Realizing I know less than I thought - a steep learning curve is ahead.
For my first clinical experience in nursing school, I was placed in a retirement home in Peterborough for two weeks and spent the next eight weeks at a long-term care home just outside Peterborough. On my first day of clinical placement (January 16, 2018) at the retirement home, I had the opportunity to talk to a resident living with
dementia. The situation I am describing here became significant as soon as I entered the patient’s
room. Despite her dementia, I still thought she would be expecting a nursing student. However,
she seemed confused and annoyed by my presence. The resident was hard of hearing, and
although she was able to converse, her dementia presented clearly and it was difficult to
complete the required interactions. She eventually told me she was tired and I decided to say
goodbye. The difficulty I had communicating was significant because I have experience talking
with older people as I am a volunteer with Hospice Peterborough. I generalized this skill to all
older adults, not fully realizing the difficulty that comes with talking to those hard of hearing and
with dementia. The experience left me thinking “If I can’t communicate properly, how will I be
able to care for and nurse others?”
The first factor affecting this experience is that the resident didn’t seem to understand the purpose of the visit, perhaps due to her dementia or the activity not being fully explained to her. I walked in assuming the resident knew why I was there, and I learned a very important principle in nursing: it can be dangerous to act solely upon assumption. It is important to assess the resident’s understanding of what will happen before commencing any task. Another factor affecting this situation was my preconceived notion of dementia. As someone who has never encountered dementia, I thought people with dementia were unaware of their surroundings and had limited ability to converse. At first, the resident was able to converse adequately, albeit the hearing loss. However, when what she was saying stopped making sense in the context of what I had asked her, I realized that dementia can hide and manifest itself unexpectedly.
Focusing on my strengths and how I can apply them to my weaknesses will allow me to improve my ability to communicate during difficult situations. I know that I am good at talking to older people as I am very friendly and open. However, I often struggle with focusing. While I understand what the other person is saying, I often don’t focus on the meaning behind the words and this is important for therapeutic communication. I plan to read more about dementia so I will know how to best interact with individuals who have dementia. When I first joined Hospice Peterborough as a volunteer I had to take several classes on therapeutic communication in the context of palliative care, so I could look back on the course and relate it to communicating with residents of long-term care.
While this experience was jarring for me, it must have been confusing for the resident. As a nursing student, I knew my purpose and I set about fulfilling it, but I made the incorrect assumption that my resident understood what was happening. I learned that I am not an expert in therapeutic communication. I was over-confident due to my past experiences and I didn’t realize how different this experience would be. I need to focus on actively listening to others and exploring hidden meanings. In terms of being a professional, I learned that it is up to us as nurses to ensure we are informing the resident of what is happening, rather than assuming the resident is completely aware of the situation. Additionally, going in with a deeper understanding of dementia and how to communicate with those with dementia and hearing loss would put me more at ease in this kind of situation. This is important because it is difficult for the resident to feel comfortable in any situation where the nurse is not. This first experience in my clinical placement was eye-opening to how much I still have to learn regarding the elderly and therapeutic communication techniques.
Note: this is an excerpt from a journal reflection originally written on January 31, 2018 as part of the clinical course. Some sections have been edited for clarity and brevity.
The first factor affecting this experience is that the resident didn’t seem to understand the purpose of the visit, perhaps due to her dementia or the activity not being fully explained to her. I walked in assuming the resident knew why I was there, and I learned a very important principle in nursing: it can be dangerous to act solely upon assumption. It is important to assess the resident’s understanding of what will happen before commencing any task. Another factor affecting this situation was my preconceived notion of dementia. As someone who has never encountered dementia, I thought people with dementia were unaware of their surroundings and had limited ability to converse. At first, the resident was able to converse adequately, albeit the hearing loss. However, when what she was saying stopped making sense in the context of what I had asked her, I realized that dementia can hide and manifest itself unexpectedly.
Focusing on my strengths and how I can apply them to my weaknesses will allow me to improve my ability to communicate during difficult situations. I know that I am good at talking to older people as I am very friendly and open. However, I often struggle with focusing. While I understand what the other person is saying, I often don’t focus on the meaning behind the words and this is important for therapeutic communication. I plan to read more about dementia so I will know how to best interact with individuals who have dementia. When I first joined Hospice Peterborough as a volunteer I had to take several classes on therapeutic communication in the context of palliative care, so I could look back on the course and relate it to communicating with residents of long-term care.
While this experience was jarring for me, it must have been confusing for the resident. As a nursing student, I knew my purpose and I set about fulfilling it, but I made the incorrect assumption that my resident understood what was happening. I learned that I am not an expert in therapeutic communication. I was over-confident due to my past experiences and I didn’t realize how different this experience would be. I need to focus on actively listening to others and exploring hidden meanings. In terms of being a professional, I learned that it is up to us as nurses to ensure we are informing the resident of what is happening, rather than assuming the resident is completely aware of the situation. Additionally, going in with a deeper understanding of dementia and how to communicate with those with dementia and hearing loss would put me more at ease in this kind of situation. This is important because it is difficult for the resident to feel comfortable in any situation where the nurse is not. This first experience in my clinical placement was eye-opening to how much I still have to learn regarding the elderly and therapeutic communication techniques.
Note: this is an excerpt from a journal reflection originally written on January 31, 2018 as part of the clinical course. Some sections have been edited for clarity and brevity.
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