Reflective Report On communication between nurses and

mothers at postnatal unit

While I was at the hospital especially in the maternity unit (post-partum) to
complete requirements of my study as a post-graduate student, I met many women at their
post-partum stage; some of them were immediately post-partum. In this assignment, I
have reflected on a situation that take place during my clinical work experience. This
situation helped to develop and utilize my interpersonal skills, helping to maintain
therapeutic relationships with patients. This will be done through a clear description of
the situation, analysis of feelings, evaluation of the experience, and an action plan to
examine what to be done if the situation arose again.

I was on an evening shift at 6.00 pm. My reflection is about a particular patient, , I

will refer to as Mrs. R. It concerns an event which took place when I was working on a
maternity unit. Whilst there were women at the post-partum stage and others in different
stages of labor. On this particular day, I noticed that a Philippino nurse received one of the
mothers who transferred to the maternity unit immediately after recovery from C/S. She
was Mrs. R., a 34 year old who had been undergo elective C/S for the first time to deliver
her first baby. She was unable to move or eat. the nurse speak to her to give some
instructions to the woman including not to eat or drink before passing gases. because Mrs.
R. did not understand English, she looked more worried and was looking at any other one
to explain it to her. The other woman in the room also didn't understand English. Mrs. R
was unemployed. This was her first C/S, because she was unable to give birth naturally
due to breach presentation of the fetus.

The phillipino nurse gave the instructions to the mother and try to explain in
simple manner, but Mrs. R., looked worried. I suggest that she did not understand
anything but did not ask any questions, she looked there and there looking for anyone to
translate to her. I stepped in because I said to Mrs. R., ‘no food, no drink, and I
demonstrated with my hands and face that they are prevented until passing gases. She
understood and said ‘ok’ but I could still see that she was not comfortable. The nurse
came again, and tried to massage Mrs. R., abdomen and pelvic area but could not do it
due to her inability to communicate effectively with the mother. After a long discussion
and explanations, Mrs. R., let the nurse to massage her.

In this paragraph, I will discuss my feelings and thinking regarding the situation. I
empathized with Mrs. R. because she don't not speak English. Because of Mrs. R., limited
English language, caring for her was more difficult and the nurse was very irritated with
her. I knew I could help both the nurse and Mrs. R.. I tried to build up a good relationship
with them by doing a proper introduction of myself, who I am and to try to put them at
ease. My first attempt was to explain what the nurse try to say in a way Mrs. R., could
understand, I was acting as an intermediary between Mrs. R., and the nurse. I was
explaining as simply as possible, so they became very comfortable with me and trusted
me. I really felt useful and helpful as they responded to me as I put myself in their
situation.

Effective communication with patients and health care workers is a key process in
safe and quality health care. Patient and clinician relationships rely on good
communication, resulting in improved patient satisfaction, adherence to medical
recommendations, and better healthcare outcomes (Wynia & Osborn, 2010). The
empathetic listening is in relation to the willingness to know the other individual not just
judging the person’s statement. I used some facial expressions and hand gestures which
could be understood by the mother and the nurse. I was also using simple words. I was
unsure whether to continue or not because I felt the nursing staff might think I was not
being professional, but according to Almutairi & McCarthy, (2012) body gestures and
facial expressions are referred as a non-verbal communicating. So I continued because I
knew that would help Mrs R. The language and cultural barrier affected the care Mrs R.
was receiving because the staff was not communicating with her and did not appreciate
that good explanation were essential for this mother with her particular circumstances of
limited English and understanding. I stayed Mrs. R and kept eye contact with her because
direct eye contact could express a sense of interest in the other person.

I feel I made the right decision to accompany Mrs,R. Furthermore, I could develop
my caring role for patients by understanding that they all will have different needs and
will require different care. I think my approach with Mrs,R. was a good approach. The
nurse and Mrs,R. did benefit from my effort. It was also my responsibility to care for her
so that she was getting the best care and understood all instructions and what was done to
her. I was able to improve my verbal and non-verbal communication skills in my
conversation with Mrs,R. during my time with her, and I know she was now getting the
necessary information that she needed at this time.

I demonstrated emphatic listening. Then I touched Mrs R. shoulders, kept talking

and raised my tone a little because I was unsure of her reaction. At the same time, I used
body language to communicate the action of eating and drinking. I paused and repeated
my actions, but this time I used some simple words which I though Mrs R. would
understand. Mrs R. looked at me and nodded her head. As I was giving her the
instruction, I maintained eye contact as I didn’t want her to feel embarrassed. If
communication is a problem for one or both parties in an exchange, they will have an
interest in improving it In Mrs R. case, the lack of time, did not permitted this.
Discrimination is usually due to miscommunication however this should be lower in
hospitals especially when the relationship between the nursing staff and patients has been
sustained for a longer period.

In evaluating my actions, I feel that I behaved correctly since my actions gave Mrs
R. both the assistance she needed and provided her with some company. I was able to
successfully develop the nurse-patient relationship. I feel that the situation involved both
good patient and task centered communication. I feel that I treated Mrs R. with empathy
because she was unable to perform certain tasks herself due to her inability to move as a
result of C/S. It was my duty to make sure that she was comfortable and felt supported
and reassured. My involvement in the nurse-patient relationship was not restricted to task
centered communication but included a patient centered approach using basic techniques
to provide warmth and empathy toward the patient.

There are a number of effective ways to maximize communication with people, for
example, by trying to gain the person’s attention before speaking – this makes one more
visible and helps to prevent the person from feel being under pressure; the use of sensitive
touch can also make them feel more comfortable. I feel that the interaction with Mrs R.
had been beneficial to me in that it helped me to learn how to adapt my communication
skills both verbally and non-verbally. I used body language to its full effect since the
language barrier made verbal communication with Mrs.R. difficult. I used simple
sentences that Mrs R. could easily understand in order to encourage her participation.
 Reflecting on this event allowed me to explore how communication skills play a
key role in the nurse and patient relationship in the delivery of patient-focused care.
Whilst I was trying to assist Mrs R. when she was attempting to walk, I realized that she
needed time to adapt to the changes in her activities of daily living. I was also considering
ways of successful and effective communication to ensure a good nursing outcome. I
concluded that it was vital to establish a rapport with Mrs R. to encourage her to
participate in the exchange both verbally and non-verbally. This might then give her the
confidence to communicate effectively with the other staff nurses; this might later prevent
her from being neglected due to her inability to understand the information given to her
about her management and the benefits of it.

I have set out an action plan of clinical practice for future reference. If there were
patients who needed help with feeding, drinking or with other procedures, I would ensure
that I was well prepared to deal with patients who were not able to communicate properly.
This is because, as a nurse, it is my role to ensure that patients are provided with the best
possible effective care. To achieve this, I need to be able to communicate effectively with
patients in different situations and with patients who have differing needs. I need to
communicate effectively as it is important to know what patients need during their stay at
the hospital. Whilst I have a lot of experience in this field of practice, communication
remains a fundamental part of the nursing process which needs to be developed in nurse-
patient relationships. Active learning can also help to identify the existence of barriers to
communication when interacting with patients. Active learning means listening without
making judgments. I always try to listen to patients’ complaints since this gives me the
opportunity to see the patients’ perspective. On the other hand, it is basic to avoid the
barriers of communication with the patients and be able to detect language barriers. This
can be done by questioning patients about their health and by asking them if they need
help in their daily activities. I set about overcoming such barriers by asking open-ended
questions and interrupting when necessary to seek additional facts.

Almutairi, (2015) reported that there is a communication barrier between patients

and health care workers such as healthcare workers demonstrate low cultural competency.
Despite the fact that the government provides programs for expatriate healthcare workers,
there is a need to further improve educational and orientation programs regarding the
culture and language in Saudi Arabia

References

Almutairi AF, McCarthy A. (2012). A multicultural nursing workforce and cultural

perspectives in Saudi Arabia: An overview. The Health; 3: 71-74.
Almutairi, K.M. (2015). Culture and language differences as a barrier to provision of
quality care by the health workforce in Saudi Arabia. Saudi Med J 2015; Vol.
36 (4): 425-431
Wynia MK, Osborn CY. (2010). Health literacy and communication quality in health
care organizations. J Health Commun; 15 Suppl 2: 102-115.