Communication in Nursing Literary Review - Essay Example

Introduction Introduce the focus of your topic. Briefly discuss the process of the literature search and any difficulties encountered. Communication is a vital activity undertaken by all human beings in the course of their day to day activities. At the most basic level, communication has been described as an act or action performed to impart or transmit information (Ruesch and Bateson, 1968). A job is well done when there are clear instructions, or in other words, the communication is clear. Messages have to be delivered in simple, clear styles, keeping in mind the mental and social make-up of the target audience. Effective communication occurs when the message or signals sent by the sender are received and interpreted by the receiver without any change. Of all the industries, sectors that require professionals to continuously interact with non-professionals need effective communicators. Industries like hospitality, media, medical, legal and other service sectors need people not only with strong professional backgrounds, but also excellent communication skills. Nursing is a profession where nurses are required to not only assist the doctor in his work, but also ally the fears and apprehensions of the patient and his relatives. Nurses in hospitals become the primary care-givers and spend considerable time with the patients. They would very frequently find themselves in a position where they are the bridge between the specialist doctor and the patient. Thus, their role extends to that of an effective communicator. Various researchers have highlighted the importance of effective communication by nurses in their works. "Effective communication is a fundamental element of nursing care that is integral to the provision of quality patient care." (Ravert et al. 1997, Wilkinson et al. 1999, Bowles et al. cited in McGilton, 2005). By going through the literature available in various nursing journals, it would be easy to narrow down to the topic of my dissertation. Although a lot of research has been done in the field of effective communication as an integral part of the nursing profession, there are many grey areas even today. A lot needs to be done to achieve cent percent efficiency in the field. Surveys, trainings, evaluations, further research would provide a means to fill the lacunae in this field. Process of Literature Search The literature search was carried out through online medical/nursing journals .These have given a wide and varied range of literature on the subject. This literature review has used the results of studies and experiments carried out across the globe. The literature review includes research papers from Toronto Rehabilitation Institute, Canada; University of Alberta, Canada; Griffith University, Australia; Communication Disability Center, University of Queensland, Australia; and The Martlets Hospice, Hove, UK. These papers were downloaded from such vastly spread out sources so that there would be very little scope for bias and the review would be a well-balanced one. Under the keyword "effective communication", the review includes topics ranging from complex continuing care facility, palliative nursing, factors that influence communication between people with communication disability and their healthcare providers in hospitals, effective communication as a core competency for collaborative practice among nurses to effective parent-nurse communication. These articles have been published over a period of nine years from 2001 to 2009.Thus, they include the latest research in the field of effective communication between nurses and patients and ways and means of achieving it. Also, these articles are themselves very well-researched and offer excellent secondary sources of reference. Findings The research studies definitely show that there is a lot of scope for further research and recommendations in the field of effective communication among nurses. The studies covered parent-nurse interactions and patient-nurse interactions under various circumstances and illnesses. The first paper covers issues and innovations in nursing communication and means to enhance this communication with patients under complex continuing care facility. This paper explores the social life of patients living in long term care and complex care facilities. With limited exposure to the outside world, they are to a large extent dependent on the care-giver/nurse for their social interactions. "For those residing in long-term care (LTC) and complex continuing care (CCC) facilities, opportunities for socialization occur primarily during interaction or communication with staff" (Williams et al. 2003 cited in McGilton, 2005).The paper also explores the impact of very short and short term trainings on the satisfaction levels of patients and nurses during their interactions.1day, 3 day and Solution-Focused Brief Therapy Technique (SFBT) adopted by other researchers have been discussed. The aim of this study was to examine the effects of a communication enhancement intervention on outcomes. The hypothesis was that an enhanced communication approach would increase nursing staff comfort while communicating with patients. To enhance the accuracy of the data, data on patients' cognitive ability were collected by using the Recall Score (RS), which was based on information from the Resident Assessment Instrument Minimum Data Set (RAI-MDS 20). The RCS consisted of six items based on conceptual definitions of empathy and reliability.(McGilton, et al. 2005).The nurses were trained in various communication strategies, the main one being an additional 2-minute session with the patient asking him/her simple open ended questions that would be very easy to answer. The focus group data showed that the training program had resulted in encouraging nursing staff to ask patients about their feelings, hopes and desires. Consequently, the staff came to know their patients better and this led to better empathy and communication. The conclusion however, of all earlier studies and the current study was that while there was an improvement in the job satisfaction levels of nurses, there was not much difference in the satisfaction levels recorded for the patients after the nurses underwent the trainings. There were a few limitations like lack of proper framework and guidelines for the intervention, improper implementation and exclusion of patients' viewpoint in the evaluation process. The second paper focuses on the interaction of nurses and parents of infants in NICU wards. This study examined how mothers and fathers discerned effective and ineffective communication by nurses in a neonatal intensive care unit (NICU) environment. Communication accommodation theory (CAT) was used as the framework for this study. The study concluded that accommodative and interpersonal communication by nurses was very effective when compared to under- accommodative and intergroup communications. "Good quality support for families from health professionals has been found to be associated with less parent stress." (Semin Neonatol 2003, cited in Liz Jones et al,2007).References in the study suggest that nurses are a significant source of information and support for parents through this transitional period and nursing communication is highly valued by parents(J Neonat Nurs 1996, cited in Liz Jones et al,2007). The results showed that there was a difference in perception between mothers and fathers and mothers were happier when their role with nurses was more collaborative than one akin to student-teacher Reassuring and consistent information was well-received ;fathers particularly disliked conflicting information. Fathers mentioned the interpretability strategy and disliked vague or indirect communication about their babies. There has been limited research in this field and thus there is ample scope for new research and findings. The next paper focuses on palliative care where the patient is no longer responding to curative treatment. One of the core elements of good palliative care is effective communication, among health professionals and between health professionals and patients (Buckman, 1993,cited in Wallace,2001). Wallace quotes Crawford et al (1998), while stating that the fundamental aim of nursing is to communicate 'care'. She describes in detail about the Peplau's model for humanistic interaction and its therapeutic benefits to the patient. She asserts that expression of patients' innermost thoughts and feelings may facilitate their coping with the impact of the disease process. Interpersonal and communication skills consciously acquired through trainings can help nurses provide nurturing care in terminally ill patients. By being aware of the language they use, nurses can sensitively and skillfully influence patients' perceptions of their life changes, facilitating acceptance and understanding of their illnesses and the restrictions imposed on them. Thus, Wallace has emphasized the need for an understanding of communication theories and models among nurses working with palliative patients. With nurses finding normal communication with people quite challenging, it would be useful to examine the effectiveness of their communication with people with disabilities. This tricky area and factors influencing it was studied by a group of researchers at University of Queensland. Various environmental factors influencing the communication between people with communication disability and their healthcare providers within the framework of International Classification of Functioning, Disability and Health have been discussed in detail in the paper. Communication problems of hearing impaired, visually impaired and other categories have been highlighted. She concludes that people with communication disabilities are at risk of not being able to communicate effectively with their healthcare providers and this might directly compromise their health, healthcare and their right to participate actively in decisions about their healthcare. The group concluded that the healthcare provider's knowledge, skills and attitudes influence the communication efficiency while the facilities, infrastructure and policies of the hospital also have a bearing on the patient. The Radiology Department, in particular faced difficulties while delaing with patients with disabilities. "The number and complexity of these environmental factors also indicates that the development of communicatively accessible hospitals will require commitment from governments, healthcare services and healthcare professionals and most importantly the collaboration of people with different types of communication disabilities."(Halloran et al, 2007). The next article from the Journal of Interprofessional Care elaborates the role of effective communication between nurses and people from other professions. The Interprofessional Education Consortium [IPEC,2002] explains Interprofessional competency as the ability to work with professional from other disciplines to deliver collaborative, patient centered care. This competency is a critical element of a nurse's professional practice. Norman (1985) feels that the skills of a professional worker must go beyond knowledge acquisition and include general skills like clinical, technical, communication and problem solving skills. This article describes the importance of teamwork and role clarity in the nursing profession, just as in any other sector. Teamwork requires clear communication and conflict resolution skills. Suter (2009) feels that role clarity, understanding and effective communication are essential for collaborative practice among healthcare providers. Conclusion It might be safe to conclude that while nursing is a noble and service oriented industry, it also has to run on the modern principles of role clarity and teamwork. It is imperative for the nurses to be sensitive to the needs of the patients, especially ones having special needs like palliative care or communication disabilities. While a regular nurse might be able to cater to the needs of patients in the Casualty ward specially trained nurses might be required in dealing with patients having terminal illnesses, or requiring long and complex continuous care or even in the NICUs. These nurses, while technically sound at their jobs must also be trained in effective communication strategies to be able to effectively communicate with their patients. There could be one or two specially trained nurses in each hospital to be able to efficiently deal with people having communication disabilities. "No research to date has explored the effects of any intervention strategies to enhance communication between adults who are deaf or hearing impaired and their healthcare providers in acute hospitals." (Halloran et al, 2007). The study of these five papers from various journals from across the world definitely shows that there is a need for research in the area of effective communication in the nursing profession. To bring out the best from their technical knowledge, nurses need to be equipped with optimum communication strategies. They must not only have a human approach to any problem, illness, they must be able to communicate to the patient in a reassuring and patient centric way. This will help them collaborate well not only with the patients, but also with the patients' relatives and other professionals involved in treating the patients. The article Issues and Innovations In Nursing Practice (McGilton, 2005) states that "Over 20% of the staff stated that the interactions were a challenge." This is where the real challenge lies. If strategies can be devised to enhance the communication skills of nurses at regular intervals, the efficiency and job satisfaction from the profession would shoot up like anything. Thus, there is ample scope for research on the strategies to be identified for effective communication techniques among care-providers. Thus should help them perform even better in their chosen field of humanitarian service. References: 1. McGilton, Robinson, Bocart, Spanjevic (2005). 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