In this reflective essay I have chosen scenario 4 to reflect upon. This scenario involves a first year student nurse named Grace, observing her mentor while he undertakes a patient assessment. I will be specifically talking about patient centred care through referring to how communication skills play a part in this. I will also be talking about the standard of professional behaviour, exploring the strengths and weaknesses of the given situation. I will reflect on emotional intelligence and how this can help the relationship between a nurse and patient.
In the scenario, Grace finds the experience of her mentor losing eye contact and showing un-positive facial expression unsettling and she worried about her mentor’s approach to the patient. Grace observed her mentor using poor communication skills and unprofessional behaviour. Specifically, when the mentor lost eye contact with the patient on several occasions, gazing out of the window, yawning while the patient was talking and interrupting the patient’s responses asking him unrelated questions. I have chosen to focus on the facial expressions that are involved in the nonverbal communication aspect of the scenario and will relate this to good practice using communication, professionalism and emotional intelligence.
This particular scenario made me feel saddened that a health care professional would behave in such a manner. Reading the scenario surprised me, as communication is considered to be a very important aspect of being a good nurse (NMC 2008). It upset me that simple skills were not being used in healthcare. I also felt relieved that the student nurse found her mentor’s action wrong and decided to reflect on what she had seen, making herself learn from the mistakes of others.
According to the NMC (2010) educational standards guidelines, all nurses must recognise when people are anxious or in distress and respond effectively, using therapeutic principles, to promote
their wellbeing, manage personal safety and resolve conflict. They must use effective communication strategies and negotiation techniques to achieve best outcomes (NMC 2010). The nurse within the scenario continues throughout the conversation to lose eye contact with his patient, which may suggest that the nurse is not interested in what the patient has to say as eye contact keeps the conversation flowing and regulates turn taking.
The patient on first impressions was likely to make the assumptions that the nurse was difficult to communicate with. Research conducted by Birdwhistell in 1970 which is still significant today, suggested that when you are communicating with someone there are three factors that influence the interpretation of meaning, in that 55% of communication is body language; 38% is the tone of your voice and only 7% is the words spoken. The nurse repeatedly gazes out the window which is not only disrespectful to the patient but provide negative ambiances. Body language has been reported as being of great importance when communicating with patients, for example Egan (2004) suggested using the acronym SOLER (see appendix 1). By using all of the nonverbal skills it implies that a nurse is interested in what the patient has to say. Nelson Jones (2004) also suggests the main part of the body to send messages is the face. To send a message that is warm and caring, the nurse should use friendly and relaxed facial expressions. If the nurse had a direct gaze towards the patient, this is seen to be more positive than faces with an averted gaze regardless of whether the face was smiling or not (Ponkanen and Heitanen 2012). Shapiro (2009) also carried out research which found that eye movement can help patient with post-traumatic stress disorder. Dr F Shapiro founded EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioural therapy with bilateral eye movements. This demonstrates how important the eyes…