Clinical Placement: My Clinical Experience

Establishing effective communication with the patient is a critical factor in promoting patient quality care. Good communication is fundamental when providing safe and effective care at the beside in order to increase the quality of patient care. One of the many communicative barriers that exists between patients and the healthcare team are language barriers. Language barriers are considered an initial problem of translation or code-switching. Individuals who speak different languages require a certain code breaker in order to facilitate effective communication (Gregg & Saha, 2007). Furthermore, language barriers may hinder the quality of patient care and interfere with optimal clinical outcomes. According to Happ et al., 2011, nurses have the unique responsibility to engage in communication with patients and have control over the timing and method of communication. Evidenced based interventions such as communication boards are needed to improve nurses’ communication skills in order to achieve effective communication.

This made me nervous as to how I was going to communicate with her. My mentor stood back in order to allow me to administer the medications and I felt unable to ask the question, “How do I communicate with this patient?”

Communication and language play a vital role in establishing good connection between patients and their respective health care providers such as nurses. Mejico (2004) concluded that, “it is in their own mother tongue that a person can truly express his innermost sentiments, ideas, perceptions, and attitudes.” Relating it to class discussions, most Filipino students find it easier to learn and understand if the teacher considers a balanced use of the English language and the native language in explaining the lecture; the same is true for a patient-and-nurse relationship. It will be

Since first year we have learned how to communicate with patients in the hospital through the proper skills that professors have taught us to use. Often, when we communicate with our patients it takes place at the bedside. Because I have been practicing communication since first year I had some idea of what it may be like when I met the family. Before my visit I wrote a number of questions that I planned to ask my family when I met them. It was challenging for me because I wasn’t sure if the questions were acceptable to ask, and I did not want to break privacy or ask inappropriate questions. During my first visit I realized that I was using nursing terminology when I was asking a question and when I was explaining an assignment.

The most effective method of communicating with patients with limited English is the use of a certified translator. When using this method, it is important to speak to the patient, not the translator. Eye contact should be utilized in the appropriate manner for the patient’s culture. The same terminology used with English-speaking patients

To communicate seems easy enough to most of us. We have been doing this from the moment we were born. We expressed ourselves with grunts, moans, crying, smiling and yelling. We started communicating even before we made words with our nonverbal forms of communication. Communication is important. It allows individuals to share information and messages in the form of ideas and feelings (Giger, 2013). It gives us direction and allows us to interact with others. Can you image getting the entertainment system in parts in the mail with no instructions as to how to put it together? It is essential that we all communicate effectivity in order to ensure the best quality of care. Language barriers threaten the patient safety and overall quality of care of these individuals. By having efficient practices in place it will lower those risks and increase quality care.

On a more localized view, such as a community hospital, standardized language plays an important role in patient perception, trust and confidence in the nursing profession. Patients have been known to become irritable and uncomfortable when nursing staff speaks in another language other than English while in their

The clinical intern met with Xavier, in the presence of the case manager, to provide him with an individual counseling session. The clinical intern initiated the individual counseling session by asking Xavier how he was doing. Xavier stated that he was doing okay. Clinical intern asked Xavier how were things going for him at the facility. Xavier stated that there are no problems. Xavier stated that he is staying out of trouble. Xavier stated that he took the “Pledge Test and moved up to “Pledge Level” this week. Xavier stated that he has the highest level on the unit. Clinical intern congratulated Xavier for his accomplishment. Clinical intern ask Xavier about the status of the GED test. Xavier stated that he was not able to take

This is the last semester of my radiologic sciences bachelor program. Throughout the many months, there have been countless situations which prompted me to form and execute decisions which have led to a patient’s well being. Although this is a subjective statement, I genuinely believe that I was able to impact many of my patients in a positive fashion. From experience it seemed that patients understood my intention and allowed themselves to trust me. The clinical experience this program has entailed is outstanding in respect to the other programs. I was given the opportunity to intern at multiple sites ranging from Santa Clarita to East LA to Santa Monica. With that being said, the demographics in these areas are so different and allowed me to adjust to various ethnic and social groups. The following examples are situations, which occurred throughout my final fall semester.

The past weeks at my clinical were memorable and exciting, I was exposed to many learning opportunities, which I took advantage of. Also, I had to provide care to more patients than required per shift and each patient had their different ways of care. From week one I was nervous, shy and had a little difficulty developing a therapeutic relationship with my client. However, by the end of week one, I had so much confidence in providing care to my patients. I was placed in the complex continuing care which involved complex skills and complex patients. My unit had two sides, one side was rehab floor and the other side was complex floor; so I had the opportunity to work in both floors. My greatest growth were mastering the skills needed in providing care to the complex patients like suctioned patients with tracheostomy, monitored patient with continuous bladder irrigation, assessed, changed and care for patient’s ostomy independently, administered feedings and medication via G-tube, packed a deep wound, developed a therapeutic relationship with my patient, been able to achieve many skills required for semester four and providing emotional support for my client. By week three, the expectations required to care for my patients were more because it was the half of the pregrad, I strived to accomplish most of the skills listed in the self-assessment skills. I had my ups and downs with my patients which would have discouraged me about my profession but it did not, rather it

As a healthcare provider working with non-English patients can sometimes be challenging. We use the tools that are provided by our work organizations to assist between language barriers. We believe that the interpreter is given an accurate interpretation of our patient’s healthcare needs. Unfortunately, this is not always the case. According to Giger, a person may be educated in the same language, but not know the true meaning of what the patient is trying to say. In many dialects there are nuances pertaining to words and phrases, that do not translate fluently (Giger, 2013). I believe a translator of the same culture will be able to not only translate the words, but in addition to identify its true

I found that on the micro/mezzo level, I have incorporated the social constructionism to help me address the particular issue that I mentioned above. From my understanding, social constructionism focuses on how people change and adapt in their social surroundings. One of the examples include language where the use of medical terms is used a lot at my placement where residents are often referred to as patients and not clients. The reason why I found this theory helpful is because it views individuals as continuously being in an ongoing process of one where one never stops recreating their identity or their environments, which is what I have interpreted. Knowing this had helped me focus on improving my skills and increasing my comfort level with

In the 22 years of working in the healthcare field, I have always felt uncomfortable with not knowing the Spanish language. Often, I feel discouraged having limited knowledge of the tongue and sense insecurity at war with my confidence level while interacting with the patient during care. There are times when I frequently ponder “does the patient along with family understand the plan of care.”

Adherence to medical appointments is important to the management of HIV disease. Missed appointments are associated with negative clinical outcomes such as inability to suppress HIV and few studies have assessed the effect of system barriers on medical appointment compliance. Alternatively, clinics providing Medicaid assistance (OR=7.30) and those clinics with more than 10% uninsured (OR=3.65) were more likely to have the majority of their patients missing scheduled appointments. Smaller clinics may offer more personalized attention leading to higher rates of appointment compliance. Availability of mental health services may also be an incentive for patients to keep their appointments. On the other hand, uninsured patients have a higher risk

After a total of three clinical days so far, I have already encountered different situations and gained a great deal of experience. However, one particular event seems to stand out and this event happened on my third clinical day. In this episode, I was trying to get the patient up from bed to get her ready for breakfast but she refused to cooperate.