How does what we believe affect how we communicate?

How does what we believe affect how we communicate? How does religious belief intersect with professional life, especially when the profession is health care? These questions piqued my interest in 2005 and I had the opportunity to explore them as I pursued my Master of Arts degree in communication at Marquette University. I defended my thesis and graduated in 2006. But I still had more to learn and to share, so I took my thesis research on the road. I presented my findings at the International Conference for Communication in Healthcare in 2007, and then began the process of submission, rejection, revision and resubmission to get my thesis research published. The result was a more refined look at the question that first caught my attention: How does what we believe affect how we communicate? In the survey, I found that a nurse's religious beliefs can enhance the clinical experience without the nurse trying to impose his or her beliefs on the patient, as the nurse works to make sure the patient's religious beliefs are upheld.

The article has been accepted for publication in Patient Education and Counseling. You can find the article here. If you do not have access to an academic library and would like to check out the article, please let me know.

The danger of nurse stereotypes

Theresa Brown, an oncology nurse and regular contributor to The New York Times Well column, wrote this week about a new book, "Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk.” The book and Brown's column explore the stereotypes surrounding nurses and the problems that those stereotypes can create. The stereotypes come from everything from media depictions of nurses to lack of understanding about the range and depth of nurse education. Such stereotypes can impede effective communication between patients, nurses and other medical staff, and as such can impede clinical care.

Many patients never learn the complex and diverse roles that nurses play until they find themselves in a hospital bed. Better educating the public about the many different roles in medicine will create a better clinical environment for everyone and will take some of the mystery, and fear, out of the medical experience.

Can nurses care too much?

The New York Times Well blog featured a guest blogger earlier this week that touched on an issue of particular interest to me: nurses and empathy. Theresa Brown, an oncology nurse, shares her stories about caring for patients and wonders if it is possible to care too much. You can find the story here.

What do you think? How can nurses balance empathy and the emotional strength to get through what can be a very draining profession?

Parish Nurses

My hometown newspaper The Milwaukee Journal Sentinel published an article today about the pivotal role of parish nurses. Parish nurses are usually registered nurses who are either hired by or volunteer at churches, to provide care for parishioners. But because they have a unique opportunity to build a sustained relationship with the individual patient and the community of patients, they can provide care in the context of the patient's spiritual and home life, and as such, are able to care for the whole person. In their trusted role, they can also help patients prepare for physicians visits, with pre-interviews to help patients prepare for doctor's appointments, and post-interviews to help patients put doctor's orders into practice.

These nurses play an important role in helping patients navigate the health care system, but also act as a warm and caring extension of the ministry of their respective churches.

You can find the article here: http://www.jsonline.com/story/index.aspx?id=741547

A child's view of ADHD

The New York Times Health blog ran an article on an interesting study published in the Journal of Pediatric Nursing. Drs. Shattell, Bartlett and Rowe conducted in-depth interviews with college students diagnosed with ADHD as children. The study yielded rich, personal accounts of what it is like to learn and live with the disorder, as well as the coping strategies the students developed and the reaction from parents, friends and teachers.

You can find a link to the article here: http://well.blogs.nytimes.com/2008/02/01/a-childs-view-of-attention-deficit/ and Dr. Shattell included a link to a PDF of the full journal article here: http://www.monashattell.com/uploads/FINAL_I_have_always_felt_different_--_exp_of_ADHD_in_childhood.pdf.

The authors said that nurses will be able to use this knowledge to improve the long-term care and outcomes of children with ADHD. Improved knowledge of what its like to actually have a condition can help providers empathize and better communicate with patients. And better communication can improve patient satisfaction and outcomes in the long-term.

Nurse religiosity and relational control

As a means of introduction to my new blog, I am posting the abstract of the poster I will be presenting next month at the International Conference on Communication in Healthcare http://www.aachonline.org/programs/internationalconference/ I will try to post a pdf of the poster itself once it is finalized.

The impact of nurses’ religiosity on their willingness to relinquish relational control in conversations with patients about end-of-life care

Introduction - Nurses and physicians are taught to approach communication in the clinical setting in a task-oriented manner, but discussions about certain topics such as end-of-life care may bring up personal religious values. The study attempts to examine how religious beliefs may influence patterns of communication in the clinical environment. The study was grounded by relational control theory, which says that conversation partners assert control through patterns of conversation indicating who is in charge. Previous studies indicate it is helpful for patients to have some control of conversations, but medical providers do not always relinquish control.

Hypothesis – It is hypothesized that nurses that are higher in intrinsic religiosity will be more willing to relinquish control. Clinician empathy is expected to be an intervening variable, diminishing the impact of intrinsic religiosity on willingness to relinquish control.

Method – An online census survey was administered to the graduate students in the school of nursing at a Midwestern university. The survey was designed to measure: relational control, as measured by the subscales of dominance and task orientation in Burgoon and Hale’s scale of relational communication; clinician empathy, as measured by the Jefferson scale of clinician empathy; and intrinsic and extrinsic religiosity, whether religious views are held for deep personal reasons or social reasons, as measured by the Maltby and Lewis scale, designed for religious and non-religious samples. Data were analyzed using multiple regressions and one-way ANOVAs.

Results and Implications – Intrinsic religiosity and empathy were both associated with the willingness to relinquish relational control in certain contexts. Many clinicians with intrinsic religious beliefs are willing to let patients guide their own care. Some respondents struggled with the language used on the relational control scales, so future research should consider different methods and language sensitive to the clinical culture to measure relational control in clinician-patient interactions.