Reflective Essay On The Barriers To Communication

has an impact on recovery time. Effective communication in the clinical setting creates a relationship with the patient that allows the collection of crucial health information for the planning and management of a patient condition (Norouzinia et al., 2015). It also promotes increased coordination of care between members of the multidisciplinary team. However, several barriers affect the communication process. These obstacles are broadly classified as physical, language, socio-psychological, organizational or cross-cultural in nature.

Using my personal reflection in the last couple of days in the ward, I identified several barriers that most medics encounter when dealing with the patients and their colleagues. I remember a session I had with one of the people with a mental health condition during a group therapy session review. I began the interview with fundamental questions about how she was feeling. After asking a few closed-ended questions, I realized that I was having several communication difficulties. To begin with, Mrs. Julie did not talk much. She only gave short and brief responses to my questions in a shaking voice. She also continuously tried to re-position herself during the interview taking several different postures at a time. Additionally, I realized that she kept asking me to repeat the questions as she could not hear them correctly plus some noises coming from a group of patients who were having a heated debate about football made it harder. Finally, I noticed that she did not understand most of my recommendations as she could not tell me in her words what we had agreed though she pretended to understand throughout the sessions.

Reflecting on my session with Mrs. Julie, I realized that I controlled most of

the communication flow by asking closed-ended questions. These questions did not give Mrs. Julie an opportunity to express herself. They only allowed her only to answer the question posed. Since the closed-ended questions invited short answers, I found it difficult to establish a rapport with Mrs. Julie. The dominance of a conversation by one individual is a huge barrier to effective communication in the clinical settings (Norouzinia et al., 2015). Dominance occurs when the medical personnel guides the course of the interview limiting the patient’s contribution. Though it is important for healthcare providers to tailor interviews with patients to assess the essential information for proper management, it is equally important that they allow the client express his/her concerns. Open-ended questions can be used to elicit the client’s thoughts and perspectives without influencing the direction of an acceptable response (Kourkouta and Papathanasiou, 2014). This gives the patient an opportunity to provide more information on his/her perceived health needs. Nurses should use both open and closed ended questions to avoid dominance that impairs communication with patients and colleagues.

Hearing problems is another barrier to effective communication in the clinical settings (Morrissey and Callaghan, 2011). Patients with hearing impairment cannot pick up sound waves. Mrs. Julies have progressive hearing loss as evidenced by her consistent request for people to repeat instructions using a louder voice. However, she refuses to wear her hearing aid as it feels uncomfortable. As a result, she normally has problems communicating with medics and fellow patients. Nurses need to stress the need for wearing the aid to assist patients with hearing impairments pick sounds thus communicate effectively. Additionally, nurses should speak slowly and clearly for

patients to read the lips. Using non-verbal cues can also promote understanding of the conveyed message (Firstein, 2016). In cases of complete hearing loss, nurses should use sign language or write to communicate with the patient. Additionally, it is important to limit background noises when dealing with patients as it can be a significant barrier to communication. There should be a secluded room free from environmental noise and other distractors to promote successful communication with people with a mental health condition (Morrissey and Callaghan, 2011).

The lack of a proper rapport with patients can also be a significant barrier to communication, especially when dealing with mentally ill patients (Morrissey and Callaghan, 2011). Mrs. Julie could not maintain eye contact during the whole session. She kept looking on the ground even when answering questions. She spoke shakily and haltingly which made it difficult for her to express her feelings. I associated this with some nervousness due to increased stigmatization of mental illness. This lack of trusting relationship made it difficult to get information from Mrs. Julie. Therefore, it is important to create a long trusting relationship with mentally ill patients to promote self-expression during interactions (Firstein, 2016). This requires the medical personnel to eliminate the status difference and go the level of the patient. Reassurance can help calm the patient and make him/her feel relaxed to share experiences without fear of reproof.

Another barrier to communication that I identified among most medics and patients is the use of jargon, overcomplicated and unfamiliar technical terms. The use of medical terms with patients creates a huge barrier to the efficient conveyance of the intended message. Most patients have limited health

literacy which reduces their knowledge about the conditions they suffer (Graham and Brookey, 2008). However, most medical personnel make a grave assumption that patients understand complex medical information and terminologies. Patients also fail to ask the meaning of some of the explanations for fear of embarrassment. As a result, they fail to follow the required steps to maintain health. Therefore, it is important for nurses and other medical professionals to bridge the literary gap with their patients through the use of simple terminologies for effective communication and understanding (Graham and Brookey, 2008). The presentation of medical information should be without jargon. In the end, the nurse should ask the patient to put the information in his/her words to assess their understanding and provide clarifications in areas with shortcomings (Graham and Brookey, 2008).

In conclusion, the provision of high-quality health care services depends on the existence and maintenance of effective communication between health professionals and the patients in the critical settings. However, several barriers impair communication with patients in the clinical settings. These communication barriers include physical barriers such as noise, hearing problems, reduced attention span, lack of a trusting relationship with the patient, health worker dominance, and the use of complex medical terminologies. These barriers significantly impair communication between the medical personnel and the patients impacting on the quality of care negatively. Therefore, nurses need to formulate and integrate evidence-based practices into the health care system so as to reduce these barriers and promote effective communication with the patients. Establishing awareness of the issues through reflection can help medics to commit to the issue by identifying areas of shortcomings and implementing various measures to promote communication.

These actions include the creation of a good rapport, the minimization of environmental distractors such as noise and the use of simple language to promote understanding. This will lead to the creation of therapeutic communication with the patients thus improve health outcomes.

References

1. Firstein, I. (2016). Barriers to Effective Communication. online GoodTherapy.org Therapy Blog. Available at: http://www.goodtherapy.org/blog/barriers-to-effective-communication/ Accessed 22 Nov. 2016.
2. Graham, S., and Brookey, J. (2008). Do Patients Understand? Permj, 12(3), pp.67-69.
   Kourkouta, L., and Papathanasiou, I. (2014).
3. Communication in Nursing Practice. Materia Socio Medica, 26(1), pp.65-67. Morrissey, J., and Callaghan, P. (2011).
4. Communication skills for mental health nurses. 1st ed. Maidenhead: Open University Press, pp.2-17. Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M. and Samami, E. (2015).
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