The Importance of Communication in Nursing

This particular day in a nursing home was apparently one of the most harrowing experiences in my life. Despite being knowledgeable about my nursing roles and taking various classes on how to handle patients, nothing had prepared me for that this day on the floor. The place was a madhouse to say the least. Nurses were jostling everywhere. Residents were persistently calling for assistance, ringing their call bells, but the employees were too busy attending to different patients to answer them. What I recall more than anything else on this day was not the chaos. I was standing in one of the resident’s room when an elderly man’s small, wobbly hand clutched my leg and pulled me close. The man, who appeared to be in his 80s, was crying, wobbling with anguish, and he began calling out to me. “Assist me! Please assist me! My mom...my mom! Is she here? There she is! Let’s go let’s go.” As an individual, I have constantly prided myself on being realistic and I believe that there is a solution to each problem. Willpower can get anyone through anything. However, here...I came to realize that I could not cure the patient; I could not provide him with the visit he so desired. There was neither a rational solution to his problem nor a cure to his condition. He was scared, confused, and lonely with absolutely no idea of where he was. I felt sad and compassionate at the same time; I knew I had to do something. I tried to calm him down. However, he became hysterical and kept requesting me to take him to his mother. This man had lived his life; he had come down with a horrible illness. He would spend his last few years in this hospital setting; Alzheimer’s eating away important memories, week days and fundamental life skills, until nothing was left.

Analysis – Part I

       The key issue related to my role as a nurse in this experience is communication. I could hardly make sense of what the elderly patient was saying, but the constant mention of the word “mom” gave me a clue that he desired to see her. Yet this was impossible; his mother had already died. Alzheimer’s disease gradually erodes the skills of verbal communication, the words and expressions of the ill person thus make little or no sense. In turn, the Alzheimer’s patient might experience challenges in interpreting the words of others. As a consequence, there are misunderstandings that fray tempers all around, making communication to be even more challenging.

Analysis – Part II

       According to De Vries (2013), communication skills are vital when it comes to establishing relationships in environments of care, and in enabling individuals suffering from dementia to take part in positive social activities. This is a big contrast compared to what I experienced in the clinical setting. The nurses in charge of the patients did not inculcate a culture of communicating with their patients in the home. Instead, they usually treated the elderly patients like children and always instructed them on what to do; they hardly listened to the patients. Perhaps this explains the chaos that I saw in the hospital. De Vries (2013) also notes that social interaction and self-care skills may be compromised as well when skills of communication are affected. Obviously, individuals suffering from dementia have a tendency of expressing their anger and frustration by either resisting care or expressing agitation. I experienced this first hand with the Alzheimer’s patient. As a nurse, I tried to calm him down and offer him support but he resisted. Instead, he became agitated and began walking around the home calling out for his mother in a hysterical manner. An analysis of communication has made me realize its importance in providing care for dementia patients. Therefore, I will always ensure that I always encourage my patients to talk about the issues that disturb them and give them an ear whenever necessary.

Revision – Part I

            If I could do this event again, I would change the way I responded to the patient’s problem. Clearly, my first response did not work as it made him more hysterical. Therefore, given another chance, I would have utilized visual cues to promote better understanding. On that note, I would hold his hand and direct him towards his room while making him believe that we were going to see his mother. Once in the room, I would then try to calm him down.

Revision – Part II

       Based on my reflection of the event, I would still assist the patient even though our meeting was by chance. You see, I would have decided to ignore him and went on to carry out my activities for the day, that is, care for my patients. I decided to help the patient because I felt became compassionate towards him. I was determined to make a difference in his life.

New Perspective

            Based on this reflective learning, I have realized that I need to enhance my communication skills especially when it comes to working with people suffering from dementia. I also need to familiarize myself with strategies that I can use to effectively communicate with these patients. In order to achieve these learning needs, I will research more on literature and identify evidence-based practices that are efficient in promoting good communication between nurses and patients with dementia. I will also consult fellow nurses on the same.

Reference

De Vries, K. (2013). Communicating with older people with dementia. Nursing older people,

            25(4).