family communciation

Follow attached document rubric and instructions to write a discussion post and also reply to two discussion reply posts per the rubric. i WORK in ICU.so when you use senarios please see if you can use something pretaining ICU.

DISCUSSION POST 1-ASHELY Module 2: Discussion 2 (Communication is Key

Functional communication is vital in a healthcare setting to ensure safety and satisfaction for both patient and healthcare provider alike. One example of both a functional sender and a functional receiver I have witnessed happened just yesterday while at work. A mother, Jane, was hospitalized for severe pre eclampsia at 27 weeks 3 days gestation. Her labs were getting progressively worse and the decision had been made to proceed to delivery via primary cesarean section. Dr. Taua, a neonatology fellow came to Jane’s bedside to discuss her baby’s prognosis and begin to develop a plan of care. Dr Taua sat in a chair right next to Jane’s bed. He began by clarifying exactly who he was, and proceeded to explain in detail what he would expect from a fetus of that gestation. He expressed, as Friedman, Bowden, & Jones (2003), term it, “Intensity and Explicitness” (Friedman, Bowden, & Jones, 2003, p 272), by being open with the fact that he needed the parents to consent to certain procedures should they want Dr. Taua to do everything in his power to save the life of their child. He used specific statistics, expressed his prior experiences, asked Jane and her husband for their questions and clarified his responses appropriately, done all according to Friedman’s “Clarifying and Qualifying Messages”, “Invites Feedback”, and “Receptive to Feedback” (Friedman, et al., 2003, p 272). Jane and her husband were very functional receivers of all the information. They were intently listening to Dr. Taua’s words, maintaining eye contact, nodding or responding as appropriate. They shared their own thoughts and desires and asked for clarification as necessary. Finally, they were able to repeat back the plan of care they developed with Dr. Taua for their child. All of their actions were excellent examples of Friedmans, “Listening”, “Giving Feedback”, and “Providing Validation” (Friedman, et al., 2003, p 273) qualities.

Unlike the impressive communication of Dr. Taua, there are some physicians do not always communicate functionally. For instance, we have a young Jehovah’s witness patient currently residing on our unit. She has multiple complications resulting from her pregnancy, one of which is her being at a significantly high risk of hemorrhage. Being a Jehovah’s Witness, she is adamant that she is to receive no blood products, aside from a few specific ones. Dr M is a staunch Catholic who has, on multiple occasions, expressed his negative opinions regarding her particular faith. I was able to witness such an exchange just recently. Dr. M was trying to persuade this patient into receiving blood despite her strong convictions. He seemed to make very strong statements to her which in turn sounded like he was berating her religion because of the rules she follows. He was certainly casting judgment upon her. According to Friedman, judging others upon what Dr. M thinks is right is a form of dysfunctional communication (Friedman, et al., 2003, p 274). The patient, feeling offended and like she had to now be on defense stopped listening to Dr. M. She understood what he was telling her regarding her healthcare, but she had already made up her mind. Furthermore, she refused to even acknowledge what he was saying. Both “Failing to Listen” and “Failing to Validate Messages” (Friedman, et al., 2003, p 275), are what Friedman would qualify as qualities of a dysfunctional receiver.

References

Friedman, M. M., Bowden, V. R., & Jones, E. G. (2003). Family nursing: Research, theory, and practice (5th ed.). Upper Saddle River, New Jersey: Pearson Education, Inc.

DISCUSSION POST 2-NEED REPLY

Roberto Ruiz Jr

Communication is Key

03/07/2018

Communication is essential in all parts of life. Relaying the intended message to the opposite party is not always as easy as it sounds. It is also very circumstantial. If a person is in a situation where they must act quickly, the intended message may not always come across clearly, and there can be some miscommunication. Sometimes, we as healthcare workers allow our emotions to dictate how we respond to others in certain situations. By studying and understanding the basic concepts of communication such as described in pages 271 through 276 of Family Nursing Research, Theory, practice, one can develop better communication skills, and avoid the problems that come with miscommunication.

I recently had a patient who was in end stage liver failure. He was going to get on a transplant list but was unable to stop drinking. He and his family were very close and were devastated to hear that he was unable to stop drinking when he had the chance. Our ICU physician, Dr. Hilburn, spoke with the patient regarding the state of his liver disease, and how at this point he was not able to be put on a transplant list, nor would he have the time to be put on one. His prognosis was bleak. Dr. Hilburn communicated to the patient effectively by clearly stating his words, inviting feedback from the patient, and clarifying and qualifying his responses. He recommended to the patient that he go home on hospice care. The patient was a functional receiver of the message and gave feedback regarding what he was hearing and validated the worth of the message he was receiving. The conversation, though unfortunate and sad, was well communicated between the functional sender and functional receiver.

A few days ago, I helped another nurse care for a patient who had terrible sepsis and was in multiple organ failure. She was placed on a ventilator and her liver had gone into massive shock and shutdown as well. This was all very unexpected, and the family of the patient was not ready to accept her death. Our physician that day was frustrated with the family as they did not want to place the patient in a do not resuscitate status after we had coded her multiple times throughout the day. The physician spoke with the family in aggression, making assumptions and judgmental responses. He did not express his feelings effectively due to his high state of emotions in the situation. Due to this aggression and frustration from the physician, the family failed to listen to what he had to say and failed to explore the messages the physician was trying to communicate to them. The kept the patient in a full resuscitation status until another physician came and spoke with the family regarding the prognosis of the patient. This conversation between the family and physician was dysfunctional from both the sender and receiver’s standpoint.

References

Friedman, M. M., Jones, E. G., & Bowden, V. R. (2003). Family nursing: research, theory, & practice (5th ed.). Upper Saddle River (N.J.), NJ: Prentice Hall.