels comfortable sharing emotions and other information (Kwame & Petrucka, 2021).

Impact on patient safety

Therapeutic communication is a crucial skill in nursing that significantly influences patient safety, satisfaction, and health outcomes. It helps build trust, therapeutic communication encourages patients to express themselves openly and feel heard, understood, and respected. (Sheldon et al., 2014).

I understood that patient safety is extremely important, but certain barriers such as lack of privacy and excessive background noise can affect communication between nurses and patients. A patient who is in pain, feeling anxious, or affected by medication might not be able to express themselves clearly, and important symptoms or needs may be missed. This can put their safety at risk if they are unable to communicate effectively. The value of effective communication in nurse-patient interaction. Nurse and other health care workers must ensure that they develop therapeutic relationship with clients and families. Additionally, when the nurse and patient come from different cultural backgrounds, misunderstandings can occur. That is why it is essential for nurses to use clear, respectful, and culturally sensitive communication to ensure that patients feel safe (Nursing Times, 2018).

Barriers

Effective communication in healthcare can be challenged by various barriers. These include time constraints that limit meaningful interaction, as well as environmental factors such as noise, lack of privacy, and distractions. A patient’s physical discomfort, such as pain and fatigue, can also hinder communication. Emotional factors, including embarrassment and anxiety, may prevent patients from expressing themselves openly. Additionally, the use of medical terminology can lead to confusion if patients are unfamiliar with the terms. Differences in personal values and beliefs may influence how messages are interpreted. Furthermore, demographic characteristics, cultural and linguistic backgrounds, health beliefs can also act as a barrier in communication. Information overload can also reduce patient understanding. Addressing these barriers is essential for delivering patient-centred and effective care (Nursing Times, 2005–2025).

On going education and peer feeding

peer feedback is very important for enhancing the nursing student’s reflective abilities, clinical competencies and sense of empowerment. Peer feedback promotes self awareness and promote the best practice in therapeutic communication. Receiving peer feedback student gain self awareness of strengths and area for improvement. The lack of consistent constructive feedback can be detrimental to the competent nurse (Wong & Shorey, 2020).