Thi Pham APNP E-portfolio

Western Sydney University, Bachelor of Nursing

Critical Reflection

I was involved in an incident which have an impact in my future nursing practice, and which I will be using the Gibb’s Reflective Cycle (1988) to discuss. In the high care unit at Lansdowne Nursing Home I encountered a patient in his late 80s of Asian appearance who seemed to be in pain. I approached and asked him about his issue but he seemed incomprehensive and confused. I realised that I was asking him in English and he probably did not understand, so I switched over to Vietnamese and luckily he understood.

I calmed him down by letting him know I would get help very quickly and immediately informed the registered nurse (RN) on-duty as per protocol at this facility, and she in turn contacted the in-house doctor of what was happening.

The RN informed the doctor of what has occurred. As soon as the doctor entered the room to assess the patient, I realised I would have to get involved as both the RN and the doctor did not speak Vietnamese and the patient did not speak English.

The patient clearly was waiting for me as he did not respond to the doctor and seemed to be relieved when I joined the room. So I asked him to explain to me about his pain and I calmly translated to the doctor. The 3-way communication was effective and the doctor was able to diagnose and started the treatment plan within the hour.

According to Wang, Xiao, Yan, & Yasheng (2018), language difficulty is a common problem among the older generation of migrants, and particularly in this facility. So I felt satisfied because I was able to get treatment for the patient in time by using effective communication. A positive aspect of this incident was that the patient was treated in time. Conversely, the negative aspect of this incident was that the patient was probably in pain for longer than necessary.

From this incident, I learned that effective communication within a multi-disciplinary team promotes therapeutic care for the patient, and effective communication assists patient to take action and make better decisions about their care and treatment (Bramhall, 2014).

Looking back on this incident, I should have realised that it would have been more effective to communicate with the patient in Vietnamese sooner.

In the future, I would not hesitate to engage with other health professionals and with elderly patients of non-English speaking background using effective communication, and according to Smith (2017) emphasising the value of diversity and cultural competence to support personal development and professional nursing practice.


Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard, 29(14), 53-59. doi:10.7748/ns.29.14.53.e9355

Gibb, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford, England: Further Education Unit, Oxford Brookes Universdwifery Board of Australia:

Smith, L. (2017). Cultural competence: A guide for nursing students. Nursing2017, 47(10), 18-20. doi:10.1097/01.NURSE.0000524770.18720.96

Wang, Y., Xiao, L., Yan, P., & Yasheng, A. (2018). Nursing student's cultural competence in; caring for older people in a multicultural and developing region. Nurse Education Today, 70, 47-53. doi:10.1016/j.nedt.2018.08.012

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