Bachelor of Nursing Assignment 7: Therapeutic Communication Analysis

This report analyzes a video scenario depicting a breast cancer diagnosis in a hospital consultation room, focusing on the therapeutic communication between the doctor, nurse, patient (Bronwyn), and her family. The assignment identifies breaches of therapeutic communication, such as the lack of silence, clarification, comfort, and orderly communication. It explores misaligned expectations and fear as factors hindering effective communication. The report evaluates the scenario, highlighting both positive aspects (nurse's follow-up) and negative aspects (short encounter, lack of engagement). The analysis proposes solutions, emphasizing the use of encouraging language, appreciation, silence, and humor to improve communication strategies within the healthcare setting. The report concludes with an action plan to enhance therapeutic communication, suggesting ethical and educational considerations for patients and families.

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

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Description of What Happened in the Film
From my observation of the video, three people whose names have been identified as
Bronwyn (an adult female who happens to be the casualty), John (a middle-aged man who
seems to be the husband to Bronwyn) and Taylah (a young lady, probably a daughter to John
and Bronwyn) were present in a hospital’s consultation room. The main reason for their being
in this room is that Bronwyn has come for the results of the past tests as instructed by the
doctor. Shortly, a doctor was with them and was explaining that the diagnosis of Bronwyn
had shown the presence of breast cancer, which had started spreading to other parts of the
body. The victim, however, remained wondering about her situation on whether to believe or
disagree and a nurse took the opportunity of counseling her before handing over a card
containing her number so that they could keep their connection via phone call.
As I watched the video, I realised the lack of professional and communication
strategies. The first one I observed was that the encounter lacked the use of silence:
Therapeutic communication entails the various techniques that doctors and nurses use to give
priority both to the mental, emotional, and physical comfort of their clients who are the
patients (Halcomb, Stephens, Bryce, Foley & Ashley, 2017). There were various forms of
therapeutic communication breached in the short video encounter. The first form of
communication is the use of silence. Silence is an element of communication which allows
patients to think critically on ways forward based on the anticipated results of their tests. In
the video, there was no place that silence was observed, and in such a case, Bronwyn had to
remain nervous for the whole moment as she did not have any option to lack of time for self-
introspection.
Seeking clarification: - This technique used as a form of therapeutic communication is
more or less similar to active listening. At times, points spoken might not be so precise for

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the audience; for example, medical language is mostly understood by the doctors, nurses, and
other people of similar professions (Janssen, Ruiter & Waters, 2018). For others, they remain
in the darkness in terms of meaning. I took Bronwyn as the major actor in this film because
all the issues revolved around her. She was not ready to listen to the doctor as she looked
uncomfortable with the results provided. The doctor mentioned the name of the disorder as
metastatic breast cancer, which she might not have known. It was John, the husband, who
popped in to ask for what that disease means.
I observed a total lack of comfort and encouragement: -in hospitals, patients are taken
as people who appear to have lost hope of living and should be put under holistic care
(Butchibabu, Sparano-Huiban, Sonenberg & Shah, 2016). Bronwyn was diagnosed and
happened to be a victim of a critical disease which has a limited survival rate. Everybody
who was in that room was supposed to show some sense of comfort and encouragement
through encouraging words, holding or touching the victim, and making her feel as if the
disease is not a big deal. Instead, the doctor and the nurse spoke and finished their parts; the
husband and the daughter were kind of amazed and had nothing to do, leaving the victim to
struggle alone with her condition.
Feelings
The video was characterised by misaligned expectations: this cause of poor
therapeutic communication refers to the different views of each party depending on their
opinions and experiences. From the film, the doctor and Bronwyn both had different results.
The doctor did his diagnostic tests and came up with the correct conclusions from the
laboratory showing that Bronwyn was found to be a victim of metastatic breast cancer, and
the tumor was swiftly spreading to other body parts. Bronwyn, on her side, had the feeling
that the pain is too little and the time since she started to experience deteriorating conditions

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was too short to account for all the conclusions that the doctor made. At some moment, she
was captured refusing that the doctor’s analysis is wrong. (Spence Laschinger, Zhu & Read,
2016) Possession of such conflicting opinions always hurts the dissemination and reception
of the intended information.
Fear: according to me, anxiety is one of the most significant problems that may have
contributed to the issues of therapeutic communication shown in the short film. Fear could
have arisen from various perspectives. The first perspective was from the doctor’s side.
Cancer is a critical condition which may result in very awkward reactions when people are
told they have it (Light & Mcnaughton, 2015). The doctor may have feared the reactions of
Bronwyn if he could have delayed the process through observing silence. The second
perspective may have been on the side of the victim. The fact that family members were
present in the venue may have contributed Bronwyn’s fear because she might not have
wanted the family to realize her situation. In that case, she tried not to give the doctor time
once the doctor had confirmed the presence of cancer in her.
Disorderly communication: orderly communication follows the rule of turn-taking
and active listening as an observation of Doorley & Garcia (2015). However, the video
presented a scene containing people gathered together and who spoke whenever they needed.
The doctor started to speak, and he was given ample time as other people listened. However,
after unveiling the results, Bronwyn kept talking without giving the doctor his precious time
as she waits for her time. In between the doctor’s speech, John popped in with a question
about the spread of metastatic breast cancer with which he successfully changed the doctor’s
line of communication. Before the doctor finished speaking, the nurse had come up with her
issues of providing care guidance and counseling. Mahler, Keusgen, Tufvesson, Zemen &
Caire, (2016) argue that in such a situation, it would be complicated to understand everything
that Bronwyn was required to follow.

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Evaluation of the Scenario
My assumption based on the script is that most of the requisites for successful
therapeutic communication were not followed. Some of the reasons to justify my claims are
already outlined in the aforementioned paragraphs. However, as I critically viewed the video
for more than a second or third time, and as per the provisions of Weber and Farrell (2016), I
realize that making a conclusion on the video based on the professionalism of communication
is not easy. At moments, there was an observation of the rules regarding successful
therapeutic and professional communication, which formed the good things in the video. One
such good things include the nurse providing her contacts and address and promising to keep
connecting with the patient and the family. She set to meet the patient in two weeks, but in
the case of a call requiring her to reach early, she promised to be available. The move by the
nurse confirmed her readiness to perform follow-up activities to know the condition of the
patient and to offer relevant help to improve her situation (Doorley & Garcia, 2015). One of
the negative features that I happened to observe was that both the doctor and the nurse were
out to give results and had no time to engage the victim, and that made the encounter too
short due to lack of engaging content.
Analysis of the Scenario
After realizing that professionalism in communication was not followed, there was a
need to analyze the scene and give possible solutions in terms of the communication
strategies that ought to have been applied to make the encounter look more successful. The
video provided a picture of the hospital platform, which is highly faced with a lot of mood
swings from patients. The communication strategy that would have best suited the video and

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improved the quality of the information was the use of encouraging language and
appreciating the audience (Yeh, 2017). Bronwyn started the whole conversation with stress
arising from unknown results and ended it with the stress of the conflicting results without
the comfort of anybody. Such an act made the patient feel like she was isolated, and nobody
was interested in their situations. It can also contribute to cases of suicides due to stress in the
future.
Both the doctor and the nurse did not appreciate their clients for visiting them. Even
in the social platform, whenever a person gets a visitor, they must appreciate them for coming
which both the doctor and the nurse failed to do (Brownie, Scott & Rossiter, 2016). The
actions of the nurse and the doctor may make the family of the patient to development
thought that they were wasting the time of the doctors or the doctors are not entirely
interested in helping them to solve the issue. The two strategies should thus be implemented
to help improve the performance of therapeutic communication in any hospital.
Conclusion and Action Plan
The quality of communication vary between and amongst different people depending
on the context, audience addressed, and many other factors like age. The type of
communication that has been shown on the video may have a tiny percentage of performance
or may not yield a lot of positive results. The first problems were the introduction where the
doctor just came in and started giving results without creating some excellent rapport to keep
the encounter lively. At the end of the meeting, both the doctor and the nurse do not
appreciate their clients but instead give a contact to necessitate their next meeting. Most of
the standards of professional practice were observed except that the video should include
more of ethics and education of the patients. On the other hand, the communication strategies
that I would embraced include the application of silence and humor. Both the standards of

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professional practice and the procedure would enlighten the patients and encourage them to
make them feel valued by other people.
References
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in chronic and complex care. Nursing Standard, 31(6), 54. :
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Doorley, J., & Garcia, H. F. (2015). Reputation management: The key to successful public
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Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2017). The development of
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https://digitalscholarship.unlv.edu/thesesdissertations/2833
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http://hdl.handle.net/10755/623159

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