Any health professional needs to know a brief history of a patient before offering any help (Waxler & Wood, 2005). The information given by a patient can help a health professional to understand the type of experience of the patient. However, when a patient refuses to give information or decides to give wrong information, the healthcare process may not be effective and pain management may not be possible (Wood, 2006). In addition, when wrong information is given by a patient, wrong medication may be administered which can be very dangerous to the patient’s health. This does not mean that every treatment given to a patient depends on the information given by the patient but in situations where a patient can speak, the information relating to pain can easily be obtained and used to administer medication (Macintyre, Schug, Scott, Visser &Walker, 2010).
In my acute practice as a nurse, I came across a patient who was continuously coughing. The coughing was generally dry; the patient was not coughing with ease. After coughing, whatever the man spat had some stains of blood. During coughing, the man could be seen holding his chest indicating that the man had some chest pains. When I asked the man to tell me for how long he had been experiencing the symptoms, it was unfortunate that the man could not recall the exact duration of time he had been sick but he could recall that he had been sick for more than one month. It however became very difficult for me as a nurse to understand what the patient was saying because of the language barrier. The man was an illegal immigrant from Somalia and he had very little knowledge of English. He had a very good understanding of Somali and Arabic languages. On the other hand, I could only understand and speak English. From the way the man was answering my questions, I could easily tell that his level of education was either very low or he did not have any formal education at all. I also later realized that women are expected to give men very high degrees of respect to an extent that women do not generally interview men in Somali. This difference in culture portrayed me as an unusual lady to the patient and in some instances, I could sense that he was angry. In such a situation, as a nurse or any other health professional, it is important to understand interpersonal communication skills to offer appropriate help (Bull, 2005).
Listening is one of the communications skills whereby an individual pays attention to what another person is saying. It simply means to keep quiet when an individual who needs help or just wants to pass information is talking and then be able to grasp the information being passed across (Botti, 2008). The eye contact between the person delivering a message and the intended recipient of the message can indicate whether good listening is taking place or not. It is therefore important for one to maintain eye contact or use natural gestures to suggest effective listening is taking place. Listening contributes to good communication in the sense that a person can be able to give good responses in cases where responses are required. Good listening skills can also assist an individual to make the right decisions which definitely can only be arrived at when an individual receives the right information (Wall & Melzack, 1999).
Leading is a communication skill that is used to encourage a person who needs help to be able to effectively respond to some questions or even ask some questions that are relevant in a particular helping process. In the context of nursing, leading can simply be described as the act of a helper (nurse) as the act of anticipating the need of a patient and responding to answers offered by a patient with encouraging remarks (World Health Organization, 2010). During a helping process, the interviewer needs to pose open questions which can allow a person who needs help to explore several alternatives when giving appropriate answers. Closed questions should be avoided during a helping process because they may make a person being interviewed feel that the interview is an interrogation. This may limit the discussion and the interviewee may just respond by giving “no” or “yes” which may not appropriately answer the intended questions (Crisp & Taylor, 2009). Leading contributes to good communication in the sense that a person being interviewed can feel free and explore several alternatives in giving the right answers to the questions being asked. Leading also encourages the person being helped to actively participate in the helping process and eliminates a situation whereby a person being helped fully depends on the information being given by the helper.
Reflecting is a communication skill that is used by a helper to portray to the person in need that the helper knows and understands the concerns being experienced by the person in need (Adler & Rodman, 2003). It makes an individual feel that a helper is concerned with the situation at hand and can therefore offer appropriate help. Reflecting on communication skills makes people in need feel that a helper is trying to perceive situations the way they do. Reflecting is a way in which a helper can bring feelings that have been vaguely stated into a clear sense and thus communication can be very effective. A nurse, therefore, has to use this communication skill to express the feelings of a patient. When reflecting is used as a communication skill, a person in need of help can know that the helper is paying attention to what is being said (Brammer, 1993).
In a helping situation, another very important communication skill that a helper must employ to ensure effective communication is known as confronting (Hewitt & Herdman, 2004). The use of this kind of communication skill is realized when a helper points out to the person in need that the helper is very much aware of the situation at hand. This communication skill is well achieved when an interviewer or in this case a nurse directs an open question to an interviewee to start an interview process (Egan, 1998). Confronting contributes to good communication by helping an interviewer to be actively involved in an interview process.
Interpreting is a communication skill that can be used by a helper to describe a scenario differently from that known by the person requiring help. It is therefore an active process that can be used by a helper to involve an individual in explaining a problem (Lobo, 2000). Interpreting a problem contributes to good communication by making the helper understand more about the person to be helped. On the other hand, informing is a process of making an individual understand something new. It is a very important communication skill in a helping process especially when a helper informs a person in need of help about a new idea (Cassar, 2003).
Summarizing means putting together the contents of what has been said into one idea that can easily be understood (Chirinko, 2000). For the case of a nurse, it is important to be able to gather all the ideas and information given by a patient to offer appropriate help (Roig, 2003).
In my interaction with the patient, I was able to effectively use listening and leading as communication skills. For example, when I asked the patient to explain how he was feeling and then I listened to the explanations the two communication skills were manifested. I later interpreted and summarized what the patient was trying to say. The patient was describing his experience in many words which were not well connected and therefore I could not have helped him without interpreting and summarizing the words. However, reflecting, confronting, and informing are some of the communication skills that I did not make good use of during my interaction with the patient. I think they are very important communication skills that I should effectively use in the future when interacting with a patient.
There are many obstacles to good communication which can either lead to distortion of information or lead an individual to withhold vital information that should be shared (Graham, 1970). In a healthcare environment, the obstacles to good communication can come from a healthcare giver, patient, or simply the physical condition of the patient. During my clinical interaction with the patient social issues were some of the obstacles to good communication. This was manifested when the patient asked, “Why are you asking me many questions as if you are a man?” It was evident from this question that the patient had negative attitudes towards women and he possibly thought that only men should ask questions. The social life of the patient, in that case, proved to be an obstacle to good communication. I had to come down and tell the patient with a low tone that I wanted to offer him medical help before he could voluntarily accept to respond to my questions. In the future when I meet such patients I will give a brief introduction of myself and let them speak to know if they will be willing to give information.
Another problem I experienced during my interaction with the patient was patient-related obstacles to good communication. Every nurse is expected to be objective when giving information concerning patients (McCain, 2005). Physicians rely on the objective arguments offered by nurses to set the base of attention that should be given to patients. A nurse can only have objective arguments about the condition of a patient if the patient-related obstacles to good communication are eliminated (Resnik, 2007).
The patient I was interacting with was not initially willing to give me the required information and when he finally agreed to give the information, the language barrier become a problem. The patient was not able to speak in any international language and thus my communication with him became a bit difficult. However, I was able to deal with this situation by simply interpreting the explanation and words of the patient. In the future, when I come across a situation where there is a language barrier I will try to find a translator. In addition, as a nurse, I also plan not to use technical languages when communicating to patients who seem not to be well informed about the nursing profession.
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