Nursing Standards Related To Therapeutic Communication Stimulation Session: An Evaluation

Identify nursing standards related to the situation.
 

In the current therapeutic communication stimulation practice, Mrs. MacDonald was the focus. She came to the stimulation practice after she collapsed in her garden. I was an observer. I observed that she was not able to walk and came to the center by walking. The nurse, after introducing herself directly asked about her vital signs. However, the nurse did not ask about her current medication. After completion of her complains about the symptoms, she directly asked about her daily diet. Mrs. Macdonald addressed that she is not taking her meals properly. She skips her dinner and takes sandwich for lunch. She is not involved in any social activities. The nurse did not asked about the reasons as to why she did not eat well. In addition, the nurse did not give the proper results about her BP. She showed tachycardia and breathing shortness as her vital sign. Therefore, I have understood that the nurse who was appointed for her stimulation practice did not complete her job properly. Rather she provided wrong information about Mrs. Macdonald’s vital signs. When she was asked about her weight, she did not realize that the nurse was talking about her malnutrition. So, the nurse did not played her required role properly.

The first nursing standard related to the situation is ‘2.2 communicates effectively and is respectful of a person’s dignity, culture, values, beliefs and rights’.  It is related to the situation because the current practice is therapeutic communication stimulation, where the patient would be stimulated through effective communication. The next standard is ‘2.3 recognize that people are the experts in the experience of their life’ (Bamber & Anderson, 2012). It is related to the situation because in this process the nurse asked about patient’s vital signs to identify her health status. The third standard is ‘4.2 uses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice’. It is related to the situation because the stimulation practices involve assessment of patient’s physical and psychological status through different techniques (Bradbury et al., 2012).

The therapeutic communication stimulation practice helped me to recall some nursing standards. At the start of the therapeutic communication stimulation process, I started to think that the nurse would take enough time and would use sufficient assessment tools to identify the vital signs of the patient and would stimulate patient’s thought process about her physical and psychological status. I saw that the nurse started the conversation by introducing herself to Mrs. Macdonald. I felt quite surprised that why she did not asked her about her medication because it is important for the nurse to know patient’s current medication, as it helps to understand the actual reason behind patient’s status (Davies, 2012). Finally, which made me more surprised was that the nurse did not give the actual results of her BP. It could be an offensive act because based on the vital sign the action plan is made. Therefore, the session surprised me as to why the nurse did not followed nursing standards while working with a patient. In addition, observing the patient’s situation, I felt sad for her. I felt sad because I realized that the patient did not get adequate support and appropriate health reports which she was expecting.

Feelings

I thought that the nurse would go through an effective session. However, evaluating the nurse’s action towards the patient, I did not see that she had gone through an effective stimulation session. The nurse directly started the conversation by allowing the patient to complain about her symptoms including breathing shortness, tachycardia and tiredness. After completing this part, the nurse did not ask about her current medication.

Next, she asked directly about her diet. She replied that she only takes tea at breakfast and sandwich at lunch. In spite of showing vital signs of cardiovascular symptoms she addressed that she loves ham and stays alone at home, thus is socially isolated. Moreover she even skips her dinner.

After listening to these, the nurse did not ask why she skips meal. However, it was very important for the assessment. As an observer I would say that the nurse should be more focused towards patient’s dignity and should play her role with more in-depth pattern. She attempted to complete the session very briefly and quickly (Dossey et al., 2012). The worst part in the session which based on my evaluation was that, she provided incorrect results the patient’s health. She did not provide proper results about her BP. It can be a legal issue. Based on the reports, the physician would make her action plan. Therefore, with an incorrect result, the physician can make an inappropriate action plan that can affect her health negatively. 

5. Conclusion

According to the person centered care plan, the nurse should always focus upon the health benefits after analyzing the basic health needs of the patient, as opined by Hatlevik (2012) However, in this case scenario, the nurse did not assess the patient’s health needs through a proper assessment plan. The nurse can use some proper assessment techniques for understanding the patient’s basic health needs.  Next, after introducing herself and seeking permission from the patient for their vital sign, the nurse did not attempted to establish a positive relationship with the patient which is the basic factor in the person centered care approach. From the viewpoint of Henderson et al., (2012) a positive relationship establishment can help to enhance her health benefits. Another factor which has been observed was that the nurse did not ask about her current medication, whereas it was a necessary action in regards to making an action plan for the patient’s health benefit.

Evaluation

Therefore, the alternative approach should involve the awareness about her current medication. Another shortcoming of the nurse was that the nurse after addressing patient’s inappropriate diet, did not attempt to investigate the reason for her inappropriate diet and also she did not try to make the patient aware of her malnutritious status, which was evaluated according to Hilsdon (2012). Finally, she provided inappropriate health report to the patient which was not expected from a health worker. From the viewpoint of Howatson-Jones (2013), a person centered care, collection of cues and establishment of therapeutic communication were the correct processes for the patient’s health benefit.

From the therapeutic communication stimulation session, I have learnt about the importance of following the nursing competency standards in health care settings and what negative consequences can happen due to the non-compliance of the nursing competency standards (Thompson & Pascal, 2012). I have learnt that the implementation of person centered care would have a more positive impact upon then health and well being of the patient while dealing with the therapeutic communication stimulation. I have observed that the nurse, who attended Mrs. Macdonald, did not meet the nursing standards and showed disrespect towards the proper procedure of patient’s assessment and their communication process. I have understood that, for gaining a well established nursing career, I have to fulfill all the necessary standards and ethical considerations of nursing.

I have understood that collecting cues about the patient’s health needs, focusing upon patient’s nutrition and advising the patient about healthy diet and its importance are necessary aspects of person centered care practices and therapeutic communication stimulation session (Gibbs & Lowton, 2012). I have also understood that the nurse could do the session better by achieving all the standards and focusing more on patient’s needs. Therefore, the alternative management for the patient would be the person-centered approach implementation. In this condition, the nurse would be able to provide holistic care to the patient, while meeting all the health needs of the patient. In addition, through the alternative process, the exact health reports of the patient would be provided. 

Reference List

Bamber, V., & Anderson, S. (2012). Evaluating learning and teaching: institutional needs and individual practices. International Journal for Academic Development, 17(1), 5-18.

Bradbury, H., Frost, N., Kilminster, S., & Zukas, M. (Eds.). (2012). Beyond reflective practice: New approaches to professional lifelong learning. Routledge.

Davies, S. (2012). Embracing reflective practice. Education for Primary Care, 23(1), 9-12.

Dossey, B. M., Certificate, C. D. I. N. C., Keegan, L., & Co-Director International Nurse Coach Association. (2012). Holistic nursing. Jones & Bartlett Publishers.

Gibbs, C. L., & Lowton, K. (2012). The role of the clinical research nurse.Nursing Standard, 26(27), 37-40.

Hatlevik, I. K. R. (2012). The theoryâ€Âpractice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing, 68(4), 868-877.

Henderson, A., Cooke, M., Creedy, D. K., & Walker, R. (2012). Nursing students' perceptions of learning in practice environments: A review. Nurse Education Today, 32(3), 299-302.

Hilsdon, J. (2012). Rethinking reflection. The Journal of Practice Teaching and Learning, 6(1), 57-70.

Howatson-Jones, L. (2013). Reflective Practice in Nursing: SAGE Publications. Learning Matters.

Thompson, N., & Pascal, J. (2012). Developing critically reflective practice.Reflective practice, 13(2), 311-325.