Breach in Therapeutic Communication: Analysis of a Nursing Scenario

This paper analyses a nursing scenario where there was a breach in therapeutic communication. It identifies the problems associated with the video and the possible causes of the issues. The paper evaluates the communication in the video clip and recommends strategies to improve the performance of such an encounter.

Running head: BACHELOR OF NURSING ASSIGNMENT 1
Bachelor of Nursing Assignment
Student’s Name
Institutional Affiliation

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Description of the Scenario
The video clip commenced by presenting three people sitting in a hospital’s
consultation room. The three people included Bronwyn, an adult female who happened to be
the victim of circumstance in the hospital. The second person was John, who seems to be the
husband of Bronwyn and the third person is Taylah, a young lady who addressed Bronwyn as
‘mum,’ meaning, she was probably a daughter to the two. Bronwyn walked around the table,
looking like she was depressed about something. She touched books and dropped them again,
and her actions seemed not to be taken kindly by her daughter, who called upon her to have a
seat instead. John called on the two ladies to maintain silence for some time and not long
after that, the doctor had already got into the room and was addressing the group of three with
a nurse sitting next to him. The doctor completed to give results of the previous diagnosis of
Bronwyn, and the nurse took over the chance to provide a care plan.
I realised that there were several problems associated with the video that could be
used as evidence to show a breach in the delivery of therapeutic communication. Therapeutic
communication is essential between the doctors, nurses, and patients among other relevant
persons as it promotes quick understanding of instructions of medication encourage
despairing patients and also helps the doctors to understand the exact problems faced by their
clients (Ahlsén & Saldert, 2018). The first evidence of unprofessionalism I spotted in
communication was that the doctor and the nurse came in and proceeded directly to their
point even without preparing their audience. The doctor also spoke very fast and seemed not
to want to repeat anything unless asked to do so.
My observation also spotted a lack of concern in the encounter. Before the doctor and
the nurse got into the room, the patient (Bronwyn) was stressed and moved up and down
eagerly waiting for the results of the tests done on her. The duo came in, and the doctor went

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direct to give the results. The results further stressed Bronwyn, and she had to disagree with
them. According to me, the main issue was that she had nobody to support or comfort her.
Therapeutic communication needs to have the language of a nurse, somebody who cares and
is willing to comfort and to encourage at the hour of need (Meloncon & St. Amant, 2018).
The first thing that the doctor needed to do was to create a rapport characterized by laughter
and which makes everybody in the room feel that there are no problematic situations. He was
to give the results, and in the case of discomfort to the patient, it was the responsibility of the
nurse to offer comfort, and together they needed to encourage the patient.
In my view, the observation of silence is a significant component of any form of
communication, be it therapeutic, social, or any other professional platforms. Silence gives
both the speaker and the audience time to rephrase points and to analyze the information
provided, respectively. In the entire scenario, there was no maintenance of silence and
inferior form of turn-taking in communication. Everybody spoke whenever they wanted, and
seemingly, the information delivered by the doctor may have failed to reach some of the
members successfully (Weber and Farrell, 2016). The doctor and the nurse ought to have
observed silence while making direct eye contact with the patient they addressed. That will
give you a glimpse of whether or not the patient was interested in their information and
whether or not she was understanding. The doctor talked, the patient was also taking the
whole time refuting the results from the doctor, and nobody cared.
Possible Causes of the Issues
After watching the video, I realised that one major factor that caused poor therapeutic
communication between the doctor and the patient was the differences in the results expected.
Doctors always perform their laboratory analyses and come up with well-reasoned out results
from the laboratories. However, patients usually gauge the results based on the amounts of

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pain or complications they experience on the health. For example, from the clip, Bronwyn
refused to accept the doctor’s findings, and she argued that the period was too short for her
health to be in such a critical condition (Yeh, 2017). The doctor, on the other hand,
maintained that the status provided was accurate and provided the presence of metastatic
breast cancer which had started spreading to other body parts and will soon develop into a
severe issue if not managed.
A second problem I observed was a disorganized manner of communication. While
addressing a group of people, there should be high maintenance of the organization in the
mode of communication (Butchibabu, Sparano-Huiban, Sonenberg & Shah, 2016). The
organization should entail active listening for those who are not speaking. For the one who is
addressing, he/she should make sure that time is allocated to different people at different
moments to avoid collision of points (proper turn taking). The case in the video clip was a
very different one and which was characterized by controversial processes. The doctor was
given time to speak at the early moments, however, after he mentioned the results, the whole
thing changed with Bronwyn not taking heed of any information but participating by
speaking at the same time as the doctor. John popped to ask a question even without
excusing himself, and that changed the doctor’s line of communication to come back and
make a clarification. Isobel & Delgado, (2018) argue that without proper observance to the
communication strategies, the points needed to reach the audience will automatically be
interrupted, thus belittling the work of the speaker while the audience can be termed as poor
listeners.
Evaluation of Communication in the Video Clip
Although my assumption remains steadfast on the fact that the encounter in the video
failed to recognize most of the strategies required for professional dialogue, further watching

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the video created a controversial opinion. Various factors were also followed and used to
ensure that the delivery of the information was successful (Lochner, Duenser, Lutzhoft,
Brooks & Rozado, 2018). Both the doctor, the nurse, and the family, including the patient,
practiced some of the things which could be termed as excellent and professional and which
could be used to improve the quality of the communication. The first aspect lied on the side
of the patient. She had a diagnosis which was not presented in the video and was instructed to
be back on a particular day. I watched her present at the venue and awaiting the doctor’s
results. According to Elmi, Wardatul, Mahardika & Eko, (2018), the move also shows that
the doctor followed the right path in observing professional standards of practice through
planning to give results after a diagnosis.
The nurse has also shown a good move by accepting to give a care plan to the patient,
which involved a follow-up procedure to know the progress of the patient’s condition. The
action of the nurse rebukes my prior stance that the video presented a total lack of concern for
the health of the patient. However, at the end of the video, there was a high expectation that
both the nurse and the doctor would appreciate their clients for showing up (Janssen, Ruiter
& Waters, 2018). It was regrettable that it did not happen and that could be used to negate the
feature of concern which had already been developed.
Analysis of the Situation
Based on the arguments presented in the paper, there is evidence of a breach in
communication professionalism in the video clip presented. There is, therefore, I need to
recommend some of the strategies of communication and professional standards of practice to
help improve the performance of such an encounter (Gertsch et al. 2018). The first standard
of training that I will propose is planning the contents of the information to be given. A well-
structured speech was not to contain the results part alone as for the case of the doctor’s

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speech, but should have several elements which are all relevant to the setting of the scenario.
The other practice needs to be the identification of the possible issues that have deteriorated
the health condition of the patient, especially when the patient does not believe in the results
provided. Two strategies that I would propose to be embraced are silence and empathy. The
practice chosen would help to provide well-planned and detailed information regarding the
health condition of the patient (Hutt, 2018). The strategies, on the other hand, improve patient
analysis and also give a sense of acceptance of the patient.
Conclusion
The differences that occur in the ability to disseminate information depends on the
communication strategies employed by the speaker. If the speaker can manage his/her
audience, then it is undoubtedly that sufficient data will reach the audience. The video clip
presented did not show much of the components of successful therapeutic communication
and thus needed a recommendation for both the best strategies and professional standard of
practice. Once the best procedures and practices are included in the encounter, there would be
a high performance towards the intended goal. The practices that should be recommended
include precise information planning and the identification of issues which shall help improve
the interaction with the patient on several matters. The strategies that should be emulated
include the use of silence and a show of empathy, which are all aimed at analyzing the patient
and giving comfort and encouragement should the results be negative and unpromising.

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