Health

Assessing the communication need of mr lawrence and way communication can be improced for him by using various communication models

Introduction

Effective Communication in healthcare setting is important aspect of providing qualitative patient care as well as improving patient's service satisfaction. The communication requires being such so that the key needs and demands of patients are met and the problems encountered by them are properly resolved. In this assignment, the communication need of Mr Lawrence is identified. Moreover, the communication models are used along with proper explanation regarding the way they are to be implemented to enhance the interaction with the patient for providing him improved healthcare setting.

Patient Scenario

Mr Lawrence is seen to be suffering from altered bowel habit and has lower mobility due to osteoarthritis. Moreover, in the present situation, he is seen to have taken picolax for executing colonoscopy due to which he is feeling discomfort and showing anxious behaviour in front of the nurse in the surgical day ward. Later he was found to leave the hospital without executing colonoscopy as he was feeling ashamed and experienced non-cooperation from the nurses (moodle.nottingham.ac.uk, 2018). At the present, his key communication need is a two-way supportive and assured interaction with the nurse where he can inform about his needs and demands of assistance to resolve his problem as well as to feel clam and comfort in the situation. The needs can be effectively accomplished by using Client-Centred therapy and BOE model of communication.

Client-Centred therapy communication model

The Client-Centred therapy has three key qualities for the therapist to be maintained which are unconditional positive regard, genuineness and empathetic understanding (Eyssen et al. 2014). As mentioned by Wilkins (2015), the key goals to be accomplished by using Client-Centred therapy are personal growth and health development, increasing patient’s self-esteem, enhance the patient’s understanding of them and mitigation of distress faced by the patient. Thus, using this model can be effective to bring in positive health benefit for Mr Lawrence as it guides the nurse regarding the way they can gradually meet his communication and health needs. According to the model, the initiation of Client-Centred therapy is executed by forming a psychological contact with the client by the therapist (Whalley, 2015). This aspect is to be used by the nurse in meeting the communication need of Mr Lawrence so that he feels positive to initiate sharing his exact needs and the reason behind his discomfort to the nurse. As mentioned by Fransen et al. (2015), effective psychological relationship between the patient and the nurses helps the patient to develop trust over them as they can relate with one another. Thus, by using this aspect of the model while initiating the two-way communication need for Mr Lawrence the nurse require to develop trustful relation with him. This, in turn, is going to help the nurse in understanding the key needs of Mr Lawrence such as he is suffering osteoporosis and has taken picolax which has made him more anxious to be unable to go alone to the toilet.

The second aspect of Client-Centred therapy is that nurses need to understand the patients are emotionally upset due to their health issues and are in a state of incongruence (McCorquodale and Kinsella, 2015). Therefore, the anxious behaviour and repetitive asking for assistance to go to the toilet and when to be reviewed by the doctor by Mr Lawrence is required to be effectively attained by nurse. This is because he is doing so as a result of being emotionally upset by his diseased state and therefore needs assistance to get relived from the situation. As per Rogers (2012), in Client-Centred therapy, the counsellor requires being genuine and aware of patient’s own feelings. Therefore, this aspect of the model is to be used by the nurse in taking action to manage Mr Lawrence by making him feel okay to not control his toilet even if some points badly about him in the doctor’s chamber. This would make him feel comfortable and relaxed apart from being anxious and shameful of the act which avoids him to take help or see the doctor out of shame. The other nurse who shared incidence about bowel cancer to Mr Lawrence need to refrain doing such act because the patient is already in a state of anxiousness due to his health issue.

The other aspect of Client-Centred therapy model informs that the counsellor requires having unconditional positive regard for the client (Cameron and McColl, 2015). As mentioned by Bertilsson et al. (2016), the unconditional positive regard means whatever the patient does is to be accepted by the therapist without any constraint and be supported in any condition. As seen in the case study, the nurse was getting irritated with the repetitive behaviour of Mr Lawrence for asking where the toilet is and he could not go there alone. Thus, this aspect of the model is to be used by the nurse in managing Mr Lawrence by providing him effective support and assistance without getting irritated of his repetitive behaviour of asking for help and assistance to go to the toilet. Moreover, the nurse who made Mr Lawrence fear about facing bowel cancer should not do so and require making him feel that whatever his health situation is would be resolved to effectively support him.

The Client-centred therapy model informs that the counsellor requires acting empathically in understanding the needs of the client and requires informing this understanding to the client (Rogers, 2012). This is because it forms the basis for positive therapeutic relationship as the client feel that he is personally taken care of by the counsellor. As per Njelesani et al. (2015), positive therapeutic relationship is required to make the client feel satisfied with the healthcare services, in turn, improving their health. Thus, this aspect of the model is to be used by the nurse in managing Mr Lawrence by giving him assistance to go to the toilet as he is not able to move properly due to his diseased state of osteoporosis. The assistance would make him feel that he is empathetically understood regarding his inability to go to the toilet alone. The empathetic understanding is going to make the client recognise that the counsellor has unconditional positive regard for them, in turn, creating successful client-centred therapy (Rogers, 2012). Therefore, the assistance for Mr Lawrence is vital as per the aspect of the model because it forms the basis for him to recognise that the nurse has unconditional positive regard for him. Thus, the nurse requires personally taking effective approach is assisting Mr Lawrence to go the toilet and make him feel relaxed that he would be cared in time by the doctor.

BOE model of communication

The other communication model that could be used by the nurse in assisting Mr Lawrence is BOE communication model. As per Crawford et al. (2014), BOE communication model assists the nurse to take immediate action in providing better healthcare services to patients. The BOE model stands for brief, ordinary and effectiveness. According to Silverman et al. (2016), Brief in BOE communication model involves the time spent in communicating with the patient in understanding their needs of care and assistance. Thus, according to this aspect of the model, the nurse needs to develop effective communication as well as understand the requirements of the patients by utilising time spots such as eye contact, body posture, small talk and others. Therefore, the nurse in the given scenario requires identifying brief regarding Mr Lawrence that he is inefficient to properly move from the body language that he is using a stick to walk. Moreover, Mr Lawrence anxious asking of going to the toilet and when to be reviewed by the doctor requires the nurse to identify in brief that he is not feeling well and needs to be assisted in going to the toilet. Moreover, the nurse, who later attended Mr Lawrence, does not require sharing her mother's consequence of bowel cancer by understanding the anxious behaviour of the patient that he is already feeling vulnerable.

The brief regarding the patient’s condition is required to be identified properly so that the nurse can understand the immediate requirements of care to be given to the patient (Amutio-Kareaga et al. 2017). This, in turn, avoids issues with the patient that he is not properly taken care of by the nurse. Further, according to the model nurse during brief communication with Mr Lawrence need to maintain a positive body language so that the patient does not feel offended and refrain from sharing details of requirement of care assistance. As mentioned by Robinson et al. (2016), ordinary is the aspect of BOE model where it is referred that healthcare setting of the patient is required to be made homely. Thus, the nurse communicating with Mr Lawrence requires making him feel homely by using generic and pragmatic communication. Therefore, the nurse who informed about her mother with similar symptoms like Mr Lawrence of having bowel cancer to the patient should not do so because it would make him feel anxious. The nurse require to act pragmatically by provide assistance to Mr Lawrence that he would be healthy in no time and the colonoscopy is not going to hurt him anyway. This is because it would make Mr Lawrence feel relaxed and homely due to mental support from the nurse.

The Effectiveness in BOE model refers the importance of interaction on clinical outcomes and informs that the model is driven by promotion of patient satisfaction, evidence-based practise and effective steps taken by the practitioners and organisations (Crawford et al. 2014). Therefore, based on this aspect to accomplish the effectiveness part of the model the core skills to be performed by the nurse according to BOE model are suggested. According to the initial core skill, the nurses require making them available for care and assistance to the patients in all condition (Biglino et al. 2017). Therefore, the nurse communicated by Mr Lawrence need to show a personal urge to make him feel that the nurse is available for asking any form of assistance by him. As mentioned by Crawford et al. (2014), one of core skill according to BOE model is that the nurses require being friendly in nature and empower patients by encouraging their self-determination. In the given case scenario, the nurse is seen to communicate with Mr Lawrence in a professional manner. Moreover, the other nurse was seen to share unfamiliar incidences of bowel cancer to Mr Lawrence. Thus, both the nurses require keeping informed about this skill and developing friendly and empowering conversation with Mr Lawrence to make him feel relaxed and ask for assistance without hesitation.

The communication ended by the nurse with Mr Lawrence was seen to mutually unsatisfying as the patient was seen to go home without executing colonoscopy due to shame and anxiousness. This is because the first nurse showed irritating and frustrating behaviour at the end of the conversation which is disrespectful for the patient while other made him fear of bowel cancer. As per Expósito et al. (2018), core skill mentioned in BOE model is that nurses require executing and ending conversation with the patients in a mutually respectful and satisfying manner. Thus, the nurse while executing and ending communicating with Mr Lawrence require sharing positive information and develop respectful manner of talking. As asserted by Barker and Williams (2018), the BOE model refers that nurses require being able to build sustaining rapport with the patients by using warmth, genuineness and positive body language as core skills. This is required to be abided by the nurse while communicating with Mr Lawrence so that he can be made to feel familiar in the surrounding. Moreover, it is required to avoid him to think that he is vulnerable to experience a grave disease and would not be helped or relived from the disease thus assuring him protection and satisfactory healthcare services.

Conclusion

The above discussion shows that the initial need of Mr Lawrence was to successfully establish two-way communication so that he can communicate his needs and demands of service to the nurse. The Client-Centred Therapy model is seen to inform that the nurse communicating with Mr Lawrence need to be empathetic, genuine and have unconditional positive regard for providing effective healthcare services to him. According to the BOE communication model, the nurse requires developing a brief regarding Mr Lawrence through effective communication. Later, the nurse needs to form familiar and ordinariness to provide services to Mr Lawrence for effectively assisting him in resolving his service demands of assistance for going to the toilet.

References

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