The History About Stereotyping

Published Date: 02 Nov 2017

Log One

What made the biggest impact on me on the first day of the module was realising the true extent of the lack of communication in healthcare. After witnessing how badly some service-users are affected by poorly educated health professionals, (Scarborough K, Dramatic Voices, 2011). I now know there is a lot more to communication than just spoken words.

Throughout my life, I have always felt I have managed to communicate well with a wide range of people. This may be due to being brought up in another country which has helped my self-confidence and my ability to interact with different people in the appropriate way. Age has bought more experiences my way and has taught me how to deal with difficult situations sensitively without causing offence to people involved. I understand that good communication is a constant skill to keep learning as everyone is individual with different circumstances and needs.

Lavender (2010) has suggested that communication should be a process of shared sending and receiving of messages between persons. Arnold and Boggs (1999 cited in Lavender, 2010) states that providing excellent patient-centred communication has been linked to an improvement in ones self-esteem and confidence, this therefore can empower patients, helping them prepare for any resulting situations from their bad health When caring for people of different ages and nationalities, it is important to provide care accurately by recognising their individual needs. I will then be able to promote a safe and positive communication environment. It is important that as a healthcare provider I can recognise where communication barriers are and ways they can be broken down.

A barrier than can affect good communication is stereotyping. This is also known as labelling by sociologists. Stereotyping can result in miscommunication consequently affecting the care being given to a patient. Although stereotyping can enable us to quickly respond to situations by drawing on previous experiences, there are disadvantages. These are making generalisations and ignoring the fact that all people should be treated on an individual basis (Walker, 2007).

What I have learnt from this first session and I what I will make sure when I am practise, is that I am open-minded and not judge the women and their families. I plan to do this by making sure I listen to what individuals have to say without before casting any judgements. Rogers (1957) noted that the way in which individuals behave is due to how they perceive the situation they’re in. This therefore means that I need to ensure that I am self-aware. I will then be able to offer unconditional positive regard when caring for others. I do however understand that there will be times that I will be busy, but possessing these important skills to will ensure that the women in my care will get the treatment they are entitled to.

Log Two

On day two of the module, we were asked to complete two exercises about compassion and empathy. For the first exercise, we were asked to listen to an extract by Carel Havi (2008). Afterwards we had a discussion about what we think compassion is and how it could be defined. This proved hard as it was made clear that one of the difficulties in considering topics such as compassion is that everyone, including patients, healthcare providers and the general public, do have their own individual, subjective ideas of what compassion actually is. This could be due to personal definitions which fit in with our own view of the world, but these may have little in common with the views of other people. The second exercise consisted of group work, where we were asked to construct a poster about empathy. This illustrated a similar problem, what is empathy?

As I have previously noted, each of us have our own definition of compassion, and empathy is the same. This therefore results in a problem when caring for others as each healthcare professional will demonstrate compassion and empathy in a different way.

Rogers (1975) proposed that key principles should be followed when providing effective person-centred care. These key principles such are empathy, congruence and unconditional positive regard. A study conducted by McCabe (2004) showed that nurses who demonstrated empathy and who seemed more genuine gained more trust from their patients. Trust is essential in maintaining a therapeutic relationship in midwifery. If the relationship is not strong, the woman may not disclose relevant information, leading to possible health problems.

The key principles noted by Rogers (1975) are similar to those noted in the NMC (2008) code of conduct, which stresses the importance of respecting the dignity of those who are receiving care. Student midwives are assessed on their ability to provide compassionate care in clinical practice. As well as following the NMC (2008) code of conduct, the NMC (2007) also identified compassion, care and communication as essential attributes midwives and nurses should possess.

The importance of displaying true compassion and empathy to the women in my care is what has made a biggest impression on me on day two. I have learnt that it will take time and patience to realise what true compassion is as it many people perceive it as different things. When on practice I will need to ensure that I treat each patient with individual care relating to their own personal circumstances. I feel that time constraints will be a main issue that will cause difficulties in me achieving this. Having efficient organisation skills and being aware of my limitations will allow me to delegate myself effectively. I will have to make sure that I am giving all my attention the women I will be caring for by providing them with one to one individualised care. Making sure I can empathise with their different situations will ensure the women know I am understanding their needs. It is important that I am aware of body language and tone of voice as congruence is main part of person centred care.

Log Three

Due to health reasons, I was unable to attend the last four sessions of the communication module. I will therefore be using my experiences from my first placement in practice as well as evidence and literature to explore the next four topics.

Where I was situated on my first clinical placement, there were a diverse range of cultures and religions. At school I had a lot of friends from different countries and religions which I felt had given me a greater understanding of other cultures. However, after a few weeks on placement a family arrived in postnatal clinic asking about circumcision for their seven day old baby boy. I found this practice quite hard to understand so remained quiet throughout the conversation allowing my mentor to take control. On reflection, my behaviour could be construed as rude, this was not my intention. I was just merely embarrassed due to my lack of knowledge of the situation. I feel this could be the problem in clinical settings where healthcare professionals are not open minded and educated in different cultures beliefs and practices.

There are a number of personal characteristics of which are covered by The Equality Act 2010 (Gov.uk, 2013) to give individuals protection against being treated unfairly in the workplace and wider society. These protected characteristics are race, disability, gender reassignment, sex, marriage and civil partnership, pregnancy and maternity, religion and belief, sexual orientation and age. A basic tenet of nursing and midwifery is caring for the whole person and therefore noting and accommodating cultural differences must be one of the carer’s first tasks in developing a relationship with a client (NMC, 2008).

Arnold and Boggs (2003) recognise the importance of understanding that all people are individuals. This understanding is fundamental in providing good care as all care needs to be adapted adequately. Kai (2003) also states the necessity for people who live in a diverse society to become more accepting of others, whether they find the differences uncomfortable or not. Noticing that developing knowledge about local cultural practices and beliefs is also beneficial.

I feel that I need to learn about more practices in other cultures that are relating to midwifery and having this knowledge will enable me to provide help and advice whilst being confident that I am providing accurate care. Working in such a multicultural city will enable me to care for a variety of different women and their families and carrying on learning about diversity will help me to apply my knowledge efficiently (Olafsdottir O, 2008).

Log Four

As I have been working with a diverse range of pregnant women and their families in the community midwifery setting, it has shown me how important the possession of effective communication skills can be. When first entering the clinical workplace, I found that I communicated with most of the women in the same manner, which resulted in me not being capable of building that important therapeutic relationship needed in midwifery practice. I think this was due to me not having confidence in myself and being inexperienced in practice. However, after a few weeks I began to understand that there is a lot more to communication than just verbal speech.

I have discovered that communication does not just consist of speaking and listening. It is important that us as healthcare professionals understand that non-verbal communication is as important as verbal. Making sure that facial expressions and eye contact is maintained appropriately will help the women in my care to know that I am giving all my attention to them. When speaking to women’s family members, it is important to remember that their family members, especially their children will need to be spoken to in a different manner and the ability to adapt my communication to all ages is very important (Coupland, N. and Giles, H., et al)

Sheppard (1993, cited in McCabe, 2004) has identified that in nurse–patient relationships, the communication involves more than just transmitting information. Acknowledging the patients feelings and letting the patient know that these have been recognised is an important part of communication as it is demonstrating empathy. It is also suggested that not all nurses always communicate in a patient-centred way even when they have the ability to do so. This can be due to time constraints at work and also by the atmosphere in the organisation.

My introduction to learning communication skills when working with women and their families was an eye-opening experience. I discovered how alienated some women can feel when being cared for and this has showed me I want to provide the best possible care I can. I now understand that situations will sometimes occur where providing efficient communication skills may be compromised by time schedules. I have learnt that being able to alter my pitch and volume, facial expressions and eye contact is important in ensuring that I am meeting the woman’s needs and making her feel she is not being excluded, (Lavender, 2010). Consequently in me learning how to use effective patient-centred communication skills will help to encourage the women to participate and negotiate in decision-making regarding their own care (Langewitz et al, 2008 as cited in Lavender, 2010).

Log 5

Being a student midwife is a rewarding experience, however at times it is possible for some people to take advantage of my position. During my placement I suffered this from some healthcare professionals and although I have always thought of myself as a fairly confident person, I felt completely out of my depth. Having the ability to be assertive with people who you are not on familiar terms with, and of whom are more experienced is challenging but is necessary attribute to possess.

I understand that the ability to be assertive is a skill that I need to master as situations may arise in my future career where I need to challenge someone, for example situations such as me noticing discrimination or bullying in the workplace.

After researching and reading about assertiveness, I discovered that it is important to be aware of ‘rights’. Anderson, C. and Martin, M (1995) states that there are four types of communicators, passive, aggressive, passive aggressive and assertive. If I am being aggressive, I am not recognising the other persons rights, only my own. However, when I am demonstrating assertiveness, I am recognising that there are rights for the other person and myself. Lawton and Stewart (2005) have discovered the relationship between assertiveness and the use of non-verbal communication. By being aware of my tone, volume and the pitch of my voice as well as body language and facial expression can help me stay assertive, without becoming aggressive. Lawton and Stewart (2005) also discuss four specific techniques in helping healthcare providers to develop assertiveness skills; the ‘broken record’ or repetition technique, fogging, negative assertion and negative enquiry. All of these techniques are useful for midwives as they are involved in feedback which is vital for reflection. For my own development, I intend to use negative assertion technique as I feel that it is within this area which I need to improve on most.

Using the assertion techniques and reflection will allow me to process information, which will enable me to be more prepared when making decisions based on my needs as well as those of other individuals. Sometimes I will require assistance with the women I am caring for. Due to the busy nature of maternity wards it may not be possible to get other healthcare professionals attention as they will be busy doing other jobs and may not listen to my concerns. In this kind of situation I will have to be assertive whilst not becoming argumentative or threatening. Although being a student midwife can be a lonely job, it is however my duty to care for others. If I sit back quietly due to the fact I want to be liked by other staff I will be putting my patient’s health in jeopardy.

I recognise that due to assertiveness being a new concept to me, I must be persistent as I am learning a new behaviour and mastering this can take time. It may result in me feeling awkward at first, however practicing this attribute will lead to an improvement in me and the care I can offer to others. As I am quite a passive person I know that becoming assertive will be out of my comfort zone feel but the rewards are worth the effort and I must recognise when I have done something well.

Log 6

This module has taught me the importance of working within my personal limitations and has provided me with skills to use, such as assertiveness, becoming an effective communicator and empathy. Since beginning university, I have changed into a more open minded person and have learnt how important it is to value others. I have also learnt invaluable non-verbal skills that I will be able to bring into practice with me. Being a more empathetic midwife, will allow me to gain trust from the women I will be caring for which will in turn enable for more efficient communication.

Due to learning assertiveness skills, I will now be able to give and receive feedback more effectively due to understanding the importance of listening and accepting what others say, even if I don’t agree. I have previously found it hard receiving feedback, even if it has been positive due to only focusing on any negative feedback I received as this made me feel anxious and inadequate. I understand now that being an assertive person will enable me to make conscious choices about how to respond to any criticism I may obtain. I now can appreciate the importance of being able to ask for clarification to make sure I fully understand what the other person is saying. This will help me to validate other people’s feelings, without necessarily having to agree with the person’s feedback.

In conclusion, I feel that this module has enabled me to understand the importance of communication in healthcare for not only the people I am caring for, but also for the staff I will be working with. I know that I need to be aware of my own limitations and when asking for more responsibility, I must expect to be held fully accountable for my actions. Due to midwifery practice constantly being updated by guidelines produced by government organisations, it is important that I gain self-managed learning. This will be achieved by becoming more self-disciplined and listening and learning from other staff and especially my mentors also by keeping well informed with new and upcoming material

In practice I will need to be compassionate and display empathy as I cannot expect people to trust me if I am not willing to be trustworthy for them first and foremost trust is an outcome of fulfilled expectations.