Reflection on Therapeutic Communication in Nursing: Incident Report

This report is a reflective analysis of a nursing student's encounter with an elderly patient who was involved in a traffic accident, and the challenges posed by a language barrier. The student utilizes Gibbs' Cycle of Reflection to describe the incident, analyze their thoughts and feelings, evaluate the experience, and draw critical insights. The reflection emphasizes the importance of therapeutic communication, particularly in overcoming language barriers, and highlights the application of Nursing and Midwifery Board of Australia (NMBA) standards of practice. The report underscores the significance of non-verbal cues, emergency response, and cultural sensitivity in providing effective patient care. The student concludes with an action plan to improve cultural and language competency in future practice.

Running head: REFLECTION ON THERAPEUTIC COMMUNICATION
Reflection on Therapeutic Communication
Name
Institutional Affiliation
Reflection on Therapeutic Communication
Introduction

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Effective therapeutic communication is crucial for successful therapeutic relationships in
nursing practice. The nursing career as a profession involves encounters with patients from
diverse cultures and coworkers from different backgrounds. As a result, nurses ought to be
equipped with proper skills in communication to navigate barriers that may affect their
profession and the nursing profession at large. The Nursing and Midwifery Board of Australia
(NMBA) (2017) has clinical standards of practice to guide, protect, and regulate behaviors of
nurses and midwives. This reflective paper uses Gibbs Cycle of reflection to reflect on my
encounter with an elderly patient who had been knocked down by a speeding motorcycle.
Gibbs Stage 1
Description
It was late in the evening and I was running to the grocery store when I saw a woman
groaning in pain on the right side of the road. I was in a hurry and felt that attending to her could
waste my time, but I felt determined to help. She was uttering words in the language I could not
comprehend and she kept pointing her hand to her purse that had dropped about three meters
from where she was lying. She was sobbing and had been overcome by emotions, so it was
difficult to hear what she was saying. I calmed her down and assured her of immediate medical
attention before handing her the purse. She scrolled the phone and dialed a number, and the only
thing I heard from the language she was using was the name of the lane where we were standing.
I created a calm environment of trust as discussed by Newels and Jordan (2016) as a requirement
for patient-centered care. She learned that I did not understand her language and joined me in
using signs. I dialed an emergency number on my phone to call an ambulance. I told them to
consider coming with a translator because the woman was speaking in her first language. The

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team arrived in time and we took her to the hospital where I made sure that she had been
attended to before I left to attend to my duties.
Gibbs Stage 2
Thoughts and Feelings
This was a shocking experience because I had never considered that communication
could be a barrier for therapeutic intervention. I had anticipated that I could diagnose the cause
of the problem immediately and help, but I ended up watching her as she groaned in pain. I,
however, managed to think immediately and seek external help from the emergency team which
arrived in time and saved her life. They did emergency first aid before taking her to the hospital.
I felt empathy because I wanted to help, but this was not possible because of language barrier.
Empathy is defined by Amery (2016) as an effort to understand the patient’s pain and
experiences without emotionally joining them. Sympathy, on the other hand, involves engaging
the patient’s experiences using emotions. I was happy after realizing that I had used non-verbal
cues to understand the woman and make proper interventions to help.
Gibbs Stage 3.
Evaluation
Generally, the incident was satisfactory for me because I applied what I had learned
about therapeutic communication. This was a practical test to my nursing profession because I
had not encountered such a situation where language barrier makes it impossible for medical
intervention. I read in Conway, Tsourtos, and Lawn (2017) that communication is one of the
barriers that affect delivery of quality health services to indigenous people in Australia.
Communication barriers contribute to health disparities experienced by Aboriginals and Strait
Islander people of Australia. Overcoming these barriers involves understanding factors such as

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communication as explained by (Denniston, Molloy, Ting., Lin, & Rees, 2019). I do not think
that it could have been difficult to intervene if the woman was of my native language or if she
was bilingual.
Gibbs Stage 4
Critical Analysis
I have completed my analysis as required by the Australian Nursing Standards
Assessment Tool (ANSAT) (2019). Since thhe nursing profession requires competency in
language profession in and out of clinical settings, the skills has been practically applied in this
analysis. Halcomb, Stephens, and Foley (2017) explain that communication proficiency reduce
medication errors and increase patient satisfaction. I did not capture the language of the patient,
but I used non-verbal cues help save the life of the patient. Even though I did not make direct
intervention to save the life of the patient, I was able to call the emergency team that helped save
her life. Australian Nursing Standards Assessment Tool (ANSAT) (2019) requires that nurses
are fluent in communication and assessment. The incident made a significant contribution to my
understanding of professional requirements in nursing practice.
In terms of the application of the Nursing and Midwifery Board of Australia (NMBA)
(2016) and the Australian Nursing and Midwifery Federation (2017) codes of practice, I have
practically applied critical thinking and communication skills. When I relate the incident to
section 1.3 of the NMBA (2016), I find that I did what was required to help the woman in need.
Section 1.3 of the NMBA codes of practice (2016) states that nurses respect all cultures and
experiences, which includes to responding to families and factors that underpin the health of the
Aboriginals and Strait Islander people and those from other cultures. I used this standard to

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make sure that the woman received proper and immediate medical intervention, despite of her
difficulties to communicate in English language.
I used section 2.2 of the NMBA (2016) by engaging in therapeutic communication with
the patient. Section 2.2 of the NMBA standards for practice (2016) states that nurses ought to
communicate effectively and respectful of other peoples cultures and upholding the patient’s
dignity. I used this standard when engaging the patient and the emergency team that came in to
attend to the patient. Additionally, the sixth NMBA standard of practice (2016) states that
nurses provide safe, appropriate, and responsive care to patients (Cashin, Heartfield, Bryce&
Fisher, 2017). Safe practice has to meet the cultural expectations of the patient as well as be
responsive to the need of the person including physical and psychosocial needs (Vermeir &
Vandijck, 2015). In this case scenario, I exhibited competency by focusing on the health of the
patient to prevent further physical and emotional pain.
Conclusion
This encounter challenged and motivated my attitude towards the nursing profession. It
tested my application of therapeutic communication. The encounter with the patient and other
professionals confirmed my commitment to nursing career because I did not ignore the need of
the patient even though I was in a hurry. Additionally, it challenged my cultural perception
regarding diversity in nursing. The knowledge I gained will help me in my future practice.
Action Plan
I am determined to increase my knowledge on cultural and language diversity to
overcome language barriers. I will keep studying other languages as well as enhancing non-
verbal cues to help patients. I am determined to update myself with the NMBA standards and

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other professional requirements to deliver the best services to patients regardless of cultural and
language barriers.

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References
Australian Nursing Standards Assessment Tool (ANSAT) (2019). Retrieved from
http://www.ansat.com.au/
Australian Nursing and Midwifery Federation (2017). Professional practice framework for
nurses and midwives. Retrieved from
http://anf.org.au/documents/policies/PS_Professional_practice_framework_for_nurses_a
nd_midwives.pdf
Amery, R. (2016). Recognizing the communication gap in Indigenous health care. Medical
Journal of Australia, 3(4). Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/28659103
Cashin, A., Heartfield, M., Bryce, J., & Fisher, M. (2017). Standards for practice for registered
nurses in Australia. The Australian Journal of Nursing Practice, 24(3). Retrieved from
https://www.collegianjournal.com/article/S1322-7696(16)30003-8/fulltext
Conway, J., Tsourtos, G., & Lawn, S. (2017). The barriers and facilitators that indigenous health
workers experience in their workplace and communities in providing self-management
support: a multiple case study. BMC Health Services Research, 17(1). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415721/
Denniston, C., Molloy, E. K., Ting, C. Y., Lin, Q. F., & Rees, C. E. (2019). Healthcare
professionals' perceptions of learning communication in the healthcare workplace: an
Australian interview study. BMJ open, 9(2). Retrieved from
https://doi.org/10.1136/bmjopen-2018-025445

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Halcomb, E., Stephens, M., & Foley, J., B. (2017). The development of professional practice
standards for Australian general practice nurses. Journal of Advanced Nursing, 73(8).
Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28181277
Nursing and Midwifery Board of Australia (2016). Registered Nurses standard for practice.
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Newels, S. & Jordan, Z. (2016). The patient experience of patient-centered communication with
nurses in the hospital setting: a qualitative systematic review protocol. International
Journal of Clinical Practice,4(3). Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/26447009
Vermeir, P., & Vandijck, D. (2015). Communication in healthcare: a narrative review of the
literature and practical recommendations. International Journal of Clinical Practice,
69(11), 1257–1267. https://doi.org/10.1111/ijcp.12686