Challenges in Communication: Barriers to Patient Care

Challenges in Communication: Barriers to Patient Care Hina Mirza Communication has always been a fundamental need of human beings. Communication can be defined as an act of transmitting or imparting, which includes not only verbal messages, but all human behaviors (Sundeen et al., 1994). It is a vital part in mental health nursing or psychological care, because its a key to its achievement. It empowers health care provider to help clients in their anguish, to explore more essential data which can help to give better care to the patient. As literature states, interaction and care that is patient focused results in positive patient outcomes and increase chances of diagnostic accuracy (Rouf et al., 2009). There are several barriers to communication, could be from patient side or from the health care provider. On the other hand, managing patients with distinctive mental wellbeing issues is challenging, particularly when the patient is discouraged, detached or unmotivated (Sheldon, 2009). In addition to it, different clients have distinctive needs, as a health care proficient one ought to be equipped enough to evaluate those needs through different abilities, and make client competent enough to assess oneself. This paper will highlight some of the patient’s internal barriers to communicate, such as patient’s unmotivated behavior, and health care provider beliefs such as stigmatization about mentally ill patients which ultimately affect patient care and strategies to limit those barriers simultaneously. The case below is of a patient who was diagnosed with schizophrenia. It will highlight the barriers that can affect good communication: A 23 year old patient came with complain of social isolation. Further history revealed substance abuse since 4 years. While taking interview of the patient, he was drowsy and seems to be not interested in talking. During the interview, late verbal response was observed; he was not maintaining eye contact, answered 4 to 5 questions after emphasizing and consuming lots of time for replying. Moreover, the patient sometimes repeats the same sentence of the interviewer. Due to consumption of plenty of time by the patient, I was not able to take a proper history from the patient, and lots of information remained incomplete. When I reflect back to the patient’s statements and body language, I realized he was unmotivated and discourage due to his substance abuse behavior. Next day, again same behavior was observed. After asking question related to change in behavior, patient reassures that he is at guilt and stated that his family will not accept him again due to his addicted behavior. The above situation highlights many issues, one of them is, substance abuse that itself a source behind criticism for the patient and upon all that patients unmotivated or debilitate conduct. Also, the patient was not maintaing eye contact that resembles his social convictions, as numerous social beliefs may impact the correspondence styles and may affect on mental wellbeing like their way of expression, their family support and their coping mechanism. Some characteristics such as socioeconomic status, occupation, education, gender have more powerful effects on an individual which can alter the person’s behavior their way of communication (Fortinash et al., 2012). A part of the patients own cultural beliefs, the health care providers own values about the patient’s addicted behavior may hinder in patient care. As evidenced by literature that the mental health nurses values and skills shape their practice and care giving behavior (Morrissey et al., 2011). Analyzing the issue from different perspectives of patient and health care provider which leads to ineffective communication. Firstly, the patient was given late verbal responses, as well as communicating in low voice volume, as the patient was diagnosed with schizophrenia, it could be one of the reasons that altered speech and it may be due to the disease process. â€Å"Abnormalities in language are central to psychosis, particularly the schizophrenic syndrome† (Kuperberg et al., 2003). Another related symptom was echolalia which was one of the reasons of consuming more time for replying. A psychotic condition, i.e.; patients with schizophrenia, Echolalia (repeating what someone else just said) may be observed (Kuperberg et al., 2003). Taking in concern this issue, as a health care provider one needs to be competent enough for dealing these kind of patients and certain strategies should be used such as giving more time to the patient to express his feelings, using frequent pa uses, listen to the patient very carefully to make him feel about worth of explaining himself, paraphrase and summarize for the patient to reassure what patient meant to say, provide space without or with minimal distraction, use non verbal communication as interviewer expressions and body language is more communicative such as maintain eye contact other than staring. Moreover,the impact of difficulty in speech may have poor conversational skills, poor social perception and all this may hinder in socialization which could be a cause of isolation (Nacro, 2011) which was stated by the patient in the above scenario. Secondly, patient was apathetic or unmotivated due to his addicted behavior and dealing with such patient could be a challenge for nurses for motivating the client. For such patients, counseling style such as motivational interviewing (MI) was developed by Miller and Rollnick (2002). This is widely used approach for the patients with substance abuse which emphasize on explo ring and reinforcing the intrinsic behavior of the client that leads to motivation of healthy behavior (Barnett et al., 2012). If through this approach client’s motivational level increase so his communication pattern will also improve. Looking forward to the staff internal and external barriers to the communication one of the highlighting issue in this scenario was patient drug addiction which could be a foundation of stigmatization and may limit health care provide to provide efficient care. Here, theoretical framework of VCAT can be applied that choosing, prizing and acting accordingly with the prioritize responsibility of a nurse. Moreover, to gain knowledge about the specific behavior of the patient related to substance abuse and deepen the understanding could be one of the source to give empathy to the patient and change the behavior of oneself and others in society to help patients to recover instead of marginalizing the one in need. If a health care provider his/herself is affirmed in their value the better care will be provided as a result. On institutional level staff training should be provided for therapeutic communication to give quality care. The care of the nurse should be in light of Care Framework to provide holistic care to the patient. According to the scenario, making patient realize the process of self harm by using drugs, using hidden self strength to cope up with such behavior and that realization could be achieved through therapeutic communication. It will enable the patient to engage effectively in health care (Shepperd et al., 2003). To conclude, communication is the basic tool to approach effective care of the patient. Several barriers that can hinder the communication could be from the patient side that results from the disease process or patients own perception or could be a lacking of healthcare provider. Overall, a nurse should be competent enough to evaluate patients need through effective communication process limiting all barriers by using different strategy to indulge patient in his/her own care. References Barnett,E., Sussman,S., Smith,C., Rohrbach,L.A., Spruijt-Metz,D. (212). Motivational Interviewing for adolescent substance use: A review of the literature.Addictive Behaviors,37, 1325–1334. Fortinash,K.M., Holoday-Worret,P.A. (2004).Psychiatric mental health nursing. St. Louis, MO: Mosby. KUPERBERG,G.R., CAPLAN,D. (2003). LANGUAGE DYSFUNCTION IN SCHIZOPHRENIA. Morrissey,J., Callaghan,P. (2011). Communication Skills for Mental Health Nurses: An Introduction.McGraw-Hill International. Nacro. (2011).Speech, language and communication difficulties Young people in trouble with the law. Wales. Rouf,E., Chumley,H., Chumley,A. (2009). Patient-centered interviewing and student performance in a comprehensive clinical skills examination: Is there an association?Patient Education and Counseling,75, 11-15. Retrieved from www.elsevier.com/locate/pateducou Sheldon,L.K. (2009).Communication for nurses: Talking with patients. Sudbury, MA: Jones and Bartlett Publishers. SHEPPERD,C., MCALLISTER,M. (2003). CARE: A framework for responding therapeutically to the client who self-harms.Journal of Psychiatric and Mental Health Nursing,10, 442–447. Sundeen,S.J. (1998).Nurse-client interaction: Implementing the nursing process. St. Louis: Mosby. Social Networking: Current Trends And Its Future Social Networking: Current Trends And Its Future Its not a rare thing to people around the world nowadays, the social network. Social network becomes trends not only in certain country but worldwide. People in this era make the social network something that you must participate nowadays. Also, its an odd matter if you dont participating in any social network. Not only that, participating in social network are important as people can know you better and also important for communicating and keep in touch with friends and family. Many different definitions are made for social networks. According to dictionary social network is an online community of people with a common interest who use a website or other technologies to communicate with each other and share information, resources, etc. There are some that define social network as a group of individual who share a commonality. In business perspective, social network is the practice of expending the number of ones business and social contacts by making connections through individuals. As for me, social network is a centre to communicate with someone especially friends and family and know their latest activity. Therefore, there are many more definitions that people make from their different perspective. Do you know that social network start from 1997 with the first social site, SixDegrees.com? It operates from 1997 and stop operated in 2001 but has been restarted to the previous members only. In 2002, Friendster is created and a year later followed by Myspace. After that, in 2004 Facebook make it appearance and targeting college students. Then, 2 years later new social network is launched with different approach, Twitter. New social network keep coming until this days. The 21st century has made the social network more interesting and evolves. There are many social networks nowadays. There are many currents trends of social networking. Everyone knows that the Mark Luckerbergs website is the most popular social network, which is Facebook. Facebooks users are more than 900 million users. While, Twitter is one of popular social network but different than Facebook. Its allow users to create messages and post it known as Tweets. Another popular social network is Youtube. Although, its not considered as a social network but it has some social network features. Its a place that allowed you to upload your video to share with others. There also a business social network that is LinkedIn. LinkedIn allowing you to publish your CV, post your business references and search for any business contact. This social network helps many human resources in some companies to search for employees. But, it has limited function and theres a monthly user fee if you want more option. One of the social network that allowed you to take photos and shared them in Instagram. You also can apply various digital filters to a photo before post it. This application usually used by people that have smartphones. These are few examples of social network. There are many more social networks such as LinkedIn, Google+, Instagram, Pinterest, Flicker, Myspace, Foursquare and etc. Around the world, people that spent time online are increasing with the evolution of smart phones. According to Strategy Analytics, the numbers of people using handphones to online have increase four times in the last four years. Also, most time that they spend online is for social networking. Universal Mccann International Social Media Research indicates that much latest news available in internet is from Asia region and the largest community bloggers are located in China and Japan. Not only that, much new information and news can be obtained in the network. Nowadays, social network has become one of the main materials to obtain latest news and information that occur in the country or around the world. Next, social network in employees prospective has become important. They can search information about any company for search job. Also, they can learn about the company for interview or to know what the companies do. Not only that, the human resource department in some companies can obtain information about someone before they employed through social network. This will allow them to know if the person qualified to join the company. Its easy to know about someone nowadays as there are many social networks that can allowed you to know more about them. After social networking are created with different features such as Facebook, Twitter and Instagram. With this new function are created that most people like to use this days. The function is that it can be simultaneously posting across different social networking. For example, if you want to post a picture in Instagram you can also post it on Facebook or Twitter or both. This will make ones life easy that you dont have to repost it many times. As we know, social network is free and everyone allowed using it but there must be something that must be control. This is for ones safety to use the social networks. For individual, internet privacy is a must. Also, if you want to share something it is up to you but dont share something that is too private. This will be dangerous and there will be negative impact. For example, dont share your personal information such as your identity card, your credit card and etc. Also, in 2012 the European Parliament has proposed about the right to be forgotten. This was a request to removed personal data from internet and from company data base. This action is a precaution to all employers and users. In social network, we cant control what people want to comment or post. But, ones must remember that there is also some etiquette. For example, dont use poor grammar or spelling as it will lead to disastrous consequences. Using harsh words also will make you look bad and people will take action to remove you as their friends. One more thing is that dont constantly asking for followers or friends. This will make people become annoyed. Not only that, filter the content that you want to post and dont post sensitive issues. As mentioned earlier we cant control what people want to post but you must be alert not to post something that are sensitive such as religion issues. For example, there are ones someone posted about religion. She said that some religion is bad and she hates the religion that she mentioned. This kind of things shouldnt happen as we are now in 21st century. In my opinion, she only does it for fun but in reality it hurts many people and it has become big issues. Video call also one of the famous social networking such as Skype. Skype is very useful for many people. It is used to call family and friends and also can see them through video call. Not only that, there are also business people or employees that using Skype for meeting. Its easy as they can have meeting at home or where ever place that they preferred. Nowadays, there are social networkings that are increasing its popularity. WhatsApp is the application used by many smarts phones user, it can send message but through the internet. With this, many people preferred to use internet rather than phones lines. But, there are also applications that are new and its popularity keep increasing that is WeChat. WeChat allowed you to send text message as well as voice message. Although WhatsApp also has the function of sending voice message but WeChat become more popular as you dont have to type out the message. According to a survey, the time that many people spend on Facebook has decreasing compare to several years back. But, this doesnt means that time that people spend in social networking is also decreasing. Nielson Media stated that the time spent in social networking is rising over the previous years. Many will think are people abandoning social network in future? With this the best answer obtained comes from Social Media Analyst and Entrepreneur Bob Zukis. They said that peoples expectations are changing. The social network must have some purpose. At first it is fun to play around with social network without any purpose but at some point it becomes board. Also, do we really want to know what everyone is doing everyday and every time? So, it has to have some obvious purpose. This is because of the absent of this purpose the behavior will cease. At first, the social network has good purpose that is to share with friends and also to keep in touch with friends that are not meet in long time. But, in reality how many people we can keep in touch with? Therefore, we need an application that can directly recruits and times to connect with others will make it more effective. So, what should we do? That is somewhat random approach we take today. This is the idea of future social network. Also, social network will continue to be used but using which social network is not the question but what we want to accomplish is the main point.