Communication Between Patients And Nurse

Communication Between Patients And Nurse Essay Paper

Communication Between Patients And Nurse Essay Paper

Breakdowns in communication, within teams or with patients, can occur in many ways. Common examples include outbursts of anger, misunderstandings of tone or volume of voice, cultural differences, inappropriate humor, the use of touch, and others. All of these breakdowns can result in stressful work environments, costly turnover in staff, and poor clinical outcomes. This process-driven, highly interactive, two-day course with extended follow-up is designed to remediate distressed or disruptive clinicians who employ a broad range of unproductive or challenging communication behaviors. The course aims to return clinicians to meaningful careers properly equipped with the tools they need and a Personalized Protection Plan for communicating effectively and professionally in the future.Communication Between Patients And Nurse Essay Paper

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Prior to arrival at the seminar, participants begin our course with online pre-course assignments that include a personal essay and a Communication Self-Assessment Test. Our confidential and non-judgmental small-group seminar format creates a safe environment for honest disclosure and self-assessment. Through the use of the PBI Incivility Formula ©, participants are guided by faculty to openly examine their own personal vulnerabilities, risk factors, and resistance to self-assessment. Seminar participation and final presentation of a stratified Personalized Protection Plan to the course faculty and the class are required.  Communication Between Patients And Nurse Essay Paper

Upon concluding the in-person course, the weekly, telephonic post-course Maintenance and Accountability Seminars (MAS) reinforce what was learned in the classroom. These sessions elevate participants’ accountability through revisiting their Personalized Protection Plans, and engage them in a community of peer review and support.

Communication involves the exchange of messages and is a process which all individuals participate in. Whether it is through spoken word, written word, non-verbal means or even silence, messages are constantly being exchanged between individuals or groups of people (Bach & Grant 2009). All behaviour has a message and communication is a process which individuals cannot avoid being involved with (Ellis et al 1995).
In nursing practice, communication is essential, and good communication skills are paramount in the development of a therapeutic nurse/patient relationship. This aim of this essay is to discuss the importance of communication in nursing, demonstrating how effective communication facilitates a therapeutic 
Communication involves information being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a number of communication skills; which in a nursing context generally focuses on listening and giving information to patients (Weller 2002). This process of sending and receiving messages has been described as both simple and complex (Rosengren 2000 in McCabe 2006, p.4). It is a process which is continually utilised by nurses to convey and receive information from the patient, co-workers, others they come into contact with and the patient’s family.
Models of Communication.
The Linear Model is the simplest form of communication and involves messages being sent and received by two or more people (McCabe 2006). Whilst this model demonstrates how communication occurs in its simplest form, it fails to consider other factors impacting on the process. Communication in nursing practice can be complicated, involving the conveyance of large amounts of information, for example, when providing patients with information relating to their care and treatment or when offering health promotion advice.

Reflection is a vital key for effective communication with patients and their families.Communication Between Patients And Nurse Essay Paper

The main claim to this paper, is to prove, to have effective communication with patients and their

families, firstly, one must know oneself. Communication is a two-way street Yes…but for

effective communication to be understood, one must acknowledge oneself first, Communication

starts with ourselves. we need to address that we, too, are human beings, with our own thoughts,

feelings, beliefs, attitudes, prejudices and preferences. There is an increase in the healthcare

profession that we must care for ourselves before caring for others (Burnard,2001). (Older reference

but very supportive towards this paper). The quality of communication is a critical factor in meeting the needs of

individuals, families and communities, (Crisp & Taylor 2009).

Communication is an expressions of ones thoughts…To convey what one person is trying to say to

another. When communicating there is a messenger and a receiver but sometimes due to the way

the message is delivered there maybe misunderstandings, and confusion arises and the message  Communication Between Patients And Nurse Essay Paper

maybe misunderstood. Be clear and precise in what you’re trying to say and why, (Crisp & Taylor

2009). Body language has a great deal to do with communication and it is believed that body language is

the greatest form of all communication skills because it is hard to control and therefore, maybe even

more acknowledged that the spoken word, (Crisp & Taylor 2009). From birth, body language is the

basic skill and the only way a baby has to communicate, as a teenager spoken words are often

mixed with bad reactions but again their body language is without doubt the best way of

understanding our confused teens, Adulthood is often confronting, their peers may use prominent

words, which to the receiver may be complicated, and hard to follow the meaning of.

Nurses possess a tremendous amount of medical knowledge and clinical expertise. Yet their greatest challenge — and perhaps most vital task — is communication. Every step of the way, from patient intake to patient discharge and beyond, nurses must communicate well to provide comprehensive care.

Using Gibbs: Example of reflective writing in a healthcare assignment
  • Description
    In a placement during my second year when I was working on a surgical ward, I was working under the supervision of my mentor, caring for a seventy-two year old gentleman, Mr Khan (pseudonym), who had undergone abdominal surgery. I had been asked to remove his wound dressing so that the doctor could assess it on the ward round.

    I removed the dressing under my mentor’s supervision, using a non-touch procedure, and cleaned the wound, as requested by the doctor. My mentor was called to another patient at this point, so at her request I stayed with Mr Khan while we waited for the doctor to come to see him.  Communication Between Patients And Nurse Essay Paper

    The doctor had been with another patient, examining their wound, and I noticed that she came straight to Mr Khan to examine his wound, without either washing her hands or using alcohol gel first. I also noticed that she was wearing a long-sleeved shirt, and I was concerned that the cuffs could be contaminated. I thought for a moment about what to do or say, but by the time I had summoned enough courage to say something, I thought it was too late as she was already examining Mr Khan.

    Feelings 
    I was alarmed by this, as I had expected the doctor to wash her hands or use alcohol gel before examining Mr Khan. However, I felt intimidated because I felt that the doctor was more experienced than me as a second year nursing student; and I didn’t want to embarrass her. Also, I didn’t want to make Mr Khan concerned by confronting the doctor in front of him.

    Later, I spoke to my mentor about the incident. She suggested that we speak to the doctor together about it. My mentor took the doctor aside, and asked her whether she had washed her hands before examining Mr Khan. She looked quite shocked. She said that she had been very busy and hadn’t thought about it. My mentor discussed the importance of hand hygiene with her, and the doctor assured her that she would wash her hands before examining every patient in the future.  Communication Between Patients And Nurse Essay Paper

    Evaluation 
    The incident was extremely challenging for me. I regret that I did not act to challenge the doctor’s practice before she examined Mr Khan. However, I am pleased that the doctor responded so positively to the feedback of my mentor, and I have observed that she has now changed her practice as a result of this incident. I too have learned from the incident, as it has taught me the importance of acting assertively with colleagues, in a sensitive manner, in order to safeguard patients’ well-being.

    Analysis 
    The Royal College of Nursing (2005) states that hand hygiene is the single most important activity for reducing cross-infection, and points out that many health care professionals do not decontaminate their hands as often
    as they should. Recent guidance published by the Department of Health (2007) highlights the possibility of staff transmitting infections via uniforms, and the need to review policies on staff dress. The Nursing and Midwifery Council Code of Professional Conduct (2004, section 8) states that as a nurse ‘you must act to identify and minimise the risk to patients and clients’. As the student nurse caring for Mr Khan under my mentor’s supervision, this also applies to my own practice as a student nurse.  Communication Between Patients And Nurse Essay Paper

    Looking back on this incident, I can see that I should have acted sooner, and that I should have ensured that the doctor washed her hands before examining Mr Khan. I can now see that my inaction in this incident put Mr Khan’s well-being at risk. After discussion with my mentor, I recognise that I need to develop the confidence to challenge the practice of colleagues, putting the well-being of clients at the forefront of my mind. I realise that I need to be supportive to colleagues, understanding the pressures that they may be under, but ensuring that their practice does not put clients at risk.

    Action Plan 
    In future, I will aim to develop my assertive skills when working with colleagues, in order to ensure that the well-being of clients is maintained. In my next placement, I will make this a goal for my learning, and will discuss this with my mentor to work out strategies for how I can achieve this.Communication Between Patients And Nurse Essay Paper

Communication can be approached in terms of the skills needed to get a hoped-for response. By seeing communication in terms of skills, it is easier to focus on what skills you already have and use. Once you have a reasonably clear picture about this, it is much easier to see where you might want to increase your communication strengths and decrease any weaknesses.

It can be useful to try assessing what you see as someone else’s communication skills before you think about your own.

Author Neil Thompson (1996) has pointed out that these verbal aspects of communication can all give important clues about how people are feeling. So it is not just what people say that counts, it is how people say it, too. If someone seems to talk rather quickly, this may be because he or she is angry or worried. In contrast, if someone speaks slowly, this may be because he or she is tired. Or it may indicate a lack of confidence in what that person has to say. It is also possible to interpret why people may use a particular tone of voice. As Thompson (1996, p. 83) points out, tone of voice is “an important indicator of emotional state. It gives important messages about how the person is feeling. It indicates a whole range of feelings: anger, sadness, joy  Communication Between Patients And Nurse Essay Paper

Similar comments may be made about pitch. Thompson suggests that:

flat, unmodulated pitch can reflect a depressed mood, while high or fluctuating pitch can signal … anger, fear or excitement.

Thompson (1996, pp. 83–84)

Thompson (1996, p. 84) suggests that quiet speech can indicate a lack of confidence, fear or anxiety whereas loud speech can suggest aggression or a lack of sensitivity. Loud speech may also be used by someone who is fearful or anxious.

Facial expressions, according to Thompson (1996, p. 95), “are very powerful in conveying information.” As far as eye contact is concerned, it is important not to have too much eye contact as this can be seen as challenging or threatening. On the other hand, too little eye contact can be interpreted as indicating that someone is not trustworthy. It is important to note that these interpretations can vary from one culture to another. Some cultures see it as being polite to avoid eye contact as much as possible.Communication Between Patients And Nurse Essay Paper

Experience is sometimes regarded as the best teacher. Many things can be learned in a classroom and by formal academic study, but many cannot. Reflective practice is a form approach to learning through experience. Reflective practice is a lifelong learning process to promote continual development of the nurse. Reflective writing practice helps the nurse to gain knowledge and to challenge their own ideas and concepts. The idea of reflective practice is not only to see what happened, but to see the situation through new eyes, eyes that can help in personal growth and to develop ways to respond differently in the future. Effective reflection helps the practitioner to see the situation from an outsider’s perspective, so that they can develop a better way to respond to a similar scenario in the future. Reflection is meant to achieve a change in practice, rather than simply repeating the same mistakes (Schon, 1983). Many different models exist for structuring the reflective process. Regardless of the framework used, the reflection models are meant to accomplish three things. They are supposed to promote reflecting on events, self-evaluation and analysis, and a plan to change actions in the future. This Reflective essay will utilize Driscoll’s ‘The What?’ model as its structure (Driscoll, 1994).Having the chance to experience clinical rotations on the telemetry, medical surgical, labor and delivery and postpartum floors so far have been incredible. Although, throughout these last few months, I have certainly seen many nurses converse and behave in ways I would never imagine a registered nurse to. From these experiences I learned easier ways to quickly set up equipment, how to properly address situations when the family is present, and how to effectively communicate between doctors, physical therapists and case managers. As for the nurses who improperly cared for their patients, those nurses will be examples of who I tell myself I will never become.
The top three priorities I have for myself in my nursing practice as a student and that of which I plan to carry on throughout my career are not to be the cause or route of transmission of any nosocomial infection; to take the time to listen to my patients and their families; and to never stop learning.
A common barrier that I will encounter when performing all of my priorities is going to be the essence of time. As a nurse, I have to be ready for any situation to change for the good or bad at any time of the day. I have to be flexible but I also have to take the time to slow down in order to provide the safest and best quality care to my patients. Barriers that are present when trying to avoid being the route of transmission of an infectious bacterium are going from patient to patient and doing an assessment while not wearing a pair of gloves since I did not touch any body fluids or open wounds. Even though I did not come into contact with any known pathogens, It is my duty to protect my patient  Communication Between Patients And Nurse Essay Paper

Having the chance to experience clinical rotations on the telemetry, medical surgical, labor and delivery and postpartum floors so far have been incredible. Although, throughout these last few months, I have certainly seen many nurses converse and behave in ways I would never imagine a registered nurse to. From these experiences I learned easier ways to quickly set up equipment, how to properly address situations when the family is present, and how to effectively communicate between doctors, physical therapists and case managers. As for the nurses who improperly cared for their patients, those nurses will be examples of who I tell myself I will never become.

The top three priorities I have for myself in my nursing practice as a student and that of which I plan to carry on throughout my career are not to be the cause or route of transmission of any nosocomial infection; to take the time to listen to my patients and their families; and to never stop learning. Communication Between Patients And Nurse Essay Paper
A common barrier that I will encounter when performing all of my priorities is going to be the essence of time. As a nurse, I have to be ready for any situation to change for the good or bad at any time of the day. I have to be flexible but I also have to take the time to slow down in order to provide the safest and best quality care to my patients. Barriers that are present when trying to avoid being the route of transmission of an infectious bacterium are going from patient to patient and doing an assessment while not wearing a pair of gloves since I did not touch any body fluids or open wounds. Even though I did not come into contact with any known pathogens, It is my duty to protect my patient

The aim of this report is to look at a critical incident that occurred in placement and relate this to the theory and knowledge regarding communication and interpersonal skills, so as to demonstrate an understanding of my views on the art and science of reflection and the issues surrounding reflective practice Reflection is part of reflective practice and a skill that is developed. It can be seen as a way of adjusting to life as a qualified healthcare professional and enhancing the development of a professional identity (Atwal & Jones, 2009).
Reflection is defined as a process of reviewing an experience which involves description, analysis and evaluation to enhance learning in practice (Rolfe et al 2001). This is supported by Fleming (2006), who described it as a process of reasoned thought. It enables the practitioner to critically assess self and their approach to practice.
Reflective practice is advocated in healthcare as a learning process that encourages self-evaluation with subsequent professional development planning (Zuzelo, 2010). Reflective practice has been identified as one of the key ways in which we can learn from our experiences.
The incident that was chosen was so for the reasons that the situation made the student aware of inadequacies on his own part and those of the staff on the team, which made him reflect upon the situation and how this could be learned from, so as not to make the same mistake again.
Before the critical incident is examined it is important to look at what a critical incident is and why it is important to nursing practice. Communication Between Patients And Nurse Essay Paper

The nursing profession is one of the most challenging and rewarded careers in my opinion. Mostly in the XXI century that we are living, with the constant challenge of the healthcare system in our communities that continue to rise with a higher standards of care in all different setting in the nursing care. Everyday our patients and communities expect more from nurse as leaders in the shifting healthcare model. The recognition well deserved that we as nurses find in our patients is all because those many wonderful nurses that came before us and showed to the world how important is the job we do and how critical is taking our word in consideration when in taking care for our patients. I would like to emphasize today in a beacon of acknowledge in our profession and example of a great nurse.
Dorothea Orem born in 1914, Maryland and her Theories about Self-Care in Nursing will be the center of our discussion on this article. She earned a Nursing Degree from Providence Hospital School of Nursing in Washington DC in the 1930’s. Later in the early 1940’s she a bachelor degree and later on a master degree both from Catholic University of America in Washington DC. The Self-Care Nursing Theory of Orem’s Model of Nursing was developed by her during her all career between 1959 and 2001. It’s considered a grand theory meaning that covers a broad of general concepts that applied to all fields of nursing. The main idea of Orem’s theory is that patients want to take care of themselves and they will recover sooner and holistically better when they do their own self-care as much as they are able to do it.

Assessing someone’s communication skills is always going to be difficult as since different interpretations are always possible. It is not always easy to decide which interpretation is “true.” The point is to become as aware as possible about the messages that other people are sending out so that you can improve the likelihood of reasonably successful communication. Let’s see what Karen has to say about her communication skills.Communication Between Patients And Nurse Essay Paper

I think I have learned how to read body language when I am speaking to people—I’m more observant. People don’t always say how they are feeling, so if you can read their body language, it’s easier to pick up on things. I am probably more confident with my questioning. I am listening and taking in the messages I am receiving from people and also giving them a lot more opportunity to make their own choices.

A 2014 research paper, Communication in Nursing Practice, found that nurses who display courtesy, kindness and security to their patients — through both their actions and words — are generally more successful in establishing a good rapport. The paper suggested that nurses must go beyond simply demonstrating these niceties though. They need to approach every patient-nurse interaction with the intent to understand the patient’s concerns and experiences as well as demonstrate that they are open to truly hearing patient’s input.

To do so, nurses must carefully consider where and when to talk to patients. Nurses should allow sufficient time for each patient interaction. For example, patients may be hesitant, nervous, upset or otherwise incapacitated, which may extend the time needed to have a thorough discussion of the issue at hand. Patients may find a rushed conversation frustrating or even rude. It may hinder the ability of the nurse to establish open communication with the patient, thereby slowing down or negating the treatment process.

Nurses must also be mindful of the location in which these interactions occur. Selecting an area that is free from distractions — to the greatest extent possible — may help to facilitate a more positive flow of communication. Additionally, this promotes confidentiality and protects the patient’s personal health information.Communication Between Patients And Nurse Essay Paper

Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience.

The Nursing and Midwifery Council (NMC) has set out at least four domains of competencies for entry to the register in Adult Nursing. In this brief, I will focus on the second domain of communication and interpersonal skills. Communication plays a crucial role in addressing the needs of the patients. Adult nurses are expected to communicate effectively, listen with empathy and advocate for their patients (Department of Health, 2012a, 2012b). Specifically, the Department of Health (Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser, 2012) has introduced the 6 Cs of nursing, which encompasses compassion in nursing practice. Compassion in care is only possible when patients feel that their nurses understand their feelings and show empathy (Chambers and Ryder, 2009). Communication is essential in helping patients articulate their needs (Hall, 2005). Similarly, poor communication could result to misunderstanding, anxiety for the patients and poor quality of care (Chambers and Ryder, 2009).Communication Between Patients And Nurse Essay Paper

In this brief I will focus on the domain of communication and interpersonal skills since these form the foundation of my relationships with my patients. Developing my competency in this domain would help me identify both verbal and non-verbal messages of the patients and address their needs accordingly. Meanwhile, effective communication is needed when I communicate with my colleagues and other healthcare practitioners. A focus on my communication skills with my patients will be made in this reflective brief. Communicating effectively with my patients and other health and social care professionals would help improve the care received by my patients. Benner’s (1984) stages of clinical competence would be used to underpin my development from novice to competent. Gibb’s (1988) reflective model will be utilised to reflect on my experiences in the last three years from novice to competent.Improving my communication skills has been a work in progress starting back in the early years of my life. I have always been my own worse critic. Usually beating myself down through interpersonal communication. Now as an adult I have made great improvements but still have trouble dealing with perception and self-image. Not being raised in an environment of positive reinforcement and poor communication in the workplace I have made it a point to change that trait in my own family and professional environment.
When reading the opening lecture I cringed at the thought of dealing with communication. Sort of that belly ache feeling you get when you had to do an oral presentation in front of the class in elementary school. I understand have a number of strong qualities but self-image and my perception are still traits I long to improve.
My self-image is so low that I have a tremendous amount of self-pity or self-hatred. I do however want to find that happy median where I’m comfortable in my own skin. It’s odd how my feelings about myself change from day to day. I engage quite often in interpersonal conversation, question my motives and encouraging myself to move forward. Communication Between Patients And Nurse Essay Paper

Professional Development from Novice to Competent Level
Reflective practice (Gibbs, 1988) allows healthcare practitioners to improve current practice by learning from incidents and one’s own experiences. Pearson et al. (2009) explains that one’s own experiences are another form of evidence in healthcare. With the focus on patient-centred care, the NHS (Department of Health, 2012b) has encouraged evidence-based care when addressing the needs of the patients. I will use Gibbs (1988) model in reflecting on my communication experiences in years 1 to 3. This model starts with a description of an incident followed by analysis, evaluation, conclusion and action plan.Communication Between Patients And Nurse Essay Paper

In this essay, I intend to reflect on a situation I encountered during my first community placement I had the opportunity to develop my communication skills not just theoretically but also practically, facing a real life environment. My placement made me aware of the importance of interpersonal and communication skills which are very important in the delivery of care. Throughout my nursing career, I will be encouraged to develop reflective practice skills and become a reflective practitioner. Reflection refers to a series of steps that you may take to question and explore an experience with the aim of learning from it. I will discuss the importance of communication in order to maintain a therapeutic relationship. Communication Between Patients And Nurse Essay Paper

Effective communication in the healthcare setting improves recovery rates and reduces pain and complication rates. (Wilkinson et al, 2003). Many complaints to the NHS are attributed to poor communication. Effective communication is reliant on the nurse working in partnership with the patient. It is essential that the nurse establishes a rapport and most of this will be achieved through the use of facial expressions. In my practice, it is important that develop a therapeutic relationship with the patients so that they can be able to put their trust in me. The therapeutic relationship is solely to meet the needs of the patient. In this relationship, there is a rapport established from a sense of mutual understanding and trust. To build a good nurse-patient relationship, I would have to show qualities of empathy, caring, sincerity and trustworthiness. During practice, if I am approaching a patient and the patient looks anxious, I should approach with empathy.Communication Between Patients And Nurse Essay Paper

Composing a reflective essay on effective communication in nursing can be difficult for some. Producing this style of paper will need the basic steps taught and some variations on the way it is written. When writing most types of papers, it is taught to come up with a thesis and explain, in the most informative and clear way, what it is. This style of paper consists of reflections made on the subject including emotions and experiences on the matter. The difference in this introduction is in your own way summarizing the conclusion. Having the room to produce your experiences without concern of facts opens the door for that all important creativity.

Emotion is more crucial than facts

To say no facts does not mean it is not true. Everyone sees and feels different things when looking at the same thing. The better you are at putting these things down on paper, the more interesting your work will be. Imagination and memory are two strengths that must be paid close attention to. In the world of nursing there is a lot of turmoil and confusion in a life and death situation. Sometimes the difference between saving and losing a life is a very fine line.Communication Between Patients And Nurse Essay Paper

Effective communication is crucial

The ability to clearly hear instructions or the patient’s needs can be drowned out in the confusion. Working with a regular staff can be a plus when you know the skills of the other personnel. Descriptions of the injuries are a must for not only the nurse but the doctor. The skill of recalling what you see can be very important in order to keep the patient alive.

Life as a nurse

Explaining how uncomfortable it was in the beginning, working with new staff and injuries, will automatically bring up memories and emotions felt by you personally. There will not be a shortage of sight, smells, and sounds that only a nurse could know and understand. Dealing with the sick and dying is working with man at its worst. Learning the skill of carrying on conversations with these types of people only makes you a stronger and better person. Explain how you felt and worked around these individuals in the beginning and how you handled same situations at this point in your career. People whose scenarios have led them to a visit to a hospital can be very weary of the kind of treatment they receive from personnel. The ability to look back and describe all of those experiences in your own way will make the interest of the reader while they are reading, but will remember those insights well after they have finished. Composing a reflective essay will help others appreciate what nurses go through.Communication Between Patients And Nurse Essay Paper

An incident during my year 1 exemplifies how I developed my communication and interpersonal skills as a novice. I was assigned to the mental health ward and assisted an elderly patient with dementia who was admitted for pneumonia. During his first day in the hospital, my senior nurse performed a nutritional assessment and informed me that I should assist the patient during feeding time. This was consistent with the Patient Mealtime Initiative (PMI) (NHS, 2007) implemented in our ward. As a student nurse, I would be assist the patient to self-feed and make his environment comfortable and uncluttered. During mealtime, I talked to the patient and informed him that I would assist him in eating his food. He stared at the wall and did not respond. I gently asked him if he was ready to eat. When he turned to me, I informed him that he could now start eating. He only stared at his food and did not seem to understand my instructions. I placed the utensils near his hand so he could grab it and eat. When he did not respond, I asked him if he wanted me to help him eat. After a few minutes, he got his spoon and held it for a few minutes. I began to realise that he did not seem to understand my instructions so I started to place the spoon with food in his mouth and gently touched his chin to remind him to chew his food. My senior nurse passed by and informed that I have to put some pressure on the patient’s chin and make some chewing motions to help remind him that he needs to chew his food. It took me an hour to feed my patient.Communication Between Patients And Nurse Essay Paper

On reflection, communicating with older patients with dementia could be a challenge. Most of these patients suffer from cognitive impairments, which make it difficult for them to communicate their feelings and concerns (NICE, 2006). A significant number of older patients with dementia who are admitted in hospital wards are underweight (World Health Organization, 2014). Jensen et al. (2010) explain that many of these patients have forgotten how to eat and chew their food while others lack cognitive abilities in understanding instructions on feeding. Hence, the National Institute for Health and Clinical Excellence (NICE, 2006) guideline on nutrition for older patients highlights the importance of assisting the patients during feeding. For patients in the advanced stages of dementia, the main aim of nutrition is to maintain hydration and comfort feeding. Meanwhile, some patients could also suffer from swallowing problems, making it more difficult to ingest food (Lin et al., 2010).Communication Between Patients And Nurse Essay Paper

The hospital ward environment is also new to older patients with dementia and might trigger anxiety and fear (Lin et al., 2010). Since patients are in unfamiliar surroundings with unfamiliar people, they might express their fears and anxieties through aversive behaviours (NICE, 2006). It is shown that nurses react negatively to aversive behaviours of older patients with dementia (Jensen et al., 2010). On reflection, the incident taught me to be more patient and to understand both verbal and non-verbal messages. It took some time for me to realise that I have to feed the patient since he appeared confused. I was also unprepared on how to communicate with an older patient with dementia. As a novice nurse, my feelings and apprehensions are normal and are also shared by other nurses (Cole, 2012; Murray, 2006). Best and Evans (2013) have shown that nurses feel unprepared to communicate and care for older patients with dementia. On reflection, I should continue with my professional development by joining training and seminar on how to communicate with older patients with dementia and address their nutritional needs. When faced with a similar situation in the future, I am better prepared and would not need more supervision from senior nurses on how to communicate with older patients with dementia and address their needs. For instance, I am now aware that these patients have difficulty verbalising their needs and I have to be sensitive of non-verbal cues and interpret aversive behaviour as possible signs of distress, anxiety or fear (Best and Evans, 2013).Communication Between Patients And Nurse Essay Paper

The second incident occurred during year 2 in my placement in the Urology Department. At this stage, I already considered myself as an advanced beginner (Benner, 1984). I was assigned to care for a 45-year old male patient who was admitted due to testicular pain. I introduced myself to the patient and informed him that I was part of a team that would be caring for him during his hospital admission. I noticed that he was uncomfortable communicating with a student nurse and asked for a more senior nurse. I gently informed him that my senior nurse was supervising other student nurses and he was left to my care. I tried to communicate and noticed that he had difficulty with the English language. I asked him if he needed a language interpreter. Once an interpreter was identified and assisted me with communicating with my patient, I noticed a change in his behaviour. He began to open up and was willing to take his prescribed medications. I slowly understood that he was anxious about his condition and wanted a male nurse with the same ethnic background to be his nurse. When he realised that most of the nursing staff are composed of female nurses, he began to accept me as his nurse.Communication Between Patients And Nurse Essay Paper

On reflection, this incident illustrates the importance of taking into account individual differences and using communication strategies to understand the patient’s needs. Specifically, I became aware that he had difficulty with the English language. The act of getting an interpreter greatly improved our communication. One of the competencies stated under communication states that nurses should be able to use different communication strategies in order to identify and address the patient’s needs (Nursing and Midwifery Council, 2010; National Patient Safety Association, 2009). It was apparent that the patient was self-conscious that a female nurse was addressing his needs. It is shown that a patient’s perception about his condition is also influenced by their cultural beliefs and ethnicity (Department of Health, 2012b). He was uncomfortable that a female nurse was providing care when he was suffering from testicular pain. However, the patient shares similar ethnic background as the interpreter and only became comfortable when the interpreter assured him that he could trust me. I realised that patients with different cultural background could be anxious about their treatment and might have difficulty communicating.Communication Between Patients And Nurse Essay Paper

On evaluation, I felt that I was able to address the immediate language barrier gap by getting an interpreter to help me communicate with the patient. My experiences during my first year in placement with patients who have different ethnic backgrounds and have difficulty expressing themselves in English helped me prepare for this situation. As Benner (1984) stated, nurses develop competency through experiences. I felt that I have improved on my communication skills and have achieved the advanced beginner level during year 2. Being sensitive to the communication needs of my patient is also consistent with the 6 Cs of nursing (Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser). In this policy paper, nurses are encouraged to show compassion in caring through effective communication.Communication Between Patients And Nurse Essay Paper

On analysis, I could have improved my communication skills by learning how to communicate with patients with different cultural beliefs about human sexuality. The patient was shy that a female nurse is part of the healthcare team managing his testicular pain. As part of my professional development and action plan, I will participate in training and seminars on how to communicate about health issues, such as testicular pain, that are considered sensitive and may carry some cultural taboo.

Communication is a vital skill for the nurse, but in this age of increased technology use and high-level skills, it can be forgotten. Donna Davenport calls for communication to be put back on top of all our professional agendas Communication Between Patients And Nurse Essay Paper

A recent visit to hospital to see a close friend following surgery for bowel cancer made me think about how important good communication skills are. During the visit a nurse approached the bedside to empty his indwelling urinary catheter. As she approached she didn’t make any eye contact and duly went about emptying the catheter, recorded the details on his fluid balance chart and walked away. At no time during the procedure did she speak.

It really made me think about how essential communication skills are when caring for patients. Had he wanted to ask a question the opportunity was lost. What about holistic care, wouldn’t this have been a good opportunity to take a look at the patient and perhaps ask how he was feeling? Maybe she didn’t want to interrupt his visiting time, as healthcare professionals often have to work around extended visiting hours.Communication Between Patients And Nurse Essay Paper

Verbal and nonverbal communication are used by healthcare professionals every day, and we all like to think we are skilled in this area, but are we? As qualified professionals when do we update these skills or do we just learn from experience? I can recall many times as a sister in A&E having to tell relatives that a loved one had died, but how do you prepare for this, and how do you know if you did it well? Agenda for Change (factor 1) acknowledges six different levels of communication and the complexities and skills involved.1

We need to break down barriers to communication and ensure that patients feel able to discuss concerns and worries? Evidence suggests that many of the complaints received in the NHS are due to a breakdown in communication. So how can we improve this?

In this age of increasing reliance on technology and high-level skills it is easy to forget that the fundamentals of care and good communication should be at the heart of everything we do. A good consultation should start the moment you see the patient. Their nonverbal communication will tell you a lot about how they are feeling before they even speak. Listening to what they have to say about how they feel is an essential aspect of communication.Communication Between Patients And Nurse Essay Paper

Pressures to collect data for Quality and Outcomes Framework targets, for instance, can mean that we sometimes look at the computer to see what needs doing rather than taking time to look at the patient. How do you overcome this?

Recent press coverage has called upon nurses to “smile more” and this is certainly an important aspect of communicating with patients if we are to put them at ease and gain their trust, particularly when they are feeling unwell and vulnerable. Good communication is an essential component of high-quality care if we are to ascertain the patient’s level of understanding of their condition and encourage them to feel comfortable to ask further questions.Communication Between Patients And Nurse Essay Paper

One of the pleasures of working in primary care is that we can really get to know our patients and their families and there is a wealth of evidence to support the fact that patients value their time with nurses who often explain things better and spend more time with them.

Our Health Our Care Our Say set about aiming to achieve four main goals:2

  • Better prevention services with earlier intervention.
  • More choice and a louder voice.
  • Do more to tackle inequalities and improve access to community services.
  • More support for people with long-term conditions.

Communication is at the heart of these goals and patients are being encouraged to be more involved in their care. This can only be achieved if patients fully understand what is available and feel empowered to make those choices. So next time you are talking to a patient, take time to reflect on how you think the consultation went and how it could be improved. Did you use jargon or abbreviations, and more importantly did you find out if the patient understood what had been said?Communication Between Patients And Nurse Essay Paper

Some time ago I asked a family member about their experience of general practice and how it could be improved. He remarked that on the rare occasions he had visited the GP he had always arrived on time and yet inevitably he had been made to wait 30-45 minutes after his appointment time. Immediately I became defensive and explained that while appointment times are given sometimes patients need longer or may have attended for a routine appointment only to find something more complex on examination and therefore require longer. He replied, “Yes I understand that but why can’t someone tell you that they are running over on arrival? The fact that no-one tells you what is happening makes you feel that your time is less important and you should expect to wait. At least if you knew you were going to be delayed you could contact work and let them know you are going to be late!”Communication Between Patients And Nurse Essay Paper

The third incident happened during year 3, in my placement in the surgical ward for orthopaedic patients. At this stage, my previous experiences in communicating with patients during year 1 and 2 have helped me develop important communication skills. These included recognising non-verbal messages, understanding how culture influences my patients’ perceptions of nurses and the care they receive. Culture plays a crucial role in how patients place meanings on the words and symbols I use when communicating (Funnell et al., 2009). Apart from culture, I realised that the patient’s own perceptions of the illness and pain they are experiencing could also influence the quality of our communication.Communication Between Patients And Nurse Essay Paper

In the incident, I was assigned to assess the level of post-operative pain of a patient after surgical operation. He was a 32-year old male and was unable to communicate even after four hours of surgery. I tried to communicate with him to help assess his level of pain. Since he could not verbalise his level of pain, I used the visual analogue scale (VAS) to identify the level of pain. On analysis, I felt that I have done the right thing and have fulfilled one of the competencies under the domain of communication. Specifically, the NMC (2010) states that nurses should be able to use different communication strategies to support patient-centred care. The use of the VAS helped the patient articulate his level of pain. The VAS is often used as a tool in healthcare practice when assessing the patient’s level of pain. This tool is reliable and has been validated in different settings (Fadaizadeh et al., 2009). On analysis, my personal experiences in the last three years helped me become acquainted with current guidelines on pain assessment. It also helped me identify a simple but valid and reliable tool in assessing patient’s level of pain.Communication Between Patients And Nurse Essay Paper

Pain perception in post-operative patients is highly subjective and could be influenced by several factors (Gagliese and Katz, 2003). These include age, gender, prior pain experience, medications and culture (Lavernia et al., 2011; Grinstein-Cohen et al., 2009; Gagliese and Katz, 2003). Regardless of the factors that influence pain, nurses should be able to assess the patient’s pain accurately and communicate with the patient strategies on how to control pain (Clancy et al., 2005). Hence, communication is crucial in ensuring quality post-operative care. On reflection, I was aware that the patient has difficulty communicating. Hence, choosing a more complex tool in assessing pain could add to more distress and anxiety for the patient (Gagliese and Katz, 2003). I realised that choosing a simple assessment tool helped calm down the patient since I was able to deliver care appropriately.Communication Between Patients And Nurse Essay Paper

On reflection, I would follow similar procedures in the future. However, I would improve my knowledge on pain assessment by participating in pain education nursing classes in university or in the hospital where I am assigned. This would form part of my continuing professional development and action plan. Abdalrahim et al. (2011) argue that nurses with high knowledge on patient education are more likely to accurately assess patient pain, leading to earlier relief and management of the patient’s pain. However, Francis and Fitzpatrick (2013) express that despite high levels of knowledge on pain management, there are some nurses who have difficulty translating this knowledge into actual practice. One of my roles as a nurse in an orthopaedic surgical ward is to manage post-operative pain of my patients. Failing to manage pain could lead to chronic pain, longer hospital stays and poorer health outcomes (Grinstein-Cohen et al., 2009). I also realised that effective communication with patients is needed to ensure that the patient’s needs are addressed.Communication Between Patients And Nurse Essay Paper

In conclusion, the three incidents portrayed in this reflective brief demonstrate how I evolved as a nurse practitioner from novice to competent. Specifically, my communication skills have developed from year 1 until Year 3. In the first incident, I had difficulty communicating with older patients with dementia. Beginner nurse practitioners have no experience in the situations they find themselves in. This was true in my experience with the older patient with dementia. It was my first time at communicating with a patient with cognitive impairment and feeding him. I lacked confidence in carrying out the task and only improved after several meetings with the client. However, in year 2, my communication skills improved. For instance, I was able to immediately identify the needs of the patients by depending on verbal cues and non-verbal messages of the client. I was able to get an interpreter and communicate with him. However, I also realised that I still need to improve by participating in classes and training on how to communicate effectively with patients with different ethnic background.Communication Between Patients And Nurse Essay Paper

Finally, in year 3, I was now more competent in communicating with patients. Even when the patient in post-operative care could not communicate, I was aware that he was in pain. I was also able to use an appropriate assessment tool that is consistent with the guidelines in our hospital. I realised that I possess more confidence in communicating with the patient and identifying his needs. My previous experiences in communicating with different groups of patients helped me become competent in identifying the needs of the patients. Importantly, care was delivered promptly since I was able to appropriately assess the level of pain of the patient. All these three experiences show that I could hone my skills in communication. My communication experiences in nursing will help me become more competent and ready as a future nurse registrant.Communication Between Patients And Nurse Essay Paper

Nursing as a health care science, focuses on serving the needs of human as a biopsychosocial and spiritual being. Its practice requires not only scientific knowledge, but also interpersonal, intellectual and technical abilities and skills. This means a composition of knowledge, clinical work and interpersonal communication (1). Communication is a vital element in Nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education and health promotion (2). The nursing process moreover as a scientific method of exercise and implementation of Nursing, is achieved through dialogue, through interpersonal environment and with specific skills of verbal communication (3).Communication Between Patients And Nurse Essay Paper

As communication we can define the exchange of information, thoughts and feelings among people using speech or other means. Therapeutic practice involves the oral communication of public health officials and nurses on the one hand and the patient or his relatives on the other. It is a two way process. The patient conveys their fears and concerns to their nurse and helps them make a correct nursing diagnosis. The nurse takes the information and in turn transmits other information to the patient with discretion and delicacy as to the nature of the disease and advises with treatment and a rehabilitation plan for health promotion (4).

Effective communication requires an understanding of the patient and the experiences they express. It requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient. To understand the patient only is not sufficient but the nurse must also convey the message that he/she is understandable and acceptable. It is a reflection of the knowledge of the participants, the way they think and feel and their capabilities (5).Communication Between Patients And Nurse Essay Paper

In order for the nurses to be successful in their work they have to study communication and interpersonal relations in their education with special courses and internships. They need to learn the various aspects and applications of communication in various fields of nursing (6). In this context it is understood that emphasis must be placed on the importance of communication between nurse and patient and nursing education must focus on communication skills of nurses.

Communication can be defined as a transaction and message creation. The entire process occurs in a context consisting of physical space, cultural and social values and psychological conditions (7). Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional. When health professionals are not trained in communication skills, they face more difficulties separating work from their personal life, tending to transfer problems from one side to the other (8).Communication Between Patients And Nurse Essay Paper

Communication is an intrinsic characteristic of human nature. Nobody cannot communicate. Communication has content and value. The contents regards to what was said, whilst the relationship regards as to how it was said. The nature of the relationship depends on how the two parties understand the communication sequence (9). Communication is never unidirectional. It is an interaction in which each sender becomes receiver and vice versa. The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes (10).

Moreover, the message sent is not the same as the message received. The decoding of the messages is based on individual factors and subjective perceptions. This fact, in conjunction with the process of feedback makes communication. We interpret something that we heard not according to what the sender actually said but according to our own code (11). Particular attention should be given by the caregivers to use technical terms and medical terminology during their contact with the ill, because it is often found that the patient ascribes different interpretations to what he hears or even more cannot understand what is meant exactly, mainly by the therapist, thus increasing mental stress, a fact which makes it more difficult to communicate with the patient (12).Communication Between Patients And Nurse Essay Paper

Communication happens without words. It is an ongoing process. This non-verbal communication is expressed by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor (13). It is important that there is an agreement between verbal and nonverbal communication. Particularly under stressful conditions where it is difficult to see the changes in the non-verbal messages of the patients with whom we mostly communicate (14). Moreover, each patient has his own specific characteristics that influence not only behavior in the process of communication, but also if and how to cooperate with nursing services and how they will undertake self-management of health (15).

Listening is important in communication. It is responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and non-verbal messages emitted by each patient. By listening, nurses assess the situation and the problems of the patient; they enhance his/her self-esteem and integrate both the nursing diagnosis and the process of care at all levels (5).Communication Between Patients And Nurse Essay Paper

Good personal relationships are described as the ability of the nurse to ask questions with kindness and provide information in a way that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society (16). The therapeutic relationship is an important prerequisite to effective communication between health professionals and patients in order not only to transmit information, but also to effectively address mental processes which are activated by it. The communication between health professionals and patients include the ability to express sincere concern for the care of the patient and the patient becomes a partaker of this interest (9).

Communication between health officials-in this case nurses-and patient is a process that begins with the first contact of the two and lasts as long as the therapeutic relationship. The nurse, who wants to create the right relationship with the patient, must win him/her from the first moment. This will happen if the conversation is held in appropriate conditions. Even though it seems obvious, it should be noted that courtesy and kindness on part of the nurse is required (4, 17).Communication Between Patients And Nurse Essay Paper

The patient should feel comfortable with the nurse, but the latter should protect his/her prestige and not give rise to misunderstandings. A key element is the need for a peaceful environment with no external distractions, which will ensure appropriate confidentiality of the dialogue. Frequently we see the phenomenon of serious discussions taking place in the middle of the corridor of the outpatient department or the nursing department, clinic, or in some office of the hospital, in which third parties unrelated to the care of the individual patient are coming in and out (18). In such an environment the patients are ashamed to express themselves freely (19).

Unfortunately, the concept of privacy is pretty much unknown to the Greek hospital system. Skilled nursing operations for the patients are made in chambers without screens or in hallways, in front of others. Patients and visitors of hospitals move without restriction in all the areas of the nursing and clinical departments. However, it is up to us to teach our colleagues and especially the new nurses and their patients setting the right example, in order for things to slowly change for the better (20).Communication Between Patients And Nurse Essay Paper

Even more than the comfort of space, communication with the patient requires ample time. Each patient has his own way and pace to reveal his problem, but it takes some time to get to know the nurses and feel the confidence necessary to face them. The patient should have the feeling that the time-whether it is five minutes or an hour-is entirely his. The patient who has the undivided attention of the nurse reveals his problem sooner, with the satisfaction that the nurse has listened and observed him (21). After the nurse has listened to the ill, he/she should also talk to him. The language he uses for this purpose is very important. Often the patient is bombarded with big words with little or no significance for him (22). Once again the nurse may be directed to the ill in an incomprehensible way. Patients that are ashamed of their ignorance or are hesitant, avoid seeking an explanation, and as a result the consultation is inadequate and does not lead to the right outcome for the patient. The language of communication should therefore be at the level of the listener, who is not able to assess our scientific knowledge, but has to understand what we are telling him (23).Communication Between Patients And Nurse Essay Paper

Another important requirement for proper and successful communication between nurses and patients is frankness and honesty. The discussion with the patient should leave no suspicions, doubts and misunderstandings. For example, if the patient suspects that while chatting with him we are making gestures to an escort, he/she will suspect that we are not telling him the whole truth (4). Where there is a need for a separate and private discussion with someone from the patient’s environment, we should be very careful of the place, manner and time of this communication, which should be independent of the discussion with the patient (24, 25).Communication Between Patients And Nurse Essay Paper

Communication as already stated is bidirectional, but the nurse or other health professional is responsibility for its proper conduct. The patient comes into the dialogue under stress and the emotional events he/she is facing. Moreover, depending on the psychosynthesis it can be more or less calm. Reactions such as anger, disbelief, moaning, aggression and denial of reality are known defence mechanisms, which are recruited to help him adjust to the new situation he is facing (8, 26). The angry patient usually does not have any previous personal differences with health professionals, although they are the direct recipients of his anger. The latter should understand and accept these mechanisms which serve the underlying anxiety of the patient and to respond with information, awareness and readiness to provide all possible assistance (27).Communication Between Patients And Nurse Essay Paper

Finally, people differ in their needs for communication. Some expect or require patient listening, without caring much about the answers. Others want a specific explanation for everything that happens to them. These different needs should be treated accordingly by the nurses, who should be able to detect what each patient wants (28). What of course in any case should be avoided by the caregivers is silence and indifference to the questions of the patient. In the best cases, the patient will leave disappointed and in the worst really indignant with nurses (9).

Communication with the patient is an individual part of the ‘long art’ of Hippocratic medicine (19). It is not only based on an innate ability that varies from person to person, but also on the necessary training and experience that one acquires during exercise (13). The need also for education in communication has been recognized worldwide (6). The results of this will be to demonstrate greater understanding among patients with greater benefit to patients and personal satisfaction to nurses in the performance of nursing (29).Communication Between Patients And Nurse Essay Paper

Good communication also improves the quality of care provided to patients, which is observed in the results. Additionally, it is considered an inalienable right and a prerequisite for building a genuine and meaningful relationship between patients and nurses and other health professionals (30).

So in order for modern Nursing as a service to humans to realize the project, there is a need for dialogue and a good interpersonal climate that develops personally with each sick person, especially in our modern multicultural society. The best expertise training and continuing education of nurses in matters relating to the proper technique of communication will enable them to respond adequately and humanely to the expectations of patients.Communication Between Patients And Nurse Essay Paper

THE BENEFITS OF COMMUNICATION

Studies show that good communication between nurses and patients have many benefits. First, it greatly contributes to the ability to provide patients with individualized care. Nurses who take the time to understand the unique challenges and concerns of their patients will be better prepared to advocate on their behalf and properly address issues as they arise. This greater focus on communication frequently leads to better patient outcomes as well.

Second, patients who feel like they are receiving all of the nurse’s attention during an interaction are more likely to disclose the true extent of their feelings and symptoms much quicker. Patients may also feel more satisfaction with their care if the nurse provides them with undivided attention.Communication Between Patients And Nurse Essay Paper

Third, interpersonal communication can satisfy the innate needs of the patient as outlined in Maslow’s hierarchy of needs. Those needs include the feelings of safety, love and confidence, all of which are important during a patient’s treatment and recovery.

Finally, research shows that communication in nursing not only benefits the patients, but the nurses as well. Nurses who communicate well with their coworkers tend to witness an improvement in morale as well as job satisfaction. A 2014 article titled theEffective Interpersonal Communication: A Practical Guide to Improve Your Life reiterates the negative effects of poor workplace communication. High turnover rates, increased stress, and lower morale and job satisfaction are among the many downsides.Communication Between Patients And Nurse Essay Paper

Not everyone is a natural communicator, and even the best communicators can benefit from additional training and insight. Due to the important clinical, emotional and psychological benefits for nurses and patients, many online RN to BSN programs are now incorporating communication training into their curricula.

Coursework in professional interpersonal communication — including written and verbal techniques — can help prepare nurses for the workplace. While the significance of verbal communication is well understood, the necessity to use clear and concise written communication is often underestimated. With the rise of electronic medical records, malpractice lawsuits and insurance denials, it has become increasingly important for nurses to fully document patient encounters and treatment plans.Communication Between Patients And Nurse Essay Paper

Those who study the role of communication and its effects on interpersonal relationships are expected to have a distinct advantage upon entering the field. Students should have the opportunity to evaluate various techniques and apply those in the classroom and clinical settings. Nurse-patient interactions must be handled with care, and students need to learn how to approach different scenarios. For example, nurses should refrain from overwhelming the patient with irrelevant details or complex language. Learning to communicate at the level of the listener, whether a patient, caregiver, or another nurse or healthcare provider, is a crucial concept.

COMMUNICATION IS KEY

Nurses have a multitude of responsibilities when it comes to patient care. Arguably, communication tops the list. Nurses act as the hub of communication, relaying and interpreting information between physicians, caregivers, family members and patients. The ability to establish effective communication in nursing is imperative to providing the best care and patient outcomes possible.Communication Between Patients And Nurse Essay Paper

Developing these skills starts in the classroom, where students can study techniques in more depth. Coursework covering professional interpersonal communication, including both verbal and written, is ideal. Many online RN to BSN programs offer this training as part of their curricula now due to the growing impact that effective communication has on patients, nurses, and their coworkers. Communication Between Patients And Nurse Essay Paper

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