Analysis and Reflection for Effective Communication

Running Head: Analysis
Analysis and Reflection
Name of the Student
Name of the University
Authors Note

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Analysis and Reflection
Analysis for Effective communication
One of the most important aspects of a therapeutic relationship is effective
communication. Effective communication helps the patient to feel the safe and quality of care
is enhanced with this type of communication (Arnold and Boggs, 2019). Effective
communication involves both Verbal and Non-verbal communication. Verbal communication
establishes a dependency with respect and integrity (Holmes and Parker, 2017). Non-verbal
communication is also very important as it helps in building a stronger therapeutic
relationship with care, tenderness and interdependence.
Physicians, nurses and caregivers should improve the therapeutic relationship with the
patients, especially in palliative care or end of life care treatment to make them feel
comfortable and free to ask any question regarding their health. Clinical integrity and
decision making rights of patient should be promoted throughout the treatment. Autonomy
and Justice are also very important in this type of care as the person does not know whether
he or she will be alive or not. Therefore, the doctors and nurses should execute the
responsibilities more sensitively, so that the patient will not feel isolated or disrespected.
This essay will discuss the effective and ineffective therapeutic communications
provided by Healthcare workers such as nurses and doctors to a patient who is having the End
of Life Care treatment. The above-mentioned context was taken from a movie name WIT
featured in 2001 directed by Mike Nichols. The essay will describe effective and ineffective
communication. It has to impact on patient’s psychology and will reflect the knowledge and
skills gap from the context of the movie.

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Analysis and Reflection
The protagonist of this movie is a literature professor named Vivian Bearing who is
diagnosed with ovarian cancer. The doctor told her that she is in stage five and they would
like to commence an experimental eight months treatment to treat her. The doctor, Harvey
Kelekian is a prominent name in the medical industry as shown in the movie. The physician
has an efficient team including Vivian’s student Jason Posner. Susie Monahan is the primary
nurse of Vivian she would take care of her throughout the treatment (Wit 2001). There are
different evidence where physicians and the caregivers were involved in ineffective
communication by influencing emotional pain in her, during the conversation. For example
“how are you feeling today?” is the phrase which has been frequently used in the film to greet
the patient but the phrase is insensitive for the patient. This question was painful as for her it
is very insensitive to ask this question while she is dying.
Vivian Express that how she was asked about her health every day. The physicians
also asked her the same phrase after 4 hours of operation (Wit 2001). At a point of time,
Vivian told that she was tired of answering the same question again and again. One of the
scenes shows that Vivian replies that she was fine as an action of reflex. A scene of the film
shows that Dr. Posner was examined her and instructed his fellow doctors about Vivian’s
health. At that point of time, Vivian felt that she was used as a specimen for testing and
applying the existing knowledge of the doctors. While Vivian was taken to the isolation
room, she expressed that the assessment procedure was not a good experience for her. She
also expressed how she felt much embarrassed and neglected as Dr. Posner and his team not
even addressed her by her name. Throughout the film, it has been observed that Vivian
replied with her dry wit during the conversations with the doctors or in her soliloquies (Wit
2001). Vivian has expressed the distress she is facing during the series of treatment in the
sake of experimental diagnosis. The phrase became just like an enquiry for assessment rather
than a greeting. Her feelings towards that phrase transformed into disgust as she did not feel

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Analysis and Reflection
encouraged to answer that question. The phrase was a polite version of assessment question
for getting detailed feedback from the patient. According to a study, sometimes regular
phrases like “how are you?” or “how do you do?” answered by the listener as a spontaneous
act of reflex.
On the contrary of insensitive and ineffective communication from physicians
example of effective communication and the positive therapeutic relationship was depicted
by the registered nurse Susie (Sancar & Aktas, 2019). The nurse acted compassionately to
live with Vivian. The nurse asked Vivian whether she (Vivian) is facing any problem to wake
up at 4:00 a.m. (Wit 2001). Vivian explained she was not been able to sleep as she drowned
in the thoughts. The nurse help Vivian to change her position and postures. The nurse makes
the continuous eye to eye contact during communication which is a good sign of effective
communication (Ricou, 2020). As a result, the nurse could able to form a good rapport with
the patient. Non-verbal communication was fairly executed by the nurse with a gentle touch
when the patient was suffering extremely due to chemotherapy.
She (Susie) helped her during the primary check-up when Dr. Posner left her without
releasing the stirrups (Wit 2001). The nurse observed that Vivian had no one to visit her. She
offered Vivian to call someone to visit her. As a result, she used to visit Vivian regularly. The
nurse showed empathy throughout her treatment. In the famous Popsicle scene, the nurse
gave her a Popsicle. In return Vivian split the Popsicle and give another part to her. This was
Vivian’s first unsolicited act of kindness.
The body language and eye contact of a nurse have a greater impact on patient’s
treatment as they feel familiar with the touch and non-verbal communication. Susie informed
Vivian about the truth of her treatment (Purnell, 2018). As a result, Vivian connected with her

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Analysis and Reflection
and she also shared her views with Susie, that she might not get back her life after
chemotherapy. Vivian decided to opt for DNR (do not resuscitate).
Reflection
The movie WIT is based on Pulitzer Prize won American play WIT written by
Margaret Edson. This movie can be considered as a guide for the physicians and the nurses in
communication. This film is very educative for the practicing health professionals and the
students of medical fraternity. I have learnt that small act of kindness and little sensitive
behaviors towards an ailed person. I have learnt that how effective communication and
therapeutic approach of treatment will help both patient and the health professionals in
maintaining the relationship in between them. IUCN codes of ethics promotes justice,
autonomy, beneficence, non-maleficence, and integrity of patient during treatment. I have
understood that the bookish knowledge and good compliance towards the professional codes
of conducts are not enough to treat the patient with maintaining his or her respect and dignity
(Bidabadi et al., 2019). Perfect diagnosis and prognosis are not effective when patient is not
feeling motivated towards life. Medical professionals should take care of patient’s physical
health status along with psychological well-being (Bidabadi et al., 2019). In this film Dr.
Posner is an efficient doctor as his knowledge and diagnosis are very accurate as per medical
terms. However, he failed in maintaining effective therapeutic relationship with the patient
(Vivian). He failed to maintain interpersonal positivity with both the patient and his
colleagues. He didn’t addressed Vivian wither name and didn’t opt for collaborative decision
making. I felt that the information regarding her chemotherapy were not explained to Vivian
in a proper way. Though she was told to be “tough”, the responsiveness towards her

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Analysis and Reflection
emotional needs was not met. I never understood why Dr. Posner didn’t ask any open-ended
question to Vivian; perhaps he was too proud and satisfied with his popularity to act
sensitively with others. In the very beginning of this film we have seen that Vivian use to run
one place to another to have different physiological reports and the medical workers were too
cold to ask the impersonal questions which hurt her like anything. I felt that the questions
were the part of their job and they are tired of doing the same with multiple patients, so that
the disgust and fatigue reflect from their cold behavior toward Vivian (Dobbins, 2011).
However, I cannot support the way they communicated with the patient. Susie, showed the
true responsibilities towards a patient. She not only treated Vivian by administering
medicines but also respond to her emotional needs and tried to facilitate positivity with
affectionate touch and therapeutic communications (Ozcakir and Bilgel, 2014). In the
Popsicle scene she communicated with Vivian as an empathetic human being. This film has
shown that being empathetic does not mean to become fragile. Dr. Vivian also didn’t allow
Posner to meet his grandmother before term paper submission before he joined medical
school. Both Vivian and Dr. Posner failed in showing empathy in different time frame.
However, Dr. Posner had to show adherence to the professional commitment (to maintain
therapeutic communication) rather than Vivian needed to show empathy towards her student.
To improve my professional experiences by removing knowledge gap I will always
try to maintain therapeutic patient-nurse relationship and non-verbal communication with
empathy. I will maintain affectionate body language while taking care of my patients. This
will improve my communication strategies and approach towards patients with better positive
expression. The body language is significant in conveying effective communication to a
patient and therefore an imperative that I should address earlier I start performing nursing. I
have observed that I did not recompense attention to my nonverbal communication. I have a
weakness when it derives to aligning my verbal communication with body language. A

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Analysis and Reflection
humanistic method allows nurses to yield a holistic approach of care to a patient that
substitute emotional and mental health in addition to the physical ailment. I will improve my
skills by taking training and improving my knowledge towards code conducts. I will study on
substitute expressions that can be used to ask evidence from a patient. This will include
revising past research effort on effective communication for interested patient information.
The plan will enhance the effectiveness of my interactions while creating satisfying
association as a health care professional.
In conclusion, this essay has described that effective and therapeutic relationship in
the improvement of condition of the patient. Health professionals or health care workers
should also take a humanistic approach when serving health care to hospitalized patients.
This will allow physicians to stable among research and qualified exercise benefits when
treating an investigational condition.

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Analysis and Reflection

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Analysis and Reflection
References
Arnold, E.C. and Boggs, K.U., 2019. Interpersonal Relationships E-Book: Professional
Communication Skills for Nurses. Elsevier Health Sciences.
Bidabadi, F.S., Yazdannik, A. and Zargham-Boroujeni, A., 2019. Patient’s dignity in
intensive care unit: A critical ethnography. Nursing ethics, 26(3), pp.738-752.
Dobbins, E.H., 2011. The impact of end-of-life curriculum content on the attitudes of
associate degree nursing students toward death and care of the dying. Teaching and Learning
in Nursing, 6(4), pp.159-166.
Holmes, W.T. and Parker, M.A., 2017. Communication: Empirically testing behavioral
integrity and credibility as antecedents for the effective implementation of motivating
language. International Journal of Business Communication, 54(1), pp.70-82.
Ozcakir, A. and Bilgel, N., 2014. Educating medical students about the personal meaning of
terminal illness using the film,“Wit”. Journal of palliative medicine, 17(8), pp.913-917.
Purnell, L., 2018. Cross Cultural Communication: Verbal and Non-Verbal Communication,
Interpretation and Translation. In Global Applications of Culturally Competent Health Care:
Guidelines for Practice (pp. 131-142). Springer, Cham.
Ricou, B., 2020. Psychological Impairment in Professional Caregivers. In Post-Intensive
Care Syndrome (pp. 261-273). Springer, Cham.
Sancar, B. and Aktas, D., 2019. The relationship between levels of Alexithymia and
communication skills of nursing students. Pakistan journal of medical sciences, 35(2), p.489.
Wit 2001, Motion Picture, HBO Films: New York.