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Look Back

I had a chance to participate in a simulation on , at … which was a scenario of a patient –

Sherry Sulin, diagnosed with Type 2 Diabetes and our group's responsibility was to communicate

with her. Through the scenario, I was allowed to join in and experience the way to care for a

patient and develop the therapeutic relationship between nurses and clients. During the scenario,

our group of six was struggling to deal with the patient’s situation and I was surprised at how the

patient reacted when we prevented her from eating too much sweet. Looking back on what we

did in that simulation, I think I could learn from that experience, be more active in solving the

problem by using critical thinking and do better in the future.

Elaborate

Before starting the simulation, my class was divided into one group of six and one group

of seven and each group was assigned in different scenarios, I was in the group of six. My

group’s scenario was Sherry Sulin, 66 years old who was diagnosed with Type 2 Diabetes for the

last 10 years, she is overweight but always asks for snacks and chocolate which had high calories

and too much sweet for her. Due to her poor Diabetes management, she has lost almost her

vision and only can see shadows and differentiate between dark and light. She had family, but

her son and grandson were too busy with their own life and merely visited her in the hospital,

which upset her a lot. She seems not to have hope for living and keeps saying that she is going to

die anyway and the way she enjoys her life is to eat whatever she wants. Our team members in

this scenario were all nurses, and our task was to introduce ourselves to the patient, developed a
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way to communicate with her and provided health promotion which could stop her from eating

snacks. When the simulation began, we knocked on the door to come in, provided privacy, then

we noticed that she has lost almost her vision so we did not touch her at first so it cannot startle

her, we all entered the patient room and started to introduce our names and our role as “Sheridan

nursing students”. Then, we checked her information and compared it with her two identifiers.

When everything was correct, we started with some questions about her family to make her

familiar with us but received all negative answers. She said she is so lonely, and she kept asking

us to give her chocolate. I tried to ask if she could consume sugar-free products instead since

they tasted the same but were better for her, however, she rejected my suggestion and started

yelling, at that time I was stuck, and I did not know what to say next. We tried to calm her down,

so we gave her ¼ piece of the chocolate bar saying that we would divide it into several pieces

and give it to her several times a day, and luckily, she agreed. We came to the chair and sat next

to her, held her hand and communicated with her about how she felt, and how life was going. We

told her that we were her nurses and always here to support her and offered a walk if she wanted

it. She said she wanted to cry as she missed her family too much, feeling that nobody was with

her. We knew that crying was better than keeping those feelings inside, thus, we kept silent and

let her cry. After all, she said she was better and began to receive her illness treatment, the

simulation also came to an end.

Analyze

Our group’s simulation went well in the end, even though there was some confusion

during the work. We collaborated with each other and worked as a real nursing team. Before

entering the patient’s room, we had to discuss and remember her disease and symptoms from the

document, through that activity, I learnt how to filter out necessary patient information and use
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critical thinking in an effective way to develop the care plan for my patient. During the

simulation, our team was put in a difficult situation several times trying to give Sherry good

responses as we were afraid of hurting the patient’s feelings or making her even more upset.

After talking to her for a few more minutes, my team seemed to be calm and brainstormed great

solutions for the patient’s problem. However, we forgot to reposition her into Fowler’s position

while talking, so that made her a bit uncomfortable and uncertain. As Sherry lost almost her

vision and she had a mental breakdown, we have learnt about and knew that “Active Listening

Skills” which includes a procedure called “SOLER” should be used for being a good listener, but

we did not remember the whole procedure to practice. Additionally, our team forgot to discuss

with a dietitian about the patient’s nutrition after having a conversation with her.

The simulation helped me to understand the difficulties and pressure when dealing with a

patient rejecting her treatment, taught me about the use of therapeutic communication techniques

and was a good experience to remind me to compare my work with “SOLER” procedures to

decrease patients’ stress and anxiety, helping them to receive treatments and get back to normal

life.

Revise

If I have a chance to do the simulation again, there will be things that I would like to

change and need to be changed. After reviewing the patient’s document outside, I will be

prepared with a bundle of questions and answers to communicate with Sherry, so I will not get

stuck during the conversation. In addition, while confiding with the patient, I will raise the bed to

a high Fowler’s position, thus, our spaces will be closed, and it helps the patient feel more

comfortable exposing her feelings. I will focus on therapeutic communication techniques which

would be “SOLER” in this scenario stands for S- sit facing the patient, O- open posture, L- lean
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toward the patient, E- eye contact intermittent, and R- relax, SOLER is a non-verbal

communication and a method for counselling (ACS Distance Education, n.d). In communication,

I will ask open-ended questions to encourage the patient to share her story and feelings. Every

piece of information she said will be crucial for me as a nurse to determine what she needs most

in the present and assist her in time. Finally, after communicating and determining her problem

which I consider would be nutrition, I will ask and discuss with another professional (dietitian)

for help in developing a new treatment in this case.

New Trials

There were many lessons I have learned through this simulation. I had a good opportunity

to understand how communication techniques play an important role in healthcare and how to

use them effectively. Even though I have been taught about it, I hardly used it. With the

experience I have had in this simulation, I will apply it to my clinical placement in the next

semester if I need to deal with patients who refuse treatment and lose hope for living. I will pay

attention to every word and acts I make toward the patients because it can hurt and create

emotional damage. Furthermore, not only “SOLER”, I am also working on other essential

techniques such as “I-SBAR-R”, “SOAP, and “DAR” to assess the patient (Potter et al., 2019).