Effective communication between the patients and the health care providers has a significant impact on the health outcomes of the patients. As the verbal and nonverbal communication has vast importance in the therapeutic relationship in the care scenario, the lack of effective communication can lead to various medical errors and even misdiagnosis threatening the life of the patient (Kourkouta and Papathanasiou 2014, p. 65). The nursing workforce is the point of contact between the patient and the care delivery scenario, the only channel for the patients and their family members to share their grievances and demands are the nursing professionals. As mentioned by Brandenburg (2017, pp13-18), the patient assessment is the first step of the care delivery scenario and without effective communication between the nursing professional and the patient, correct patient assessment is impossible, leading to misdiagnosis. This assignment will attempt to critically evaluate the communication quality exhibited by the case scenario selected and will reflect on my personal experience of difficult conversation and how the effective communication exhibited by me helped achieve the communication outcome.
Effective communication is not just associated with the verbal communication; the nonverbal communication has a more profound impact on the success of the communication approach and achievement of the care outcomes. In the communication video that has been selected for the assignment, there has been a significant gap in effective communication demonstrated by the nursing professional. Elaborating on the communication barriers, Kourkouta and Papathanasiou (2014, p. 65), have mentioned that there are five different categories of communicational barriers, such as, language barriers, psychological barriers, physiological barriers, physical barriers, and attitudinal barriers (Arnold and Boggs 2015, p 98-110). In this case, the nurse had been exhibiting signs of psychological and attitudinal barriers to communication. In order to illustrate the barriers to communication that the nurse has displayed in this scenario, the barriers include lack of attentive active listening, lack of attention, societal taboos regarding depression, lack of interest, distractedness with phone calls and other people passing by, differences in perception or point of view, false assumptions and prejudices, stereotypes, jumping into conclusions, lack of compassion of empathy, facial expression, personality, lack of eye contact and reflection, casual and disrespectful attitude, tone of voice and gestures (Aslakson et al. 2012, pp.910-915).
In order to describe the important patient-clinical communication that the nurse must have exhibited, first and foremost is a respectful and compassionate communication approach. As mentioned by Berman et al. (2014, p 509-520), a respectful and compassionate approach to communication and gesture can help the patients feel a sense of safety and value and helps them share their issues and grievances. Another effective communication skill that the nurse should have exhibited is speaking slowly and clearly helping the patient understand the need for the question and how it is associated with her treatment and recovery. The third skill that the nurse should have demonstrated includes active listening, the nurse in the scenario had interrupted the patient multiple times while speaking which can scare or irritate the patient and can lead to lack of participation affecting the outcome of the assessment interview. Lastly, non verbal communication is another very important aspect for patients with mental disorders. The nurse should have used body language, facial expression, and gestures to express optimal empathy and compassion towards the patient in order to make her feel comfortable and respected instead of feeling inadequate (Berman et al., 2014, pp 509-520).
This ineffective communication that has been demonstrated in the video task can have a significant detrimental impact on the recovery of the patient. The nurse had been very disrespectful, judgmental and prejudiced against the depressed state the patient had been in, which can lead to extreme lack of self worth and confidence in the patient and can further deteriorate her depression (O’hagan et al. 2014, pp 1344-1355). The lack of empathy and compassion can lead her to have a negative perception of seeking mental health care and can make her to not seeking out mental health in the future. Overall the negative experience can deteriorate her mental health and can disrupt her recovery.
Effective communication is a key requirement of scope of practice and standards of registered nurse. According to the standard of practice of NMBA, standard 2.2 discusses that the nurse are required to communicate effective while maintaining the dignity, culture, values, beliefs, and rights of the patient (Nursingmidwiferyboard.gov.au 2018). According to the code of ethics of NMBA, the value statement about the informed decision making states that the nurses are required to administer effective communication with the patients, their family members along with the colleagues in order to be able to help the patients make informed decision about their treatment and health status and ensure optimal safety and efficacy of care. As per the code of ethics, it is also very important for the nurses to maintain respect and kindness when communicating with the patients while assessing them, planning care and implementing care (Nursingmidwiferyboard.gov.au 2018).
Hence, a few effective communication strategies that could have helped the nurse communicate better with the patient includes active listening, use of non-verbal communication strategies such as body language, facial expression, gesture, and eye contact to comfort the patient and ease her in conversation and using empathy and compassion for the patient. Another very important communication strategy that can be used by the nurse will be therapeutic communication with empathy and compassion towards the sufferings of the mentally unstable patient.
In my personal experience there had been a scenario where I had been a part of a difficult conversation and where I had to use my best understanding of the effective communication strategies to improve the scenario. In my second year I was given the opportunity to communicate to my class regarding an optional infection control workshop that we all could participate in and I had prepared a formal notice and hung it in the classroom notice board with all key information. However, most of my classmates misunderstood the fact and thought it was a mandatory workshop and the students will have to stay back from the spring break to participate in it. They all came to me complaining about it and it soon turned into a chaotic situation.
However, I used a few effective communication strategies to handle the situation and resolve the communication conflict. The first strategy I had used includes the active listening, where I made all the complaining classmates sit down and communicate their issues one by one while I listened to them with attention. Next I attempted to use the strategy of effective and assertive communication where I conveyed to them that it had been an optional workshop and none are mandated to join, whereas, everyone is cordially invited to join as it will be a great educational opportunity for the student nurses. All the while I maintained nonverbal cues of communication such as respectful yet confident body language, posture, facial expression and eye contact to help them feel included and respected in the communication. These communication strategies helped me reach the complaining classmates effectively and I was able to resolve the communication conflict successfully.
References:
Arnold, E.C. and Boggs, K.U., 2015. Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
Aslakson, R.A., Wyskiel, R., Thornton, I., Copley, C., Shaffer, D., Zyra, M., Nelson, J. and Pronovost, P.J., 2012. Nurse-perceived barriers to effective communication regarding prognosis and optimal end-of-life care for surgical ICU patients: a qualitative exploration. Journal of palliative medicine, 15(8), pp.910-915.
Berman, A., Snyder, S.J., Kozier, B., Erb, G.L., Levett-Jones, T., Dwyer, T., Hales, M., Harvey, N., Moxham, L., Park, T. and Parker, B., 2014. Kozier & Erb’s Fundamentals of Nursing Australian Edition (Vol. 3). Pearson Higher Education AU.
Brandenburg, S.J., 2017. Nurse Perceived Barriers to Effective Nurse-Client Communication. pp. 13-18.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia socio-medica, 26(1), p.65.
Nursingmidwiferyboard.gov.au. 2018. Nursing and Midwifery Board of Australia – Professional standards. [online] Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx [Accessed 9 Jun. 2018].
Nursingmidwiferyboard.gov.au. 2018. Nursing and Midwifery Board of Australia – Code of ethics. [online] Availableat: https://www.nursingmidwiferyboard.gov.au/Search.aspx?q=code+of+ethics [Accessed 9 Jun.2018].
O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., Webb, G. and McColl, G., 2014. What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), pp.1344-1355.
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