Assignment 1: Structured Reflection
Sarah Makin
4227650
LUSL 1207: Self and Others 2: Interpersonal Relations
Professor McGill
February 6, 2015

Structured Reflection Communication, an ongoing process that involves the perceptions of ourselves and others as well as verbal and non-verbal messages, is one of the most important tools utilized by nurses (Sawada, Mendes, Galvao & Trevizan, 1992). Florence Nightingale was one of the first people to realize the importance of nurse-patient communication, stating that leaving a patient uninformed and with a fear of the unknown will cause more harm than any illness could (Nightingale, 1859). When a nurse is able to successfully communicate with their patients, consequently they are then able to begin to develop a therapeutic relationship. In order to gain a better understanding of therapeutic communication and relationships, Johns Model of Reflection was used to analyze a video that showed a nurse-patient interaction. Many different terms, such as caring, helpful or purposeful, have been used to describe what a therapeutic relationship between a nurse and a patient should look and feel like (Kiteley & Vaitekunas, 2006). The nurse presented in the video not only failed to demonstrate these terms throughout her interaction with the patient, but she also failed to adhere to the College of Nurses of Ontario’s (CNO) components and statements regarding a therapeutic relationship. When reflecting upon, or analyzing an experience, Johns (2006) requires significant issues to be addressed, and within this video, three issues stood out. The first significant issue was the absence of client-centred care. The CNO (2006) describes client-centred care as working collaboratively with the patient to ensure that the nurse is meeting all of their patient’s needs, and includes showing sensitivity and respect for the patient’s choices. However, instead of meeting these standards set by the CNO, the nurse in the video showed extreme sarcasm through the tone of her voice, and her facial expressions and gestures conveyed a lot of judgment upon hearing about choices that her patient had made, such as his drinking and smoking (Video, 2008). Furthermore, the nurse did not even attempt to include her patient in his care, failing to ask him at the beginning of the appointment what had brought him to the doctor’s that day, and then continuing to ignore his attempts at asking her questions about his hepatitis, and trying to explain his symptoms (Video, 2008). The CNO (2006) defines therapeutic communication as using many different communication strategies in order to initiate nurse-patient relationship, and includes the nurse introducing themselves and their role with their patient, addressing the patient by their name, and providing the patient time to explain themselves. The lack of therapeutic communication that the nurse in the video showed was another significant issue, as she not only failed to introduce herself by her name or role and did not address the patient by his name, but there was also no time provided for the patient to explain his reason for seeking care (Video, 2008). When the patient tried to speak multiple times, the nurse showed that she was clearly disinterested in what he had to say by completely ignoring most of the things he said, and staying very task-oriented (Video, 2008). Protecting her patient from abuse was the final significant issue that became very apparent throughout the interaction between the nurse and patient. The CNO (2006) states that protecting the patient from abuse means ensuring that all abuse, physical and verbal, is not only stopped, but also prevented and reported. This includes not only with other healthcare providers, but also the nurses themselves ensuring that any physical, verbal or non-verbal behaviours toward their patients are not disrespectful or abusive (CNO, 2006). Although the nurse’s behaviours in the video were not physically abusive,