Journaling and Barrett's Power Theory

Journaling is not my strongest passion, although I love to read them. Throughout my high school and college years I found myself loving to read historical journals. Reading journal entries that were written by people of the past shows me how precious our lives are, and how different one's life can be compared to others. When we were first given this assignment I was not sure how to feel about it. I as a person find it difficult to describe my feelings and emotions not only to others but to myself on paper. I tend to keep my feelings to myself so I do not feel as though I am applying any of my problems or difficulties on others. Since the beginning of this assignment I have journaled six times. Although this may seem like a low number compared to others, I feel as though it is a lot compared to what I am used to doing.

My journal entries are mainly based on patients in which I encountered at my clinical sites. While reading over my journal entries I noticed that the majority of my entries pertained to my personal and professional life as a nursing student. In the beginning of my clinical rotations I struggled with properly communicating with my patients. At the time I was very shy and unsure of how I felt on speaking to people that I do not know. For most people this is common when they are just meeting new people, but these aren't just new people they are my patients. After a couple of clinical rotations I then began to open up more to my patients. This not only made me more comfortable in my clinical environment, but I also noticed that it made my patients more comfortable. After reading my first couple of entries I had noticed how shy I was becoming to my patients, and I went out of my comfort zone to do the one thing that I love and that is helping others. This journaling assignment allowed me to open up about myself and showed me how to open up more not only with my patients, but also in my personal life. To begin my clinical rotations now I take a minute to myself where I take a deep breath and tell myself that I can do it. Nursing is one of the true things in life that make me happy, and for that I will risk changes to help those in need. When caring for patients it is important to make them feel comfortable and relaxed in their time of care. Proper communication and positive tones help with healing. After I began to open up more to my patients I noticed a change in the patient interactions. They began to become friendlier and open to what they needed to take or have done. I as a person, would never intentionally make a patient feel uncomfortable, and now with the outcome of opening up more I can enhance my behaviors.

After writing my journals I was able to notice the changes in my communication with my patients, an example of this was last Wednesday at my med surge clinical. In my clinical site majority of the patients are elderly. Some may have been coming from hospitals as post op patients, and some are sent over for Hospice care. That day I was assigned a patient who had been post op after a full hip replacement surgery. Many of the nurses on the floor explained to me that the patient can be quite harsh and may want the head nurse to come into the room instead of a student. Before entering the room I grabbed the vital cart and prepped the instruments to proceed with the vitals. Upon entering the room, I knocked on the patient's door and slowly opened it. The patient was lying in bed with the lights out. Once she had seen me she yelled “who are you?!” In my head I began to panic but on the outside I stated my name and that I was a Mercy College student who was here to take her vitals for the head nurse. She then gave me a blank look and stated “fine”. Although I was very uncomfortable with speaking to a patient who was not in a good mood, I kept my composure and proceeded with my vitals. To make the situation more comfortable and not awkward I began to talk to the patient, asking how she was feeling and if she would like me to open her blinds to get some sun light into the room. The patients tone then lowered as she stated she would like to have her blinds open. As I proceeded to take her blood pressure I decided to keep the conversation going, this allows the patient to become more comfortable with their caregiver. I asked her what her pain level was and if she was having any visitors that day, and if she was having guests if she would like me to help her get ready. The patient stated that her pain level was an eight out of ten, and that she was not having any guest today or any day. After she told me her pain level was high I immediately excused myself and went to the med nurse on our floor. I explained to her that the patient’s pain level was an eight. The nurse then explained to me that when I give her the patient's vitals she will give the patient pain medication. After that I went back into the patient's room and explained to her what the med nurse had told me. I then asked her if she felt comfortable telling me why she was not having any guest. She looked me up and down and with a slightly sad facial expression told me that she had no one to visit her. None of her family members wanted to come visit her in the nursing home. It is common that patients in nursing homes become lonely when they do not have friends and family in their time of need, this can affect the patient's mood and can cause them to become angry or depressed. After the patient had told me this information I then explained to her that I cannot imagine how she is feeling and that if she needed someone to talk to I would talk with her. Immediately after I stated this to the patient her mood began to brighten. Later on that day, she asked if the head nurse and I would help her get dressed and maybe take a walk down the hallway with her walker. The option of being rolled down the hallway in a wheelchair was also provided to the patient is she was not ready to walk with a walker.

I found that Barrett’s power theory helped me with communicating better with not only my patients in my clinical setting but also in my social life. As stated earlier I was a very shy person when speaking to others whom I do not know, and with this theory it helped me open up more to my patients, as well as making me more comfortable interacting with them. Barrett states, “Power is the capacity to participate knowingly in the nature of change characterizing the continuous mutual process of people and their world” (Barrett, Par.1). With these journal entries it has shown me how I as a person can change to help my patients, as well as for my social life. I now have the knowledge on how to better my communication skills with my patients. Throughout this process I have learned that when properly communicating with your patients you can receive better communication back, and with that can lead to better care for the patient. I now before beginning my shift in my clinical sites take a minute to prep myself. With being more comfortable communicating with my patients I can give the best nursing care that I can. With that being said, I am proud of myself and the person I am becoming.