Effective Communication Skills Are Essential - Essay Example

Prof. A.D.Paul Page Effective Communication Skills are Essential When Facilitating Learning for Nurses and Human communication is the process of sharing feelings, ideas, information, and messages with other people. Communication includes sounds, orthographic elements and nonverbal aspects, such as facial expressions and body language. Communication is a pivotal element in human interaction. It is all the more true in the area of health care especially in mental health care. Communication is a complex means of interaction between nurses and people and its nature varies according to the different groups they serve (Ellis1995). The study proposes to give an overview of the challenges of human communication in a multilingual and multicultural milieu with special reference to issues in mental health care. It is not merely enough to identify the daunting nature of communication challenges in nursing. The training should have strategies in place to ensure that the nurses are trained and equipped to meat the challenges of their career. This will call for an evaluation of present training and practice of nursing career in the light of significant literature on the subject. This will naturally result in the need for qualitative changes in the area of training and practice of nursing profession. Page 2 Nature of Human Communication It is good to have an overview of the nature of human communication to understand its broad implications in successful health care practice and its particular importance in mental health care. All health care involves an appreciable amount of communication. There are three main components in the process of communication. They are the sender, the message and the receiver and the process is usually a two way process with the sender and receiver intermittently changing their roles between them to respond to the messages. In the process of communication the message that is developed in the mind of the sender is coded into a sound, letter, picture or gesture and transmitted. The message is understood if the receiver is able to decode the message and able to grasp the intended meaning of the sender (Ellis 1995). The process of human communication is very complex as it involves both verbal and non-verbal aspects. Now the practice of health care is exercised in a multilingual and multicultural milieu and the demands of modern health care task can be daunting and nurses need to be well trained to face the challenges of our complex world. The verbal aspects of human communication are very well understood to a large extent and it can be acquired by the Page 3 proficiency in the language used in a place. When it comes to the non-verbal aspects of communication we enter an area of great risk because most non-verbal communication is linked to culture, religion, sex, ethnicity etc. Even if the nurse attains the daunting task of adequate language skills in one or more languages it is very difficult to learn the cultural aspects of communication which are acquired from infancy by a process of unconscious imitation in a community. It is desirable t o chalk out the gateways and barriers to human communication by identifying the important aspects of communication. Essential Elements in Therapeutic Communication Communication is an intricate, continuous, interactive process and forms the foundation of genuine interpersonal relationships. It includes verbal and non-verbal ingredients. Modern communication heavily depends on technology and uses a wide range of media in addition to the familiar face-to-face interactions. Effectiveness in group interactions is also called for in today’s communication requirements. Apart from the visible communications skills, in the interdisciplinary work scenario, the communicator should have the qualities needed for a team player, as health care is becoming a collaborative exercise involving many Page 4 stakeholders. From the days nursing came to be practiced as a systematic discipline, the realization that communication is at the core of health care was in the air. Florence Nightingale (1859) devoted a full-length chapter for stressing the importance of communication in her Notes on Nursing. She ruefully noticed the isolated, fatigued and helpless condition of the patients. In this condition they longed for someone who would speak to them and she had realized the critical nature of the nurses communication with the sick. Nothing else could substitute the encouragement that the genuine human touch can give. Communication is a science today but it has an art to it. A nurse’s skill in this area is indeed greatly enhanced by scientifically studying the art of communication. There are certain key elements that ensure hassle free communication. A nurse should have an appreciable level of self- awareness. Self- awareness in this context is the insight a nurse has about herself. A slow process of introspection about oneself develops this element. Lots of work has been done in this area and scholarly consensus have achieved on the salutary effects of self-awareness in therapeutic communication. The opinions of Burnard (1992) and Stein-Parbury (1993) categorically states that self-awareness is not being Page 5 Self-conscious. A person who is self-aware has a distinct identity. She or he is able to involve in the clients sufferings fully at the same time remaining professionally detached from the client. The self-awareness of the nurse makes her selfless and goads her to commit totally to the client on the basis of a highly empathetic relation. It is imperative that a nurse should be a good listener. Stein-Parbury (1993) has delineated the essence of helpful listening. Listening is not the same as hearing. Hearing is an impersonal activity and anyone with a functional ear can hear, while listening involves paying undivided attention to the verbal content and observing the non-verbal aspects that are essential to assess the client’s feelings. In fact 60% of human communication is non-verbal and this forces the nurse to listen not only with her ears but also with her eyes. Communication has always been a complex thing in the most normal situations in every day life. It will be naïve to expect communication to be snag free in health care, especially in mental health care. The task of listening is not complete unless the nurse is capable of understanding and responding. Positive listening leads to an empathetic understanding of the patient’s existential reality. This calls for a response. According to Stein-Parbury (1993) Page 6 the most obvious way of responding is through words. The verbal response could be by advising, evaluating, reassuring, questioning, interpreting, paraphrasing and summarizing. In the cognitive level the process gives sufficient data to the nurse to understand the condition of the patient. As for the client the process conveys the message that his problem is given sufficient priority and in his suffering he or she is not alone. Communication and Cultural Diversity It is desirable to evaluate the challenges of nursing communication in the background of cultural diversity. Cultural diversity, is not fiction, it is a reality. This brings about challenges in the verbal and non-verbal aspects of communication as well as in the manner and matter of communication. The obvious manifestation of this diversity is seen in the difference in religion, ethnicity, and nation of origin, language and gender. Culture is the sum total of a style of living. It encompasses values, beliefs, language, ways of thinking, behavior norms, sartorial habits, styles of communication etc. These ingredients guide the decisions and conduct of the group. It is imperative that a nurse understands the value the client gives to his culture. Insensitivity to religious and cultural beliefs and values of the patient is a grave failure in communication. PP Page 7 Nature of Nursing Communication Communication being a dynamic interpersonal process involving continual adaptation and adjustments between two or more human beings engaged in face-to-face interactions, it is necessary, that each person is aware of oneself and the other. However it is hardly possible to expect awareness from the client undergoing treatment. This is particularly true in the case of clients suffering from problems of the mind. Communication is part of the existential nature of man marked by exchange of factual content and diversity of emotions. Two dimensions of communication are the attitude with which one communicates and skills or medium one uses. The nursing communication should be humanizing because it perceives the unique predicament of being human. Humanizing communication has dialogue, equality, positive regard, respect, concern, acceptance, empathy, authenticity, intimacy and the desire to empower the client. Strategies for Quality Enhancement in Nursing Communication In recent years there have been a salutary awareness in scholarly circles of the importance of communication in all walks of life. Most broken relations whether it is among nations or individuals is the result of broken down communication. This awareness has resulted in a Page 8 number of communication related studies in all disciplines. The schools of health care training have been in the forefront of research. The plethora of literature that is churned from the academic circles speaks for the level of importance that society gives to communication in health care. The next step is to incorporate the findings in the every day training of health personnel in as many centers as possible so that the benefits of the painful scholarly study may filter down to as many people as possible. Indeed as the popular proverb says, There’s many a slip twixt the cup and the lip (Encarta Quotations. Microsoft Encarta Reference Library 2004). However great the findings of the research is, unless and until the results are translated to action and the ground reality changes, the whole effort that scholars put in is at best an exercise in futility. This makes it imperative that strategies are evolved to bring about changes in the training of the nurses in effective communication so that the health care scenario especially the area of mental health may witness a sea change, salutary in every way, to the clients. Assessment has been a foundation of nursing practice and is the basis for theory and knowledge development. The nurse and the clients should engage in a therapeutic partnership to be effective. For this he or she must communicate with them and first assess the client as a person, his or her Page 9 health problems, and the circumstance in which those problems are evident. The assessment data will function as a guide for shaping individual plans of care. This data is to be stored and should be retrievable from information systems for continuous update. Real time solution for the client’s problems can be quickly arrived at with the support of the evidence in the system. This means an integrated nursing training with adequate language skills and knowledge of the information technology should be mandatory in nursing curriculum. In addition to this, assessment of student should go on continuously and this must be followed by constructive feedback and discussions focused on building knowledge (Quinn 2000). This assessment is not only an incentive for study but also helps them to learn to live in a group and equips them to be team players. At the same time standardization of the tool of assessment is also needed (Neary 2000). Communication technology is a handy tool available to the nurse to facilitate the continuity of care. Technology has greatly changed the way we communicate. While the face-to-face communication by going home and hospital stay of the client were the available choices for the nurse, advances in communication technology have provided more options for continued contact with clients and their families. Repeat consultation, now and then, in the physician’s chamber is the Page 10 minimum that we were doing for the client. Is it sufficient in health care, especially in mental health care? The range of modern distance communication gadgets have thrown open before the nurse a wealth of opportunity for sustained, inexpensive and personal care. The use of distance communication gadgets can be used to provide training to the clients also. Todays patients are quickly discharged from hospitals and would be in domiciliary care. Client conscientisation is cardinal today in nursing and nurses are asked to use every teachable moment for this (Barber- Parker E.D. 2002). The opportunity of integrating client teaching and the tools of in house teaching and distance delivery of information are signaling the need for multidiscipline approach to nurses training. Therefore knowledge of distance technologies should be imparted to the nurse so that he or she is equipped to put them to use in the therapeutic practice. Communication competence not only with the clients but also with the public, policy makers and large groups using mass communication technology should be an integral part of nursing curriculum. Liberal education is an unavoidable foundation in a nurse’s education. It has a direct effect in the clinical judgment skills of the nurse. A solid foundation in the arts and sciences promotes critical thinking and enhances the skill in decision-making. The students encounter a diversity of thought Page 11 and cultural patterns in the their books and this in itself helps them to appreciate the diversity of human experience. While study of science enables them to have competence in clinical profession, arts give them insight into different minds and give them the skill in articulating ideas in suitable language. Proper grounding in the liberal arts and sciences enable them to practice their profession with the support of broad based knowledge Conclusion The perception of the importance of communication in health care, especially in imparting mental health care, is very old. Communication in humans is essential for relation building. In health care, it has, in addition to the social aspect, a therapeutic side too. The knowledge of the elements of human communication enables the nurse to take remedial measures to correct the flaws as an ongoing process. The cultural aspects of communication are very difficult for a nurse to acquire and this underlines the importance of a liberal education and it has to be given an adequate priority in the nurse’s curriculum and training. The communication technology promises more scope for the communication of the nurse with the client and this calls for more thrust in the syllabus Page 12 for the study of the distance communication techniques. The painstaking research undertaken in nursing communication has created awareness about its importance. Time indeed is ripe for the implementation of the strategies for the use of more enriched manner of communication in the health care especially in the mental health care so that the nurses may fulfill their life’s mission with greater benefit for the clients entrusted to them to serve. ================= . Works Cited. Barber- Parker E.D. (2002) Integrating patient teaching into bedside Patient care: a participant-observation study of hospital nurses. Patient Education and Counseling. 48: 107-113. Encarta Quotations. Microsoft Encarta Reference Library 2004 Burnard, P (1992) Effective Communication Skills for Health Professionals. London: Chapman & Hall Ellis, R. B., Gates, R. J. and Kenworthy, N. (1995) Interpersonal Communication in Nursing. London: Churchill Livingstone.comm. 1 Neary, M. (2000) Teaching, Assessing and Evaluation for Clinical Competence. Cheltenham: Stanley Thornes. Nightingale, F (1859) Notes on Nursing: What it is, and what it is not. London: Harrison Stein-Parbury, J (1993) Patient and Person: Developing Interpersonal Melbourne: Churchill Livingstone Quinn, F. M. (2000). Principles and Practice of Nurse Education. (4th edition). Stanley Thornes (Pub) Ltd; Cheltenham Read More