Analysis of Therapeutic Communication in Nursing: NUR1102 Assignment

This essay analyzes a nursing case scenario involving ineffective communication between an elderly patient with hearing impairment and a nursing assistant. The assignment explores the principles of geriatric care management and the importance of therapeutic communication in enhancing the quality of life for older adults. It identifies communication breakdowns, such as the lack of informed consent and the absence of the patient's hearing aid, which led to patient agitation. The essay emphasizes the significance of strategies like SBAR, active listening, and clear communication, including the use of simple language and direct eye contact, to foster trust and understanding. It highlights the impact of psychosocial challenges faced by elderly patients and the need for care models that extend beyond the biomedical approach. The analysis underscores the role of effective communication in improving patient outcomes, satisfaction, and health literacy, ultimately advocating for the avoidance of communication failures in future interactions.

Running head: NURSING
Case scenario 2
Name of the Student
Name of the University
Author Note

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Introduction- Nursing professionals are expected to adorn the role of patient advocates,
while maintaining a professional and therapeutic nurse-patient association, within the boundaries
of their role. With the aim of delivering excellent quality health care facilities to patients in
hospital settings, it is imperative that nurses should be able to appropriately communicate with
the patients, interdisciplinary team members, and family members (Arnold & Boggs,
2019). Therapeutic communication is an umbrella term that refers to the face-to-face procedure
of converting and interacting, and it places an emphasis on improving the emotional and physical
wellbeing of a patient (Annoni & Miller, 2016). This assignment will analyse a scenario that is
characterized by ineffective communication between the patient and the nurse, following which
will explain the relevant concept of care and the skills and approaches that best support
communication in healthcare settings. Communication strategies such as, SBAR, active listening,
eye contact and use of simple words will also be discussed, in relation to therapeutic
communication.
Body- An analysis of the case scenario suggests that ineffective communication occurred
with patient when the assistant in nursing (AIN) left while showering the patient, without
informing the latter about her sudden disappearance from the setting. The case involved an
elderly adult who required assistance while performing activities of daily living, and also
suffered from hearing impairment. Taking into consideration the fact that the patient did not
carry the hearing aid during showering, and that the AIN gestured to leave the bathroom, it was
not possible for the patient to be aware of the situation.
Sudden disappearance of his caregiver made him agitated and he started shouting, and
behaving in an uncontrollable manner. Therefore, it can be stated that inadequate informed
consent of the patient prior to assisting the AIN during his showering, no information given to

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the patient about the sudden absence of the AIN from this scene, and miscommunication due to
absence of his hearing aid were some of the issues that resulted in poor communication in this
scenario.
The concept of care relevant to the scenario is geriatric care management that refers to
the procedure of formulating and coordinating care for elderly patients, having mental or
physical impairment, with the aim of enhancing their quality-of-life, addressing their long-term
care needs and maintaining their independence for the maximum time possible. The care
concept refers to working with individuals of old age, in addition to their family members, in
rendering, managing, and referring countless care services. Geriatric care management involves
psychological and health needs, with other required services such as, assistance with activities of
daily living, socialization or nutrition services. It is based on the basic principle that aging is not
an illness; however it increases vulnerability of the older adults to suffer from diseases (Engel et
al., 2016). Taking into consideration the fact that older adults not only suffer from physical
ailments, but are also emotionally distressed due to their gradual lack of independence, it is
central to establish therapeutic communication with them, through the use of body language,
gestures, written words, and other forms of nonverbal communication, in order to convey them
the willingness to address their health needs.
Several aspects of nurse patient communication, predominantly with the elderly patients
are affected by the characteristics of the latter like their socioeconomic status, income level,
ethnicity, mental health status, and educational attainment (Cappell, 2017). The therapeutic
association between nurse and older patients is under the strong influence of the psychosocial
challenges that are faced by these patients, who primarily depend on their health care providers
to respond to their concerns and needs (Wedgeworth et al., 2017). This calls for the need of

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approaching such patients with care models that extend beyond the biomedical model, in order to
provide effective treatment. Older patients have a tendency of being hesitant while being treated
by the healthcare providers, and the failure of appropriately responding to their needs and
preferences result in ineffective communication.
Analysis of this case scenario suggests that communication with the AIN can be best
initiated by utilising the SBAR (Situation, Background, Assessment, and Recommendation) tool.
This tool has been developed in order to address the existing communication gap, and the
aforementioned four components of this tool help in streamlining healthcare communication
(Stewart, 2016). Prior to assisting the AIN while showering the elderly patient, it was essential
for the AIN to provide the concise statement regarding the current situation of the patient,
following which pertinent and brief information, his background and clinical situation should
have been discussed. This must have been followed by recommendation and requests for
addressing potential challenges that might arise why dealing with the patient. A consistent
strategy for effective therapeutic communication enhances higher efficiency and also offers a
best practice procedure, thereby optimising patient information sharing. This tool would have
enhanced effective therapeutic communication by promoting efficient collaboration with the
AIN, in addition to enhancing patient outcome, and increasing his satisfaction, with the
assistance provided to him while showering (Simamora & Fathi, 2019).
Another significant strategy that best supports therapeutic communication with the
elderly patient focuses on allowing extra time. Older adults also require undivided attention
during communication, which in turn helps in establishing the impression that all their concerns
will be addressed by the healthcare providers. Hence, efforts must be taken to avoid distractions,
while communicating with the older adult, and providing full attention to them during the entire

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care process will not only enhance their health outcomes, but also increase their satisfaction (Al-
Ruthia et al., 2017). Active listening involves the use of verbal and nonverbal cues such as,
smiling, nodding, and speaking affirmative sentences that encourage the patients to continue
sharing their opinion and ideas. Active listening not only encompasses displaying interest in the
information that patients and their family members have to share, but also focuses on
acknowledging that the healthcare providers are understanding and engaging with the consumers,
throughout the interaction procedure. Similar to active listening, seeking clarification from
patients when they provide ambiguous or confusing responses is significant. This helps in
ensuring that the actual need of the patient is being appropriately comprehended, which in turn
helps the latter to thoroughly process their ideas (Giger, 2016). Hospital stays are often lonely
and stressful, and offering help and assistance to the patients during the length of hospitalization
helps in displaying that the patients are valued. Giving them the much needed recognition also
helps in acknowledging their behaviour in absence of any overt compliment, owing to the fact
that such compliments are often considered as condescending, particularly when they are
associated with routine daily living classes like showering, grooming, feeding, or brushing.
Several older adults as in this case scenario suffer from hearing and vision impairment
and it might be difficult for them to understand the intended messages of the information that is
been conferred. Therefore, sitting in front of them and maintaining direct eye contact will help in
showing interest and foster the development of a comfortable and positive atmosphere, which in
turn will make the patients open up and share necessary information about their preferences or
demands, regarding the care that is being delivered (Conceição et al., 2019). Sitting face to face
with older adults has been found to increase patient compliance with the recommended treatment
regimen. In addition, another effective communication strategy focuses on speaking clearly,

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loudly, and slowly with the use of simple and short words and sentences (Campbell, Aredes &
Dhari, 2017). Simplifying the information that is being shared, with the family members in a
manner, which can be understood by them, ensures that they are able to follow the nursing
instructions. Use of technical terms or jargons that are typically difficult for them to understand,
result in poor satisfaction and leads to poor communication (Weber & Farrell, 2016). Therefore,
it is necessary to use comfortable and familiar words with the patients and family, while
speaking loudly enough to enable them hear what is being conveyed.
On analysing the case scenario I can suggest that it helped in enhancing my health
literacy skills including listening, speaking, interaction, and communication, all of which are
essential for delivering care to patients. From this case scenario I understood that ineffective
communication in healthcare setting not only leads to a deterioration in the quality of care, but
also declines the health outcomes for the patient.
Conclusion- Thus, it can be concluded that the case scenario involved ineffective
communication with both the ANI and the elderly patient, which eventually resulted in the
patient becoming agitated and behaving in an unexpected manner. Therefore, geriatric care
should focus on determining the quality of life and living situation of the older adults, in order to
help them live a meaningful life to their maximum potential. Effective communication between
nurse and patient encompasses the exchange of psychosocial and biomedical information, in
addition to the effective and emotional care that is imperative to the health outcomes of older
patients. Elderly patients typically obtain less information about their health and intended plan
of care from the providers, in comparison to their young counterparts, thereby desiring more
communication and information. Considering the increased requirement of effective

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communication and likelihood of the older patients to communicate poorly, such instances of
ineffective communication must be avoided in future.

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