Review

The Patient

Question 1
List any general observations you made about Prabjheet during the film clip.

Suggested Answer

  • Prabjheet speaks limited English and was not offered an interpreter
  • Unable to understand what is being said in the conversation due to language differences
  • Scared
  • Crying
  • Pain? (postoperative)
  • No social supports or family members

Question 2
List any observations you made about Prabjheet’s verbal and non-verbal communications.

Suggested Answer

  • Tears
  • Anxiety
  • Fear
  • Varying tone of voice
  • Distressed expression on face

Question 3
List some significant factors that may have contributed to Prabjheet’s distress.

Suggested Answer

  • Sub optimal staff communication
  • The conversation was rushed
  • No family members are present
  • Both staff exerted power over the patient by not using an interpreter or other communication strategies
  • The non-verbal communication of both staff members

 

Situational Factors

Question 1
List any observations you made about the environment in which the conversation took place.

Suggested Answer

  • Both staff members were standing rather than sitting next to the patient when delivering the difficult news
  • An interpreter service was not used
  • The news was given in the recovery room
  • No family members were in attendance
  • The clinicians came rushing in to start the conversation

Question 2
List any situational factors that may have contributed to Prabjheet’s distress.

Suggested Answer

  • The length of the conversation
  • The conversation was short and Prabjheet was left distressed
  • The doctor and nurse walked off in a hurry
  • The nurse did not contribute to the conversation
  • Prabjheet wasn’t given time to prepare for the conversation
  • The conversation took place in the recovery room shortly after Prabjheet came out of surgery
  • No other staff were available to support Prabjheet
  • Confusing environment

 

The Staff

Question 1
List any general observations you made about Doctor Michael’s verbal and non-verbal communications.

Suggested Answer

  • Aggressive tone of voice
  • Not listening to nurse Gemma or Prabjheet
  • Negative body language
  • In a rush
  • Forceful
  • Lacking collaboration
  • Standing up at the bedside when delivering difficult news
  • Does not wash hands or ask for consent before looking at surgical wound
  • Neck is red and flushed
  • Leaning forward
  • Does not have time to book an interpreter
  • Lacking sensitivity

Question 2
List any general observations you made about Nurse Gemma’s verbal and non-verbal communications.

Suggested Answer

  • Frustrated with situation
  • Not standing as patient advocate
  • Speaks to patient in English and does not use interpreter
  • Appears agitated and walks out on patient
  • Distressed facial expression in front of patient
  • Ill prepared for the conversation
  • Standing up at the bedside rather than sitting next to the patient

Question 3
List some of the barriers to effective communication during end-of-life discussions with patients and families of CALD backgrounds.

Suggested Answer

  • Decision making that is not collaborative between clinicians and patients
  • Poor timing of conversations
  • Poor cultural competence and inability to adapt care
  • Language barriers and inappropriate language
  • No consideration of the impact of gender
  • Cultural expectations of the family and patient
  • Non-trusting relationship between clinicians and family
  • Cultural differences in practice and beliefs
  • Lacking use of interpreter services in conversations with patients of non-English speaking backgrounds
  • Clinician lack of training and education in communicating with patients and families of CALD backgrounds

 

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