Therapeutic Communication - Part 3
This critical reflective report was written as a requirement for the Professional and Therapeutic Communication Class (Nurs11152). There are many techniques for writing which will separate out the descriptive, personal and emotional components from the analytical and reflective – a lot of which I have used in this report to move any reader into imagination and metaphor to create more insight (Rolfe, Jasper & Freshwater, 2011). As a writer, I wanted to put myself in a place of the other person in the event and tell the story from her point of view to move beyond barriers, thus, the use of the third person.
Read on and let me take you on my journey via the Group Dynamic Stages (Tuckman, 1965). The Story They were new people. She looked around the sea of unfamiliar faces – blondes and brunettes, round and squinted eyes, alabaster skins, aquiline noses, very, very tall people – she did not know anybody at all. That thought made her shiver. And that shivery thought made her feel like the smallest person in the room, literally and figuratively. She was the new girl. She arrived a day later than the rest of the international students in that class. She was the newest girl. And it was a very unfamiliar territory.
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Any person brought into unfamiliar surroundings experiences fear. “Fear is the emotional response to the perception of an alternating loss of control and regaining of control. (Saliba, D. , 1980). A person fears what he is unfamiliar of, maybe because the sense of familiarity somehow gives people a sense of comfort. And any student, even those who are not achievement-motivated, fears to be seen as incompetent and unable in the eyes of others (De Castella, Byrne & Covington, 2013). In a room filled with blondes and blue-eyed people, being Asian was being a tad different from the rest.
Arriving in a foreign country was something new. Attending a new class was something exciting. It was something to look forward to because from that day onward, they they were going to be learning new things and, most importantly, they were going to be communicating. Communication is a fundamental part of any encounter and in this boundary-crossing experience for international students, it was an essential topic (Jirwe, Gerrish & Emami, 2010). To communicate professionally in a language that is not your native tongue is a daunting task. That is why it is very important to learn this.
Apart from that, communication is important because it is needed both in written and oral: written for nursing documentation and oral for clinical handover (Jefferies, Johnson & Nicholls, 2012). The first thing that they had to struggle with was the culture shock. Culture shock is the psychological discomfort of adjusting to a new cultural situation (Klyukanov, 2005). Because culture shock is caused by an absence of shared meaning, you are likely to feel it most profoundly when you are thrust into another culture through travel, business, or international study (Verderber, 2010).
However, having people who are experiencing the same things that you are helped them get through this stage. Forming Stage The professor asked the class to form into groups of 4 for the Objective Structured Clinical Assessment (OSCA). A group is a gathering of two or more individuals who share a common purpose (Arnold, C. & Boggs, K. , 2007). The purpose was already there but the people weren’t. It might have been a little helpful to get the new people to group together. That was what they did. They were a group of Asians huddled together all with jet black hair but only one was chinky-eyed.
They entered the first step in the Stages of Group Dynamics, the Forming stage (Tuckman, B. , 1965). In the Forming stage, it is where the individuals, as members of a new team learn how to work together. Members are orienting themselves to the task as well as to one another (Bonebright, D. , 2010). It was also in this stage wherein the members created the ground rules from which they formed into a Team Contract (Appendix A). In the case of these three Filipinos and one Chinese group, it appeared to be easy.
The Filipinos had immediately established a sense of cultural bond being different from the rest of the Mandarin-speaking population in that room. While it is true that when our conversational partners or people in our group speak a different language than we do, it is easy to say that we have incompatible communication codes (Verderber, 2010). They still assumed that one Mandarin speaker wouldn’t hurt at all because she seemed to speak very good English. It is in this light that we realize the value of communication. In order to achieve the goals that the team has sent for themselves, they have to achieve competence.
And the only way to achieve competence in the OSCA is to communicate effectively. Communication competence is communication effectiveness (Keyton, J. , et al, 2013). Proper communication is needed for success. Effective communication plays a role in a person’s professional excellence (Showry and Manasa, 2012). Entering a university will help mold people into the professionals that they were intended to be. And to communicate effectively will be a challenge for everyone especially in a group who does not have English as their first language. Part of the Forming stage is the choosing of the group leader.
The group knew that there were better and more reasonable ways of selecting a group leader. Usually, groups select leaders with the use of a list of competencies which may include but is not limited to attentiveness, assertiveness, strong interpersonal skills, problem solving, team motivation, crisis management, staff development and empowerment, creativity, initiative and performance under pressure (Picker-Rotem, Schneider, Wasserzug, Zelker, 2008). But in that case, since the Mandarin speaker was wearing a white uniform, she was the only one different among the navy blue ones.
It sounded pretty simple because they didn’t think the leader would be of much importance anyway because a group of four would not really be very hard to manage. Little did they know that the leader would actually play a really big role. There have been too many researches done regarding Leadership Theories. To understand the entire leadership phenomenon, it is helpful to study about these theories: Great Man Theory, Trait Theory, Situational and Contingency Theory and Transformational Theory (Jones, R. , 2007). However, not one of them could ever answer what makes one a good leader.
The group was yet to discover what type of leader they have chosen. Conforming Over the course of time, the group had a lunch dates also known as group meetings. They were entering the second stage of Group Dynamics, the Conforming Stage. The agenda of these meetings can be viewed through the Minutes (Appendix B). Conforming is a stage where the individuals work together so well that it was almost as if the team lacked creativity, originality or other innovative ideas (Edison, 2008). Everything went smoothly and everyone agreed to what the other had to say.
Their friendship seemed to have made a great impact on their group relations but it wasn’t making a great impact on their plans for the presentation. Storming However, the third stage cannot be avoided. In the Storming Stage of Group Dynamics, This stage represents a period of conflict within the group because of personal issues as one seeks to express his own individuality which may or may not clash with the individual characteristics of another (Bonebright, D. , 2010). Each member wanted to do things her way. There were many issues that they had to face during this time. The first issue was time.
They never seemed to have a respect for time. It was either one of them could not make it because of family issues or the other had to be late because of work. Basing on the Team Contract (Appendix A), team responsibility includes, first, that the ttendance, punctuality, and participation at all team meetings is expected of all team members and, second, that the team members are expected to complete their allocated actions within the set timeframe. The second issue was communication. It finally dawned on the members of the team that communication was so much more than speaking the same language.
Part and parcel of the communication accomplishment would mean the communication skills applied. This includes verbal and non-verbal responses which means everyone should listen to what anyone has to say. This also pertains to efficiency and effectivity in disseminating the necessary information to all members of the group (Compton, 2013). It was also stated in the Team Contract (Appendix A) that “communication is done via Facebook and Viber. Immediate reply to any issue regarding the OSCA is required for every team member.
Upon receiving the message, each member must reply to the message immediately. If a member does not send a reply, the other members will immediately assume that the member has not read the message. ” Apparently, this was not followed. Yes, the communication was always there. They always kept in touch but it was not the communication that was expected of them basing on the contract. In a study conducted by the Youth Studies Australia (2011), it was found that immediate family, romantic partners and close friends play significant roles in the lives of this sample of predominantly young working men.
This is indicated in a number of domains, including when apprentices are sharing good news, trusting significant others with a personal matter, discussing the events of the day or seeking support. This is in line with research on close relationships and relationship networks. In the team, because they were the closest friends in the entire university, they shared good news to each other most of the time but they rarely discussed about the team project which was supposed to be the most important discussion of all. The third issue was respect.
People who are closely connected mutually relate to each other, and have relationships that are characterised by openness, trust, self-disclosure, friendliness and respect (McCann & Baker, 2001). But sometimes, because of friendship, other members become too lax. The team felt that very well. According to Barker, “organizational conflict arises because of rapid and unpredictable change, new technological advances, competition for scarce resources, differences in cultures and belief systems, and the variety of human personalities. ” I believe the latter is the most common cause of conflicts.
The differences in human personalities cause us to act and react in various ways which others may find to be suitable or not. And in order to address these differences, the group leader in cooperation with the members must find ways to compromise. Norming During this stage, the group understands their differences, accepts each other’s idiosyncrasies and finally develops cohesion. (Bonebright, 2010). The group finally found a way to work together, to work things out without letting go of the great ideas that they all had and most especially the great friendship that they all shared.
Tuckman (1965) stated that in this stage, the group becomes an entity as members develop in-group feeling and seek to maintain and perpetuate the group. It is in the time that conflicts are solved and avoided. It is true that no single conflict resolution strategy is universally effective. Kenneth Thomas and Ralph Kilmann (2012) identified five main styles of conflict resolution. The first identified style was a Competing which is useful in emergency situations because in this style, the people take charge with the use of power (Thomas and Kilmann, 2012).
Competing might mean standing up for your rights, defending a position you believe is correct, or simply trying to win (Trainer, 2010). The second identified style was a Collaborating wherein cooperation is emphasized because the person acknowledges that each member of the team is vital to the conflict resolution (Thomas and Kilmann, 2012). The third identified style was a Compromising which is a style that leaves everyone in the group partially satisfied so everyone else contributes his own form of sacrifice (Thomas and Kilmann, 2012).
The fourth style is an Accommodating which makes a member of the group give up his own needs for the benefit of another (Thomas and Kilmann, 2012). The fifth style is Avoiding which is characterized by lack of cooperation and assertiveness (Trainer, 2010). People who favor this style avoid conflict altogether. This is a weak approach and usually does not produce favorable results (Thomas and Kilmann, 2012). The group mainly used the Compromising style which combines both being assertive and being cooperative (Trainer, 2010).
The group tried to find a middle ground between competing and accommodating, giving up more than competing but less than accommodating because they wanted to accept each other’s ideas but they also wanted each of them to understand that these many differences will help make them all a better team (Trainer, 2010). It was in its entirety a give and take process. Performing In this stage, the roles of each member of the team become ?exible and functional, and group energy is channelled into the task (Bonebright, 2010).
Came the day of the OSCA, the group felt prepared. They still felt the jitters because that was an expected reaction but they knew that they had practiced well and were ready to take on the challenge. Adjourning This final step re?ected a group life cycle model in which separation was considered an important issue throughout the life of the group (Bonebright, 2010). However, in that group, they were not going to be separate. Yes, it was the end of the team project but it was not the end of their friendship. It was a great experience.
The new girl looked around the sea of faces… they were not anymore unfamiliar to her. They have become the people she wanted to graduate this Bachelors degree with. I was the new girl. Conclusion The experience was a great source of learning. It did only make the class understand therapeutic and professional communication in various ways but it also made the class understand the value of teamwork. Recommendation Looking back at what happened during the OSCA, our group had little lapses.
Recommendation on Performance. We performed well but there were a few things that we could have improved including the way that the introduction was given or the way the nurse approached the situation because she seemed to give more emphasis on the security rather than the rash assessment. Next time, the script should be studied well to make sure all aspects are incorporated properly and fairly. Recommendation on Documentation The documentation part was also another area to be improved to because only I did not have to retake it. The group should have reviewed about documentation together while having their OSCA practices so that we will be able to learn from each other.