Purposeful Conversation, Essay Example

Having a purposeful and meaningful conversation is highly effective communication. This is powerful depending on the words and gestures used. Positive communication is a practice which supports the shift from just talking and having a truly meaningful conversation. There are several keys words to be avoided such as “should” or “ought.”  Changing these terms to “I want you to” transform the conversation through a perception of positivity from negativity.

Understanding the dynamics of a purposeful conversation is particularly important between a nurse and a patient. Often patients are upset and feel bad which creates a feeling of being out of control and confusion.  Some patients deal with this differently than others. Allowing the patient to talk and vent their frustrations and feelings is important to opening the pathway to a trusting encounter. Showing the patient the integrity and respect they deserve is the foundation for gaining their trust. Body language is also important to watch and monitor as the patient is speaking and receiving feedback from the nurse. The interactions between the nurse and patient must be positive and encouraging; particularly from the nurse.  Dedication to purposeful communication skills by the nurse will empower them to show the patient their confidence and courage. The patient will recognize the passion and ethical nature demonstrated by the nurse and can easily slip into the conversation feeling assured the nurse if attentive to their needs and will be noncritical or condescending.

I traveled to the University of Iowa to meet with a patient specifically to engage him in a purposeful conversation. I met with John, a 50-year-old man admitted for pancreatitis. John had encountered several upsetting and frustrating situations with the healthcare industry.  He had grown to distrust anyone associated with medicine and healthcare. Upon my initial introductions to John it was easy to tell he was also skeptical of my presence and what I might represent. He glared at me and watched every move I made. He was negative about entering into a conversation with me.

I immediately told him that all I wanted was to speak with him and learn how the healthcare system had mistreated him. I asked him to convey his story to me.  He began by telling me that he had six long years of fighting with health insurance companies before he was accepted for coverage. He has a history of alcoholism, although he has been sober for many years. As he speaks of insurance companies he nods his head a lot and flings his hands as if to dismiss something close to his face. He relates a feeling of being “warehoused” at one facility where he was given morphine and solid foods; to appease him not to cure him.

After this he went to the Mayo Clinic. Initially he drove 500 miles for testing but he was turned away.  However, he did return to the Mayo Clinic later.  At this facility the doctors referred to him as an “alcoholic” which upset him further. During this part of the conversation he was very animated with head shaking and hand flinging. During his treatment there he asked not to be given oxycodone as this would upset his pancreatitis. However, he was given this drug which did create a pancreatic attack and also upset his known stomach ulcer. He feels he was treated poorly and not listened to by the medical staff. He has a strong opinion that the healthcare system pushes drugs and does not want to help the whole patient. If doctors would treat the patient instead of pushing medicines at them, he feels he could get better.  As he talked about this belief he looked exhausted as if the fight over his healthcare and insurance battles had tired him.

He is also aware that if he had not had health insurance all of the tests, procedures, hospital visits and office visits would have left him bankrupt.  He feels that this is unfair to the community and particularly insensitivity on the part of the insurance companies who try to control everything. During two attacks of pancreatitis he was off of work for weeks. He was hassled by the insurance companies and feels the doctors were contradictory in how they filled out reports to the insurance companies regarding his diagnoses and delivery of care. During this part of the conversation John was again agitated and his body language demonstrated anguish and hatred for the healthcare industry. His primary gestures throughout the conversation were head nodding and hand flinging and sometimes using his entire arms.

I allowed him to tell me his story without interruption as I felt he needed to tell it in it’s entirely.  I then began to talk to him about how he felt.  I tried to be honest with him as possible and told him that although I had not been involved in his care throughout his ordeal that I could sympathize with him and his feelings. I spoke about how some healthcare organizations are better than others just as some healthcare personnel are better than others. But that I wanted him to not be discouraged but rather try to be proactive and positive in his healthcare. I also reminded him that his condition needed medical attention and to not give up.  When he would respond to my conversation I would listen and smile, holding my hands in my lap and trying to show a peaceful and calm stance. This encouraged John to reflect on the positive healthcare experiences he had encountered. As I continued to comment on the positive things he had experienced and we talked about ways to improve his current condition, his body language and demeanor calmed and he was less animated and his hands and arms remained quiet and motionless. As we talked I said phrases such as “I hear you” and “how did that make you feel.”  As he began to calm I also joked a bit with him and did get him to smile.  I ended the conversation on a positive and encouraging note.  He seemed to have enjoyed our time together and said he was going to take a more positive attitude towards his health and change how he spoke with the healthcare professionals; trying to be less demanding and more available to openly discuss the best treatment for him.