The Role of Effective Communication and Personal Involvement by Nurses for Effective Practice - Essay Example

Write an essay that responds to the following debate-The role of effective communication and personal involvement by nurses for effective practice: The entire essay is based on the debate that has aroused in field of health care practioners off late with the turn of century and with the change in generation, thoughts and society is that: Should medication be considered and developed in the personal or impersonal level. To narrow the field further let us discusses the echoes of this question galore on the Nursing field. Abstract This assignment can be considered as an answer or pull of to the debate that has been around in health care field due some decades. This assignment first opens up with the debate between Stein –Parbury ,who argues personal involvement (level to be judged by the situation) and effective communication in the nurses fraternity is essential to provide excellent health care, arguing that ,it is the purpose of the department. But Strong contradicts this by saying that in this” micro second” world involvement is not possible and only the essential attention could be only given. As to unravel the basic fact ,the essay starts with by explaining the importance of nursing,followed by role of communication in nursing. Then it spread out the view of Stein -Parbury about various relationship between nurses and patients, balanced by strong’s view. Then follows the mportant part of the essay, that stacks the features supportive of Stein- Parbury, and the answers to the queries that decries his view .it ends with an conclusion that the purpose of medical field is to take care and nurses care and involvement with the patient is important for quality health care. The debate: According to Stein-Parbury, 2005, he is very strong on the ideology that effective communication is some thing that can be achieved in the nursing field that would further help nurses to understand patient’s condition, views and feelings better that would eventually result in better health care provision. He futher argues that in the health care provision the relationship that develops between the patients and nurses varies with the varied level of involvement extended by the patient and nurses. He further advocates that as a successful part of nursing it is the duty of the nurse too decide about the level of involvement required that is demanded by the situation. (1) But Strong’s (Dingwell & Aleen, 2001) view point is that in this fast and automated world nursing profession also has to be with the speed of race and doesn’t have the nuances for personal involvement. It is his view that with the way healthcare is considered in the developing Nations care has to be provided in the burecratic, impersonal way with routine, surface courtesy delivered to each citizen, with certain fixed entitlement of mundane emotion work but no more than that is to be expected. (2) Nursing the field of selflessness: Nursing, in general can be described as a perfect combination of art and science where both mind and heart should work in confluence. The goal of the nursing is always the well being of the patient. The nursing work from time immemorial has been designed to relieve, contain and prevent the symptoms and sufferings. Nursing work can also be described as an emotional work that stems at the social transaction. Responding of nurses to the patients and their distress requires time but is an efficiency driven system. Nursing’s role and duties had been variedly described by different people and in an angle it involves invisible social transaction that is essential for the social transaction. Other than the mundane work nurses are expected to communicate to different people, multitude of departments and agencies with monumental speed. (Kelly,2004) (3) Communication in health care: Thus owing to the fast paced management care environment, communication can be considered as foundation of relation ship and it is the need of the hour especially for the healing relationship. Since from immemorial it is considered that positive patient- practitioner relationship is a critical part of healing relationship and according to Zoppi and Epstein, good communication is both a way of well being and skill that austerely promotes good patient - practitioner relationship. Generally for any process good communication is the practice that leads to greater patient satisfaction, improved clinical outcomes and increased patience compliance. Neuwrith confirms that much contrary to the common belief communication is not an inborn talent or skill but is a skill that can be developed and learned, much like the playing of musical instrument that only requires continuous practice and improvement thus fostering the patient’s positive relationship. (Alliex & Irurita , 2004) (4) After the pondering about the basic concept now it becomes necessary to substantiate that, to which side of the debate I belong. I personally consider Stein –Parbury’s view about effective communication holds very true and am the concept that best explains the role of nurse in the live hood. Than Strong’s view. So now I tend to explain Stein –Parbury’s view and then turn to Strong’s view then would argue about the positive points in Stein –Parbury’s concept and try to answer the question raised by Strong’s theory, with an conclusion that would stress the need for nurses to go with and learn the technological advancement and outpouring results of the researches conducted. Stein –Parbury’s view about relationship: They identify the patients nurse relationship as three types as instrumental , protective and reciprocal.(Ramo’s,1992) levels of interaction as practical ,social, personal and transcendent with which three type of relationship could be described, clinical ,therapeutic and connected relationship.( Morse ,1991), each type characterized by the level of involvement. In clinical relationship, relationship is routine, following the standard protocol with the duration being minimum and perceives minor health setback. The skill used here is listening and that is primarily focused on the patient’s content and not on feeling. (Ramos, 1992., Morse, 1991). Therapeutic relationship formed between the patient and nurse is unilateral mainly, the relationship being controlled by the nurse, the duration being short duration and condition of patient not serious with the relation primarily is as patient later though he is considered as person. Here the focus on skill being listeni9ng to the patients feeling concerned with the medication so her attention here focused both on factual data and patients perception. Connective relationship is the one where the nurse and patient get involves in a degree that they think of themselves as person first and then as nurse and patient. Generally this type of relationship takes time to develop but when the patient is serious or critical and when he is dependent it develops fast. Here both of them are responsible for the relationship and the nurse goes extra mile care... here they are able to listen, perceive and connect to patients feeling So basically it is important that the nurses know the type of relationship and its progress. Only issue that has to be taken care of , before involving in the relationship awareness of their own personal feeling and attitudes, approach and judgments. The main pillar on which the relationship is formed is trust, mutual assessment, and initial interview with control and power and emotionality being the leveraging factor. Thus they conclude that in developing relationship nurses not only focuses on the patient’s personal experience but also on the level of involvement desired by the patients. (1) Strong’s perspective about present day nursing: It is well accepted fact according to this theory is that gone are the days of golden era in healthcare where holistic approach for health care was possible. Any profession in the society can be considered to have two phases as mandate part, its assertion about its contribution to the society and license, its actual term of contract with the society. The analysis of mandate refers to the cultural and ideals where as the license leads to material and structural constraint, invariably the world now is ruled by the license factor and thus the emotional factor cannot successfully play in the health care. It is well accepted fact that earlier nurses had the only role of tending and taking care of patients, but now with the varied range of work they have to take up, emotional involvement or effective communication with the patients is Herculean task. (2) Now its time to retrospect on the point of why these two authors included two perspective in their description. If we analyse why Stein –Parbury considered his argument to be important,, In an research conducted by School of Nursing, midwifery, Manchester, the result stressed the point that though the community and world has changed drastically, pallitative working is one of the universal virtue of nurses that is valid world wide.as an example of excellence. ( Caren etal,2000) (5) Latest research shows that Patients requires an empathetic nurse ,who is competent in dealing with their specific problems and who sees patients as people and are committed to building a strong therapeutic relationship with them and their families.and such nurses are desired by all. Supporting Stein’s theory. (Health and Age,2006). (6) In an research done to validate the staff ,patient ratio and nurses sense of job satisfaction, it was found that the much time and care taken by nurses for individual patients rob their sense of satisfaction, supporting Strong’s view. (Mark, 2000) (7) Facts that form as a supportive prop for Stein-Parbury’s theory: Advocacy is considered to be a very important component from the days of nightingale who advocated for the wounded and sick soldiers of the American civil war, thus underlying the importance of effective communication. The advocacy by nurses creates a legal image for them helping them to understand and protect patient’s rights better. According to Millette, who researched through the preferential advocacy among bureaucratic, physician and client advocacy, client advocacy emerged as winner, important factor being nurses and patients sharing a common humanity and cultural environment. The concept of advocacy was thought to have emerged when the nurse’s sense of commitment changed from physician to patients. The feeling of advocating for patients among nurses have been found to have emerged either from childhood or by interacting with practitioners or gaining confidence as years of services proceed. (Foley , Minick & Kee , 2002) (8) More importance gather for the point of effective communication when critical conditions as patients in serious condition, families of medically fragile children and nurses emergency care sector play a pivotal role in interacting with the patients and his community. For example in medically fragile children the major challenge the family would face is when the kid moves out from the safety haven of medically monitored house to school. There researches show that nurses play an very important role in helping them to understand the do’ s and don’ts to be followed in transition with confidence and the illness hat can be anticipated. In emergency care they play a main role in explaining to the terrified patient about his condition and that he need not worry about the medication and in explaining about his condition gently to his relatives thus reducing the emotional trauma.( Carr , Proctor & Davidson ,2003) (9) (O’Gara P & Fairhurst ,2004) (10) (Tommet ,2003) (11) So in recent years with increasing health care information patients are becoming more knowledgeable and they demand greater involvement in clinical decision making. So it becomes essential that a practitioner creates a good rapport with the patients and explains them about the facts and myths explain about the priorities and deciding about the level of disclosure of the fact. This way nurses can play a major role in pain management. (Gustafsson & Willman , 2003) (12) One another field is geriatrics, where communicating with the sick old people is the main key point to the success of the treatment. The medical fractioned should understand the patient’s mentality , feeling towards their own ailment, treatment provided where in many cases it has been seen that, they subject to treatment only with the effective balancing of nurses between the medical fraternity and humanity. (Williams K, Kemper S & Hummert L , 2004) (13) The queries decrying the theories and the answers to them: The main point that is raised is that nurses should give fixed care and attention only that meets the clinical standard, being impersonal is that the point that the patient’s privacy is affected. Since it becomes the duty of the nurses to provide 24 hrs cares, they are considered as the prime offenders of privacy. The privacy aspect being discussed under four subheadings as privacy of the body, space, information, and personal behavior. The bodily privacy is felt to be insulted when they are bodily exposed during medical practices, space privacy being offended when curtains and blinders cannot be used by patients when desired, information privacy thrashed when their medical history is discussed in public in the name of case discussion and when their social relationship and valises and behaviors when cannot be guarded is taken as behavior privacy. (Johnson , 2005) (14) The answer to this would be that nurses as they have developed their communication effectively should know the value of privacy and should try not to step over in the name of care provider. The personal involvement from nurses would be deleterious if the nurses individual emotional level is too disturbing and their emotional connection with the ailing patients still more affects their mentality would result eventually in their depression rendering their work to be the burden for them thus reducing their ability. (Kalischuk R & Thorpe K, (2002) (15) ` The solution might be nurses of these category should try to improve their emotion strength as, usualy in the patient centered therapy the patients look up on the medical parishioners as their source of strength. Unlike the olden golden days the nurses of the present day are forced to step up in their role as the maxi nurses or mini doctors due to adverse staffing ratio. Thus now they are expected to do, multiple roles other than their duties so the question of emotional involvement or effective communication with the patients is practvally possible. (Liaschenko J ,2002) (16) It can only be said that the basic essence of the nursing profession is providing health care to the patients it should never be forgotten in any circumstance. The new generation of students who have undertaken the nursing profession as long forgotten the concept of compassion, love, service, caretaking look upon nursing as any other profession that demands professional knowledge and technological skills. (Holdstrom I & Larson J ,2005) (17) It becomes the sole and soul responsibility of the senior nurses in enlightening the emerging nurses about the values, principles, concepts and the nobility of the profession. Thus, turning the hi-tech generation to the path of nobility. Conclusion: After going through both the sides of the debate it become necessary that nurses should understand that effective communication and personal involvement that the circumstance demands is necessary for successful medical practice. It should be remembered that this feature is not an inborn attribute but a concept that can be developed with interest and patience. For this effective dissemination of knowledge becomes essential. Dissemination of research findings is one of the ways to improve knowledge, maximize health gain and implement good quality care. Apart from knowing the research nurses for complete successes should practice it during the days to follow. Thugs the knowledge should filter down from acadamecia to practice. ( Norwood S , 2001) (18) (Rassool G ,2005) (19) References 1. Stein-Parbury (2005). The patient-nurse relationship 2. Dingwell & Allen (2001) the implications of healthcare reforms for the profession of nursing. Nursing Inquiry 2001. 3. Kelly J (2004) Accountability and recent developments in nursing: be bold, be holistic: a review of the literature, DCCN Dimensions of Critical Care Nursing, pp: 23(1): 31-37. 4. Alliex S & Irurita V (2004) Caring in a technological environment: How is this possible? Contemporary Nurse, pp: 17(1-2): 32-43 5. Karen A. Luker , Lynn Austi, Ann Caress , Christine E. Hallett (2000) The importance of 'knowing the patient': community nurses' constructions of quality in providing palliative care Journal of Advanced Nursing 31 (4), 775–782. 6. Health and Age, 2006, http://www.healthandage.com/Home/!gc=5!gid7=983 7. Mark.W. Statson, 2000, Hospital Nurse Staffing and Quality of Care Research in Action, Issue 14 8. Foley B, Minick M & Kee C (2002) How nurses learn advocacy, Journal of Nursing Scholarship. pp:34(2): 181-186 9. Carr S, Proctor S & Davidson A (2003) Models of public health nursing. Community Practioner, pp:76(3): 96-99 10. O’Gara P & Fairhurst W (2004) Therapeutic communication part 1: general approaches that enhance the quality of the consultation. Accident and Emergency Nursing. pp:12(3): 166-172 11. Tommet P (2003) Nurses-patient dialogues: Illuminating the evolving patterns of families with children who are medically fragile. Nursing Science Quarterly, pp : 16(3): 239-246. 12. Gustafsson B & Willman A (2003) Nurses’ self-relation- becoming theoretically competent: the SAUC model for confirming nursing, Nursing Science Quarterly, pp: 16(3): 265-271 13. Williams K, Kemper S & Hummert L (2004) Enhancing communication with older adults: overcoming elderspeak, Journal of Gerontological Nursing, pp : 30(10): 17-25 14. Johnson M (2005) Notes on the tension between privacy and surveillance in nursing, Online Journal of Issues in Nursing. pp :10(2): 11 15. Kalischuk R & Thorpe K (2002) Thinking creatively: from nursing education to practice, Journal of Continuing Education in Nursing, pp :33(4): 155-163 16. . Liaschenko J (2002) Thoughts on Nursing Work, Journal of Nursing Administration, pp: 32(2): 69-70. 17. Holdstrom I & Larson J (2005) A tension between genuine care and other duties: Swedish nursing student views on their future work, Nursing Education Today, pp :25(2): 148-155 18. Norwood S (2001) The invisibility of advanced practice nurses in popular magazines. Journal of the American Academy of Nurse Practitioners. Pp :13(3): 129-133. 19. Rassool G (2005) International Perspectives. Dissemination of nursing knowledge: the application of a model of change. Journal of Addictions Nursing. pp: 16(1-2): 79-82 Read More