Nursing Reflective Essay Name of the University Author Note

This essay is focused on my reflections of the problems I faced regarding communicating with the patient, what steps I took to form a bond with her and how well it worked out. This essay is focused on my reflections of the problems I faced regarding communicating with the patient, what steps I took to form a bond with her and how well it worked out. However, her medical history was incomplete and it was hard for me to understand the actual problems as the patient clearly had a lack of prior professional

Running head:TITLE
Nursing Reflective Essay
Name of the Student
Name of the University
Author Note

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As a nursing student who is currently in their 4th semester, the practice throws new
obstacles at me every day. One of the biggest hurdles include my ability to communicate with
patients from different backgrounds and culture. Recently, I was allocated a patient where my
abilities were challenged. This essay is focused on my reflections of the problems I faced
regarding communicating with the patient, what steps I took to form a bond with her and how
well it worked out. Finally, it aims to highlight my experiences and what I learned from those
experiences (Rawat & Sharma, 2020).
WHAT
Last week, I was working at the respiratory ward of my hospital. I was assigned a
patient who I came to know was a part of the Maori clan of New Zealand. Right of the bat, I
was faced with the clear problem of a communication gap. From her information chart, I
came to know that she had a history of Asthma, hypertension and was non-compliant with her
medications. However, her medical history was incomplete and it was hard for me to
understand the actual problems as the patient clearly had a lack of prior professional care. She
was currently experiencing shortness of breath and fatigue for the last two days, and the
condition was worsening rapidly since the last hour. This was very apparent from trying to
talk to her as she was wheezing continuously and was trying to tell me something. She
continuously motioned towards her neck and chest and made very specific signs. However,
she did not seem to comprehend what I was asking her, which told me that she probably did
not understand English (Gustafsson & Nordeman., 2018). This was a clear problem as I did
not speak Te Reo, which was the language usually spoken by the Maori People. I was not
understanding as it seemed to make her aggressive and irritated. Hence, I tried to
communicate with her non-verbally. This proved to be difficult as well and she was not very
responsive towards my actions and seemed to get offended by my actions. I contacted the
person who she was previously assigned this patient and she reported to have faced the same

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problem. From observing the patient and reading her history, I guessed that she may have
been suffering from Pulmonary Obstructive Disorder. However, it was crucial that I
confirmed this diagnosis before I could administer any sort of care. When I tried to further
communicate with the patient non-verbally, she became more irritated. So I opted to offer her
the inhaler in order to help her, but she swatted that away that made me realise she did not
want my help and was probably waiting for another healthcare professional to help her. This
was a problem as the primary step to administering medical care to a patient is to connect
with them and form a bond so that they trust the one who is taking care of them. This patient
clearly did not trust me to give them the proper care and in the meantime, her wheezing
continued. At this point, I was kind of losing all hope to form any sort of bond with them, so I
informed my supervisor about the problem. However, my nursing leader let me know that
there was no other staff who was free to take care of this patient. So the only option I had was
to try and create some sort of bond with the patient so that I could administer a primary care
for them. It was important that I at least stabilized the patient so that she could be sustained
till another nurse became free to take care of her. For now, I had to care for her, no matter
what. However, the patient simply refused to communicate with me. It was clear that she was
offended by me not understanding their language and she took it as a personal insult that I did
not know Te Reo. So I had to take certain steps to make sure she let me care for her as much
as I could.
SO WHAT
Firstly, I decided to let my supervisor know about the problem in further detail and
asked her to send anyone who knew Te Reo to help me with this patient. Then, I decided to
search up as much as I could about the Maori culture as I could. For starters, I learned how to
say ‘hello’ in Maori (maoridictionary.co.nz, 2020). Then I tentatively tried to say hello to the
patient. She said hello back and seemed to be more open to communicating with me non-

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verbally. She seemed to be taking me more seriously. She took the inhaler when I motioned
her to, and she also let me help her sit up on her bed. Apart from that, I tried to maintain some
distance from her as I learned that they do not like to come within close proximities of other
people. This may have been the reason why she was getting irritated with me as I was trying
to come close to her to help her. Talking with a calmer tone also seemed to help her be more
open to my gestures. I maintained an even tone while talking to her and this was the best
thing I could have done. She was much more open to an even tone of talking rather than me
frantically trying to help her out or trying to communicate with frantic hand gestures. I
maintained a steady eye contact, but also stayed at a respectful distance. I also calmed myself
down so that I could understand her gestures better. She motioned towards her chest and
made a strangling motion with her hands. This helped me understand that she was feeling
tightness in her chest. I tried to convey through her gestures that I was willing to listen to her
and help her out with her problems. A light smile also helped me in my gestures. I made sure
not to scare her by being overly expressive or over-zealous. After that, I decided to learn
more about how treatment is administered to Maori people. I picked up certain article to
understand more about Maori people, that: how they live how they have their food and what
are their practices. While I was administering further care, I started with the seven common
nursing plan for the situation ("WHO | COPD management", 2020). The care plan I thought
of administering were: providing ineffective airway clearance, nutritional imbalances i.e.
providing nutrition less than the body need, taking care of the risks of infections due to
pathogens and impaired gaseous exchange. When I found that the women is gaining trust on
me as I interacted with her in their language I also assured her giving food which were
cooked underground. The food made her understand that I can relate more prominently to
their culture as they only have food cooked underground and hence she allowed more of my
interventions to be applicable for her treatment. Thus, I started with the nursing care plan of

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inappropriate diet without making her know that she is being taken care of and hence it stood
to be a two-way mechanism of gaining trust and providing nursing care for her. The next
nursing intervention I thought of was the provision of gaseous exchange, which was
impaired. By providing of such method she felt a bit comfortable as the alveoli which was not
being provided with appropriate oxygen came to function and hence the path of the airway
again started functioning. However, the following nursing interventions were the primary and
point methods, which were only possible when the patient was at the ward. The real
challenge came of making the patient survive when she will be returning to her own place
and thus as a nurse my first thought was how to make her continue with all these
interventions which she have been provided with at the medical facility. The care might have
lessen her pain and have made her feel better than the prior state but it was a temporary
mechanism and being a indigenous people and non habituated with our language can also
misinterpret the mechanism as she moves back to her origin.
NOW WHAT
The thinking that prevailed in my mind was now what to be done further for the
smooth flow of the life of the patient. The things that came to my mind was to provide her
education with the mechanism of the modern medicines and use of the equipment such as
asthma pump and the use of oxygen carrying mask. Moreover, the other most important thing
that I felt that I should be making her know is the provision of the education that when to call
for a medical support. However, the barrier of the language again came on the way of
provision of education. Apart from the language barrier, the most prevalent barrier was the
utilization of the knowledge of diet she should know in order to lead a healthy lifestyle. What
I felt that, being back at her native place will she be able to make her people understand about
the habits she need to follow. The most prevalent challenge that came in my path was that
Maori people have no written language to follow. Thus in this situation even if I could write

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down the interventions for her, it would not do any help for her. The thing which can help her
at the present moment is the language of signs and portraying her the “to do” activities by
sketches and drawings. On the first place I acted with the sign language for her to make her
understand about her medications that she need to take and also made her understand the
course of the medicine. On the next place, I sketched up detailed mechanism of the use of the
asthma pump and the use of the oxygen mask that she may need to use. Moreover, I used the
sign language and sketches to make her understand that what type of diet she need to follow
up with in her post treatment and how she need to understand when to call for medical help.
The following mechanisms made her understand a bit and the final assurance was met when
she replied with a smile that she had understood the “to do” mechanisms for the same. On the
next moment, I realized that I should ask her to come back for a check-up in order to make
her function properly. The barrier I faced in registering the whole case was she tried
describing her location, however, due to lack of knowledge of her Te Reo language I could
not get the point how to register her case and how to make her know about the possible
facilities at her location. Thus, I made it possible by showing her pictures that where to
contact for when she will be seeking help at the time of need if she lacks the reach to highly
classified modern facilities. However, I realized that the possible interventions that I could
have made have been done from my part and my views, although the challenge remained,
was to make her accustomed of these and she might not be having a daily life nurse to help
her in doing so. The quick possible mechanism I could thought of was learning the term
“nurse” in their language to make her understand that whom to seek for help in her daily life.
The overall conclusion I drawn from the case was that what challenge a nurse or a
health care professional can encounter and how to overcome it. In the realm of life, how one
should be performing towards their profession and how they need to learn day-to-day
methods to restore the health of their client being a professional nurse. The more important

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thing that came across during this case was how to develop interpersonal relation with a
patient from any background. It is known that how important is the interpersonal relation
build up when an individual is serving as a nurse or as a health care professional. The case
helped me evident one most critical case of relational build up with the client, and the
knowledge gained can help me serve for the most vulnerable patients as well.

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References
Gustafsson, T., & Nordeman, L. (2018). The nurse's challenge of caring for patients with
chronic obstructive pulmonary disease in primary health care. Nursing open, 5(3),
292–299. https://doi.org/10.1002/nop2.135
maoridictionary.co.nz. (2020). hello - Māori Dictionary. Maoridictionary.co.nz. Retrieved 2
March 2020, from https://maoridictionary.co.nz/search?
idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=hello.
Rawat, D., & Sharma, S. (2020). Case Study: 60-Year-Old Female Presenting With
Shortness of Breath. Ncbi.nlm.nih.gov. Retrieved 2 March 2020, from
https://www.ncbi.nlm.nih.gov/books/NBK499852/.
WHO | COPD management. Who.int. (2020). Retrieved 2 March 2020, from
https://www.who.int/respiratory/copd/management/en/.