Poor Nurse Patient Communication In Mental Health Setting Nursing Essay

Poor Nurse Patient Communication In Mental Health Setting Nursing Essay Communication is defined asthe imparting or interchange of thoughts, opinions or information by speech, writing or signs. It is the tool which strengthens healthcare provider-patient relationship through which therapeutic goals are achieved (Park et al, 2006). Effective communication occurs when a desired effect is the result of information sharing, while poor communication leads to uncertainty and frustration. There are many situations where poor communication can lead to confusion. It includes not only building rapport but also leading to patients queries unanswered, discussing medical issues at patients bedside while ignoring them, talking harshly to patients etc. This can result in lack of support, disrespect and especially, harm to the patients. During my Mental Health Clinical at a private Hospital, I encountered a patient with diagnosis of Schizophrenia, and his Mental Status Examination (MSE) revealed that he had circumstantial ideas. I asked him a question and he talked irrelevantly about it. The nurse, who was listening to our conversation, scolded the patient saying why was he not answering relevantly. The nurses way of talking was very rebuking and lacked empathy. Upon getting scolded, the patient got aggressive and embarrassed, yet left silently. I visited the patient later, continued the MSE politely, and he answered me well. In my patients scenario, the nurse emotionally abused and demoted my patient rather than encouraging him. I believe this lowered my patients self-esteem and shattered him psychologically as evident by his gesture of leaving the room in silence due to aggression. Gadit (2011) states that verbal abuse can cause significant psychological problems in later years and brain damage. This means that skilled communication of a nurse helps a patient reduce his worries, making him comfortable. Moreover, patients verbalization of feelings and thoughts aids a nurse in correctly identifying his problems and performing interventions. Therapeutic communication holds importance as it contributes to a patients emotional growth or reinforce his or her illness. (Masilani, 2010, p.02). Thus, poor communication shatters the nurse-patients therapeutic relationship and acts as a barrier in expression of patients feelings which may lead to flawed nursing care. Nurses poor communication leaves a negative imag e in a patients mind regarding nurse and the institution, impacting greatly on his treatment. Patient would not express but build on feelings deep inside, which can lead to depression. My patient was not able to answer promptly due to his disease process. Through positive regard, assurance and encouragement, the nurse could have helped the patient. Instead the nurse demoted him and lowered his self-esteem. A model by Shanon and Weaver (1949) explains where the gap was formed. This model has 8 elements: source is an individual or a group that wants a message to be delivered ; encoder is the specified format for later interpretation; message is the idea that is being communicated; channel is the route that the message travels on; noise is any interference in the communication; decoder is the interpretation of the message from its original form into the one that the receiver understands; receiver is the intended recipient who takes in the message that the source has sent and feedback relates to the source whether their message has been received, interpreted correctly or lost in the noise. In the above scenario, I was the source who put the model into action. Encoding was my speech and expressions. I was doing the Mental Status Examination and it was my message. Noise was the nurse who interrupted and distorted my message. When the noise over rode the source, problem in the decoding occurr ed, leading the receiver to get aggressive and embarrassed. This gave the feedback that the message that was sent has got an error and needs to be revised. Building on the feedback, I gave patient sometime, and interacted with him later to continue his examination for his benefit Barriers to effective communication can impede or deform the message. There may be physical barriers that often occur due to the environment. Example of this is the shortage of staff, lack of time, increased workload, improper building etc. In the above scenario, the unit allotted for psychiatry was undersized and less spacious. Nurses and the patients were locked in the small unit, where they could easily listen to each others conversations. Second barrier can be the system fault. It refers to problems with the system in an organization. Examples include a lack of clarity in responsibilities, supervision and training. Keeping the scenario in mind, a nurse has the basic responsibility to practice empathy, as studies link empathy with therapeutic relationship (Reynolds Stewart, 2002; Neumann et al, 2012). Attitudinal barriers occur as a result of problems with staff. Examples include poor management, communication errors, personal attitudes of individual staff due to lack of motivati on and insufficient training etc. The above Private Hospital setup reflected that there was no supervision and the staff did not seem much competent. When looking into the socio cultural context, a news report reveals that mental health is the most neglected field in Pakistan (Qasim, 2012). In such conditions, if the communication flaws persist, a patients mental health is likely to be devastated. Another survey in Pakistan shows that patients satisfaction depends on a healthcare providers communication and behavior with them during their length of hospital stay (Danish, Khan, Chaudhry, Naseer, 2008). As psychiatric patients usually have repeated admissions and prolonged hospitalizations, therefore therapeutic communication can allow a nurse to deliver quality care to the patients, thus satisfying their needs. Moreover, departments of psychiatry in Pakistan are not well equipped specially in terms of psychiatric manpower (Gandit 2006). Literature emphasizes that swift pace and content is required in the field of research. Poor communication can be attributed to a number of factors. Lack of understanding, which includes value to proper communication and empathy in therapeutic relation, is one of the causes . Sometimes patient factors do not allow healthcare practitioner to communicate properly as it has been observed that harming behavior, emotional blocks and other psychotic symptoms do not allow nurses to continue therapeutic communication (Pfeiffer, 1998). It was also evident in my patients case that nurses communication can lower self-esteem and promote distress. Excessive poor communication of the nurses can lead to constant aggression and anxiety of communication, ultimately worsening patients mental health. To sustain a therapeutic nurse-patient relationship I would recommend that institutional management should arrange communication skill workshops for staff, as researches show that workshops help in improving nurses communication skills and their sense of preparedness (Lamiani Furey, 2009). The nursing supervisors should also identify the causes which hinder in communication. Moreover, nurses could reflect daily upon their communication skills, analyze the mistakes and try to work on it, as reflection is a powerful educational tool in nursing that can enhance clinical experience (Bradbury-Jones et al, 2009). They can also take ongoing feedbacks from colleagues and try to improve on their weak points. Since psychiatric patients have problems in communicating and forming relationships (Hem Heggen, 2003, p.102), therefore I would suggest that psychiatric nurses should have profound awareness of when to show empathy during communication. In my opinion medical and nursing students should focus on efficient communication while studying psychiatric course, so they can continue to practice it precisely. Furthermore, as discussed above, a barrier to effective communication is the lack of supervision. For that, ongoing rounds and evaluations should be done by the higher authorities to witness the exact situation and happenings, since it is noticed that in the supervision of the higher authorities, communication is more therapeutic. Thus, I recommend institutions to keep an eye on their staffs communication techniques in order to minimize negligence. In conclusion, nurses may commit errors but practice can make them perfect especially in a skill like communication. Thus, nurses must practice as much as possible and try reducing communication errors. As discussed, there are several causes and effects of poor communication especially in psychiatric nursing. But nurses should use themselves as a therapeutic instrument (Hem Heggen, 2003), so that they can help the psychiatric patients for their early recovery. Word Count: 1,342 Words

Educating Rita essay :: English Literature

Educating Rita essay "I've been realizing for ages that I was you know slightly out of step, I'm twenty six, I should have had a baby by now, everyone expects it, I'm sure me husband thinks I'm sterile. He was moaning all the time you know come off the pills, lets have a baby. I told him I'd come off the pills, just to shut him up. But I'm still on it, see I don't want to baby yet. See, I want to discover myself first, do you understand that? Changes take place in every one through our lives everyday; In this essay I will be exploring the changes that have happened in Franks and Rita relationship in the play Educating Rita by Willy Russell. I will be mainly focusing upon the attitudes of the two main characters towards each other and towards themselves. Rita is a mature woman seeking an education, as she didn't take the opportunity to learn when she was an amateur student because of the environment she lived around in and the fact she didn't want to learn because of her popularity and her working class culture. Frank: Rita why didn't you become what you call a proper student? Rita: you know, boring, ripped-up books, broken glass everywhere, knives and fights and that was just in the staffroom. Nah, they tried their best I suppose, but studying was just for the whimps, wasn't it? See, if I'd started taking school seriously I would have had to become different from me mates and that's not allowed. In reflected, Rita has come to realise how the law expectations surrounding her and her working class culture held her back from her real potential. She wants to change now and break this cycle. Frank, the other main character, is a teacher at the university where she has applied to do her course. He is around his 50's and is Rita's tutor. He is a lazy man, bored and frustrated by his life he too does not feel like he belongs anywhere. Frank does not like his job very much; he does not have any respect for himself at all. FRANK: my dear I actually an appalling teacher, most of the time, you see, you see it most of the time, you see it doesn't matter appalling teaching is quite in order for most of the appalling students. And the others manage to get by despite me. They expect us to teach when the pubs are open. The relation ship between frank and Rita at the beginning of the play is not strong, frank doesn't really want to tutor Rita because he

Kate Chopin and her influence on women’s rights Essay

â€Å"I would give the essential, I would give my money, I would give my life for my child; but I wouldn’t give myself† (Chopin). The rights that women enjoy today were not always as equal to that of males. The women’s rights movement transitioned America’s views of them from the way they were pre-nineteenth century to now. Novelist Kate Chopin’s literary works was a crux that aided in the strength of the movement. Women faced many hardships, and Kate Chopin, a literary genius, contributed to a lot to the movement. To begin, in the nineteenth century people married at a very young age and women did not work in that time. They were denied employment outside of seamstresses and mid-wives; therefore they couldn’t always realistically support themselves. Women had to get married so that someone could support them. Women were also not their own person; they were the property of their husbands and it was expected for them to get married and have babies. Women were not allowed the freedoms men enjoyed such as that of the law, the church or the government. Married women could not make legal contracts, divorce her husband or win the right to custody of their children. The History Education sector of the university of Maryland states: â€Å"The role of women in the nineteenth century was viewed as ‘’subordinate to males’’ and was therefore subject to the laws and regulations imposed upon them by men.’’ (Hoffberger 2) Moreover, for centuries there has always been a struggle for women to find equality and respect from men. Kate Chopin, a great writer of nineteenth century, had written novels that assisted in the upheaval of the previously stated rights of women, or lack of rights. Kate Chopin’s literary works often include male and female gender roles that are sometimes challenged by the female protagonists in the stories. Her literary works include themes about liberation and conformity in society. In Kate Chopin’s fictional short stories, â€Å"†The Story of an Hour,† and â€Å"Desiree’s Baby†Ã¢â‚¬  both show examples of the lack of freedom in the role of women in society. Kate Chopin’s viewpoints in that time period helped her influenced how other women perceived women’s rights; she was a woman far ahead of her time. At the same time, Kate Chopin was an author who was underappreciated by those in her generation. Much of this was due to the fact that she was a contemporary  author, who primarily wrote about women’s sexuality and their roles in the world. She had strong, independent women as role models in her youth so it is not surprising that these same attributes would blossom, not only in her personal life, but in her character’s lives as well in â€Å"The Story of an Hour† and â€Å"Desiree’s Baby.† While these two works do share some similarities there are also vast differences and a few parallels from Chopin’s own life. Katherine O’Flaherty, later Kate Chopin, was born in St. Louis, Missouri on February 8, 1851. She was born to stable and publicly known parents, Eliza and Thomas O’Flaherty. Eliza O’Flaherty was of French-Creole descent, while her father was a native of Ireland. Unfortunately, when Chopin was only five years old , her father was killed in a train accident. As a result, Kate Chopin lived her preteen years in a female-centered household. She lived with her mother, grandmother, and great-grandmother, all of whom were widows. Her great-grandmother encouraged artistic growth by teaching her piano and storytelling. Chopin got married when she was twenty year olds and had six children till her husband passed away. She was 39 years old when she began to write fiction, her earlier life being consumed with education, marriage and children. Without the backing of the feminist movement, which had barely begun in certain areas of the country, the sexual and scandalous events in her second and final novel â€Å"The Awakening† were cause for the majority of readers to ban it from the shelves of great literature. It was not until the mid-1900’s that the book was promoted in a new light to a more accepting audience. In addition, Peggy Skaggs, the author of Kate Chopin a critical Bibliography, states that â€Å"Chopin’s development as a writer reflect in microcosm the larger movement in American literature from romanticism and local color to realism and naturalism’’ ( Skaggs 10). Furthermore, Chopin’s works have reflected to American literature because of her focu s on love within race and ethnic aspect. In many of Chopin’s stories she has exceeded simple regionalism and portrayed women who seek spiritual and sexual freedom against the more restrictive southern society of nineteenth century. Kate Chopin has emerged as one of the greatest as well as most admired American short story novelists, poet, and essayists. Critic Cynthia Griffin Wolf exclaims: â€Å"The vision in all of Chopin’s best fiction is consummately interior, and it draws for strength upon her willingness to confront the bleak fact of life’s tenuous stabiles’’ (Griffin 6). One of the  greatest sample is ‘’ Desiree’s baby’’ which is ‘’perhaps one of the world’s best short stories’’ (Griffin 1) Assuredly, the actual settings of â€Å"The Story of an Hour† and â€Å"Desiree’s Baby† are the first instance where the two stories differ. In â€Å"The Story of an Hour†, the entire piece takes place in Mrs. Mallard’s home or the scenery outside the house. In fact, the outside scenery plays an important role to the story, paralleling the new spring with Mrs. Mallard’s new found freedom. Whereas the inside of the house does not play as major of a role, not even revealing what room Mrs. Mallard was in when she was notified of her husband’s passing. In â€Å"Desiree’s Baby†, the main factors of the setting include the Louisiana Bayou, the gates of Valmonde mansion, and L’Abri, a vastly larger group of settings than the prior. As in â€Å"The Story of an Hour†, one setting is described more clearly and most of the story takes place in L’Abri. The homestead is described as making Madame Valmonde shudder at the first site of it and it being â€Å"a sad looking place, Big solemn oaks, branches shadowed it like a pall† (Chopin, 243). The description of L’Abri foreshadowed events to come and symbolized the relationship of Armand and Desiree. Even though the two stories do not share a setting you can see the similarities that there is some obscure background with one major setting paralleling the main character in some way. This, in part, could be due to Chopin wanting to have a writing style of her own. Also the two main characters, Mrs. Mallard and Desiree, benefited from concentrating on the one main setting, largely because this setting was a reason of conflict in the character’s lives. In the same way that the settings shared likenesses and differences, the plot and theme of the two stories also do. The plots of â€Å"The Story of an Hour† and â€Å"Desiree’s Baby† obviously have to be different for the most part. In â€Å"The Story of an Hour†, the plot is a woman who finds out her husband is dead and after an initial shock she feels free to finally live her life. Thus when she has finally come to grips with all of the events and looking forward to her new life her husband comes in and she dies of shock attributed to a pre-existing heart condition (Chopin, 77-79). In â€Å"Desiree’s Baby†, the plot involves a woman named Desiree. As a child she was abandoned, and taken in by the Valmondes, but as a woman fell in love with Armand, a wealthy plantation owner. They get married and have a baby together, and after a short lived bliss come to find that the baby has  African American heritage. Armand turns against Desiree, assuming she is the one with African blood in her. As the story goes on Desiree kills herself and the baby only for Armand to find out he is the one who actually has African heritage (Chopin, 1-5). These two plots at first glance do not seem to share anythin g in common, however, there is one similarity gleaming through; the women’s relationships with their husbands. Both women do love their husbands, but the relationships are not on an equal level. In each case the women are looked upon as possessions. Mrs. Mallard’s thoughts were â€Å"There would be no powerful will bending her.† She openly felt controlled, while Desiree did not seem to care about the controlling attitude of Armand, which is shown in the line â€Å"When he frowned she trembled, but loved him† (Chopin, 2). While it is evident that the plots are for the most part different, one woman relishing the loss of a husband, and the other so fearing abandonment from hers that she kills herself, the themes are quite similar. Following this further, the themes of the two stories are also shared with many other works by Chopin, women in search of themselves (Korb, 1). Mrs. Mallard from â€Å"The Story of an Hour† can see her life finally beginning after the death of her husband, as illustrated by the line â€Å"Free! Body and soul free!† (Chopin, 79). She was looking forward to a life by herself, getting to know herself as an individual. Desiree, on the other hand, was searching for an identity, or herself, from the beginning when Monsieur Valmonde found her at the gate. While the Valmondes did take her in she did not feel like she had an actual identity until Armand gave her his name and she became his wife. After it became evident that the baby had African blood and the identity she had as Armand’s wife was taken away, she could not handle the idea of finding a new identity. Another similarity shared by Mrs. Mallard and Desiree is their death, in both instances provoked by their husbands. The similarities and differences are important because while people might be experiencing the same thing in real life, their attitudes towards it may not be the same along with the outcomes, which could have been a goal of the author’s. As stated earlier, many of Chopin’s works concentrate on women trying to find themselves and in these two cases after the ending of their relationships with their husbands. Whe n reading the biography of Chopin, there is a striking similarity with these two stories in particular. Kate O’Flaherty met and wed a man named Oscar  Chopin around 1869. She lived a happy life with him and had six children and as stated when Kate was only thirty-six year old, her husband died of swamp fever. While she loved her husband dearly, it is believed that she only first begun writing after her husband’s death (Kirszner & Mandell, 77). In a way this resembles the way that Mrs. Mallard only thought her life was beginning after her husband’s death. On the other hand, she could have been portraying her sense of abandonment by her husband in Desiree’s character in â€Å"Desiree’s Baby.† Another reason Chopin writes her characters only release from their troubles as death is because of the time period she lived in. Divorce was often unheard of or taboo. It is easy to see that one of the only main differences is the way that each of the women traveled the path to self-discovery and their outcomes. This in a large part could be from Chopin’s own marriage and life. However, all of her woman characters relate to her own life which helped shape America into a place where freedom and equality for women is possible. Although the women that she created were different, their challenges and accomplishments inspired different aspects of the feminist movement. Chopin’s literary works became highly popular in the late twentieth century and remain popular today. Thus Chopin did not quite spark the flame of the women’s rights movement, but it was tinder that fueled it into what it became. Her literary works will outlive her as a testament of the strength of women and what they can accomplish. Her contributions will survive to inspire women for generations.

Essay on Biographical References in and Hemingways Male...

Throughout the Nick Adams and other stories featuring dominant male figures, Ernest Hemingway teases the reader by drawing biographical parallels to his own life. That is, he uses characters such as Nick Adams throughout many of his literary works in order to play off of his own strengths as well as weaknesses: Nick, like Hemingway, is perceptive and bright but also insecure. Nick Adams as well as other significant male characters, such as Frederick Henry in A Farewell to Arms and Jake Barnes in The Sun Also Rises personifies Hemingway in a sequential manner. Initially, the Hemingway character appears to be impressionable, but he evolves into an isolated individual. Hemingway, due to an unusual childhood and possible post traumatic†¦show more content†¦Hemingway had to have his tonsils removed by a doctor after an earlier childhood accident (49). The operation is inferred to be successful but Hemingway liked to hold grudges, whether real or imaginary. In â€Å"Indian C amp,† after the caesarian procedure is completed, Nick Adams’ father says, â€Å"I haven’t any anesthetic, but her screams are not important† (16). Not only was this a demeaning and boorish way of referring to the indigenous female but the comment demonstrates his total indifference for the invasiveness of the procedure. Hemingway stated that he had always held it against his father for taking out his tonsils without any anesthetic† (48). To conclude the story the new-born situation lead to a discussion between Nick and his father, the doctor. They talk about death, probably in the same unique manner that Ernest Hemingway and his father did. The similarities to Nick Adams personal life are unmistakably reflected in Hemingway’s. Hemingway’s father, Ed Hemingway, was in fact a doctor and would also take his son to Indian villages in Michigan. The Indians there were the Ojibwa Indians who lived near Walloon Lake in northern Michigan (23). In fact, Arthur Waldhorn states in Reader’s Guide to Ernest Hemingway that the visitsShow MoreRelatedThe Dependence On Futility : An Analysis Of Brett Ashley1004 Words   |  5 Pagesthe novel, the lack of emotional connection between the characters becomes evident and expresses the underlying concept behind the â€Å"lost generation.† Brett, a female character in the novel, plays a significant role due to her almost overarching presence over the men. Ut ilizing his iceberg theory, Hemingway gives the reader a surface view of Brett and leaves the rest up to interpretation. However, it is evident that Hemingway uses the character of Brett in order to emphasize the futile nature of theRead More Using Love to Justify Sex in A Very Short Story Essay1121 Words   |  5 PagesUsing Love to Justify Sex in A Very Short Story    At first glance unusually normal, at second glance unusually striking, the title A Very Short Story reveals Hemingways perception of a perhaps unforgotten war experience. Man went to war. He met woman. They spent many nights together. They considered marriage. He went home without her. She moved on. He moved on. The end. The story, the relation of events, is indeed short. This is not eternal spiritual love; instead, this is the animalisticRead MoreAn Inspiration to Young Writers: Ernest Hemingway Essay1979 Words   |  8 PagesHemingway was raised with very strict, conservative values, which taught him that the most important things in life were religion, hard work, physical fitness and self-determination. Hemingway’s father, Clarence Edmonds Hemingway, taught him to hunt and fish by the forests of Lake Michigan. Hunting quickly became one of Hemingway’s most loved passions; he often uses his knowledge of the sport to his advantage in his writing. Hunting is just one o f the many inspirations that Ernest Hemingway uses to developRead MoreHistory of the Development of the Short Story.3660 Words   |  15 PagesStafford and Eudora Welty. J. D. Salingers â€Å"Nine Stories† (1953) experimented with point of view and voice, while Flannery O’Connors â€Å"A Good Man is Hard to Find† (1955) reinvigorated the Southern Gothic style. When Life magazine published Ernest Hemingways long short story (or novella) The Old Man and the Sea in 1952, the issue containing this story sold 5,300,000 copies in only two days. Cultural and social identity played a considerable role in much of the short fiction of the 1960s. PhillipRead MoreANALIZ TEXT INTERPRETATION AND ANALYSIS28843 Words   |  116 Pagesor a short story. Events of any kind, of course, inevitably involve people, and for this reason it is virtually impossible to discuss plot in isolation from character. Character and plot are, in fact, intimately and reciprocally related, especially in modern fiction. A major function of plot can be said to be the representation of characters in action, though as we will see the action involved can be internal and psychological as well as external and physical. In order for a plot to begin, some