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The Role of Self-Awareness in Improving Therapeutic Communication

Question:

Discuss about the Bachelor of Nursing for Positive and Negative Aspects.

Understanding and knowing about oneself is not an easy task. It involves both positive and negative aspects. Self-awareness in nurse or any other person can be initiated with the conscious awareness and efforts for the change. This conscious effort is directed towards providing good therapeutic environment to the patient. This good therapeutic environment can be achieved by improving communication with the patient and results in healthy relation with the patient. Communication is the most effective way for nurse to improve relationship with the patient. Patients spend most of the time with nurses other than family members. Hence, self-awareness of the nurse and its consequent effects in terms of words or actions can be effectively communicated to the patients. Complete development of the nurse in the professional practice can be assessed by nurse’s role or functions in different situations. Self-awareness would be helpful for the nurse to tackle different situations mainly through the person specific communication ability. Nurse could establish person specific communication because self-awareness, which can develop analysis capability of the individuals in nurse. Hence, nurse can communicate with each individual based on his/her strengths and weaknesses. In clinical practice, counseling of the patients is necessary. This counseling should be varied based on the disease condition of the patient. Self-awareness would be helpful for the nurse to address different issues of different patients. There should be different communication strategies for different patients and it should also vary with behavior of the patient (Eckroth-Bucher, 2010). Hence, for achieving effective communication in all these diverse situations and conditions, nurse should consider self-awareness as foundation for effective and fruitful communication with the patient.  

Self-awareness is a method of goal oriented assessment of oneself. It is very important aspect of nurse-patient relationship in the nursing practice. Self-awareness is a cerebral exercise of introspection. It helps nurse to communicate to patients in thoughtful way, with feeling about the patient, by giving belief of improvement, giving values to patient’s emotions and according to the behavior of the patient. It can be used effectively to widen therapeutic association with patients for providing holistic care to the patient. As self-awareness is an ongoing process, it can be helpful in handling issues in the actual nursing practice. It can be useful for nurses to know themselves very well and this confidence helps in building healthy therapeutic environment for care and curing. Self-awareness can be helpful for nurses to communicate in a professional manner to the patients and providing in-depth nursing service (Gessler and Ferron, 2012; Winson, 2007).

Self-awareness teaches nurses to think about themselves and it would be helpful for nurses to think about patient’s condition. Hence, nurse can understand patient’s condition effectively and communicate to the patient with respect to his/her condition. As a result, nurse can give correct message or information to the patient. As nurse can understand exact condition of the patient, verbal and non-verbal concerns expressed by patient can be well understood by the nurse. Self-awareness is a continuous change in the efforts hence nurse can modify communication to the patients based in the needs of the patient. Self-awareness is helpful in understanding ourselves in different ways and it would be helpful for the nurses to communicate to patients in different ways. This communication would depends on the condition, mood and understanding capability of patient. If patient is aggressive, nurse should communicate with patient in a calm way. If patient is unable to understand medial terminologies, nurse should communicate with patient in a very simple language. Hence, patient would feel comfort in availing nursing services. Self-awareness would be helpful in communicating with the patient based on his/her beliefs, thoughts, traits, motivations, feeling and behavior (Jack and Smith, 2007).

Assessing Nursing Practice through Self-Awareness

Nurses spend maximum amount of time with patients as compared to the other health professionals. Hence, they need to communicate with patients on regular basis and would be helpful in improving communication with patients. Listening is most important thing for the effective communication. Nurse can learn to listen to patients issues by listening to oneself. Self-awareness is useful for the nurse to listen oneself. This mastering in listening to patients can be helpful in understanding patients and responding exactly according to the condition of the patient. Communication is one of the effective ways to avoid conflicts between nurse and patient. Thus nurse can use self-awareness to avoid conflict with the patient. Self-awareness is also helpful in solving problems of both the patient and nursing service to be provided to the patient. Self-awareness is helpful in understanding the problems in a better way. Discussion of the problem with the patient would be helpful in solving it. Self-awareness is useful for the nurse to express in more open way and it gives clear message to the patient. Hence, there would not be any ambiguity in communication (Oflaz et al., 2011).


Nurse can communicate with patients with more thoughtful way and with emotions. By this, patient feels confidence in the message given by nurse. Communication would be with more clarity and it can be helpful for the patient to understand next step. Improvement in communication due to self awareness would be helpful in making patient happy and fulfilling his/her wishes. Self-awareness can be helpful in bringing evolution in the nurse and nurse can utilize this evolution for communicating to the patient. Negative traits of the patients like distress, frustration and unacceptable attitude can be effectively handled. Self-awareness is useful in turning these negative traits in more positive traits. Self-awareness is helpful for nurses to communicate own perceptions and understand patient’s perceptions (Ahrweiler et al., 2014). It would teach nurse to look towards others and to understand how others are looking at you. Self-awareness gives nurse answer of the, ‘what is effect of me on the patient?’. This understanding would be helpful for the nurse to give unique response to the patient. Self-awareness is helpful in understanding weaknesses in nurse and also helpful in building self-esteem. Accordingly, nurse can communicate to the patient to address their weaknesses and build patient’s self-esteem. Self-esteem also builds confidence in the nurses and improves their pride in the work. This confidence in the nursing practice can be communicated to the patients both verbally and through practice. Self-awareness is helpful for the nurses to take care of oneself in a better way. This aspect of the self-awareness can be effectively transferred to the patients through provision of better care to the patients (Unal , 2012; Healy and Sharry, 2011 ).   

Self- awareness is helpful in building reflective practice in the nurse. This reflective practice would be helpful for the nurse to communicate by making sense of the events and by understanding situation. Refection can be helpful for the nurse to get answers for the questions like what is the reason behind this incidence ?, and how patient reacted to me ?. Next time, communication with the patient would be helpful in preventing, rising of these questions. Hence, integration of self-awareness and reflective practice in nursing would be an effective communication strategy in the nursing. Self-awareness is helpful for the nurses to understand interpersonal skills. These interpersonal skills can be effectively communicated to the patient through practice or verbal communication (Horton-Deutsch and Sherwood, 2008).

Counseling and Communication Strategies based on Self-Awareness

Transactional analysis of the self-awareness is helpful for the nurse in understanding ego status of both nurse and patient. Thus, nurse can analyze inappropriate behavior of either nurse or patient. By this nurse can establish effective communication to address this inappropriate behavior. Transactional analysis is also helpful in knowing how to react to particular patient. Six category intervention analysis of the self-awareness is helpful for the nurses to understand areas of their improvement. By understanding this, nurse can communicate to the patients only in the areas of strength and gain confidence of the patient. Johari Window of the self-awareness would be helpful for the nurse to understand particular aspect of personality of self and patient. Based on the understanding personality, nurse can establish communication with the patient (Vitello-Cicciu et al., 2014; Webb, 2011).


Self-awareness gives confidence to the nurse to gather information about the information, assess patient condition of the patient, provide appropriate counseling to the patient and give medication instruction to the patients. By this, nurse can improve involvement of patient in the nursing practice. Thus self-awareness can be useful in establishing patient centered care for providing holistic care to the patient and achieving overall wellbeing of the patient. Communication in isolation without interpersonal skills would not be helpful for the nurse to establish effective communication with the patient. Self-awareness brings out both interpersonal skills and communication skills in the nurse. Integration of these two skills would be helpful for the nurse to give exact message to patient, understand their feeling and establish fruitful communication. It would also be helpful in avoiding patient discontent in communication. Nurse can give all the required information to the patient and involve them in the decision making. Self-awareness would be helpful in improving patient satisfaction, adherence to the treatment, healthcare services utilization and improving quality of care of care the patient, through effective communication. Establishment of relationship with the patient and breaking bad news to the patients are closely associated and complex aspects of the nursing practice. Self-awareness plays important role in breaking bad news to the patient because it helps in complete understanding of the patient. Self-awareness is instrumental in avoiding miscommunication and it can be effectively utilized to improve hopefulness and give psychological satisfaction (Scheick, 2011; Stein-Parbury, 2013).

Nurse and healthcare professionals may not be the good at communication. Self-awareness can serve as communication training to these healthcare professionals. Self-awareness can be helpful in building two way communications with the patients. In this type of communication, patient’s views can be understood and it would be helpful in avoiding biased treatment for the patient. It would also be helpful in understanding patient’s experience about the treatment. Self-awareness is helpful in building assertiveness in the nurses. Assertiveness is an interpersonal behavior which is helpful in promoting equity in relations to promote expression of human rights, thoughts and feelings. This, assertiveness due to self-awareness in nurses would be helpful in recognizing and respecting others expressions. Classroom based teaching would not be useful in implementing of actual nursing practice, however communication and nurse-patient interaction would be helpful in improving nursing practice. Nurse-patient interaction can be studied by reviewing tapes and transcripts of the earlier communications. Nurse can correlate oneself with these interactions between nurse and patient and try to improve communication with the patient. It would be helpful for the nurse to improve communication for different types of patients, indifferent situations and in different case studies (Kim and Patterson, 2016).                                

Listening and Conflict Resolution with Self-Awareness

Self-awareness brings personal growth and strength in the personality of the nurse and healthcare professionals. It would be helpful for the nurse to manage patients effectively. It is also helpful for the nurse to manage career growth and personal life stressors, hence nurse can effectively communicate with patient. With the lack of self awareness, nurse may repeat mistakes again and again and it would be difficult for the nurse to communicate right things to the patients. However, with self-awareness nurse can improve all the mistakes and can communicate correctly with the patient. Self-awareness helps nurse to differentiate between patients and analyzing similarities and differences among the patients. This would be helpful for the nurse to improve interpersonal relationship and nurse can communicate with the patients according to their needs. Self-awareness improves competency of the nurse in nursing practice and as a result patient can be highly satisfied with service. Patient would like to be in constant conversation with such competent nurse to understand more about his/her health conditions. Self-awareness can be useful to the nurse to guide behavior in the genuine way and hence there would more acceptance of nurse by the patients along with strong interpersonal relations which improves communication among them. This communication can be useful in the improving recovery process of the patient in the therapeutic environment (Webb, 2011).


Benefits of self-awareness can be effectively implemented to manage patient’s diseased condition but also unresolved personal stress. This unresolved personal stress can be managed by valuable communication between the nurse and patient. Verbal and non-verbal gestures are the most effective communication strategy nurse should use. Self-awareness would be helpful for the nurse to improve verbal and non-verbal gestures. Nurse has to face different situations with different kind of patients, from different culture and socioeconomic classes. These gestures would be helpful for the nurse to communicate to these different types of patients. Therapeutic communication is the most important aspect of the nursing practice. This therapeutic communication helps build therapeutic and caring environment between nurse and patient. Nurse can efficiently improve therapeutic communication through self-awareness. Self-awareness can be helpful for the nurses to communicate to the mentally ill patients. In case of mentally, ill patients it is necessary to understand thinking and behavioral pattern of the patient. Self-awareness would be helpful for the nurse to understand these aspects of mentally ill patient. Self-awareness makes nurse aware about the insight and it can be positively reflected in the body language towards the patient (Jack and Miller, 2008).

Conclusion: 

Self-awareness is the most important therapeutic tool for improving relation between nurse and patient and improving communication among them. High level of self-awareness achievement can be helpful for the nurse to achieve highest therapeutic environment for the patient. Self-awareness is the prime and vital concept for the nurse for improving positive communication with the patient. This is beneficial for the nurse to grow in career and providing effective caring to the patient. In this way, there can be exchange of positive communication between nurse and the patient. In healthcare facility of setup, self-awareness and its implementation for improving communication is not a one day job. Continuous and sincere efforts should be there by nurse to achieve this. Training and guidance to the nurse would be helpful in improving practice of self-awareness. Self-awareness brings positive changes in nurse like self-esteem and assertiveness. Assertiveness brings equality in the patient relation and communications. Nurse should also be with high self-esteem. This self-esteem would be helpful for the nurse to communicate confidently and effectively with the patient. In conclusion, communication is very important aspect of the nursing practice because nurse should communicate professional skills and knowledge to patient, family members and other members of the society. Self-awareness in the most efficient technique for improving communication of the nurses.

References:

Ahrweiler, F., Scheffer, C., Roling, G., Goldblatt, H., Hahn, E.G., and Neumann, M. (2014). Clinical practice and self-awareness as determinants of empathy in undergraduate education: a qualitative short survey at three medical schools in Germany. GMS Journal for Medical Education, 31(4), doi: 10.3205/zma000938. 

Eckroth-Bucher, M. 2010). Self awareness: A review and analysis of a basic nursing concept. Advances in Nursing Science, 33(4), pp. 297–309. 

Gessler, R., and Ferron, L. (2012). Making the workplace healthier, one self-aware nurse at a time. American Nurse Today, pp. 41-43. 

Healy, D., and Mc Sharry, P. (2011). Promoting self awareness in undergraduate nursing students in relation to their health status and personal behaviours. Nurse Education in Practice, 11(4), pp. 228-33.  

Horton-Deutsch, S., and Sherwood, G. (2008). Reflection: an educational strategy to develop emotionally-competent nurse leaders. Journal of Nursing Management, 16(8), pp. 946-54. 

Jack, K., and Smith, A. (2007). Promoting self-awareness in nurses to improve nursing practice. Nursing Standard, 21(32), pp. 47-52. 

Jack, K., and Miller, E. (2008). Exploring self-awareness in mental health practice. Mental Health Practice, 12(3), pp. 31-35. 

Kim, M.S., and Patterson, K.T. (2016). Teaching and Practicing Caring in the Classroom: Students' Responses to a Self-Awareness Intervention in Psychiatric-Mental Health Nursing.

Journal of Christian Nursing, 33(2), pp. E23-E26. 

Oflaz, F., Meriç, M., Yuksel, Ç., and Ozcan, C.T. (2011). Psychodrama: an innovative way of improving self-awareness of nurses. Journal of Psychiatric and Mental Health Nursing, 18(7), pp. 569-75. 

Scheick, D. M. (2011). Developing self-aware mindfulness to manage counter transference in the nurse-client relationship: an evaluation and developmental study. Journal of Professional Nursing, 27(2), pp. 114–123 

Stein-Parbury, J. (2013). Patient and Person: Interpersonal Skills in Nursing. Elsevier Health Sciences. 

Unal, S. (2012). Evaluating the effect of self-awareness and communication techniques on nurses' assertiveness and self-esteem. Contemporary Nurse, 43(1), 90-8. 

Vitello-Cicciu, J.M., Weatherford, B., Gemme, D., Glass, B., and Seymour-Route, P. (2014). The effectiveness of a leadership development program on self-awareness in practice. Journal of Nursing Administration, 44(3), pp. 170-4. 

Webb, L. (2011). Nursing: Communication Skills in Practice. OUP Oxford. 

Winson, J. (2007). Promoting self-awareness. Nursing Standard, 12(13), p. 59.

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