The good part of the challenging communication interaction with the nurse is that, despite my situation, I was willing to help a patient who needed urgent attention. It was also good that I was able to remind the nurse of my competency and ability in dealing with patients with tracheostomy. The bad part in my challenging communicative situation was the harshness and rudeness of the nurse when I requested her to look after patients with tracheostomy. The other bad thing in the situation was that when the patient required urgent suctioning and attention, the nurse was out of the room. Her response of shouting me down, snatching the suctioning equipment, and gesturing me to leave were even the worse parts of the situation leading to my reaction. These experiences reflected negatively to patients who ended up doubting my expertise in tracheostomy.
Analysis
The outcome of the incident with the nurse was that I was extremely upset and could not envision the practicality of how she treated me. The new nurse was insensitive and rude, she seemed not to care of the hurt she was inflicting in me. I had to take the responsibility of the patient who required attention as a nurse in the event, as is required by the nursing profession (Quinn, 2000). I was within the rules by immediately suctioning the patient, when the new nurse ignored the following of the protocol by dismissing my assistance. Getting angry and shouting back was useless and unprofessional of me in solving the disagreement with the new nurse. However, shouting me down and dismissing me, were predictable from the way she answered when I requested her for permission to look after patients with tracheostomy. My allocation of patients who needed minimal care must have also contributed to the unworthy situation we had with the new nurse, this from the rate at which our differences cropped up.
Conclusion
The action of suctioning the patient to relieve her of the pain was within the rules, and I would do the same given the circumstance (Quinn, 2000). In acting differently, I would have controlled myself and quietly left the room to avoid being unprofessional by shouting. This would have helped diffuse the tension between us and given a better impression of me to the patients. The new nurse could have called me aside politely and take over the suctioning in a professional manner.
Action Plan
In case a similar situation arises again, I will be calm and professional in my communication with the nurse. I will give my best to avoid expressing my anger by controlling it and making a quiet leave. I will not shout or let her actions enrage me and politely request her to have the discussion done at a different setting. This is to avoid portraying a bad opinion to the patients. I will also ensure that my professional requirement of cooperation and help to other nurses and patients come first in my order of preferences (Ghaye, 2011). I believe these actions will enable the new nurse to reconsider and realise the importance of professionalism and excellent communication skills leading to a therapeutic solution to the situation.
Analysis and conceptualisation of Reflection Models
Reflection is a tool in the nursing profession used as a benchmark to improve on decision-making and know the premises for previous decisions (White, 2005). This has led to the introduction of various reflection models, which include Jasper model that mainly details experience- reflection-action as a course of on an issue of importance (Gibbs, 1988). In my context on the challenging communication problem, the Jasper model stipulates that I revisit the problem by thinking about it (Webb, 2011). This amounts to gaining experience and gaining a deeper understanding of the communication problem between me and the nurse. The next step in the Jasper model is reflection, where in my case; I have to reflect on the feelings elicited by the treatment I received from the new nurse (Moon, 2005). Getting awareness of the feelings and making the conclusion on their implications for the outcome on the nursing profession. The last stages in the Jasper reflection model are the actions to take in case of recurrence of the situation (Ghaye, 2011). For my case, thinking of how to control myself in speech and action, deciding on action to take if unfair treatment by another nurse ever happens to me again is the last part of the Jasper reflection model.
Shon’c model of reflection follows the same guidelines as Jasper reflection model on the challenging communication interaction (Jasper, 2003). John’s model of structured reflection of 1994 requires that I describe the experience with the other nurse taking into account the factors that prompted the case for reflection. Further, the model wants me to explain the cause of the argument, my feelings, and the other nurse’s feelings in his reflection model (Callara, 2008). The model further requires me to clarify the importance of the actions taken, what I could have acted differently or better in resolving the situation. Lessons achieved from the interaction with the other nurse will also be analysed and their effect is the last action for me to take in reflecting on the communication situation.
The latest model of reflection in nursing developed by Rolf and other theorists is remarkably straightforward (White, 2005). The model has what, so what and now what parts of reflecting on the situation. What part of the model, requires that I think of the event and giving reasons to warrant reflection on the challenging situation (Webb, 2011). The so what part is the second stage and involves investigating the implications of the situation, the people involved and its importance to improving the nursing profession (Janes & Lundy, 2009). This would entail thinking of the implications of my disagreement with the new nurse, the reasons for her reactions and the importance of the argument to the development of the nursing career (Callara, 2008). The third part is what part and involves what I should have done differently, and measures possible to solve the situation including lessons learnt from the event (Hitchcock & Schubert, 2003).
Issues associated to Challenging Communication
Cultural beliefs affect challenging communication interactions due to the difference in the cultural values of certain beliefs and actions. The cultural setting and the needs of the communicating partners mostly influence communication channels and aspects in challenging situations (Brotherton & Parker, 2008). Cultural groups influence how one thinks or acts given a certain situation by instilling both specific and general expectations of a given situation. Consideration of the emic and etic views on culture by a nurse aids in effective communication. This means, to be able to solve a given challenging communication situation one has to consider the cultural beliefs and values that influence a person’s stand on a given issue. Social norms are highly influential in dealing with challenging communication situations because of its influence on thought, notions, and behaviours of an individual (Brotherton & Parker, 2008). Nurses, therefore, have to understand individual norms in order to clearly deal with challenging situations as they determine the outcome of the situation. Arguments, perceptions, and inclinations all depend on the individual norms hence extremely influential in solving disagreements and patient-nurse communication (Daly & Speedy, 2009).
Gender bias in nursing affects challenging communication and causes disagreements (Beurhaus & Needleman, 2003). Gender biased individuals increase cases of belittlement; bullying and harassment, which escalates situations of challenging communication. Embracing diversity in the nursing profession aids reduce disagreements and improve professionalism in nursing (Kraszeski & McEwen, 2010). It is mandatory for all of us in the nursing profession, to come up with measures that will aid shun away discrimination based on ethnic, racial or gender. Collaboration with other healthcare professionals by nurses is another issue that affects communication challenges (Daly & Speedy, 2009). Mostly, communication between nurses and physicians is unsatisfactory with the physician’s common behavior of intimidating, belittling, and mocking the nurses. The main reasons for poor nurse-physician communication are power issues, hierarchical differences, and negative attitude towards the nursing profession (Bullman & Davies, 2000).
Lack of collaboration between nurses and other healthcare professionals is mainly due to physician’s belief that they are superior to the nurses (Beurhaus & Needleman, 2003). They believe nurses have the mandate to do their bidding, especially older male physicians (Sirota, 2007). Power issues affect communication in the nursing profession because of the dismissive behaviour of physicians and that physicians do not take professional advice from nurses (Payton, 2008). This is evident despite the ignorance of live-saving advice in patient treatment leading to deaths (Sirota, 2007). It is, therefore, a responsibility for all of us in nursing to aim at making nurses and physician’s relation better than the present for efficient service delivery. Priority decision is another issue that affects communication in nursing where conflicts arise when doctors do not take into consideration nurse-patient relationship (McDonald & McIntyre, 2009). Empowering nurses through professional development and training aids in reducing communication challenges (Payton, 2008). Another solution to communication challenges is improving communication between physicians and nurses through a platform for approach between nurses and physicians as professional colleagues.
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