NUR 706Communication and Collaboration for Healthcare Leadership.

 

Personal Reflective Assessment of Five Days of Communication Styles as a Nurse Practitioner with Different Stakeholders
As an Advanced Practice Registered Nurse (APRN), a day's work is always quite eventful. We see, meet, and treat all types of patients with diverse personalities, behaviors, and emotions. Being human beings, we also have our own emotions, personalities, and temperaments to deal with. It is, therefore, these individual traits and qualities on both sides that mediate the type of communication style that I as a clinician will use on a given day with a particular patient, colleague, subordinate, or manager.NUR 706Communication and Collaboration for Healthcare Leadership.

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On a typical day, as an APRN I have to communicate with other healthcare professionals, subordinates, patients, and superiors. When communicating with each of these categories of people, I usually find myself using different communication styles on different occasions. Even with patients, the communication styles I use are at times not consistent, despite all my efforts to have them so. This is attributable to human fallibility which inevitably interferes despite medical training. The range of communication styles that I find myself employing in my interaction with these groups of individuals include passive, aggressive, passive-aggressive, assertive, affective, informative, nonverbal, biomedical, and biopsychosocial communication styles amongst others (Berry, 2009; Seo & Park, 2016; Alvernia University, 2018; MedPro, 2018). This paper is about my five days journal in which I discuss the communication styles I found myself using with different stakeholders.NUR 706Communication and Collaboration for Healthcare Leadership.
Day 1 (Monday)
This was a very busy day as is almost always the case. Being a Monday of the festive season, it was especially intellectually challenging, emotionally draining, and physically exhausting due to the workload. Normally, after attending to patients in the office I also have to review the ones that I admitted to the hospital in the institutions in which I have admitting rights as an APRN. Some of the care of patients who are admitted to hospital beds is of course undertaken by nurse assistants. These include such tasks as bed making, bathing the patient (if they cannot do it themselves), and feeding the seriously ill patients. This particular Monday I was unusually tired and psychologically unsettled, even as I drove into the parking lot of the hospital in the late afternoon. Now with the benefit of hindsight, I realize that I was actually suffering from burnout. This is because I had been on duty and on-call the whole festive weekend, away from my family.NUR 706Communication and Collaboration for Healthcare Leadership.
As I went round this particular afternoon reviewing my patients, I was not saying much. Then I noted that this patient, whom I had admitted with unexplained vaginal discharge, had a foul smell coming from her bedding. It was obvious that the nurse assistant had not performed her duties well in keeping the patient's hygiene. Without deliberately intending to, I found myself communicating with her about this issue using the aggressive communication style. I loudly reprimanded her and demanded that she assists the patient to clean herself. I was in effect issuing commands to her without wanting to listen to her explanations (Alvernia University, 2018). In hindsight, I am now if the opinion that I should have used the assertive communication style instead of the aggressive one I employed inadvertently. With this one, I would have expressed my disappointment while at the same time taking the NA's feelings into account (Alvernia University, 2018).NUR 706Communication and Collaboration for Healthcare Leadership.
Day 2 (Tuesday)
This other day was a Tuesday. Normally, Tuesdays are a bit lighter although from time to time they also get very demanding. This is especially true when emergencies occur. On this particular day, I saw and examined a Chinese patient who was very adamant inthe way that he wanted to be treated. It so happens that he had come to the United States to attend a conference and fell sick with suspected food poisoning. He didn't want to be treated using conventional medical and nursing interventions. What he wanted was traditional Chinese Medical interventions only. Because my training includes culturally sensitive nursing care, I was aware that I needed not to be judgemental towards this patient but understanding. I found myself adopting the passive-aggressive communication style in dealing with this patient. As I talked to him in his functional English, I tried to hide my true feelings because I found some of his suggestions outrageous. In effect, my nonverbal facial expression portrayed understanding even though deep inside I was finding it hard to carry out his wishes (MedPro, 2018; Alvernia University, 2018). Again, on hindsight, I believe that I should have adopted a more patient-centered (biopsychosocial) communication style with this patient. With this, I would have asked him open-ended questions instead of the closed questions I asked. This would have been more holistic and encouraged him to talk and express his cultural preferences without fear (Berry, 2009).NUR 706Communication and Collaboration for Healthcare Leadership.
Day 3 (Thursday)
Wednesday is not usually my resting day. But I took this particular Wednesday to refresh myself and wear out the burnout that I was clearly suffering from. This Thursday I resumed work energized and ready to continue treating patients. There were some issues related to Medicare and Medicaid that the nurse manager wanted to communicate with me about on this day. While in her office, I found myself listening to her, but adopted quite a negative nonverbal communication style. My body language in facial expression, gestures, posture, and voice tone were all not receptive of whatever she was saying. In fact, I hardly made eye contact with her. Studies have shown that most day-to-day communication at the workplace is nonverbal, hence its importance in patient care interactions (MedPro, 2018). Looking back, I feel that I should have used affective communication style in which I would have been open with the nurse manager about my true feelings (Seo & Park, 2016).NUR 706Communication and Collaboration for Healthcare Leadership.
Day 4 (Friday)
On this day, I found myself seeing a veiled hijab-clad Muslim woman who was from Pakistan. She had come to the clinic with a chief complaint of intense lower abdominal pain and was accompanied by her husband. She had to be examined with a thorough physical examination to establish the diagnosis beyond reasonable doubt. Usually, I call my more experienced male colleague if I have any doubt and need a confirmation about my provisional diagnosis. In this case, this was not going to be possible as the woman's husband protested having his wife examined by a man. I found myself adopting an assertive communication style which proved to be most effective (Alvernia University, 2018). I wasn't overbearing but went with the patient's wishes. All along I considered her feelings and they were both satisfied. Here, I am convinced that this was the best communication style to use in the situation. The situation required culturally competent care.
Day 5 (Saturday)
On this last day of the journal, I came face-to-face with a very difficult patient who had had a miscarriage last year and now came in with a complaint of spotting. The patient and her husband were unruly and wanted to dictate the orders that I wrote. With this couple, I found myself adopting the biomedical communication style which is acknowledged to be provider-centered as opposed to patient-centered (Berry, 2009). I only asked them closed questions and didn't really try to understand the reason behind their behavior. Looking back, I should have used assertive communication style which is more open and takes into account the patient's feelings (Alvernia University, 2018).NUR 706Communication and Collaboration for Healthcare Leadership.
Summary and Conclusion
In all these days, after reflection and evaluation, I found out where I used acceptable communication styles and where I didn't. At times, it was clear that my own state of mind and physical state were instrumental in making me adopt especially the unacceptable communication styles in the given situations. All in all, it is obvious that despite the rigorous training and postgraduate education of the APRN, a lot still needs to be taken into account to display appropriate communication styles in different clinical situations.NUR 706Communication and Collaboration for Healthcare Leadership.