Interpersonal Skills for Nursing Practice - Essay Example

? Interpersonal Skills for Nursing Practice Table of Contents Table of Contents 2 0Introduction 3 2.0Relationship and factors that influenced engagement 5 2.1Environmental factors 6 2.2Active Listening Skills 7 2.3Relationship Building Qualities 8 2.4Developing Ethically Sound Relationships 9 3.0Conclusion 11 List of References 12 1.0 Introduction Nurses have ways in which they are expected to communicate with the patients or clients they deal with and other people including their professional counterparts that they come across in the everyday life. Establishing this kind of effective communication in order to be understood and also get necessary feedback to help the nurse in his or her work is very essential and demanding. It requires a keen evaluation of the environment to understand the kind of people such a nurse is dealing with and find the most suitable ways of communicating with that person or groups of people. It is even more challenging when interpersonal skills are put to task together with the skills of communication so as to help solve a given situation or simply just pass information to a patient who does not seem to have it easy in receiving and giving needed feedback. Like for my case, James has cerebral palsy and thus coordination and communication becomes very difficult for him (Beckung, 2002, pp. 309-316). For James, saying a few words is possible but these are very limited to the format of yes or no kind of approach and this could at time me combined with hand gestures which need to be learnt well in order to know how to respond to his needs. The difficulties that come with interpersonal communication aside, communication remains a very critical part of any healthcare provision practice and no nursing professional is safe without this important skill. It is a fundamental concept within the care giving practice. There are variations when it comes to safe and effective communication and the situation becomes even more complicated when it is the case to do with patients from special groups such as disabled, infants, old people and others where a variety of skills are required to carry out a successful nursing practice on these groups. the practice thus involved application of complex skills and other forms of intervention which in most cases become characterized by care, compassion, respect and dignity (Creel, et al., 2002, pp.2-28). This paper deals with the application of interpersonal nursing skills which puts much emphasis on effective communication with patients and other people through the application of interpersonal skills that have been learnt in my course of study. To help me make a clear approach to explaining how I went through this process successfully, I will have to deal with various aspects of communication and would address such things as the relationship and factors which do influence engagement or relationship between the nursing professional and the patient or other people. This area will have to narrow down to various factors such as those resulting from the environment; the active listening skills which includes non-verbal communication while attending to a patient; qualities for building up good relationships; and the development of ethically sound relationships with patients and people around me. In this paper, I would try linking theory and practice by relating what I have learnt in class to my practical nursing experience with the patient, James. I am expected to give a clear and vivid explanation of what went on and how I happened to tackle it (Nursing & Midwifery Council, 2004). The patient that I dealt with in my practice and application of these skills was James as mentioned above. This patient had a spastic quadriplegic cerebral palsy and suffers from epilepsy and scoliosis. His normal functioning of the body muscles is disrupted causing stiffness of the body muscles or paralysis of the four quadrants of the body at ago. For that case, James could not walk and had impaired speech functions (Banta, 2003, pp.2-18; Brett & Scrutton, 1997, pp.291-331). He has no control of any form of activity, his neck is floppy and the patient is prone to constant seizures and has a swallowing difficulty which makes eating difficult. For purposes of consent and confidentiality principles, I used James as a pseudo name and thus it is not the patient’s real name. 2.0 Relationship and factors that influenced engagement There are various principles that underpin effective communication in the nursing practice and other disciplines too. These include knowing who the audience is. Like in this case, my audience was James and the instructor that checked on me from time to time to evaluate my progress. The other principle is my knowledge of the purpose of my communication. The main responsibility given to me was ensuring that I feed James well so that he does not develop swallowing disorders, which I did effectively. Thus purpose of my communication included ensuring that I respond well to the information he passes to me during and after feeding and interacting with him to help him get what he wants even when he cannot talk effectively. Knowledge of my topic which entailed understanding what I can share with James and to what extent. Another principle is anticipation of objections from the patient in which case I was to be very keen on the choice of food and the response given when he likes or does not like what he is being fed. Presentation of a rounded picture was another principle that I applied in which case I acted more professionally and at the same time kept an informal setting in order not to make James feel out of place because he was a person who loved good and jovial company especially with family and friends. The other principle that I applied was the achievement of credibility with my audience in terms of what I communicate to that audience. Following up on what I had said made my communication process easy since I was able to get feedback. Listening is also one of the principles I applied. This is because for someone like James, his speech is quite limited and cannot construct full sentences and thus listening keenly served me well in getting his point and communicating mine. I also applied the principle of developing a practical and very useful way of receiving feedback even though this was quite a hectic task and finally, the principle of using multiple communication techniques in different times was well received by James and my instructor (Hutchison, et al., 2003, pp. 977-983). This is because although James could not speak well and coordinate, he still responded to some well-structured non-verbal communication and also verbal communications that were put in a way that does not give him long periods of thought to figure out what I was talking. It was a kind of Yes/No approach. 2.1 Environmental factors Effective communication can be affected by various environmental factors which might either enable good communication or hinder the effectiveness of passing information. These factors include lighting conditions. I made sure that there was enough light when talking so that my face could be seen by James and also same case applied to him; distractions caused by interfering objects and other visual noise and I avoided this by ensuring that the setting was calm and friendly at all times; distance between the patient and I was kept to 6 feet; the talker’s face also is a factor and I ensured that both our faces were not covered while talking to each other. I also avoided talking to him while he was eating; other factors such as the viewing angle and vision were taken care of by my calculation of the point that James could get me more clearly; auditory factors also came into play whereby I had to control noise, know the best distance and avoid echo sounds; individual factors also did shape my environment for communicating with the patient and these included fatigue, stress, inadequate ventilation, attitude, preparation to communicate and the situation played out. I made sure that these were well taken care of (Stanhope & Lancaster, 2004, pp.56-87). 2.2 Active Listening Skills I realized that getting and giving feedback is very crucial if one has to establish good communication and enhance interpersonal connection with patients and other practitioners. I also noted that for me to have an effective communication with James, I needed to develop and enhance certain specific skills so as to enhance receipt of good feedback. These included my listening to the message completely without cutting short the other person while he or she is trying to explain a point. Here, patience served me right! I applied it most of the time when receiving instructions from my instructor due to the fact that it provoked a very strong opinion in me whenever we talked even though I was always compelled to ask questions but I could hold back first to get what the instructor was trying to pass across. James also took a lot of time trying to pass a given message especially when he needed something. It was thus important that I wait for him to fumble till I get the message first before responding to it. I tried mixing both verbal and non-verbal feedback process when communicating to him. Before giving feedback to James, I always considered his needs and the ability he had in deciphering what I had to say. This helped me simplify things for him and give short instructions and answers. I happened to apply very strong active listening skills. These skills included restating what the person said, summarizing it in my mind and at times on paper if they are instructions, use of minimal prompts that are positive in nature to encourage the person to speak out, reflecting on what has been said, giving accurate feedback to the person, emotion labelling, probing by asking questions where necessary, validation where I used to acknowledge the problems, feelings and issues that were presented by the person I was communicating to, James, through verbal and non-verbal means, application of an effective pause, use of silence when need be, messages and redirection. 2.3 Relationship Building Qualities Building good relationships with people around me has proved to be an effective tool in my studies and practice. Qualities of interpersonal communication that help build stronger relationships with patients and people I interact with makes my profession so easy to handle. I know that in the absence of these qualities, the practice would be a nightmare! There are core conditions that need to exist for there to be an effective environment for building good relationship qualities. Some of these qualities that I realized were critical for my building of stronger relationship with my patients include acceptance whereby I understand and appreciate the condition that one is in. accepting my patient the way he is helped me try to find the best way for serving him so that he does not have much difficulties to in what I supported him do. Acceptance must start with a personal evaluation of the condition and taking him the way he is instead of showing regrets to the patient. Another quality that needs to be exhibited in the nursing practice through the interpersonal communication skills is the expression of genuine approach to the patient. Being frank with the patient matters a lot and therefore I tried my best to be as genuine as possible to avoid hurting my client (Jha, et al., 2008, pp.1921-1931). And when it came to being answerable to my instructor, I was very frank on areas that were asked yet I did not know. This approach to relating with people has made me sail through hard times both in my studies and attachment sessions like the one I had with James. Empathy is like putting yourself in someone’s shoes. This entails getting to learn what the person is going through and trying to ask yourself how you would feel if it were you and treated in the manner in which the person is being treated. Empathizing with the patient made me attend to him with a lot of compassion and I was very passionate about what I did to assist him cope with his condition. This is because I understood the pain and anguish that James underwent and thus took it upon myself to ensure that he gets the best attendance one can get given the circumstances. Good relationship building qualities also involve giving your best and expecting nothing in return. It is a quality that makes me give my service without hoping for payment and has made me realize immense benefits in the art of giving free service. These relationship building qualities are just but a few among other recommended practices depending on the setting in which they are applied. Keeping one’s bargain or promise is one more quality that could be well applied and appreciated in the nursing profession when dealing with other practitioners. This brings about the concept of honesty and helps people build trust in me while I carry my duties. Trust has also been singled out as a major issue when it comes to attending to patients. Building trust means that the patient is able to get engaged to your services and is put in a position whereby he or she believes that you will act in his or her best interest at all times (Davis, 1994). 2.4 Developing Ethically Sound Relationships Ethically sound relationships are those engagements with the patient that are approved and fronted by the nursing profession. There are various ethical dimensions in the nursing profession which do affect my relating with the client. Issues to do with right to self-determination should be taken very seriously (Nursing & Midwifery Council, 2004). This is because in the patient care, the patient is the boss and thus one must act and communicate in the manner that pleases the patient or reflects the patient’s choice and preference. This brings to fore the aspects of consent, confidentiality, autonomy, equality, and uncertainty (George, et al., 2007, pp.34-47). In my relationship with James, I always sought his consent on what he needs to eat and drink since my session with him was only confined to the feeding program. I initially had a rough time coping with him because I had thought that being a nurse, I needed to do what is seen as normal practice and imagined, for example, that James being disabled he could not chew well and therefore; I needed to mash his meals to ease the digestion. But on a closer probing, I found out that actually James liked his meals being cut in sizable pieces one at a time just like a normal person feeding. I thus had to seek his consent on everything that I did to avoid jeopardizing his needs. The issue of confidentiality also came in. this is even seen in my reflective report and this paper whereby the real names of the patient have been concealed for purposes of maintaining patient-nurse confidentiality of information. I understand that sharing any medical records of James without his consent or people allowed to do so is detrimental to my career and would be against the confidentiality requirement for ethically sound relationships (Freshwater, 2003). Another issue that came out clearly was the autonomy that is to be enjoyed by the patient. This is because the patient has the right to be independent and not coerced into making concessions on what should be done. James had a schedule and checklist for things that he liked in terms of food types, texture, types of drinks, serving environment, and company, among others. The choice of things he liked and serving him the food and drinks that were his favourite made me feel that I had given him all the autonomy he needed. The concept of equality of treatment also came out. The fact that James was disabled or mentally challenged did not make him less of human. I therefore made sure that he always felt appreciated and accepted in society without preconditions. It was also necessary that I let him do what he preferred doing if he could, regarding things that other people do without prejudice. For example, he liked eating in a family setting and thus isolating him was not my approach. If he was also uncertain about what I wanted to do to help him, I would explain it to him to make him understand (Sahin & Tatar, 2006, pp. 171-183). 3.0 Conclusion I managed to take good care of James and this could be attributed to my strong interpersonal communication skills that I have developed and shaped over the years. I managed to apply the Gibb’s reflective model successfully in my analysis on reflection. I did well in taking care of James during his feeding program and this could be supported by the fact that after my attachment was done and I had to leave, James refused to be fed by another person for the whole day and I received a phone call for that matter. I also managed to establish good relationships with my patient and the instructor and this helped me learn a lot. I therefore have strength in building stronger interpersonal skills through my checked mode of communication and dealing with people (Royal College of Nursing, 2008). The theory of interpersonal communication skills has significance in my profession because it helps me serve my patient well and deal amicably with my fellow practitioners. List of References Banta, John V. (2003) “Cerebral Palsy, Myelodysplasia, Hydrosyringomylia, Rett Syndrome, and Muscular Dystrophies” in Spinal Deformities: the comprehensive text. Ronald L. Dewald, ed. New York: Thieme, pp.2-18 Beckung E. & Hagberg G (2002), Neuroimpairments, activity limitations and participations restrictions in children with cerebral palsy, Dev. Med. Child Neurol., 44: 309-316 Brett E. M. & Scrutton D (1997), Cerebral palsy, perinatal injury to the spinal cord, and brachial plexus birth injury. In: Brett EM (ed), Paediatric Neurology, England Churchill Livingstone, Edinburgh, pp.291-331. Creel LC, Sass JV, Yinger NV (2002). Client centred Quality: Client Perspectives and Barriers to Receiving Care. New Perspectives on Quality Care, Washington DC, Population Reference Bureau, pp.2-28 Davis ER (1994), Total Quality Management for home car. Gaithersburg, Md: Aspen. Freshwater, D. (2003) Counselling Skills for Nurses, Midwives and Health Visitors, Maidenhead: OU Press George R, Vergas KR, Isaac RJ (2007). Quality Assurance in Nursing Father Muller College of Nursing, Mangalore India, pp.34-47 Hutchison B, Ostbye T, Barnsley J, Stewart M, Mathews M, & Campbell MK (2003), Patient Satisfaction and Quality of Care in Walk-in Clinics, Family Practices and Emergency Departments: The Ontario Walk-in Clinic Study, Can. Med. J., 168(8): 977-983. Jha AK, Orav EJ, Zheng J, & Epstein AM (2008). Patients’ Perception of Hospital Care in the United States, New England, 17th April, (2009), J. Med., 359(18): 1921-1931. Nursing & Midwifery Council (2004), Standards of Proficiency for Pre-Registration Nursing Education, London: NMC Royal College of Nursing (2008) Defending Dignity: Challenges & Opportunities for Nursing. London: RCN Sahin B, Tatar Mentap (2006). Analysis of Factors Affecting Patient Satisfaction: Focus on Asthma Patients. J. Disease. Manage. Health, Outcomes, Date Access Sept 30 (2009), 14(3): 171-183. Stanhope M, Lancaster J (2004), Community and Public Health Nursing, Mosby CV, St. Louis, pp.56-87 Read More