Communication essay
2000 words
Learning Outcomes to be achieved:
Knowledge and understanding outcome.
3. Understand the principles of verbal and non-verbal communication and the factors that might enhance / inhibit effective communication within midwifery practice.
Ability Outcomes
5. Demonstrate effective communication skills and understanding of the factors that enhance/hinder effective communication with women, their families and other professional colleagues.
Assessment guidelines
Choose an episode of communication which has occurred with a woman during your clinical experience, and in which you have personally taken part. This may be part of an antenatal or postnatal meeting.
Please discuss your chosen topic with the module leader in order to ensure that you are able to address the learning outcomes (3 and 5) as identified above.
Write an account of the interaction as soon as possible after the event. You may wish to use a grid to record the events so that you can remember this accurately (you are not required to submit a lengthy account within the essay).
Analyse the questions and/or responses that you have made during the interaction and consider the appropriateness and effectiveness of your responses.
Your assignment should comprise a brief summary of the content of the interaction within the introduction although you should include the full account in an appendix (you may wish to use the grid to do this). Your appendix should be presented following your reference list and you need to refer to this in the essay.
You should also include within the introduction an explanation of the intentions/purpose of the essay, the significance of the interaction and the key issues that you will discuss in your essay. Remember to relate this and your essay to the learning outcomes.
You should expand and discuss the key issues, relating these to the theory studied in the module ensuring that you address the learning outcomes.
The discussion should also include consideration of the appropriateness and effectiveness of your responses and identify how the interaction may have been improved. You should also identify the factors that may have influenced the communication process (positive and negative).
You should link your discussion with the appropriate literature and ensure that you have accurately referenced the material used (see guidelines for APA6 referencing within Brightspace).
10.The conclusion. Remember you should draw conclusions from your discussion as appropriate but an overall conclusion should reflect the key points and you should ensure that you have achieved the intentions stated in the introduction. No new material should be introduced at this stage.
11.You should ensure that you have gained the consent of the client whose interaction you have chosen and ensure that anonymity and confidentiality is maintained throughout the assignment – you are expected to state that you have done this (see below).
Scenario one.
You are a student first year midwife working with your practice supervisor (Jade). Your current placement is in the community you have enjoyed your six weeks of working with Jade. The team consists of seven midwives. It is Thursday and yourself and Jade are undertaking an antenatal clinic in a GP surgery during the morning.
It will be a busy clinic, there are ten women to be seen, each of the women have a 15-minute appointment. The room has a desk with a PC (to enter clinical data). There are two chairs at the side of the desk for a woman (and possible partner) to sit. There is an examination bed for palpating. The clinic has run a little late by around 20 minutes. Jade is a little frustrated because of her workload and that the clinic appointments are delayed.
The third woman on the list is Fatima Hussein (Jade had not met her before). Fatima is 32 weeks pregnant. Jade can see from the electronic notes that Fatima is a G1P0 and appears to have had an uneventful pregnancy, to date.
Jade informs you that she will lead the appointment to try to make up the lost time and asks that you sit back and observe. Jade does ask you to ‘go and get’ Fatima from the waiting room.
You enter the waiting room and call Fatima’s name, a woman and her male partner stand and walk towards you. You introduce yourself and walk with them to the antenatal room where Jade is waiting. They both sit down in the two chairs at the side of the desk and to the side of Jade. Jade introduces herself to Fatima (they have not met before).
You sit in the corner of the room and observe. It becomes apparent that Fatima speaks and understands little English. Jade was unaware of this, as nothing appeared to be in Fatima’s electronic record. Jade is visibly irritated by the fact that Fatima speaks very little English, however Fatima’s husband (Tariq) does. Jade therefore talks to Tariq to acquire the necessary clinical details about Fatima and her pregnancy, however Tariq, does not involve Fatima in the discussion. Jade maintains good eye contact with Tariq, when talking with him.
Following this discussion, Jade asks Fatima to ‘pop up on the bed’ by gesturing this with hand movements by pointing at the bed. During the physical examination Jade tries to communicate with Fatima whilst taking her blood pressure and the by doing an abdominal palpation. Jade talks very slowly (so that she thinks Fatima will understand) but when Fatima does not appear to understand, Jade ‘rolls her eyes’ in frustration. Fatima appears to avoided eye contact with Jade. Jade then returns to sit next to Tariq, sits and looks at the floor avoiding eye contact with all.
Jade documents her clinical findings in Fatima’s electronic record, but does not discuss with either Fatima or Tariq. Jade does not maintain any eye contact or dialogue whilst inputting the data and completing her notes. After 8 minutes of the appointment, Jade asks Tariq to make an appointment at 34 weeks with the receptionist. The couple leave, say thank you and goodbye. The door closes.
“Phew’ said Jade, we have managed to make up some of the lost time.
Consider the following:
How would you maintain confidentiality for Fatima and Tariq?
How would you find and greet Fatima and her partner?
What should Jade have done on them entering the room?
Do you think that there should have been any information in Fatima’s notes about her not being able to communicate effectively in English?
If so, from whom and what could have been arranged?
How could this have been improved?
Was it appropriate to ask Tariq the questions?
By asking Tariq the questions, do you think that there are any concerns?
If so, why?
How could this have been improved?
What about the environment? Do you think that the organisation of the room could have been better?
Do you feel that Jade talking to Fatima slowly helped or hindered the communication?
What about ‘transactional analysis’ here?
What effect did Jade’s ‘eye rolling’ have on Fatima and Tariq?
Do you think that there are any privacy and dignity issues to consider?
How does nonverbal communication affect communication?
Do you feel that Fatima was given the best care?
How did you feel during this appointment?
How do you feel that this could be improved for Fatima’s next appointment?
Scenario two.
You are a student first year midwife working with your practice supervisor (Sue). Your current placement is in the community you have enjoyed your six weeks of working with Sue. The team consists of seven midwives. It is Friday and yourself and Sue are undertaking postnatal home visits in the morning.
Your second appointment is to visit Jenny (G1P1), Simon (who are English speaking) and their baby Ruben at home. Jenny is three days postnatal following a vaginal birth at home. Sue (who cared for Jenny during her pregnancy) and yourself were present at the birth of Ruben (this was your first witnessed birth and you are so excited to see them again). Jenny required sutures for a second-degree tear to her vagina and perineum. Jenny had planned to breastfeed Ruben. Both Jenny and Simon, knew that you were both going to be visiting today. You arrive at the home and Simon opens the door and greets you both with a smile.
On entering the lounge, Jenny is sat on the sofa, looking comfortable and is breastfeeding Ruben. She appears a little pale and tired but wishes to give you both a hug. Following this Sue, sits down next to Jenny and you sit in a chair close to the sofa. Simon offers you both a drink and you accept.
Sue proceeds to ask Jenny about how she is feeling and collects the clinical information through discussion ,about the following:
Physical and emotional feelings (Jenny feels well but a little tired)
Breastfeeding (her nipples feel a little sore)
Eating and drinking (no problems)
Sleeping (waking for feeds)
Vaginal bleeding (lochia) is red
Perineal discomfort (Jenny felt that it was healing well and that today, Sue did not necessarily need to see it, unless she felt the need)
Elimination. Not yet opened her bowels but passing urine well
Mobility
Caring for Ruben and managing.
Forthcoming appointments and plans
After this discussion, Sue suggests that you do the ‘baby check’ with Jenny. You ask Jenny to undress Ruben so that you can perform a physical exam (whilst Sue observes you, you do feel a little nervous). Simon asks if he can watch what you are doing with Ruben too.
What observations will you make about Ruben and how will you discuss these with Jenny an Simon?
Following the discussion and observations, Sue enters Jenny’s clinical details in her hand help electronic device, informing Jenny what information she was entering. Sue also helps you to input Rubens details. Sue then informs Jenny and Simon that you would both be back to visit them on day five.
Following the visit, Sue informed you that she was very proud of the way you did Ruben’s wellbeing check and how you explained this to Jenny and Simon.
Consider the following:
How would you maintain confidentiality for Jenny and Simon?
How did they know that you would be visiting them?
How would you greet Jenny and Simon?
Do you think that continuity of care/carer helps with communication?
How and why?
What about the environment? Do you think that Jenny and Simon being at home had an effect upon communication? How?
What effect did ‘’having a hug” do with this episode?
Do you feel that Sue sitting next to Jenny helped the communication?
What about ‘transactional analysis’ here?
How does nonverbal communication affect communication?
What type of language would you use with Jenny and Simon when checking Rubens wellbeing?
Do you feel that Jenny, Simon and Ruben were given good care?
How do you feel that this could be improved?
Do you think that Sue was effective in her method of communication? How?
What effect did Sue have on this episode, relating to her documentation?
What effect did planning for the next appointment have on Jenny and Simon’s experience?
