CNA150: The Wit Analysis Essay - Therapeutic Communication

This essay provides an analysis of the film "The Wit," examining the portrayal of therapeutic communication within a medical setting. The essay is divided into two parts: Part 1 offers a summary of the film, focusing on instances of both effective and ineffective communication between healthcare professionals and the patient, Vivian Bearing, who is diagnosed with stage 4 metastatic ovarian cancer. The analysis highlights how communication styles impact patient outcomes and experiences, including the use of medical jargon, nonverbal cues, empathy, and respect. Part 2 presents a personal reflection on the author's knowledge gaps in therapeutic communication, such as active listening, nonverbal communication, and patient confidentiality. The essay concludes with strategies for improving communication skills, emphasizing the importance of empathy, respect, and ethical considerations in medical practice. The author acknowledges the significance of the film in shaping their understanding of professional practice and the need for continuous self-improvement.

Running head: THE WIT ANALYSIS ESSAY 1
The Wit Analysis Essay
Student’s Name
Institutional Affiliation

THE WIT ANALYSIS ESSAY 2
The Wit Analysis Essay
Introduction
Promoting effective health care service delivery calls upon advocating the significance of
therapeutic communications. This paper is set to provide a summary of “The Wit” which is based
on the effect of communication on medical practice. Part 1 of this essay explores the drama,
whereas part 2 presents a personal reflection through the identification of knowledge gaps in
therapeutic communications. Furthermore, the paper extends to provide personal strategies in
overcoming the underlying gaps.
Part 1
Anticipating the elements of therapeutic communication is significant in the nursing
practice. Therapeutic communication encompasses various elements such as the mental,
physical, and emotional wellbeing of the patients. In other words, therapeutic communication
should display a high degree of concern to the feelings of the patients. Excellent communication
skills in the therapeutic setting motivate patients and their family members to point out their
grievances and concerns regarding the seriousness of their condition (Kemppainen, 2019). The
Wit illustrates this narrative, particularly how effective and non-effective communication affects
patients' outcomes. The film involves a 48-year old lady (Vivian Bearing) who is diagnosed
with stage 4 metastatic ovarian cancer by her doctor (Harvey Kelekian). In the first phase of the
scene, the patient is approached by the doctor using complex medical language and made to
agree to a chemotherapy experiment that guides in Kelekian’s research. The film also displays a
weaker use of both nonverbal and verbal communication. The doctor fails to observe the facial
expressions of the patient to acknowledge confusion. Neither does the doctor ask the patient if
she articulates the concepts. The position of a doctor also negatively affects the process of data
acquisition from the patient. For instance, standing has proven to negatively impact the patients'
confidence in information delivery (O'Hagan et al., 2014). The service lady also presents poor
communication skills when she brings a jar in the room and fails to either look or present
greetings to Vivian. The same scenario is witnessed on the radiologist, who not only speaks in a
harsh tone but also fails to keep eye contact with the patient. The radiologist fails to explain to
the patient what is yet to happen. Furthermore, the radiologist is not concerned about the patient's

THE WIT ANALYSIS ESSAY 3
status (whether comfortable or not). Looking and listening in patients' care is a fundamental
aspect of therapeutic communication (Bhat and Cook, 2011).
Effective communication is also illustrated in the film. For instance, when Susie took the
patient to Jason for medical history, Jason presents a smile on the patient's face, introduced
himself to Vivian, and asked Vivian how she was feeling. He further adds that her presence in
the room was specifically for medical history (Wit, 2001). However, he still fails to adhere to all
aspects of effective communication because he fails to keep eye contact while communicating.
On the same note, he does not request consent from the patient in answering personal questions.
Immediately after asking queries on the patient's history, Jason looks confused and asks the
patient to lie to the bed for examination (Wit, 2001). He forgets the fact that there is a third party
(another female nurse), and permission must be granted before the physical examination.
Suddenly, he recalls and rushes outside to look for Sussie while leaving the patient in an
uncomfortable position (half-naked and the door open). This aspect breaches the confidentiality
of Vivian. According to Rosenstei (2013), medical practitioners must contact themselves in a
manner that is orderly and maintains the dignity of the patients. The disordered and uncouth
examination has a profound mental and emotional effect on the patient. Vivian vomits out of
humiliation following the degrading nature of her experience.
When Vivian is asked by Susie if she needed anything, she draws concerns regarding
Friday examinations whereby doctors do not ask her permission before removing clothes from
her abdomen region. She also claims that everyone starts pressing her abdomen. Vivian
compares herself like a Guinea pig concerning how she is treated by doctors. Later, Jason
describes cancer as an amazing condition while contacting a regular checkup on Vivian. Susie
also treats the patient with kindness. The promotion of empathy has proven to promote positive
expectations among patients and a reduction in pain (Howick et al., 2018). The moment Jason
diagnoses Vivian with secondary infection, he disagrees with Susie's suggestion on lowering the
dose and transfers the patient to isolation. Vivian shares her feelings on death fear. In a
preceding event, the two share popsicle, and Susie displays available varieties. Vivian makes a
choice on the "Do Not Resuscitate” order. Later, the condition of the patient becomes severe, and
she is placed o drip by Dr. Kelekian. The final visitor received by Vivian was Dr. Ashford, who

THE WIT ANALYSIS ESSAY 4
was her old mentor. Upon seeing her old professor, Vivian starts crying. The doctor climbs the
bed to read a book and comfort the patient. Usually, patients require emotional support and polite
physical address through touching and speaking to them politely. The doctor goes to sleep,
leaving kissed the forehead of the patient. When Jason arrived, he forgot that she was on "no-
code" and rang "Code Blue" for assistance. Susie rushes upon hearing the alarm to remind Jason
but alights when it's too late. She struggles to convince the team that the patient was on no code.
Finally, Vivian's heart stops, and she is lifeless.
Part 2
Openly, this film illustrates a system that lacks complete consent and effective
therapeutic communication skills in the clinical setting. The same ideology is indicated at the
beginning of the drama, whereby Kelekian claims that if the patient agrees to the experimental
treatment, then it shall come at a higher price, including the price of her life. In this case, the
scenario illustrates how different healthcare professionals consider knowledge acquisition more
important to the extent that they neglect the life of the patient. All individuals in the clinical
setting reflected within the drama lack effective therapeutic communication skills except Susie.
Respect is a fundamental aspect of effective therapeutic communication that was heavily
neglected throughout the scene. Vivian (the patient) does not receive due respect. She is treated
by healthcare practitioners in a rough manner. Secondly, being ethical during care is very
important. However, experts in the scene are more interested in obtaining experimental results
rather than anticipating the welfare of the patient. Practitioners must be empathetic while
handling patients. Empathy promotes satisfaction and trusts among patients ((Wilma and
Bridget, 2018). Due to lack of empathy, Vivian is observed periodically losing trust in doctors
hence her fear of death.
I have acknowledged profound gaps in my knowledge efficacy upon watching the video.
Typical examples of such knowledge gaps in therapeutic communication include the ability to
employ nonverbal communication, active listening, promotion of privacy, and reinforcement of
confidentiality. It has come to my notice that active listening demands a present state of the
patient. Currently, I intend to not only develop a higher imagination potential but also learn how
to prevent interruptions while the patient is communicating. I will also keep an emphasis on the

THE WIT ANALYSIS ESSAY 5
meaning of nonverbal cues like facial expressions while communicating with patients. I have
noted that nonverbal communication is one of the aspects that I have been heavily neglected
since childhood. However, this scenario has revealed the importance of nonverbal
communication in promoting good patient outcomes (Chambers, 2013). Acknowledging
empathy as a significant aspect will greatly impact daily activities. I will empress empathy not
only in a professional setting but also throughout my lifestyle in order to achieve desired
professional development. In will engage in activities that promote comfort to patients, including
physical touching of their shoulders and providing empathetical statements
(Kuuppelomaki, 2003). I have also acknowledged that posture while talking serves a
significant role in the confidence of the patient in providing information on her condition.
Confidentiality and privacy are vital aspects of promoting medical professionalism. No patients
would like her private information delivered to the wrong hand. For instance, Vivian is worried
about the door being left open (Wit 2001). She is also concerned with the behavior of the doctors
while contacting an examination. This scenario has reminded me of asking permission before
any procedure is undertaken on a patient. I will also respect the dignity of my patients ask for
their consent before asking personal information. These are vital aspects in promoting the moral
and ethical interest of patients.
Conclusion
In conclusion, watching the film has reshaped my position on the strategies necessary in
promoting professionalism in the medical industry. It has bombarded my mind that effective
therapeutic communication is not only important but a wide topic in nursing. Currently, I shall
articulate the useful concepts obtained from this scenario into professionalism and work on my
weaknesses. The drama has profound educative lessons on medical practitioners. I shall use the
drama as a stepping stone for professional development. In particular, the scene shall guide my
therapeutic communication development enhancement.

THE WIT ANALYSIS ESSAY 6
References
Bhat, R.G, Cook, M.A, 2011, ‘Eye contact in patient-centred
communication’, Patient education and Counseling, vol. 82, no. 3,
pp. 442-447, viewed on 6 April 2019
Chambers, S, 2013, Use of nonverbal Communication Skill to
improve Nursing care’, British Journal of Nursing, vol. 12, no. 14,
viewed on 7 April 2019
Howick, J, Moscrop, A, Mebius, A., Fanshawe, T.R, Lewith, G,
Bishop, F.L,Onakpoya, I.J, 2018, ‘Effects of empathic and positive
communication in healthcare consultations: a systematic review
and meta-analysis’, Journal of the Royal Society of Medicine, vol.
111, no. 7, pp. 240–252
Kemppainen, V, Tossavainen, K, Turunen,H, 2013, ‘Nurses' roles
in health promotion practice: an integrative review’, Health
Promotion International, Vol. 28, no. 4, December 2013,pp. 490–
501

THE WIT ANALYSIS ESSAY 7
Kuuppelomaki, K, 2003, ‘Emotional support for dying patients -
the nurses' perspective’, European Journal of Oncology Nursing,
vol. 7, no. 2, pp. 120-129
O'Hagan, S., Manias, E, Elder, C, Pill, J, Woodward‐Kron,
R., McNamara, T., Webb, G. and McColl, G, 2014, ‘What counts as
effective communication in nursing? Evidence from nurse
educators' and clinicians' feedback on nurse interactions with
simulated patients’, Journal of Advanced Nursing, vol. 70, no. 6,
pp. 1344– 1355
Wit 2001, Motion Picture, HBO Films: New York.