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The initial communication problem between the RN and the patient was that the RN was not actively listening to Mr. A.  She did hear his complaints and gave brief answers to his questions, but if she had been actively listening, she would have picked up on his emotions and how upset he truly was. The other problem I noticed was that the nurse did not clarify if Mr. A understood her instructions or not, which could lead to more problems down the road.
- Sierra Kepski

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Well done!  I like how you had the patient repeat back how he will take the medications and what he should not do physically to ensure that he understands. - Savannah

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It is the role of the nurse to be an advocate for their patient and to support them by bringing their concerns to attention and empathizing with them. However, in this scenario, the proper role of the nurse was not met. The nurse did not support her patient and he did not get any of his true concerns addressed. It is also the role of the nurse to make sure the patient remains in good health. Since the patient did not assimilate any of the information about his discharge, it is more likely that he will injure himself in the healing process or not take the right medications. - Savannah

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The RN's role was to give him discharge information, to be sure he understood his plan of care, and to ask if there are any concerns and address those. This was not done. While the information was given by the nurse, it was not reaffirmed with the patient, making sure he completely understood his medication and limitations. She also did not establish good rapport, trust, or empathy with the patient as he was still upset upon leaving. Like my partner Miesha said, she should have advocated for her patient upon hearing his concerns.
Yesenia Jimenez

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Her initial role like any other nurse who may have stepped into this situation was to provide him with the proper information and person of higher authority, but she didn't do this. She was helpful at all and she failed him like the previous nurse. This was her role to play because the key aspect of a nurse is to advocate for our patientshe failed to do this.
- Miesha Jackson

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In the scenario, there was no relationship developed between the nurse and patient. The nurse did not show empathy or concern for the patient's complaints, and therefore, no trust developed. - Savannah

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I would describe the patient-RN relationship as non-therapeutic and troublesome. Severe issues could happen when a patient does not know their discharge instructions and for the nurse not to confirm that Mr. Alonzo understood is worrisome. He could go home and take the wrong medication at the wrong time, or not take it at all. Also, he may feel that he and others should never return to this health institution due to the lack of care and respect from nurses. This would create a bad reputation through word of mouth.
Yesenia Jimenez

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I think the nurse should have first addressed the patient's concern with the nurses and then move on to his discharge information, only after the patient had all of his questions answered about the nurses. By not being concerned about the patient's questions, she may become one of the nurses he complains about. - Savannah

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In my opinion, I believe that this entire scenario and interaction was poor, but a great example of how things like this do occur out there in the field of work. It definitely showed me the importance of patient adovocation and how every patients feelings are to be validated and heard whether we're busy with many tasks at once or not.
- Miesha Jackson

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I think the RN should have addressed the patients concerns early on and not just say "That sounds serious." I feel she could have been more empathetic to create an open environment in which Mr. Alonzo feels comfortable enough to share his concerns and know something will be done to help him. Then move on to the treatment plan, and make sure he understands it before he leaves.
Yesenia Jimenez

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Good, I like that you said the administrators would come see him instead of him wandering the first floor trying to find it.
- Sierra Kepski

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I do not believe that the patient assimilated the information that the RN was giving him because he was so frustrated with the other nurses and that was all he could think about. He wanted to address that problem first before he moved on to the other information. You can see in the scenario that he is not communicating back with the nurse on anything she is saying, so it is obvious that he has not taken in all of the information fully. - Savannah

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Good idea! It'll let him know that she is going to follow through with that.
-Alli S.

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The biggest problem in this scenario is that the nurse is not paying attention to Mr. A's complaints about the other nurses. She just keeps shoving information at him that he is probably not listening to anyway because he is so frustrated with the other nurses. This probably isn't making the case for her and the other nurses any better. - Savannah

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No, I do not think the Mr. Alonzo assimilated the information. I believe he was still upset and waiting for a chance to get that off his chest before he could focus on anything else being communicated  to him. There was also no communication making sure he understood, which is crucial. The conversation ended with a return to the disappointment Mr. Alonzo felt, and not with a comprehended treatment plan.
Yesenia Jimenez

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I feel in order to address the patients questions the nurse should of upon entering the room she should have cleared her mind of anything that would be of a distraction from meeting the needs of this particular patient. I think she should've been more empathetic to his questions and his feelings in general. I think she could've also been more attentive in helping to get his complaint to the head charge nurse. She should've made his feelings and concerns a top priority and made sure that there were conveyed to the proper person of authority.
- Miesha Jackson

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At the end, maybe the RN could say something like, "Great, then I will go contact the nursing director's office and let them know that you are on your way to see them."
- Sierra Kepski

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The questions that the nurse asks at the end of her explanations are a great way to tie in the patient to the conversation. Nice job!
-Meredith

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Yes looks good!
Yesenia

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No, I don't believe that Mr. A assimilate anthying that the nurse in the scenario was communicating to him. Rightfully so, because he was more focused on his frustrations with the poor care that he received from the previous nurse with caused a barrier between his communication with this nurse.

-Miesha

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love it!
K.Chamberlain

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I really like how you worded that!! Does that look okay Yesinia.
-Alli S.

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I think we should add something like that too. "I'm sorry to hear that Mr. Alonzo. While the computers are essential in documenting your info....... you should never feel neglected by them
Yesenia

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I love the rewrite ladies. It's well thoughtout  and you can definitely tell that our nurse is being more effective in her communication with Mr. A. She's being more empathetic to his needs and more attentive or receptive to what it is that he is trying to communicative to her. Nice job !
-Miesha

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Okay do you want met to add that into where the nurse is saying the computers are essential for documenting? I could say, but I am sorry that we have made you feel neglected and not a priority?
-Alli S

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The communication problems that I picked up on in this scenario was the fact that the nurse wasn't attentively listening to her patient. She was rushing with her instructions and wasn't allowing the patient time to get out his frustrations about the care that he had received from the previous nurse. Which if this were me I would've been frustrated even more
-Miesha Jackson

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I would add something in here.  Sounds like we are making an excuse for the previous nurses.  Maybe something along the lines of " But you should never feel neglected because of them"
K. Chamberlain

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A communication problem that I noticed was that the nurse did not acknowledge the patient's concerns/disappointment. She moved on until the end to bring it up again and I believe that only turned him off to the conversation and made him feel that he could not share those concerns with any nurse on the unit. It should have been an open environment focused on patient needs.
Yesenia Jimenez

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Awesome! I fixed it. Anything else that might need changed or re worded?
Alli S.

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Sounds good to me
K. Chamberlain

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How does this sound? Hi Mr. Alonzo, how are you today? Are you ready to leave and start your recovery process?

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Okay! How would you guys want to re-write that instead?
-Alli S.

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Mr. A seems satisfied...works for me.
K.chamberlain

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<-- i like that you have him read it back to you.
K.Chamberlain

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nice job!!

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My thought process was that the other nurses just went in, did their assessment, put it into the computer and left. I believe he felt that building a relationship with him wasnt the other nurses priority. -Alli S.

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Should we have the nurse ask him why he felt that way? what information was he trying to get out of the other nurses that he didnt  get answers to?
K. Chamberlain

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I went ahead and re-wrote the scenario. Feel free to make any changes once we are all on here. We can then fix the rough draft and then take the screen shot to submit.
-Alli Serd

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RN: Hi, Mr. Alonzo, how are you today? Are you ready to leave and start your recovery process?

Mr. A: I am more than ready. What do I have to do to make it happen?

RN: First, I'll take a look at your wound, then I'll check your vital signs and labs in the computer, and if everything is normal, you'll be ready to go.

Mr. A: Don't remind me of that computer. I have never been so disappointed in a place in all my life. The nurses paid more attention to the computer than to me.

RN: I'm sorry to hear that Mr. Alonzo. While the computers are essential in documenting your health information and treatment plan, you should never feel neglected by them.

Mr A: Who's in charge of the nurses around here?

RN: There's a director of nursing and a nursing supervisor.

Mr. A: So who would I talk to register a complaint about the nurses?

RN: I would suggest either the nursing director or hospital relations. Their office is on the first floor, so I can let them know that you would like to speak to them regarding your concerns with nurses after I finish your assessment. Would that be okay with you?

Mr. A: Yes that would be great, thank you.

RN: You're welcome. Mr. Alonzo, your wound looks great, and I'll make sure to leave a prescription for some pain medicine for you. I encourage you to try to take 3 ibuprofen every 4-5 hours for pain, but also be sure you take them with food. If the ibuprofen is not working, then substitute the 3 ibuprofen for 1 narcotic. The narcotic can really plug up your bowels, so try to take the ibuprofen first and for as long as you can. Can you explain back to me how you will take your medicine?

Mr. A: I will take 3 ibuprofen every 4-5 hours with food to help with my pain. If that does not work, then I will switch to taking 1 narcotic.

RN: Great! Mr. Alonzo, do not do any lifting over 5 pounds for the next 6 weeks. It is important that your abdominal muscles fully heal over that period of time. After the 6 weeks you are free to do what you would like. The doctor has also has asked that you schedule an appointment with him in 2 weeks to check in with your healing process. The  phone number will be on your prescription for you to call him. Can you tell me what limitations you will have during your recovery process?

Mr A: I cannot lift anything over 5 pounds for the next 6 weeks and I need to make an appointment with the doctor in 2 weeks.

RN: That is right! I also suggest not to drive, especially if you are taking the narcotics. You should also wait until your office visit in two weeks to go back to work. What questions do you have for me Mr. Alonzo?

Mr. A: I have no questions, thank you for help.

RN: Great! I will go ahead and contact the office of the nursing director and hospital relations and have them come see you regarding your concerns now that your assessment is over. Have a great day Mr. Alonzo and a smooth recovery

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I think it's fine, because I took it as them being humorous with one another before she brings up the actual computer.
-Alli Serd

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I think the first couple of lines are fine unless you guys want to change her tone about the hospital with the "Get out of this place" comment.  I think that only added fuel to the fire when he was already upset...
K.Chamberlain

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The RN did very little to help the patient with his nursing problem.  I would say she only made it worse by not looking deeper into the problem and she herself was ignoring him. She could have showm more empathy to his problem and got to the bottom of why he felt ignored in the first place.
K. Chamberlain

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The RN did not help the patient in any way solve his problems with the nursing staff; in fact, she only made the problem worse by ignoring his complaints and giving half-hearted answers. She did not take the time to actively listen or reflect on his current problem, but instead, she insisted on getting him discharged.
- Sierra Kepski

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In my opinion, the patient-RN relationship in this interaction was severely compromised by the lack of communication, empathy, and trust between the two. The patient was too upset with his previous interactions to assimilate what the RN was saying, and therefore he did not walk away from this interaction feeling any more confident.
- Sierra Kepski

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That's a great point, Katie. I think if the RN would have given Mr. A her full attention from the beginning and addressed his complaints, then there may have been a higher level of mutual respect between them and he would have given her his full attention once it came time to discuss the discharge instructions.
- Sierra Kepski

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I agree with you all in that I do not think Mr. A assimilated what the nurse was saying. He was clearly too upset and preoccupied with his disappointing experience to even comprehend the discharge instructions. The nurse should have addressed his frustrations and complaints before moving on to the instructions so that she would have Mr. A's full attention.
- Sierra Kepski

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The RN didn't really help the patient. The nurse gave the patient the simplest possible answers. She did not ask the patient what was wrong, or show any form of concern for what the patient was feeling.
-Meredith Rodgers

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The patient-RN relationship in this interaction was not very personal. It wasn't effective or efficient, because neither person was very receptive to what the other person was saying.
-Meredith Rodgers

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The RN did not thoroughly respond to his questions. Instead, she just wanted to wave them off and move on. She should have been more thoughtful in answering the questions, even if they were complaints. She shouldn't have moved on until the patient was ready.
-Meredith Rodgers

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I do not think the patient assimilated the information the RN was trying to communicate. Instead of asking her if he needed further instruction, he just kept asking questions that were unrelated to him being discharged.
-Meredith Rodgers

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A communication problem that I noticed was the fact that the nurse did not clarify that the patient understood her instructions. She just kept plowing through the instructions, without making sure the patient understood. Also, they both seemed to be having their own conversations, and they were not directly interacting with each other.
-Meredith Rodgers

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I would describe the relationship between the patient and RN as severely broken. The RN treated the patient like another task to be done instead of like a person in her care.  There was a lack of empathy and in my opinion a lack of respect for the patient's concerns.
K.Chamberlain

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I agree!  the RN was treating Mr. A exactly how the other nurses were treating him.  She should have listened to his concerns before moving on to the discharge instructions.  She should have given him the information he was seeking before giving him the discharge info . If she payed full attention to him he may have paid full attention to her.
K.Chamberlain

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I dont think Mr. A was paying any attention to what the RN was saying. He was more focused on his previous disappointment with the other nurses. He may have been too emotional? I doubt he understand what medication, how much, when, or even when he was supposed to be back.  The RN just brushed off his complaints and did not make sure he knew what to do before leaving him.
K. Chamberlain

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One communication problem is the initial breakdown between MR. A and the nurses who payed more attention to the computer than him. There must have been some reason to begin with that he felt ignored. Was he asking questions and they weren't properly answered? If that's the case then his frustration will only worsen as the RN discharging him isn't giving him full attention either.
K. Chamberlain

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1.     The nurse was not helpful because even though she gave him answers, she did not seem concerned about his issue because she just wanted to discharge him and probably move onto her next patient. She did not go in depth with her answers to his questions. In the end I believe she did not play her role as an RN very well when it came to the relationship with her patient.
-Alli Serd

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1.     In my opinion there was no relationship built between the patient and RN because there was that huge lack of communication on side of the RN. Also there was no relationship built between them because the RN did not listen to the patient's complaint that he was trying to address.
-Alli Serd

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1.     I think the RN should’ve waited to give him the discharge instructions and listen to the issues he was having with other nurses not paying enough attention to him. She was doing the exact same thing as the other nurse and not listening and caring at the issue at hand. She should’ve helped him and give him advice on who to contact and then ask to make sure that was helpful and if she could proceed with discharging him from the hospital.
-Alli Serd

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1.     No, I do not think he assimilated her information because he was trying to address his first problem with her before he wanted to hear his discharge instructions.
-Alli Serd

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1.     One communication problem is that the nurse is not listening to the complaint of the Mr. Alonzo about other nurses not paying attention to him and more to the computer in his room. She just keeps telling him what he needs to do once he’s discharged while also giving him some advice on who to take his complaint to. Even though the nurse is giving him his discharge instructions, she seems to not notice that he is not paying attention to those instructions and more on the fact of not receiving adequate personal care.
-Alli Serd