Verbal conversation is one of the most utilized tools of communication among nurses. There is no doubt about the importance of verbal communication since all human beings depend on it to exchange ideas. However, the context of the conversation and the subject has an important bearing on the type of conversation carried out. For example, a social conversation may allow for the use of slang, phrases, and jokes. However, comparing it to a routine discussion in a clinical care setting where patient information is shared, the language may be entirely different. There is less jargon in the conversation, the words are chosen carefully, and the language is used which is more medically appropriate. There are fewer comments of personal nature and more focus on the correct assessment and course of action to be taken based on the case presented.
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As a nurse, I find these two types of conversation very different from one another. However, I believe that even in the workplace, I need both types of interactions with my colleagues. On the more social level, it helps me understand their aspirations, their approaches, their ideals and thereby their ambitions when carrying out their duty and family life. It helps me see the persons and not only the nurse, a small projection of the whole image. Therefore, when interacting with other nurses, I am able to communicate with them in an effective manner about their likes and dislikes, which can help me perform better with them as a team.
Medical or clinical communication is very different. There are fewer social aspirations under consideration unless they are of particular importance to the patient case. There is more accuracy needed in framing sentences. To clearly identify the difference between the two types of conversation, I narrated a case with my colleague of a patient who presented to the emergency with pain and swelling in the facial region. I first gave a verbal presentation of the case, after which my colleague gave the same presentation to me again. We then compared the two presentations. The SBAR or the Situation, Background, Assessment, and Recommendations sequence was employed by both of us for the presentation of the case.
I stated that the patient’s swelling was located on the right side of the face and towards the upper jaw. The patient complained of pain and said that it was taking place all throughout the day. He said that the pain was throbbing and increased with time. The patient also stated that eating hot or sweet foods exacerbated the pain. A patient told of a dental cavity and pain last month for which he had to take antibiotics. The pain had subsided, upon which the patient did not have proper dental treatment done. Alongside, the patient stated he frequently had bleeding from gums. We discussed the possible causes of such pain and concluded that the pain and swelling may be from the pus accumulating in the upper jaw, from either an infected tooth or infected periodontium. We concluded that the patient may have to visit a dentist for a full evaluation, and the treatment may be then carried out. Meanwhile, the patient can have antibiotics started and IV fluids are given.
The same conversation was again repeated, this time with my colleague narrating the case. He mentioned that the patient was a 45-year-old man who presented to the emergency department. He was a white Caucasian male, afebrile, blood pressure of 120/80 and fully alert. The patient stated that he was having pain in his right upper jaw for the past few days, and an increase in the swelling in the same area. He said that the pain increased when hot or sweet food was taken. There was no significant medical history. The patient did tell in the recent medical history that he had pain in the same region about a month back for which he went to the dentist. The dentist told him that there was an infection in the upper right segment due to a tooth cavity, for which he was prescribed antibiotics and pain medication. Upon completion of the medication, he said that he felt no more pain upon which he did not go to the dentist again for resumption of treatment. He states that now he has swelling and pain in the same location on the upper right side of the jaw, which is increasing with time. Upon examination, it was found that there was a cavity in the upper first molar tooth on the right side. There were also plaque deposits on the entire tooth with bleeding gums. The differential diagnosis suggested the presence of dental tooth infection as well as periodontal infection. It was decided that the immediate management should be the initiation of antibiotics and IV lines to help reduce the infection and swelling. Alongside, it was recommended that the patient be referred to a dentist for further evaluation and treatment options.
As we can see, there is a considerable difference in both the presentations of the same case by two different nurses. In my version, I was haphazard in my approach and did not furnish the entire details, although I had them with me. I failed to provide the history in a chronological manner and did not emphasize the previous treatment. I also did not provide clear details on the oral examination and the findings therein.
By comparison, the second version of the same case provided a much more detailed, succinct and precise information. There was a complete mention of the patient profile. The presenting, recent medical history, and detailed medical histories were presented in a chronological pattern. There was more specific choice of words, and the entire sequence of management of the case was given in a proper manner.
Upon query as to how my fellow nurse was able to provide such a superior version of the same case, he responded that it was due to the first presentation. He said that he was able to identify the faults in the first presentation, and point out the areas which were not clearly identified. He then told me that he was able to look into the charts before presenting himself for longer time than I did, which prepared him further. Finally, he was able to see where he had to place emphasis on the discussion of the case.
These findings clearly help us see how important communication and interaction between personnel is. It helps improve the quality of communication and helps to identify key areas of weaknesses in each type of communication. It helps in providing emphasis to a pattern or a protocol that is followed in a clinical setting, which provides uniformity and in this way, helps eliminate potential errors. Such exercises in communication skills help a person identify his or her weak areas, and helps in improving the quality of health care provision (Aquino, 2008).
Regular conversations and communication with fellow nurses on clinical routines and protocols can help improve standards. Communication improves the quality of care by promoting good practice. More effort should be placed to make communication skills are part of nursing practice.
Aquino, A. 2008. Speech and Oral Communication for Nursing (Ed.). London: Rex Bookstore Inc.