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Topics About 'Communicate'.

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  1. There is a reason why nursing students avoid meeting with a nursing instructor. If fact, there are several reasons. It’s not just the intimidation factor or the words “you're really inconveniencing me” written all over the instructor’s face. It’s talking with the instructor, walking away and thinking, “what did I just say?”. Most likely, your faculty appreciates your initiative in asking a question or voicing concern. You can reduce your stress and get the most out of your faculty interactions with a little pre-meeting prep work. Let’s look at a few guidelines to point you in the right direction. Take Action Nursing school can be very confusing. Everything is a new experience from lectures and skills, to clinical assignments. Students often make the mistake of “getting stuck” in coursework because they don’t understand what the instructor expects. The semester marches on, due dates arrive and the student just “wings it” instead of asking for help. But, faculty are not mind-readers and it is up to you to initiate a meeting. STEP 1 Tips for Requesting Faculty Time Avoid confronting your instructor in front of the class and putting them “on the spot”. Read the syllabus and course information to determine if the instructor has preferred methods of communication (email, phone, office stop-by, etc). If you stop by the instructor’s office, make sure it is during office hours. Be specific on why you need to schedule a meeting. Offer several time alternatives and be open to other forms of “meetings” (phone, on-line chat) STEP 2 Do The Prep Work Be sure to review the course policies, syllabus and any applicable instructions before your visit. The answer to your question may be hiding “in plain sight”. Ask yourself, “why do I need to meet and what do I expect to get out of the meeting?”. STEP 3 Tips for the Meeting Show respect Arrive on time Use the person’s name Make eye contact Speak clearly, using positive language Stay within the allotted time-frame STEP 4 Show What You Know Briefly express some interest in the course content Express enthusiasm for what you have learned STEP 5 Avoid Dumping You want to be specific about your question or concern. You don’t want to spend the meeting time with your instructor on everything but what you need. Here are a few examples: Don’t: “I don’t understand assignment 2. What are you wanting us to do.” Do: “I am confused about the care planning process, specifically, how to assign a measurable outcome." Don’t: “I missed lab and did the class do anything that will be on the test?” Do: “Is there a convenient time I can practice in the skills lab? I want to catch up with the class since I missed class.” Don’t: “I made a D on our test. What am I doing wrong?” Do: "I did not perform well on the last exam and want to do better. I would like to tell you my main study strategy and would appreciate any feedback or suggestions." STEP 6 Own Your Part Take responsibility for any mistakes or oversight on your part. Be honest and express what you will do differently moving forward. “I now realize the importance of spending time reviewing lecture notes after every class”. “I apologize for being late to clinical. Moving forward, these are the steps I will take to ensure punctuality.” Before You Leave Be sure you and your instructor are on the same page and what are the next steps. Stop and ask for clarification (if needed) before you leave Express gratitude for the meeting. Remember You have the right to ask questions and seek clarification. You also have a responsibility to do so tactfully, and decisions made by the instructor should be respected. What tips can you share to help other students make the most out of faculty interactions? Interested in more information? Check out these resources: Tips on Communicating with a Professor Meeting With Your Professor
  2. I can vividly recall how stressful it was as a nursing student and new nurse graduate to communicate with physicians. I was already intimidated by doctors and it seemed my mind drew a predictable blank when I had to interact with them. As a novice, I had to learn how to organize my thoughts and provide the appropriate information to communicate the patient issue clearly. This is a learning process most students and new nurses will experience and build confidence. There are tips for communicating with doctors and an interdisciplinary team that may make this process a little easier. A study published in the Journal of Patient Safety, by Tija et al, found several factors that can affect nurse-physician communication. These included: Lack of openness and collaboration- nurse feeling hurried by the physician or feeling the physician was not interested in the information the nurse was sharing. Frustration with the lack of professional respect- 16% reported being interrupted by the physician before they were finished communicating important information. Logistical challenges- difficulty finding a quiet place to communicate, finding time to communicate with the physician and not being able to get in contact with a physician when needed. Language barriers- difficulty understanding physicians due to language, accent or use of medical jargon. Nurse preparedness- nurse not being prepared with assessment data or information the physician will need to make decisions and/or changes to patients care. Being aware of nurse-physician communication barriers is the first step in students and new nurses building skill and confidence in communicating with the interdisciplinary team. Scenario One: Jane is a nursing student at clinical and is reviewing a patient’s record at the nursing desk. Jane is approached by a doctor asking for information on a patient and her instructor or another nurse are not at the desk. Jane explains to the physician she is a student at clinical and the physician, frustrated, states “can you not find someone who can tell me something about my patient?”. Scenario Two: Matt is a new graduate and just completed orientation for his first nursing position. Matt is approached by a cardiologist asking why patient X was ordered a cardiology consult. Matt provides background information and the physician states, “What do they think I can do for them? This is a waste of my time!”. What do you do when you find yourself in a situation similar to the above scenarios? Your first reaction may be to go blank or become defensive. Here are some tips to help when you find yourself communicating with a difficult physician. Stick with the facts and leave emotion and opinion out of the conversation. It may be as simple as, “I don’t know the answer to your question but let me find someone who can help you”. Be aware of your body language and stand straight to convey a look of self-confidence. Take a step back to avoid a defensive or aggressive response. Respond in a respectful manner and expect respect will be returned. Apologize when appropriate. Report the interaction with your clinical instructor, preceptor or charge nurse to ensure acknowledgment of the behavior. The physician’s behavior may be a pattern and documentation may be needed to address. Do not accept inappropriate or abusive behavior- walk away, stand silently or ask to be spoken to respectfully. Practice communicating with physicians on a regular basis. The best time to practice is when you are with your instructor or preceptor. Take notes on how your preceptor approaches, answers questions and communicates with physicians. Be prepared before calling or talking to a physician about a patient. Write down pertinent information to clearly communicate the patient situation. Having information available and organize may help minimize problems. For example Patient’s name and room number Reason for call Health history Lab values that relate to your reason for calling Recent vital signs Medications related to your reason for calling Allergies Effective nurse-physician communication is key to providing safe care for positive patient outcomes. Fortunately, there are steps nursing students and new nurses can take to improve their communication with physicians. With practice and experience, the novice nurse will become confident, even when dealing with difficult physicians. What tips would you like to share to support students and new nurses? Resources: Institute for Healthcare Improvement: The SBAR Tool for Communication Tija, J., Mazor, K., Field T., Meterko, V., Spenard, A. & Gurwitz, J. (2009). Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety, Journal of Patient Safety, 5(3):145-52. Patient Safety and Quality Healthcare (2012).  Nurse to physician communication: Connecting for safety.

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