The Ramifications of Ineffective Communication with Elderly Clients
Communication is one of the most important ways to deliver your thoughts to others, verbally or non-verbally in an easy and clear way so that the person next to you can understand and benefit from it. Effective communication is critical during countless times a nurse interacts with her patients. We know that nursing is about caring and listening to patients and making an effort to improve their quality of life in all dimensions of health. As Philip Authier quotes, “Effective nursing communications is all about getting the right information to the right person in the right format at the right time in the right location — all in a way that is easily understandable”. But what if a nurse is hesitant to assess patients? How will that nurse help out needy patients?
During my community clinical, I encountered a 35 year old lady with gestational week 16 Gravida 12 Para 10+1. She came with the complaint of excessive vaginal bleeding and miscarriage. She appeared neat and clean, malnourished and lazed uneasily on her bed. I went through the patient’s blue file to collect all her data.
I was amazed to find out that it’d been twelve years of her marriage and she had conceived twelve times during this period which could have a hazardous effect on maternal health. On discussion with my faculty, she helped me identify loop holes in my history, and guided me to further communicate to the patient about the available family planning methods, along with its benefits. I assured Mam I would do as she directed me to but then I did not go back to my patient again.
At the time of the incident, my anxiety was at its peak. I was so confused that I could not even communicate confidently with my client. Concurrently, I was relieved to get out of that situation. Upon discussions with my colleagues and my own reflection, I found myself convicted for not responding to the client who might be in need.
I was regretting why I did not do something for the client? Why did I lie that I will go back to my patient, but never turned up? All these thoughts made me realized that my act was not worthy and I had failed to fulfill my responsibility as a nurse.
After analyzing the incident, I came up with the related causes. Communication failures influence the quality of health care and contribute to medical errors and adverse outcomes for patients (Nazdam, 2009, p.1735). The firstirst reason which made me hesitant to deal with an elderly young female client was a socio-cultural constraint. In our culture, talking to elders openly is considered inappropriate.
Moreover, this culturally created insecurity is so innate that whenever it comes to assess and talk to elderly female clients, an anxiety response begins that hinders our care towards the client. Our cultural backgrounds, often influence our perception, willingness to speak and ability to communicate effectively with an elderly woman. According to Dattilo & Brewer (2005), the students described experiencing personal discomfort when confronted to talk about reproductive health with patients. They add on that students were particularly uncomfortable if their patient was older than them.
Students shared that “the topic and the subject were too personal and I am too young.” Another important cause was the topic of discussion. Though as a nurses we were supposed to assess clients holistically, but we need to focus on client’s reproductive and sexual health as well. Unfortunately, we the nurses often recognize that we have a responsibility to perform towards reproductive and sexual health care, we continue to feel hesitant and rarely do it (Wilson,Manoff, & Joffee, 1997 as cited in Tsai, 2004).
Thus, when I found an elderly female patient, questions arose in the back of my mind as to how will I assess her sexual health, how will I teach her about family planning? And how will I integrate my theory into practice? These were the main reasons which made me uncomfortable to assess and provide teaching to my client.
As a student nurse, such a situation can occur again so I thought of the options that I could have opted to handle the situation in a better way and I came up with a few ideas. As the main problem was the cultural constraint, so primarily, a nurse needs to accept the notion of providing care to clients despite of any cultural barrier because care should be provided to every patient, regardless of any disparities like age, race and gender (Hughes, 2008). After this we need to find ways to deal with elderly clients without hurting our cultural values. Hesitancy in discussing sensitive topics with elderly client could also have been solved if I had made myself confident.
I could have discussed it with the faculty and other colleagues at that time, and they might have helped me in this regard. Moreover, building rapport, starting the talk with other health aspects and then asking sensitive questions could also be another way out. Furthermore, I could also have taken help from my faculty to initiate the discussion or I could have asked her to accompany me to make the situation better and support me in lowering down my anxiety.
Lastly, I should have fulfilled my promise of going back for assessment and teaching, hence not hurting or breaking my faculty’s trust. Thus, if I would have taken due actions, then this incident would have been different and I would have not regretted. But from now onwards I would not let this situation occur again.
To conclude, nurses might feel hesitant to deal with elderly patients but a nurse should not make this a barrier in a process of care because nursing cannot be restricted to ones age only and if a nurse is reluctant to a particular age comfort zone then that nurse cannot fulfill the wider role of the noble profession.
Authier, P. (2010). Enabling effective nurse communications. AVAYA Intelligent Communications
Dattilo, J., & Brewer, K. (2005). Assessing clients’ sexual health as a component of holistic nursing practice. Journal of Holistic Nursing, 23(2), 207-219. doi: 10.1177/0898010105275839.
Hughes, R. G. (2008). Patient safety and quality: An evidence-based handbook for nurses (08-0043). Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/ nurseshdbk/nurseshdbk.pdf
Nazdam, M. (2009). Nurses’ role in communication and patient safety. Journal of Nursing Care Quality, 24(3), 184-188. Retrieved from http://journals.lww.com/jncqjournal/Citation/2009/07000/Nurses__Role_in_Communication_and_Patient_Safety.3.aspx
Tsai, Y. (2004). Nurses’ facilitators and barriers for taking a sexual history in Taiwan. Applied Nursing Research, 17(4), 257-264. doi: 10.1016/j.apnr.2004.09.011
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