Importance Of Nursing Communication Skills - Essay Example

? Effective Communications With People In The Nursing Profession Introduction There are many positive attributes a nurse should have in order to be considered good in the field of quality health services. Among them would be some medical knowledge, professional conduct in the performance of duties and responsibilities, desirable virtues like compassion for the suffering, a positive attitude while working hard, and many more. In the real world, however, a nurse cannot stay with patients 24 hours a day 7 days a week in order to keep people healthy and to provide them with sound advices. Nurses must learn to utilize effective communication skills in order to succeed in health care services. In the words of Kelly, P. and Marthaler, M. (2010, p.68), “Communication is a cornerstone to achieving success when delegating patient care.” A good nurse must be able to impart accurate information about what patients can expect and how they can be safe or away from various ailments. Although this begins while patients are able to interact with nurses oftentimes in hospitals or clinics, the quality care and safety of these same patients will have to extend from the time they are able to recover and leave their sickbed to the time they live normal lives again. Effective communications, according to Kelly, P. and Marthaler (2010), involves four processes, namely, (a) attending, which means active listening to patients, (b) responding the way a nurse should be responsive to the actual needs, (c) clarifying whatever might not be clear to either the nurse or the patient, and (d) confronting the problem or issue in order to resolve misunderstandings. This essay will focus more on the first two elements of effective communications – active listening and being responsive to patient needs and preferences as part of their criteria for quality care. II.Background of Effective Communications In order to properly communicate to patients, nurses must know the background of standards set forth by the regulating body for the nursing profession. These were created for valued purposes. Haag-Heltman, B. and George, V. (2010, p.15) cited the purpose to be “an ethical framework from which all other standards might flow.” That framework included relationships between nurses and patients, between nurses and medical profession, between nurses and allied professions, relationships among nurses, aside from the relationship of a nurse to the nursing industry. Effective communication will be the means to achieving good relationships in order to achieve the goal of quality health care and safety, As a matter of fact, Webb, L. (2011, p.3) emphasized the importance of communications to the Nursing and Midwifery Council (NMC) of UK by stating that NMC 2010 considers communication as “one of the essential skills that students must acquire in order to make progress through their education and training to become qualified nurses”. It is in itself a part of the therapeutic process whenever proper communications are done. And this is because of the many benefits a patient can derive out of the effective communication of a nurse. Among these benefits, Webb, Lucy (2010) listed (a) the opportunity for patients to become open in expressing themselves to let nurses know about their emotional and physical needs, (b) the winning of patient involvement by encouraging them to ask questions in order to eventually arrive at quality care, (c) the empowerment of patients to have some control over the process of recovery, and (d) facilitation of patient compliance as a result of gaining trust and confidence, and more. III. Active Listening Theories and Practices Wolvin, A.D. (2011, p.19) discussed an “Engagement Theory of Learning” which implies the presence of an active listener’s willingness to listen. This is assumed often when two people are communicating. And because a human being is rational, there are reasons why persons become willing enough to actively listen. That theory highlights the importance of willingness to listen and be engaged in active listening for specific reasons or goals. Since there are common pre-conceived notions in trying to understand the substance of topics, the willingness referred to also implies the needed effort to control one’s perception to see the other person’s point of view rather than taking the listener’s point of view. There is always a thinking effort to process information based on what are heard and actions or signs that are observed to be coming from the patient. Another implication in the listening engagement would be an awareness of complexities because there are “physiological, psychological, sociological, and communication perspectives that ground our theoretical base” (2011, p.23). Nurses should listen with a goal in mind coherent with the requirements of the work and objectives of nursing for quality health care. Brown, S. and Smith, D. (2006) recommend that active listening should be guided by thinking of why listening should be done and the common situations wherein people sometimes do not say what they mean exactly as expected. Instead, patients can simply give details while the nurse must “read between the lines” (p.4). Funnell,R.; Koutoukidis,G.; and Lawrence,K. (2008, p.446) qualifies good nurses with effective communication skills as the service professional who “listens attentively to others”. But the other side of active listening is the skill of clear, accurate, and responsive communications to patients about the things they should be informed about. To these authors, communications can even include intrapersonal matters whereby a nurse thinks inside with the aim of self control based on facts received. It is best that part of that intrapersonal communication should be the inner awareness of a need to be open-minded enough to suspend preconceived notions with some words or body language. The reason for striving to be objective is that there are many factors (e.g. emotions, values, attraction, repulsion, roles, perceptions, prior knowledge, difference in educational background, and cultural background) capable of tinting judgements and decision making processes. Any of these can cause miscommunication. IV. King’s Theory, Orlando’s Theory in Reactions / Response of Nurses, and Theory of Mind Meleis, Afaf Ibrahim (2011, p. 236) endorsed the King’s Theory which considered all the concepts needed for sound decision making after considering the many concepts that can help make nurses attain their goals for quality health care. It considers the multiple processes involved in the interaction between nurses and patients. Examples of these are the proper consideration of patient values, needs, goals, and perceptions of both patient and nurse, the consideration of explicit assumptions and implicit assumption like a patient’ desire to actively participate in goal attainment and a patient’s wish to share in the decision making process for recovery. Orlando’s Theory, on the other hand, focused on interpersonal relationships between patients and nurses at the time when health care was needed. It favoured professional response as a discipline in every given situation. Unlike King’s Theory which had to go through evaluations considering many more factors, Orlando’s Theory believed more on the “disciplined professional response” (2011, p.247) contending the patients will behave much better as a result. That is, patients will voluntarily communicate their needs and will have less stress. The Theory of Mind is more simple from the definition of Bach, S. and Grant, A. (2011, p.23) who said it is a normal process of every person to “make constant judgements about each other. . .guesses about what we think are the causes of each other’s behaviour and what is going on through each other’s minds”.. But those were words of another author in 2006, namely Baron-Cohen. Bach, S. and Grant, A.(2011) recommended the addition of empathy to the other part of the communication process which is the responsive behaviour of a nurse. Theory of Mind would be for the side of active listening while Empathy would be for the accurate response of a nurse. Empathy considers the feelings of patients and chooses to communicate in a way that would establish an emotional bond with patients. This is not as easy as it appears because it is possible for the nurse to merely project the feelings that a patient actually does not feel. If a patient is smiling while the nurse is acting with pity in response to communicated information by the patient, instead of bonding with that patient, there might be a frustration coming from such a patient. Some people don’t want pity. Interpersonal skill requires recognition of anxiety in order to properly respond. Evidences should be taken into consideration.. According to Bach, S. and Grant, A. (2011, p.43), “false pity and false assurance. . .can appear distant and uncaring to their patients, making them feel undervalued.” There are other theories available pertaining to the way nurses should respond after proper communications with patients.(e.g. the Situation-Specific Theories also discussed by Melei, A.I. 2011). Thus, nurses have many theories to reflect about insofar as effective communication is concerned. V. Responding With Desirable Standards & The Need to Sharpen Skills in Active Listening Fortunately the Nursing Profession has set forth standards to follow in given situations requiring proper response. The hospital administration has guidelines. Nursing schools give plenty of advices and insights to different scenarios. Assuming the case at hand is difficult, I can easily consult a Senior Nurse with plenty of experience in responding properly to patient needs and preferences for quality health care. Therefore, responding effectively given a known understanding of the patient’s situation will be very workable. For this part of the effective communication process, the room for improvement would be the attainment of mastery of that disciplined professional response referred to by Orlando’s Theory. But there is a major problem about how to be sure of attaining the desired goal of quality health care even while knowing the right response to “theoretical” situations. Given the lack of experience and the need to sharpen skills in active listening, at this time, there is no certainty that my understanding of the patient’s communications will be correct or accurate. Interpreting body language, reading between spoken words, understanding various cultural values, and considering the personal, inter-personal, social, strategies and goals will mean having to learn these from actual experiences if not read about in books or heard about from experienced nurses. Although I would be wide awake trying to achieve the aim of comprehending every patient’s point of view, my comprehension would be limited to those which appear to be clear based on perceptions. Unfortunately, different patients will probably have different background in life. Their communications can mean something different from what has already been understood in my mind. The mere silence of some patients can be intriguing. It is hard to tell whether or not one silent patient has had bad experiences with other nurses and might be ready to complain the moment I communicate a message that would accidentally offend instead of get some cooperation. When a patient looks at me straight in the eye with a queer look on his or her face, and I start to smile to try to provide a happy atmosphere, there can be patients who might say, “What are you smiling about? Do I look funny to you?” I cannot tell in an instance if a patient just came from a traumatic experience of quarrelling with a wife or any relative, except perhaps if by taking the blood pressure, I discover high blood pressure is being experienced. Then, maybe, the best thing to do is to shut up and say less words hoping that less words will mean less mistakes in my communication skills. Or what might wide awake rolling eyeballs try to communicate at any given time? How about a sour-looking facial expression? All these will have to be actually experienced and properly understood by some trial and error techniques.. These are but a few of the things that experiences can best teach, knowing the complexities involved in achieving effective communications in order to facilitate quality health care for patients. The best that I can do in unexpected situations is to maintain professional conduct, positive attitude, a desire to effectively communicate, and not to be discouraged at the end of the day. One familiar thing I am aware of is that not all days will be good in the sense that patients and/or their relatives will be happy about services everyday. Nurses intend to communicate effectively with each patient. Yet it is possible for intentions to be insufficient due to unexpected misunderstanding. This is why experiences will be necessary for the development of skilful, active listening skills, and for the practice of corresponding professional response based on accurate understanding of patient communications. Most probably, the Theory of Mind will be usually applicable. And Empathy will always a desirable objective provided it will not turn out to be false pity. To expedite learning about different observations and experiences, I can practice effective communications with fellow nurses and especially senior nurses. Listening to their experiences as often as opportunities to listen will allow can add up to my own experiences. I should learn not only from personal encounters with patients but also from ongoing reading of literatures about various cases and how those cases were handled, and from actively listening to conversations of nurses. Active listening, from now on, will mean having a purpose or goal in mind for the act of listening. And since effective communication is a two-way process, I should also encounter opportunities to respond correctly. One other part of the profession should be considered helpful for my effort to learn how to properly respond or make decisions with the right response. And that is in being very willing to receive feedback without fear of criticisms. Feedback from superiors are meant to sharpen knowledge and skills. As a matter of fact, whenever I make mistakes as a nurse, and I receive unwanted feedback, I should appreciate whatever feedback and reflect on ways to improve. Effective communication skills development would be a lifelong process of learning as actual encounters with patients take place and different situations arise. As a nurse, I can only imagine how the forthcoming experiences will mould my character to be one of those with such skills. Starting with the willingness to engage in the interaction with many patients, to sharpen my active listening skills and to find opportunities to respond effectively, there will be much to be familiar with perhaps over a span of many years. References Bach, Shirley and Grant, Alec 2011. Communication & Interpersonal Skills in Nursing, 2nd Edition. UK: Sage Learning Matters. Brown, Steve and Smith, Dorolyn 2006.. Active Listening 2nd Edition. USA:Cambridge University Press. Funnell,Rita; Koutoukidis,Gabby; Lawrence,Karen 2008. Tabbner’s Nursing Care: Theory and Practice. Australia: Elsevier Haag-Heltman, Barbara and George, Vicki 2010. Peer Review in Nursing: Principles for Successful Practice. USA: Jones and Bartlett Learning Kelly, Patricia and Marthaler, Maureen 2010. Nursing Delegation, Setting Priorities, and Making Patient Care Assignments, 2nd Edition. USA: Cengage Learning Meleis, Afaf Ibrahim 2011.Theoretical Nursing: Development and Progress 5th Edition. USA, UK, HK, Australia, Japan: Lippincott Williams & Wilkins. Webb, Lucy.and Holland, Karen Ed. 2011. Nursing Communication Skills in Practice. Oxford University Press. Wolvin, Andrew D. Ed. 2011.Listening and Human Communication in the 21st Century. USA: John Wiley & Sons Blackwell Publishing. Read More