Communication and Interaction 1

COMMUNICATION AND INTERACTION I EXPERIENCED AMONG

PATIENTS/CLIENTS/CARERS
Name

Course
Instructor
Institution
City and State
Date
 Communication and Interaction 2

Communication And Interaction I Experienced Among Patients/Clients/Caregivers

Case Study
I shadowed nursing for six weeks during placements within the North Leeds Acute
Hospitals Trust and observed nurse-patient/client communication processes. During my first
week, I shadowed a male nurse who worked in a general medical ward setting. His role was to
take patient observations, give out medications and feed patients when they were unable to do so
themselves. For the rest weeks of the placement, I shadowed post-operative patients on the ward
following surgery. This was a more challenging placement for me as I worked with a group of
critical care nurses who worked in the Intensive Therapy Unit that cared for patients with
respiratory, heart, and neurological problems. These are some of the critical cases that had been
referred to by their GPs and admitted so they could receive intensive treatment to rectify their
condition before returning home.
I found this placement more challenging because, at times, I felt out of my comfort zone
when the patients were agitated or angry, and the nurses were trying to get information from
them. I was aware this occurred because they were in pain or discomfort and did not know why
they were in hospital or how long they would be there. Generally, during the overall period of
my six weeks of placement, the communication models within the care industry were used to
convey messages from health care professionals to patients. This meant I could observe the
nurse's role as an intermediary who provides information and enables a patient to make decisions
about their care.
Out of my education, I found it helpful to practice communication in my clinical
placements with my colleagues; thus, I had more time to observe the situation and process
information more thoroughly. Therefore, applying communication models effectively can allow
nurses to provide restorative care to patients and themselves without feeling awkward or out of
place when speaking with patients/clients or family members during nursing assignments.
Introduction
Communication is more commonly the exchange of messages between two or more
people. Moreover, it varies from person to person and depends on the topic being discussed.
Furthermore, communication within the nursing field is a varied and dynamic process. It is
important within the nursing practice; thus, it means that information is exchanged between
health care professionals and patients to ensure effective clinical decision-making and enhance
the quality of care (McMillan & Little, 2020, 87). For that reason, I believe that communication
models within the health care profession have played a significant role in the development of
communication for nursing to help nurses diagnose patients and understand what information is
most appropriate for a particular patient. However, I considered the three most widely used
models of nursing communication are; transmission, interaction, and transaction models. These
communication models have taken different forms, but all have one common goal: to explain by
theory or by demonstrating the principles and procedures involved in effective communication
during the nursing process.
Transmission Model
The first model of communication that I was introduced to was the transmission model.
This model is also known as the 'information processing model, and it assumes that humans are
basically rational and logical thinkers. Under this perspective, as a nurse, I used more than one
channel in the communication process, such as verbal, non-verbal, and environmental channels
(Labrague et al. 2022, 269). It focuses on encoding and decoding messages using a linear pattern
 Communication and Interaction 3

and sequential activity to move information from sender to receiver (Wu, 2021, 5). Under the
transmission model, communication is arrived at by using the following channels:
Verbal channel: Through this channel, in my nursing career, I am able to communicate
messages such as information about staff and patient details or convey a warning or instruction.
For instance, I am able to explain to patients the length of time they would have to stay in the
hospital. This mode of communication is useful especially when patients are conscious and
aware of their surroundings. It is mainly useful during the clinical process where in my
profession as a nurse, I can perform tasks such as taking a patient's blood pressure or
administering medication.
Non-verbal channel: This model is commonly useful when patients are not able to
understand verbal communication well (Davies, Kevan & Ormerod, 2019, 15). This channel
involves the use of non-verbal techniques such as touch or gestures to convey messages from a
nurse to patients. For example, if I needed to get a patient’s attention as a nurse, I would lightly
touch the patient on the shoulder.
Environmental channel: In this context, I am able to use my surroundings as a channel to
give information. For instance, while giving medication, I would place a sign on a door
indicating that ‘medicine is available here.’ The transmission model emphasizes the importance
of verbal interaction because under this model; I believed that messages are transmitted through
the use of words (Kerr et al. 2022). This means that communication that occurred under the
transmission model is mostly limited to verbal interactions. However, it has come to my attention
that modern science has shown us that non-verbal communication can help guide people's
behaviors and thoughts toward their goals or interests.
Interaction Model
The next model I was exposed to is the interaction model. This communication model is
also referred to as the 'un-coded’ or ‘unstructured’ model (Kwame & Petrucka, 2021). It assumes
that humans are basically social beings who are always trying to make sense of the world by
using their senses to perceive and learn about their environment. This means that communication
that occurs under the interaction model is an exchange of messages from sender to receiver
without a defined structure. With the interaction model, I am able to put more emphasis on the
emotions and feelings expressed between people as they communicated by making meaning out
of words (Hermann, Long & Trotta, 2019, 523). In my nursing career scenario, the model also
focuses on general feelings, such as when a client felt uncomfortable when brought into contact
with care, object, or sound. Under this model, communication is provided through the following
channels:
Verbal channel: as a nurse, I prefer this channel to get involved in direct verbal
interactions with patients/clients. For instance, I could tell patients what medications they would
take or when they would be able to eat. Non-verbal channel: This channel enables me as a nurse
to make decisions and communicate my intentions in a non-verbal manner, such as by smiling,
nodding, or shaking my head. During environmental channel: I am able to use my surrounding as
a channel for communication, such as by placing a message on a sign next to the bed.
The interaction model stresses the importance of communication occurring between two
people during nursing activities for two main reasons. Firstly, I believe that communication
occurs when two people interact with each other and create meaning in events in their lives.
However, this can be risky to me as a nurse and the patient/client as they could misinterpret it as
a threat when there is no real threat, or a misunderstanding could occur if both of us did not
 Communication and Interaction 4

respect each other's communication ability. I also believe that body language plays an important
role in helping with communications between health care professionals like me and our clients.
Transaction Model
The model is also known as the ‘interactional’ or ‘structured’ model of communication
(Labrague et al. 2022, 274). This means that communication that occurs under the transaction
model involves a structured process where I can interact with patients/clients in a way that has a
beginning, middle, and end (Kerr et al., 2022). I believe that communication under the
transaction model has a structure and that nurses like myself and patients/clients are equally
involved in completing a task. For example, the action of checking blood pressure requires me as
a nurse to give orders of checking the patient’s blood pressure and then receiving an indication
from the patient as to whether he or she has or has not complied with this request (McMillan &
Little, 2020, 89). This model stresses the importance of verbal interactions because, under this
model, I believe that messages are coded and sent through words (Hermann, Long & Trotta,
2019, 525). Moreover, this means that communication that takes place under the transaction
model is mostly limited to verbal interactions. Nevertheless, I believe that modern science has
shown us that non-verbal communication can help guide people's behaviors and thoughts toward
their goals or interests.
Common Barriers to Communication
Some of the common communication barriers I have encountered are differences in
culture, language, mental distress, and disability.
Culture
I realized that the way people from different cultures interpret and use information differs
from one another. For example, if I could tell a patient to take his or her medication and the
patient replies by declining, I would then assume that the patient did not understand what I was
saying. In turn, the patient responds by suggesting he or she did understand what I was saying,
but the patient had different beliefs and opinions regarding his or her illness. However, such
scenarios commonly result in communication breakdown because I am likely to make
assumptions regarding the ways in which people would react to certain situations.
Language
Language barrier has been my biggest obstacle to effective communication between me
as a nurse and the patients (Kerr et al., 2022). When I do not speak the same language with
patients, then many theories regarding communication are not relevant. Often patients seek
advice from a friend or family member before they visit the hospital. Thus, this can affect their
views of what I as a nurse say and lead to ineffective communication. Similarly, when clients
cannot express themselves in a language unknown to me, their opinions and concerns are likely
to be delayed since it will take time to understand what they mean.
Disability
Suppose a patient has a disability that prevents him from communicating in a way that
people without a disability do, then communication will be disrupted. I believe that nurses in
general, need to understand the barriers that can prevent their patients from communicating
clearly to make accommodations for them. For example, I prefer using an interpreter in situations
where the patient cannot convey information clearly.
Mental Distress
Patients in mental distress may struggle with communication because the body language
that a person uses to express their feelings and desires may not be visible (Wu, 2021, 2). In such
cases, as a nurse, I prefer using a calm and soothing tone with my patients. However, clients who
 Communication and Interaction 5

are in distress often could not fully express what they felt (Kerr et al., 2022); thus, distressed
patients see doctors as harsh or insensitive when dealing with their situation. For example,
people in mental distress have difficulty identifying their feelings; thus, they are unable to
describe the situation clearly. Therefore, I believe that I can make efforts of communicating in a
way that does not cause undue stress to any of my patients.
Impact Of Sensory Impairments on Communication
Communication is highly valued in many societies and cultures, and I believe that nurses
are the most important ingredient for successful patient care (Kwame & Petrucka, 2021).
Communication plays an important role in the health care setting because it ensures that
professionals and patients can understand each other (McMillan & Little, 2020, 88). In fact, as a
nurse, I am expected to provide effective communication with patients. For example, I can listen
to people talk about their experiences in order to learn how to give them quality care (Hermann,
Long & Trotta, 2019, 524). People who struggle with communication may be experiencing
various sensory impairments. These impairments include blindness, deafness, and inability to
speak.
Blindness
When a person is blind, he may struggle with communicating because vision is an
essential aspect of communication (Davies, Kevan & Ormerod, 2019, 13); thus, the person lacks
the benefit of seeing the listener's facial expressions or gestures. For example, when people
communicate, they often use visual cues such as body language in order to demonstrate their
feelings and desires. Without the ability to see, this can make it very difficult for blind clients to
demonstrate the emotions that they are experiencing (Wu, 2021, 4). In fact, a blind patient will
likely rely on my and other health care professionals’ verbal communication to feel comfortable.
Therefore, in my scenario, I believe that blind patients/clients need my and other health care
professionals’ services to treat them respectfully even in their inability to observe our body
language.
Deafness
I have had challenges communicating with deaf patients. Hearing is people's most
common sense when communicating (Kerr et al., 2022). In this regard, I have seen patients who
struggle with hearing accompanied by a translator (commonly relatives or friends) who then
relay the needed information to the patient for easy understanding. The deafness issue here is
then solved since there is a temporary solution that enables the patient to understand what I will
be saying as a nurse.
Inability To Speak
Many patients are also unable to communicate verbally due to injuries or diseases
affecting their speaking ability. Some cases may also be present since birth. For example,
paralyzed patients would wish to communicate to me about their issues, but that may not be
possible since they are unable to move or express themselves accordingly. However, due to
sufficient training in my career, I am able to read their body language or facial expressions to
determine if there might be an issue or not (Hermann, Long & Trotta, 2019, 527). Then again, a
person who has difficulty in speaking would demonstrate communication through coughing,
pointing, or nodding as a way of conveying or communicating his feelings to me or other nurses.
Improving Communication Overcome
The nurse-patient relationship is highly regarded in nursing due to its focus on
establishing trust and providing information about patients' health care needs and plans. One
method of improving communication between nurses and patients/clients comprises ensuring
 Communication and Interaction 6

that each party comprehends how to communicate effectively with each other (Davies, Kevan &
Ormerod, 2019, 6). As a nurse, I believe that I should be able to focus on my interactions with
people and make a note of any discrepancies that I may experience with the patients. When
discrepancies are found, I should be in a position of trying to make connections between myself
and the patient to ensure that we continue to communicate effectively with each other (Kwame &
Petrucka, 2021). Furthermore, by ensuring that respect is adhered to between myself and the
patients/clients on health care perceptions, I can better understand the patients under my care.
I also ensure that patients/clients know what to expect from me. I normally achieve this
by using well-defined roles for nurses and patients/clients in a therapeutic setting. For example, it
is important for patients that I care for to know that I would use a standard list of questions to
assist them with their treatment. Supposing I proceed to perform tasks without asking the patient,
can indicate that I am going in contempt of my nursing role (Hermann, Long & Trotta, 2019,
526). Overall, using a standard list of questions will help me and my patients/clients be able to
communicate effectively. Additionally, as a requirement, I should also be able to communicate
effectively with nurse managers, because it is through which I can explain why certain tasks
were done, what role my managers play, and how they collaborate with them (Kerr et al., 2022).
Thus, nurse managers that I work with should understand what changes are necessary in regard
to how nurses work on a daily basis.
Working In Partnerships
As a nurse, I believe that nurses, in general, need to work in partnership with patients,
families, and other caregivers to offer an effective, safe, and dignified service for patients and
clients. Communication is a key part of communicating effectively with colleagues and patients
and how patients could communicate their views and ideas back to us. In order for me to learn
this, I had to reflect on where my communication could be improved on. This included thinking
about what information, support, or encouragement someone needed to develop a trusting
relationship. In terms of consent, I applied functional health literacy, which involves an
individual obtaining, processing, and understanding basic health information and services needed
to make appropriate health decisions in everyday life (Davies, Kevan & Ormerod, 2019, 9). I
believe that patients and clients need to feel comfortable when freely giving and receiving
information in a confidential manner. It is important, as a nurse, to offer enough information at a
time so that the patient or client gets enough time to process it but not overwhelm him. If a
patient or client raises any concerns or questions, I should be able to address those questions and
try my best to answer them thoroughly. Moreover, patients who are functionally illiterate and
unable to complete important medical forms properly, do not understand explanations of illness
and treatment, or overlooked important information about medications or dosage instructions.
During the situations of informed consent, I am able to support patients and clients in
understanding the choices that they have available to them, equip them with essential
information about those options, and encouraged them to make their own decisions. I am able to
do this effectively since I am able to understand a patient’s values, beliefs, and goals. This means
that I am supposed to have a good knowledge of the patient’s situation and also show empathy at
all times toward patients. Moreover, while considering available choices best suitable for the
patients under care, they too are allowed to be aware of these options. I present the patient with
these options for him to be able to gain information about each before arriving at an informed
decision (Labrague et al. 2022, 276). Regarding decision-making, and as required as a nurse, I
have to support patients and clients in making choices about the direction they prefer in regard to
 Communication and Interaction 7

their health. By doing this, I am able to help a patient or client understand every option available
and enhance their quality of life.
Consideration of mental capacity involved me as a nurse considering the need for
physical and emotional support for patients and clients to feel a sense of security and
competence. In addition, I am required to evaluate patients' and clients' important health
information effectively as patients and clients sometimes needed extra support, especially
regarding mental health. Therefore, communication also needs to involve assessing whether a
patient or client understands what is said by the nurse or caregiver. As a nurse, I always use clear
and pragmatic language because sometimes patients' and clients' first language might not be
English (Hermann, Long & Trotta, 2019, 529). My ability in interpersonal communications was
an important aspect during my placement. This is because good communication skills enabled
me to take care of patients and clients better as well as build relationships with them.
Adopting Change
If I had this placement situation as a caregiver again, I will ensure that I allow adequate
time when speaking with the patient or client. I will also need to consider their personal
circumstances and keep in mind that they have different needs from others. Above all, I will
make sure that the patient felt comfortable when speaking with me and supported by me since
my communication will always involve active listening and avoid causing conflict or confusion
with my team members. My communication model would include main characteristics such as;
clarification, persuasion, and support (Kerr et al. 2022). In terms of clarification, I believe that
healthcare providers like me should avoid misunderstandings by being clear about what we
mean. Therefore, my communication will involve clear and concise words that focus on the
patient’s motives and beliefs. In terms of persuasion, I believed that healthcare providers like me
should use strategies such as evidence, reasoning, and validation in order to persuade patients to
respond positively to their message (Davies, Kevan & Ormerod, 2019, 12). Therefore, I will also
use strategies of emotion or reason by using facial expressions and tone of voice in order to
engage the patient or client. The need for persuasion can be met through a means of support
which is when communication is delivered under a cooperative framework, such as when
patients are given information that they need in order to believe in what they are told.
 Communication and Interaction 8

References
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Practice: Student Speech and Language Therapists' and Practice Educators' Learning
Perspectives. International Journal of Practice-based Learning in Health and Social
Care, 7(1), pp.1-17.
Hermann, R.M., Long, E. and Trotta, R.L., 2019. Improving patients' experiences
communicating with nurses and providers in the emergency department. Journal of
emergency nursing, 45(5), pp.523-530.
Kerr, D., Martin, P., Furber, L., Winterburn, S., Milnes, S., Nielsen, A. and Strachan, P., 2022.
Communication skills training for nurses: Is it time for a standardised nursing
model? Patient Education and Counseling.
Kwame, A. and Petrucka, P.M., 2021. A literature-based study of patient-centred care and
communication in nurse-patient interactions: barriers, facilitators, and the way forward.
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Interprofessional collaboration as a mediator in the relationship between nurse work
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McMillan, M. and Little, P., 2020. Integration: Achieving Coherence between Education and
Practice in the Professions. Journal of Problem-Based Learning, 7(2), pp.86-93.
Wu, Y., 2021. Empathy in nurse-patient interaction: a conversation analysis. BMC
nursing, 20(1), pp.1-6.