The medical dictionary describes a therapeutic communication as “A process in which the nurse consciously influences a client or helps the client to a better understanding through verbal or nonverbal communication”. This communication summary will describe an event which occurred on a work placement in practise. A reflective frame work will be used to evaluate the interaction; Gibb’s reflective model will be used within the essay. hilst on placement with the district nurse we received a call from a patient informing us that her leg was not “quite right”, as she has problems with her eye sight she wasn’t able to give us a description on what state her leg was in. I went out and discovered when observing that this patient had leg ulceration which was on both sides of her left leg. I questioned descriptively to see how long she was feeling uncomfortable, she reported that it was over two months; this enabled me to place the event in time and helped me to gain a visual picture of the circumstances.
I encouraged description of events by asking the patient how it went on noticed as she has carers visiting her twice a day to apply creams. It happened as a result in the carers having communication issues as they did not report changes on the breakdown of the patient’s skin. Whilst focusing on the wound I decided the appropriate form of intervention would be compression bandages. The patient was reluctant to have a bandage applied to her leg although I empathised with the patient by informing them what would happen if the appropriate bandage was not applied and that it was the only possible way of getting it to heal properly.
At the time I was thinking that the patient was not informing me properly and felt they were not telling me the full story of how the wound got to the stage it has. The fact that I got information from the patient was good as I was able to see how they felt and what appropriate measures had to be taken. The bad part of the experience was that the patient seemed reluctant to give me information as she didn’t want the wound to appear as bad and she was trying to avoid bandages being applied to her legs.
I realised that the situation was not managed well, and that if there was no communication issues between the carers and the district nurse the situation would have been avoided. I could have asked a lot more closed questions and kept open questions to a minimal to gather specific information. I also could have reassured the patient a lot more by telling them that the decision of using compression bandages and explained the purpose of using compression, and explained how this would make a huge different to the wound in a short period of time.
If the situation was to rise again I would approach it a lot more sensitively and I would try and gather more information by firstly gaining a better rapport with the patient, then asking open questions to gather a wider amount of information, then to gain specific information I would ask closed questions. This will allow me to get all the information I need and at the same time the patient will be more relaxed and comfortable with the decision and outcome.
Courtney from Study Moose
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