Therapeutic Communication

Abstract

The scenario in which I will discuss within my paper consists of an LPN student and a preceptor working a busy 12 hour shift on their acute care practicum. Both Patty (student) and Mary Lou (preceptor) worked very hard one evening and had not had a break when a patient requested some pain medication. They discussed their options with regards to pain management and later Patty administered Morphine 7. 5 mg SC into injector port in Mr B’s leg. At the end of the shift it was noted during a narcotic count that there had been an error with Morphine.

Patty had given the wrong amount as per order. Therapeutic Communication- Nurse Relationships as Part of a Team Before Mary Lou can organize a meeting with Patty the LPN student, she must first ensure the safety of the patient as paramount. Then she must decide the best way to approach Patty, an appropriate location to interview, the factors to consider while interviewing and the communication skills that would benefit their interview. Also she needs to determine whether anybody else should be involved. After careful consideration and all the facts gathered, Mary Lou calls Patty in for a interview.

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Discussion Mary Lou decided to call a meeting in a neutral setting that would be non- confrontational and non-threaten to Patty. A place they could sit comfortably across from each other and make eye contact. It is important for Mary Lou not to attach blame and her approach will include sensitivity and respect, after all Patty is a student and still quite vulnerable. Mary Lou wants to make it clear an error has been made and that it needs to be addressed, rectified and reported without demoralizing or belittling Patty. The methods by which it is reported or addressed should be thoughtful, maintain confidentiality, and be directed toward the appropriate person, agency, or regulatory body. ” ( Burkhardt, Nathaniel, Walton, 2010, p 200) Some factors Mary Lou considers while interviewing Patty are any possible underlying reasons for the error: what happened. It is important for Patty to comfortably clarify in her own words and for Mary Lou to actively listen to the accounts of the day. This helps both parties understand completely where the error might have occurred and they can take steps to avoid a reoccurrence.

While Mary Lou realizes Patty ultimately administered the wrong dose of medication, it is very important that Mary Lou states her role as preceptor and her accountability in the incident. The Canadian Nurses Association notes in its Code of Ethics that as a part of being accountable, ( Burkhardt, Nathaniel, Walton, 2010, p 200) “ Nurses share their knowledge and provide feedback, mentorship and guidance for the professional development of nursing students, novice nurses and other health care team members. (CNA, 2008, p18) Mary Lou also offers empathy as she was once a nursing student as well and while we strive for perfection, human error can not always be avoided. The last issue to be considered and implemented is if anybody else needed to be involved? Mary Lou decided as long as they clearly identified the issue at hand and recognized they both had an ethical and professional responsibility to report the incident and rectify their shortfalls as student and preceptor, no other entity need to be involved.

Conclusion

In conclusion I think Mary Lou did an excellent job of identifying and addressing the issue of medication error ensuring dignity and respect to Patty. Mary Lou showed empathy and understanding while focusing on responsibilities of both parties to be more accountable in their daily care of patients, which at the end of the day is their main goal. One area of improvement that I noticed of Mary Lou after viewing the recording was she could have offered more open ended questions and let Patty express herself more. While I did feel Mary Lou actively listened to Patty, the opportunity for Patty to give feedback was not fully utilized.

Over all I found this to be an interesting experience on therapeutic communication that I enjoyed completing.

References

1. Arnold, E. C. & Boggs, K. U. (2011) Interpersonal relationships: Professional Communication Skills for Nurses, sixth edition (6th ed. ).
2. St Louis, MO: Elsevier/Saunders Burkhardt, M. , Nathaniel, A. , Walton, N. (2010)
3. Ethics and Issues in Contemporary Nursing (1st ed. ) Toronto, ON: Nelson Education Ltd Canadian Nurses Association (2008)
4. Code of Ethics for Registered nurses. Author If you need to type anything after the reference list then start it on this page

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