Computer addiction and its negative effects on the student’s physical, academic and social life.

Outline

Computer addiction has negative effects on the student’s life: affects the physical health, changes academic performance and lessens social interactions.

A. Affects the physical health

1. Poor eye sight
2. Weight gain or loss
3. Premature aging

B. Changes the academic performance

1. Having trouble in completing projects, home works and quizzes
2. Failing grades
3. Repeating the subject

C. Lessens social interactions

1. Isolation from family, friends and God
2. Afraid to talk with other people
3. Don’t want to stay in public places

Computer addiction and its negative effects on the student’s physical, academic and social life

Introduction

Most of us turn to the computer to manage difficult feelings that includes loneliness, depression, boredom and anxiety. Computer is also an accessible outlet to quickly relieve stress and to escape real world problems. As a matter of fact, computer can be a great place to start great relationships, meet new people and interact socially. It also has recreational games that make the teenagers excited to play it, so that they do anything to reach a higher level of the game. In addition, computer can help us to make our work and task easily done. However, too much using of computers can lead to different risks and can affect our lives and change it into worst. The people who are attached with this machine will develop a kind of addiction which is commonly called “Computer Addiction”

Computer addiction is defined as a strong involvement to the computer which interferes with daily life and the time spent on the computer. It involves cybersex addiction, offline addiction and internet addiction which can cause negative effects on relationships, academic studies, work and communication with family. Nicholas Rushby of British e-learning academy suggested in his 1979 book entitled “An Introduction to Educational Computing”, that people can be addicted to computer and suffers from withdrawal symptoms. It was also used by Shotton in his 1989 book entitled “The Computer Addiction”. In addition, there were an estimated 2.3 to 5.6 million addicted computer users in 1997. It increased from 11.3 to 18.9 million in 2005 and that existence makes it easy for individuals to feel no remorse for their crimes and believe that there will be no severe rebuke for committing them (Mental health of children today, 1999)

Generally speaking, these studies showed that computer dependency is really a threat to us and it is one of the main problems in our society nowadays. Most of the people ignore the effects of computers which can harm them as they grow older. We must know how to properly use the computers for us to avoid getting into a problem which leads to significant effects in our daily lives. We must also have self-discipline in able to achieve our dreams and accomplish things successfully. The goal of this research paper is to raise people’s awareness about their dangers when they are attached too much on the computer. Computer addiction has negative effects on the student’s life: affects physical health, changes academic performance and lessen social interactions (Saisan, Smith, Robinson, & Segal , 2014).

Discussion

Affects the physical health

In a technological driven society, computer addiction including the offline and online addiction developed so much in the lives of many people especially the young ones and is one of the reasons why most of us experience negative consequences in life which affect the physical health. What is the importance of taking care of your health? We all know the popular saying “Health is wealth’’; this gives a large meaning to our life because health is considered the most precious and valuable for an individual. Good health is not just about the absence of disease in our body but it is how you react with your environment in a positive way (Chaterjee, 2012).

When we started browsing the computer and didn’t notice the time we wasted on it. We will just keep on playing with it until we feel something. We will notice that something is bothering our eyes which I think is the radiation. It is an energy that comes from a source or material like computer which has a serious effect on our health especially on eyes because of too much exposure on the screen which leads to poor eye sight that decreases our chance of seeing things better and the reason for wearing eye glasses at a very young age. Today, many students are working under stressful condition without any satisfaction which is detrimental to physical fitness. And as a result they suffer from many diseases. In order for us to be physically fit, we must do three important things: exercise, diet and sleep. Another effect of computers in physical health is the dramatic loss/gain of weight in our body. Severe weight loss can be cause by eating disorders like skipping meals and eating in front of the computer which is not necessary. While obesity is the condition wherein a person can’t handle his/her weight. What do you think are the reason of

obesity

? When a student just sit on the chair for long hours facing on the computer and doesn’t do any exercise, he/she may gain weight easily because not doing physical activities such as running, walking or dancing. Regular exercise reduces excess fats in the body and decreases our risks of having heart disease, kidney failure, diabetes and high blood pressure (Physical exercise, n.d.)

The third effect of addiction to computer in the physical health is the changes in a person’s appearance. Majority of the computer users are teenagers, adolescents and children but when you look at their faces and observe them you will notice the big difference between them and a child who is not a computer addict. What do you think is the consequences of this in your physical look? You will suffer from aging which is the process of becoming older. It represents the accumulation of a person over time. Aging is not really about counting birthdays; it is about how your body reacts and works in daily situations. A student who stays up all night using the computer will be exposed on ultraviolet rays which can cause wrinkles, eye bugs and pimples on the person who used it which leads to premature aging. In addition, computer users can develop skin problems which can lead to skin cancer (Charles, Reynolds, & Gatz, 2001).

Changes the academic performance

“Education is the most powerful weapon which you can use to change the world” –Nelson Mandela. This quotation is simply telling us that having education is very important because it is crucial for the development of an individual and the society. But because of the benefits they get in the computer, the students forget about their academic studies which seriously affect their grades in school. According to Dr. Maressa Hecht Orzack (1999), director of the computer addiction, about 5% to 10% web surfers suffer from some form of web dependency. This means that the students always rely on the computer every time they need to do or to know something. In this case, students were not able to study on their own and understand the lessons in school. When the students spend more than eight to ten hours in playing games on the computer, they are already connected with it and ignore their homework for which they continuously play without any doubts in their mind. For example, students tend to play first, check their emails and browse social networking sites rather than reviewing for their exams, studying for recitations and doing their assignments on time. They sleep all day because they don’t have energy to do what they need to do and to finish the tasks that needs to be done (Kirkpatrick, 2010).

There is 15 year-old boy who asked for the help of a psychiatrist “Dr. Orzack”, for his problem about failing grades. He said that when he was 11 years old, his weighted average is 1.3 which easily fell down into 3.8 because of uncontrolled usage of computer. He didn’t manage his time wisely and did not use his computer properly. To be specific, this boy has no self-discipline which is an important tool in handling daily challenges. What will happen if we failed our subjects/courses? We will enroll in that subject again, pay tuition fee and waste a lot of time on studying it for the second time. Repeating a subject has a lot of effect on us especially on our personal feelings. We will be shame to attend classes because of being irregular. I want to emphasized that the reason of failure is not because that person is stupid hence, it is about laziness and being irresponsible for the all the things he/she must finish. We just need to motivate ourselves and start to do right things (Smith, 2007)

Lessens social interactions

Good relationship is something we want and something we need in our life. It is essential to fulfill our goals and to be successful. There are three important relationships in life which includes relationship with your family, friends and God. What is a family? For me, family is the most important people in our lives. I believed that they are the ones who will accept me no matter who I am. It means to feel loved, secured and appreciated. However, there are big changes that will occur in your family when you get addicted to computer. Although computers bring joy to our lives, it can also be the reason for being isolated with your family. For instance, if a person spends so much time on the computer, other areas of life will be neglected. He/she may grow distant from her family (Hartley, 1999).

Another is about handling friendships. Do you consider you online friend as real friends? Real friends are the people that you can trust and share your emotions personally while online friends are the people that you don’t know and you don’t interact verbally. Verbal communication is very essential to a good relationship. It is the act of sharing ideas by using speech/words. Nowadays, people are enjoying the benefits that they get in the computer. They think that with the used of different networking sites, they can create better relationships rather than the real world. Facebook, Twitter and Instagram are the examples of it, which are very popular in different countries. Using computer is not as bad as the drug addiction, we just have to discipline ourselves, balance life and avoid conflicts (Neher & Sandin, 2007).

“So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand” –Isaiah 41:10, this bible verse is simply about believing and trusting God. He is the person who strengthens us. No matter how hard the challenges we’re facing today, he will always pull us up to continue our life. But when we observe our society today, we will notice that very few people go to church and talk to God. Why? It is because they are busy doing things that are not important which can be the hindrance of their dreams and wishes for themselves. Computer addiction has a big impact on each individual. Many people forget to thank God for all the blessings he gave us and ask for his guidance in handling day to day situations just like computer addiction (“Kids addiction,” 2010)

According to Dr. Philip Tam (2010), a psychiatrist at Rivendell, he has seen a teenage school boy playing 37 hours non-stop with only toilet breaks. In this case, that boy spends almost one and half of his day in front of the computer. The computer affects his mental behavior and attitude towards other people. For example, when the students are caught by their parents, they will defend themselves and feel guilty about it. For these reasons, they develop negative behavior that results from being isolationist. Computer users are afraid to talk with other people.

We cannot blame computer addicts if they don’t want to stay in public places because of being uncomfortable. For them, dealing with the outside world is very hard and complicated because they are already immune with their life inside their house or the computer room. In order to overcome this addiction, they need to find alternative ways and consider the suggestions of the professionals. The theory of Dr. Maressa Orzack states that one of the most effective methods to deal with computer addiction is the “Cognitive Behavior Therapy”. This therapy teaches the patient to identify their problem, to solve their problem and to learn coping skills to prevent relapse. It is also a way to encourage the students to join social gatherings, school activities and different organizations that will help a lot for making new friends, discovering skills, enhancing talents and exploring the world (Orzack, 2001).

Conclusion

Computer addiction is really dangerous to our lives and has consequences that affect our physical health, academic performance and social interactions. The effect of computer in our physical health includes poor eye sight, obesity & weight loss and premature aging. These are all about your physical appearance and health. The second effect of computer addiction is on our academic performance. Studying is very important to a person’s life and if we don’t study well we can experience having trouble in completing tasks at school, failing grades and of course repetition of a particular subject. The last effect of being an addict is about social interactions. Being alone and not communicating with the outside people can cause isolation from family, friends and God, afraid to talk with other people and not comfortable in staying to public places.

In addition, there are also ways to avoid, lessen and overcome computer addiction. We need to seek professional counselling, ask help from our parents and motivate ourselves to change because it is the bridge to goals, accomplishments and dreams in life. To be specific, computer addiction is not a lifetime problem. It can be change as time goes by and by having good attitude towards trials and struggles in life. Always remember that God is always at our side and will guide us for every decision we make (Rizetto, 2005).

Furthermore, I conducted this study in order to raise people’s awareness about the serious causes and effects of computer addiction on life. I also thought that this is currently happening in our generation nowadays that will serve as a warning to the users of computer. I also want to help the parents and the computer addicts to cope up with this addiction and start living healthy. This study will be also beneficial about convincing others to properly use computer even if they are stressed, depressed and lonely. For the most part, I strongly believe that computer addiction is a threat in our lives and has many effects on us and the people around us. We must learn how to use computers responsibly and learn how to appreciate what life God has given to us

References

Charles, S., Reynolds, C., & Gatz, M. (2001).

“Age related differences”

. Retrieved from en.m.wikipedia.org/wiki/Ageing

Chaterjee, M. (2012). “

The Importance of Physical fitness”

. Retrieved from http:/

www.google.com.ph

Hartley, H. (1999). In Harlley,

The family book of manners.

Uhrichsville, Ohio: Barbour and Company, Inc.

Kids addiction

. (2010). Retrieved from

http://blogs.news.com.au/dailytelegraph/yoursay/index.php/dailytelegraph/comments/kids_computer_game_addiction_ask_expert_dr_philip_tam/

Kirkpatrick, D. (2010).

The Facebook Effect.

Newyork: Jimon and Schuster Inc.

Mental health of children today

. (1999). Retrieved from

www.studymode.com

Neher, W., & Sandin, P. (2007).

Communicating ethically.

United States of America: Pearson Education, Inc.

Orzack, M. (2001).

Cognitive behavior therapy

. Retrieved from

www.nacbt.org/cognitive/behavior/Therapy

Physical exercise

. (n.d.). Retrieved from

www.englishdaily626.com/junior_english_essays.php?031

Rizetto, D. (2005).

Waking up to what you do.

Massachusettes Avenue Boston: Shambhala Publications, Inc.

Saisan, J., Smith, M., Robinson, L., & Segal , J. (2014, November).

Internet and computer addiction

. Retrieved from

http://www.helpguide.org/articles/addiction/internet-and-computer-addiction.htm

Smith, M. (2007, February 15).

Recognizing game addictions

. Retrieved from

http://www.olganon.org/?q=node/3014

Assessment 4

Issue 1: Effect of Poor services

On Reputation of Kindly Residential Care Rest Home

Generally, the reputation of an institution, particularly elderly care facilities, is very essential in order to make known to concerned clients and their families how firm the institution is in offering quality health care services. In order for an institution live up to their reputation or even exceed the expectation of the clients and be more competent than other neighboring competitors, series of quality improvement measures are then conducted all year round. The first step or approach in quality improvement is to be able to identify certain factors that have a potential or a likelihood of contributing to the rise and fall of an institution’s reputation.

1. 
   
   Patient safety
   
   

Safety for the client is always considered the highest priority and is the topmost factor to consider. Issues such as shortfalls, injury, elderly abuse and the like are indicators that help measure the quality of service rendered by the institution. If and when complaints in relation to these issues start skyrocketing, that is when measures for legislative amendments are called for. When the safety of a resident is at risk in an institution that is reputed to have substandard services and management, the said institution will be subjected to disciplinary action set by the Ministry of Health.

2. 
   
   Management
   
   

The essential component of a healthy institution is quality satisfaction derived from both the staff and, most importantly, the customer or client. And the driving force of an institution is the operational team or the management. Any quality of service rendered by the staff and level of client satisfaction would greatly reflect on the management’s performance. Poor management over staff, facility and its services would lose the trust of its staff as well as its clients.

3. 
   
   Quality assurance
   
   

The quest for an institution’s outstanding reputation doesn’t happen only once. Over periods of time, a series of audits, surveys, investigations, studies and statistics are continuously conducted to ensure that an institution lives up to its reputation. Quality assurance is there to make sure that the institution still served its purpose. At some point, certain issues within the institution have been overlooked and what has been known to be reported to responsible parties doesn’t seem to reflect the raw evidence that may arise from poor quality assurance. This would then lead people to think otherwise about entrusting themselves with the institution.

On Accountability of Private Sectors and Public Sectors

Private sectors are at an advantage when it comes to accountability. The public sector accounts more than the private sector, since most legislations and policies governing private institutions are stipulated by the public sector. When poor services are noted from the public sector, consumers or clients tend to rely more on the private sectors due to their extensive services and features. Because the government has minimal or little involvement over private sectors over quality improvement measures, the private sector may have the opportunity to expand the boundaries of their services in order to improve better client outcomes. There is no formal organizational structure compared to the public sector. Therefore, in the event that poor services may arise from Kindly Residential Care Rest Home, it may turn to be more of a challenge in order to gain competency in the health care industry.

Stakeholders

They are the persons who have a “stake ‘’ in any organization. They may be called:

Internal Stakeholders – in the Kindly Residential Care Rest Home, the Internal Stakeholders are the Owners or the Healthcare Providers, the carers, the nurses, and all who work for the well- being of the elderly especially those persons with dementia.

The External Stakeholders include the Government and Non- government organizations which contribute their time, treasure and talent to help the Residential Care Rest Homes deliver quality service.

“Quality of Care’’ is a difficult concept to measure particularly within the context of residential aged care, which involves lifestyle issues as much as health issues.

• One example is the Australian Accreditation Standards having been credited with contributing to improve care.

Though they represent only minimum standards of quality, they do not focus on clinical outcomes.

Individual facilities

might only be assessed against these standards every 3 years; and within these years, much scope for quality variations may go unnoticed.

Hence, collecting and analyzing comprehensive clinical data from aged care facility residents constitutes an essential step in the process of monitoring quality environment.

Ways to Improve

• The USA has introduced and continued to refine, a compulsory technioque of assessment within its nursing homes aimed at monitoring quality of care and clinical outcomes. There is a Minimum Data Set/ Resident Assessment Instrument which is a system of forms to be completed at certain intervals to meet a number of purposes such as care planning, case mix funding and quality monitoring. This uses Quality Indicators as a means of implementing quality assurance and improvement within residential aged care.
• Residential facilities had been subsidized by the Commonwealth Government since 1962, but funding was not regulated.
• Initiatives relevant to residential care have included a standardized system of assessment (Resident Classification Scales) to determine resident care needs and a formal system of Accreditation to ensure quality service delivery.
• Because quality of care is a multi – dimensional concept, no single area of assessment can provide an accurate indication of quality. Thus, an effective assessment should contain as many items considered relevant to quality care. Hughes et. al suggested that quality measures should be integrated into routine clinical practice.
• The Australian Society for Geriatric Medicine described the Residential Classifications Scales as the “antithesis of a funding system that generates incentives for quality health outcomes.’’
• Government –appointed bodies responsible for assessing residential care facilities compliance with standards improved quality of care within residential care facilities.
• Aged Care Standards and Accreditation Agency was introduced in 1998 that compels residential aged care facilities to seek accreditation for funding.
• Clark and Bowling (32) suggested that quality of life in residential care could be ascertained by looking at measurable indicators such as general health, functional status, mental health, comfort, emotional wellbeing, privacy, choice and autonomy.
• When considering quality assessment for residential aged care facilities, indicators of quality should encompass areas of clinical care directly related to residents’ physical health, as well as quality of life and lifestyle-related issues such as activities and family involvement.

Issue 2: Quality Management Theories

Pareto Analysis

This is a simple methodology by which prioritization of potential changes through determining the problems that can be addressed and resolved through making necessary changes. Through this technique, the organization can make prioritization according to the individual alteration that could improve the scenario.

This quality management tool utilizes the Pareto Principle or the 80:20 rules. This rule utilizes the concept of 20 percent cause that could produce to 80 percent outcome.

The Kindly Residential Care Rest Home will use the following approach while taking into consideration the principles of Pareto Analysis to achieve the best practice in healthcare services of the said organization.

1. 
   Problem Identification and List it
   

First, the problems and potential threats are listed down. In this step, possible inputs from clients and members of the Kindly Residential Care Rest Home (KRCRH), and conduct surveys to identify the existing problems in the organization.

2. 
   The root cause of problems are identified
   

In this stage, methods are utilized that warrants the team to identify the root causes of threats and problems.

3. 
   Score Problems
   

In the third step, the organization prioritizes the problems according to its severity or effect on the healthcare practices of KRCRH.

4. 
   Problems are grouped according to their root cause.
   

The identified problems are put in to a group according to their root causes.

5. 
   Add up Scores
   

In this step, scores are added up and identify which of the group has the highest and lowest score. Through this, prioritization is according to scores are done.

6. 
   Take Action
   

In the final step, KRCRH will take actions in addressing the highest priority according to the group or problem that got the highest score.

William Edwards Deming

Dr. William Edwards Deming proposed the plan-do-check-act, also known as PDCA. It is a four step methodology by which used by the organization to control and improve the services and product of an organization.

Kindly Residential Care Rest Home will also make use of this kind strategy to improve the healthcare services of the healthcare organization. The end result of this would be a high quality of services by the facility to the residents and staff of the organization.

The following are the Steps of PDCA that the facility will make use:

PLAN

Objectives and processes are established which are necessary to deliver the outcome in to the expected results. The KRCRH will have a clear view of their target and their goals in achieving their proposed target in this initial phase.

DO

The plans from the initial phase are implemented in the second step. Data collection is also vital in this phase because the data collected will be used in the later stage of the process.

CHECK

The KRCRH will do evaluation of the data gathered during the DO stage. These will be charted and analyzed by the facility to identify which needs to improved and which are well in the health care services of the KRCRH facility.

ACT

Corrective actions are done in phase. The differences between the actual and planned results are analyzed and the root causes are determined. The corrective actions are implemented to achieve the planned outcome of the KRCRH.

Issue 3: Quality Management Tools

Total


Quality Management

Behind success of Kindly Residential Care Rest Home are the people who are hand in hand managing an organization, determined to make change for rendering the best of its healthcare services. Through years that Kindly Residential Care Rest Home offers quality of care to its residents and proves its Excellency by garnering prestigious awards, positive feedback and unending trust from stakeholders, family and community its success does not end instead continuity of more complete, comprehensive and structural way of management by enhancement of strategies to improve the quality of services is their big secret towards success or the so called “total quality management”.

Kindly Residential Care Rest Home utilizes total quality management to ensure that giving the quality of care for their residents will not be compromised which can lead to poor health outcomes and downfall of the organization due to improper management. Using the total quality management Kindly Residential Care Rest Home first identify the problem and plan what to do. Second is to implement the solution then evaluate or check if it resolves the problem. And lastly integrate the solution if it works upon further evaluation. As a result Kindly Residential Care Rest

Home identified the following problems and able to resolve and improve its quality of service.

• 
  Falls Risk
  
  – most of the common problem that arises among the elderly due to physical restriction like inability to walk or unsteady gait, mental incapacity, side effect of a drug, and in relation to disease condition like poor vision, etc. To prevent this happen solutions are the following: use of sensor mat, call bell, mattress, assistive devices (walker and gutter) , side rails (as necessary and with GP`s order)

• 
  UTI outbreak
  
  – another problem that is commonly and easily acquired by elderly due to low intake of water and poor hygiene. To address this problem the following should be implemented like hand washing, proper hygiene, use of PPE, hand sanitizer to each room and even corridor, health education or information dissemination (mass production of pamphlets regarding UTI prevention), infection control, and proper waste disposal.

• 
  Patient satisfaction
  
  – one of the most important thing to be prioritize because patients are the ones who receives care and they should be satisfied or even exceed the expectation of the services being rendered to them. To be able to improve the quality of care makes the patient satisfied and happy the following are being implemented to have quarterly auditing of services rendered, quality assurance, suggestion box or feedback forms.

• 
  Incompetent staff
  
  – to give a quality of care means to have enough knowledge and skills to handle the patients and assist them according to their needs. Incompetent staff is another problem identified that contribute in poor healthcare delivery service and patient`s injury. For example clinical error, and negative feedback. To address this problem the following are being implemented like comprehensive recruitment and selection, trainings and seminars, disciplinary action, continuous evaluation and staff appraisal.

Lean Management

Lean Management is all about encouraging everyone in the facilities from the top management down to the staff to be involved in helping to participate in the improvement of quality care, and reducing errors. First, you have to identify the problem and acknowledge that the problem exists and why it is a problem, willingness to change and you can now find ways on how to solve that problem.

In Kindly Residential Rest home we value our residents, respect our residents and continue to provide quality of care. We have to understand the voice of our clients, where they coming from, and made sure to meet their needs and put into action. The most important thing in lean for healthcare organization is that the errors and mistakes are being corrected nor improve, the amount of time taken is being valued, productivity increases, and so it is easy for the staff to work easier by eliminating those waste that can provide good quality of care and productivity of the staff.

Here are some of the common Errors:

• 
  Clinical Communication
  
  – In electronic patient record, if there is any laboratory test results needed instead of waiting for a week wherein referral needed from the attending physician of the patient and then sending back the result from the physician, the system is being made to remove any unnecessary stages instead laboratory people sends electronic results so he can access right away and evaluate the result. So, it saves time and effort of the patient from travelling.

• 
  Waiting time/ Getting Appointment
  
  – Appointment System is an agreement to meet with the physician at a specific time and day and it is used also to control the demand and the problem is on the mismatch on the capacity of the patients and the physician. In order to avoid this problem the system must be monitored or may provide different type of consultation to accommodate everyone. In result, the patient is being examined on the day she wanted to be seen, less stressed for the staff.

• 
  Overproducing
  
  – spending so much time on something that is not important for the patient
• 
  Defects
  
  – wasted time and effort for the inspection of something that has been already done or inspected

In KRRH we value our residents the most, we have to eliminate those wastes and focus to what is important to our client and be able to maintain the quality of work and our commitment to our profession and to the residents as well.

Issue 4: Continuous Improvement System

It is important to maintain a continuous improvement system for delivery of service to geriatrics. Quality management is one way to improve the system and it is composed of costumer focused organization, leadership, involvement of people, process approach, system approach to management, continual improvement, decision making, and mutually beneficial supplier relationships. In order to perform quality improvement an organization must consists of team that has a deep understanding of an area that requires enhancement. Organization like the Kindly Residential Rest Home is determined to continue finding solutions for the present problems as well in the future that may arise. By continuous improvement of the system there will be a positive result that will lead to a better healthcare service it will ensure the high standard of care that is cost effective and accessible to all.

Organization must be sensitive to the needs of the patients and therefore must understand and ensure that there will be a plan of action to meet those needs. This is the result when an organization is costumer focused. Secondly is the Leadership, this is the action of leading a group of people and the leader should know how to unite people that will be involved in achieving the organization’s goals. Thirdly, is the involvement of the people in the organization at any level must do their part in their full capabilities in order to have a successful outcome that can be used for the benefit of the organization. Continuous improvement is necessary because there is no permanent in this world, even the facility in some point changes. Given an example is the technology; people depend on computers and this help in many ways like documentation, auditing and research. Many facilities depend on computer and internet because they make the job easier and efficient. Trainings and seminars are also another way of improving the system. Developing and enhancing the skills of employees will lead to better healthcare delivery.

A well knowledgeable and trained staffs has so much to offer that will benefit not only the clients but also the organization. They will be more confident as well as an important member of the facility. The residents will be satisfied with the care that they are getting from the healthcare providers and as the result they intend to stay longer. The facility will gain a good reputation and the business will be successful. This will attract more people to invest in the health care industry. By frequent assessment and analysis of the problem or changes there will be an ideal plan of action. Continuous improvement in an organization is part of duties and responsibilities of management. To achieve highest performance and success adapting to changes is essential. There is no such thing as constant especially when it comes in dealing with lives of people. Different approaches must be applied depending on the person’s character, behaviour or needs.

Communication is defined asthe imparting or interchange of thoughts, opinions or information by speech, writing or signs. It is the tool which strengthens healthcare provider-patient relationship through which therapeutic goals are achieved (Park et al, 2006). Effective communication occurs when a desired effect is the result of information sharing, while poor communication leads to uncertainty and frustration. There are many situations where poor communication can lead to confusion. It includes not only building rapport but also leading to patients’ queries unanswered, discussing medical issues at patients’ bedside while ignoring them, talking harshly to patients etc. This can result in lack of support, disrespect and especially, harm to the patients.

During my Mental Health Clinical at a private Hospital, I encountered a patient with diagnosis of Schizophrenia, and his Mental Status Examination (MSE) revealed that he had circumstantial ideas. I asked him a question and he talked irrelevantly about it. The nurse, who was listening to our conversation, scolded the patient saying why was he not answering relevantly. The nurse’s way of talking was very rebuking and lacked empathy. Upon getting scolded, the patient got aggressive and embarrassed, yet left silently. I visited the patient later, continued the MSE politely, and he answered me well.

In my patient’s scenario, the nurse emotionally abused and demoted my patient rather than encouraging him. I believe this lowered my patient’s self-esteem and shattered him psychologically as evident by his gesture of leaving the room in silence due to aggression. Gadit (2011) states that “verbal abuse can cause significant psychological problems in later years and brain damage”. This means that skilled communication of a nurse helps a patient reduce his worries, making him comfortable. Moreover, patient’s verbalization of feelings and thoughts aids a nurse in correctly identifying his problems and performing interventions. Therapeutic communication holds importance as it “contributes to a patient’s emotional growth or reinforce his or her illness.” (Masilani, 2010, p.02). Thus, poor communication shatters the nurse-patient’s therapeutic relationship and acts as a barrier in expression of patient’s feelings which may lead to flawed nursing care. Nurse’s poor communication leaves a negative image in a patient’s mind regarding nurse and the institution, impacting greatly on his treatment. Patient would not express but build on feelings deep inside, which can lead to depression. My patient was not able to answer promptly due to his disease process. Through positive regard, assurance and encouragement, the nurse could have helped the patient. Instead the nurse demoted him and lowered his self-esteem.

A model by Shanon and Weaver (1949) explains where the gap was formed. This model has 8 elements: source is an individual or a group that wants a message to be delivered ; encoder is the specified format for later interpretation; message is the idea that is being communicated; channel is the route that the message travels on; noise is any interference in the communication; decoder is the interpretation of the message from its original form into the one that the receiver understands; receiver is the intended recipient who takes in the message that the source has sent and feedback relates to the source whether their message has been received, interpreted correctly or lost in the noise. In the above scenario, I was the source who put the model into action. Encoding was my speech and expressions. I was doing the Mental Status Examination and it was my message. Noise was the nurse who interrupted and distorted my message. When the noise over rode the source, problem in the decoding occurred, leading the receiver to get aggressive and embarrassed. This gave the feedback that the message that was sent has got an error and needs to be revised. Building on the feedback, I gave patient sometime, and interacted with him later to continue his examination for his benefit

Barriers to effective communication can impede or deform the message. There may be physical barriers that often occur due to the environment. Example of this is the shortage of staff, lack of time, increased workload, improper building etc. In the above scenario, the unit allotted for psychiatry was undersized and less spacious. Nurses and the patients were locked in the small unit, where they could easily listen to each other’s conversations. Second barrier can be the system fault. It refers to problems with the system in an organization. Examples include a lack of clarity in responsibilities, supervision and training. Keeping the scenario in mind, a nurse has the basic responsibility to practice empathy, as studies link empathy with therapeutic relationship (Reynolds & Stewart, 2002; Neumann et al, 2012). Attitudinal barriers occur as a result of problems with staff. Examples include poor management, communication errors, personal attitudes of individual staff due to lack of motivation and insufficient training etc. The above Private Hospital setup reflected that there was no supervision and the staff did not seem much competent.

When looking into the socio cultural context, a news report reveals that “mental health is the most neglected field in Pakistan” (Qasim, 2012). In such conditions, if the communication flaws persist, a patient’s mental health is likely to be devastated. Another survey in Pakistan shows that patient’s satisfaction depends on a healthcare provider’s communication and behavior with them during their length of hospital stay (Danish, Khan, Chaudhry, & Naseer, 2008). As psychiatric patients usually have repeated admissions and prolonged hospitalizations, therefore therapeutic communication can allow a nurse to deliver quality care to the patients, thus satisfying their needs. Moreover, departments of psychiatry in Pakistan are not well equipped specially in terms of psychiatric manpower (Gandit 2006). Literature emphasizes that swift pace and content is required in the field of research.

Poor communication can be attributed to a number of factors. Lack of understanding, which includes value to proper communication and empathy in therapeutic relation, is one of the causes . Sometimes patient factors do not allow healthcare practitioner to communicate properly as it has been observed that harming behavior, emotional blocks and other psychotic symptoms do not allow nurses to continue therapeutic communication (Pfeiffer, 1998). It was also evident in my patients’ case that nurses’ communication can lower self-esteem and promote distress. Excessive poor communication of the nurses can lead to constant aggression and anxiety of communication, ultimately worsening patient’s mental health.

To sustain a therapeutic nurse-patient relationship I would recommend that institutional management should arrange communication skill workshops for staff, as researches show that workshops help in improving nurses’ communication skills and their sense of preparedness (Lamiani & Furey, 2009). The nursing supervisors should also identify the causes which hinder in communication. Moreover, nurses could reflect daily upon their communication skills, analyze the mistakes and try to work on it, as reflection is a powerful educational tool in nursing that can enhance clinical experience (Bradbury-Jones et al, 2009). They can also take ongoing feedbacks from colleagues and try to improve on their weak points. Since “psychiatric patients have problems in communicating and forming relationships” (Hem & Heggen, 2003, p.102), therefore I would suggest that psychiatric nurses should have profound awareness of when to show empathy during communication. In my opinion medical and nursing students should focus on efficient communication while studying psychiatric course, so they can continue to practice it precisely. Furthermore, as discussed above, a barrier to effective communication is the lack of supervision. For that, ongoing rounds and evaluations should be done by the higher authorities to witness the exact situation and happenings, since it is noticed that in the supervision of the higher authorities, communication is more therapeutic. Thus, I recommend institutions to keep an eye on their staffs’ communication techniques in order to minimize negligence.

In conclusion, nurses may commit errors but practice can make them perfect especially in a skill like communication. Thus, nurses must practice as much as possible and try reducing communication errors. As discussed, there are several causes and effects of poor communication especially in psychiatric nursing. But “nurses should use themselves as a therapeutic instrument” (Hem & Heggen, 2003), so that they can help the psychiatric patients for their early recovery.

Word Count: 1,342 Words