St Thomas University Interpersonal Communication Nursing Question

Submission Instruction

• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible. The bibliography used should be from2016-2021

Case Studies 2

What are the barriers to interpersonal communication?

The flow of communication and the ability to establish an interpersonal relationship in an interview is influenced by various factors including the patient’s age and cultural beliefs and norms. One of the major barriers to interpersonal communication that may occur in the selected patient scenarios is a lack of trust and transparency. It is quite challenging to communicate when the clinician and the patient have trust issues. The client may feel to open up and share pertinent information which is required for a proper understanding of the client’s scenario and appropriate planning. The patient may be anxious and fail to disclose important information (Alshammari et al., 2019).

The second barrier that may hinder interpersonal communication is a lack of emotional security and safety especially on the side of the client. This barrier makes the patient feel uncomfortable especially with sharing thoughts, feelings, ideas, expressing issues, and being authentic due to fear of being criticized, ridiculed, shut down, or put down. Emotional insecurity inflicts great fear in the patient hindering him or her from communicating effectively and creating an interpersonal relationship.

The communication style used during the interview process is also a key barrier to the establishment of interpersonal communication. The clinician and the patient have different styles of communication (Alshammari et al., 2019). For instance, one prefers direct communication while the other is maybe okay with an indirect approach. Some patients may prefer detailed information. The clinician may fail to understand the client due to the communication style employed.

Emotional barriers also hinder interpersonal communication since the client may not be free and open to communicate. The emotional barrier consists of suspicion, mistrust, and fear. When interviewing the pre-school-aged female client, fear is likely to hinder the establishment of an effective therapeutic relationship thus hindering interpersonal communication (Alshammari et al., 2019).

What are the procedures and examination techniques that will be used during the physical exam of your patient?

The examination techniques that I will consider during the physical examination of my patient are inspection, percussion, palpation, and auscultation. Inspection is accomplished through deliberate and systematic visual observation of the client. During palpation, I will use my sense of touch to judge vibrations, pulsations, masses, and structures based on texture, warmth, size, tenderness, and mobility. During percussion, I will use sharp and quacking tapping of my hand or fingers to produce sounds. This will enable me to locate the size, position, density, and size of any underlying structures. I will perform auscultation by eliciting or listing sounds in blood vessels, lungs, abdominal viscera, and the heart.

Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.

The subjective part of the SOAP approach consists of the patient’s personal views, feelings, and experiences. It integrates the patient’s chief complaint, History of presenting illness, comprehensive patient history, review of systems, allergies, and current medications. The “Objective” part consists of the information gathered by the clinician during encounters with the patient. The information included vital signs, laboratory data, physical examination findings, and imaging results (Kasamatsu et al., 2020). Assessment is the synthesis of the collected objective and subjective data to make a patient diagnosis. The part states the patient’s primary diagnosis and possible differential diagnoses. The planning part of the approach is used to highlight the steps and measures that need to be taken to address the patient’s problem.

Response to:

Case Study 3: 16-year-old white pregnant teenager living in an inner-city neighborhood.

What are the barriers to interpersonal communication?

There are various communication barriers with an adolescent that might hinder interpersonal communication. Trust and emotional safety is a barrier to interpersonal communication. Teenagers express the need to maintain a form of integrity based on humanistic interaction during healthcare visits and maintaining confidentiality. The adolescent confidentiality concerns result from the fear of judgment by others Kim & White, 2018). The teenager might also feel hesitant discussing her condition in the presence of her parent due to fear and guilt. Without gaining trust and informational safety, the adolescent might not feel free to share or engage in collaborative care (Kim & White, 2018). Psychological barriers also affect communication with the client. The patient may feel shy or fear talking to the healthcare provider (Kim & White, 2018). Teenagers tend to be embarrassed and anxious due to the unplanned pregnancy thus might feel uncomfortable giving information. The pregnant teenager might have issues with concentration due to fatigue. As a result, obtaining information from her may be difficult. Without proper concentration, accurate diagnosis and treatment become challenging.

What are the procedures and examination techniques that will be used during the physical exam of your patient?

Arranging for privacy and a comfortable environment is an integral part of the physical examination. Asking permission for the parent to leave is the first step to help the patient feel comfortable. The physical examination should not include intrusive procedures and will be conducted with the patient seated to avoid fatigue. I will also ask the patient if she prefers certain things done and if she feels uncomfortable. I will assess the vital signs and follow with other physical examinations including the mouth, eye, and ears. A complete physical examination will require division into multiple sessions to avoid fatigue for the pregnant teenager. The examination will provide relevant psychosocial issues and medical problems to help in creating a care plan.

Describe the Subjective, Objective, Assessment, Planning (S.O.A.P.) approach for documenting patient data and explain what they are.

Documentation of patient data serves various needs, and the notes are expanded to accommodate the specific patient needs. SOAP notes are used by healthcare professionals as a systematic method for documentation and sharing patient information. SOAP helps in the organization of patient data for easy access and following by other healthcare professionals. SOAP notes constitute four parts. The subjective section is based on what the patient says and experiences (Podder & Lew, 2020). The information included in the subjective section is the patient’s medical history, current medications and allergies, and the chief complaints, as it helps determine the possible causes of the patient’s condition. The objective section is based on what the healthcare provider sees. Objective data includes the patient’s vital signs, general appearance, test results, imaging results, and other diagnostic data. The assessment section contains the patient’s condition based on subjective and objective data (Podder & Lew, 2020). Differential diagnosis is included in this section to guide decision-making. Besides, diagnostic tests and referrals to specialists are also indicated in this section. Lastly, the plan section addresses the patient’s problem. A treatment plan including therapy, medication, patient education, and follow-ups are indicated in the plan section.