Leadership And Nursing For Contemporary Perspectives

Communication Framework

Discuss about the Leadership and Nursing for Contemporary Perspectives.

Grief and bereavement is a part and parcel of healthcare profession that requires sensitive handling, communication, understanding and support by healthcare professionals (Huber, 2013). In the provided scenario the patient’s wife is in a complete state of grief and bereavement due to the shocking and unexpected death of her husband. This situation requires a strategic communication by healthcare professional to manage her situation; therefore, present study involves “Implementation of transactional communication framework to perform effective communication for the situation of grief in present scenario”.

The transactional model of communication involves a procedure of establishing a connection between sender and receiver like engaging in the transaction. This framework of communication considered that all involved in communication are sender’s and receiver’s not merely a receiver and sender (Schnurr, 2012). Further, this model confirms that communication is effectual for all parties involved in it. According to Prelock & Nelson (2012), transactional communication framework follows the concept where communicators share the message on a similar matter as a fluid form of communication.

As per the communication theory, communication works as an art of discourse (rhetorical) to handle socio-psychological situations (Goldenberg & Goldenberg, 2012). Out of various communication frameworks, transactional model of communication helps to establish a connection and relationship between sender and receiver that is essential to resolve psychological situations like grief and bereavement (McCabe & Timmins, 2013). Therefore, transactional model is considered as proper communication framework for professional to handle the grief situation of patient’s wife in this scenario.

In the present scenario, the sudden death of the patient has created a shocking bereavement situation for his wife that is a part of psychological disturbance. She is not able to understand the rationale of the situation as they only came for a liver biopsy but sudden death occurred due to his diagnosis with cancer. Matusitz & Spear (2014) indicated that healthcare professionals can help the patient in grief by developing an interactive relationship with them. The transactional communication framework is best suited to develop a vis-a-vis interaction between two human beings. Therefore, an interactive communication with patient’s wife will help the nurse to let her explain the complete situation.

According to Prelock & Nelson (2012), the most basic feature of transactional communication is its bi-directional and reciprocal interaction between the receiver and sender as per the environmental situations. This framework also helps the sender to understand the communicative behaviour of the receiver as well as enhance the clarity of message while communicating. These features of framework compliment the present situation of grief where nurse needs to form a reciprocal interaction with the patient’s wife as well as understand her communicative behaviour to form effective communication. Further, Zarei & Shojayizade (2012) studied that transactional communication is critically affected by the surroundings termed as ‘noise’ in the communication model. These environments can be physical, psychological, emotional or any other depending on the situation. In the present scenario, this feature of the transactional model, i. e disturbance by noise can affect the better communication with patient’s wife.

Analysis of Communication Scenario

As per the present communication scenario, the most prominent element that can lead to ineffective communication is the absence of surgeon and other professionals to communicate with the patient’s wife. Bylund, Peterson & Cameron (2012) studied that in healthcare zone patients and families try to prefer physicians for communication as these physicians demonstrate a patient-centred approach looking after them or patient. Even the patient family also prefer physician rather than nurse for communication. As the physician, in present scenario left the care nurse alone with the patient’s wife this can create a hurdle in forming effective interpersonal communication. Therefore, the absence of physician in present communication scenario can be considered as one element causing ineffective interpersonal communication.

Further, adding on to conditions, the physical surroundings- environment of the hospital can be considered as another disturbing element that can negatively affect interpersonal communication between the nurse and patient’s wife in provided scenario. According to Matusitz & Spear (2014) transactional communication is a source of receiver communication without an objective channel; therefore, it is under continuous influence of external environment contributing to a mode of communication. Further, Wong & Giallonardo (2015) opined that grief and bereavement can never be handled under negative environmental conditions. The communication for reconciliation needs positivity that’s why the rehabilitation centres are meant. In the present communication scenario, the external environment of the hospital can work as an element contributing to ineffective communication because patient’s wife is in the state of trauma and shock due to a sudden death of her husband. The presence of other surrounding negativity may contribute to her trauma and create a negative effect on communication. This external environment is not even under the control of care nurse involved in the communication process.

Zarei & Shojayizade (2012) studied that giving and taking a message is a mutual and simultaneous process that needs cooperation from both the sides (sender and receiver) in transactional communication framework. Therefore, the social relationship status of both the parties (receiver and sender) is another element that affects effective transactional communication.

The transactional model of communication is very much dependant on the status of the relationship between the sender and receiver of the message because this communication framework is built for interpersonal communication. The social relationship status is a major factor that determines the effectiveness of communication (Goldenberg & Goldenberg, 2012). In the present communication scenario, the care nurse and patient’s wife share no particular social relationship being complete strangers to each other. This element of missing social relationship can work as a hurdle in communication process being another element that makes communication ineffective. According to Wallace (2015) study states that transactional communication is impossible in the social vacuum. This framework highly depends on experiences, information, viewpoint and social perception of both sender and receiver. Therefore, the absence of a social relationship in this scenario also works as an element affecting effective interpersonal communication.

Applying Communication Framework

Further, the patient mental perception about end-of-life situation is another element that can hinder effective communication because patient’s wife is a woman who has lost her husband accidently creating a shock and dilemmatic situation for the healthcare profession. Prelock & Nelson (2012) studied that individual perception works as a noise in transactional communication creating non-verbal disturbance in understanding the message and generating responses. Adding on to this, patient’s wife is right now in the mental state of shock that will work a negative factor to conduct any interpersonal communication with her. According to Rogers (2012) stress, emotions and anxiety are psychological influences of communication that found troubling situations. For a sender or receiver, it is very challenging to communicate in the presence of these psychological contexts. The present situation of patient’s wife clearly indicates her state of stress and anxiety; therefore, her psychological context can also work as element hinder effective interpersonal communication.

The selected communication framework of the provided scenario is transactional communication framework that can work in an effectual manner to manage the shock, grief and bereavement situation of vulnerable. As in this case is a sensitive matter of personal loss, the involved nurse firstly needs to understand or predict the beliefs, intention, behaviour and attitude of patient’s wife. The nurse here needs to work as a provider in the provider-patient encounter of interpersonal communication. Valenzuela & Smith (2015) indicated that provider in healthcare scenario involves a broad range of professionals that need to maintain an interpersonal relationship with the patient as well as maintain a balance of communication. In the provided scenario, care nurse need to perform the role of the provider where the communication will be individually centred as per patients identified dimensions because as per communication theories any interpersonal communication in healthcare needs to be an individual, interaction or relationship centred as per patients state of mind, the message exchanged and patient-provider relationship. In the present case, as the nurse and patient’s wife share no relationship, therefore; the nurse will adopt a goal-plan-action approach for initiating a conversation to reconcile the vulnerable.

Further, after forming a patient-provider interaction, the next step for applying transactional communication is to determine the goals of communication that need to be interaction goals. The primary goal of this communication is the nurse (provider) desire to modify the patient’s wife (receiver) situation of grief. Nguyen et al. (2015) indicated that determining communication goals help to better plan a conversation in healthcare. Further, the process involves planning to attain consent, change the relationship and change other person’s stance towards the problem further establishing counselling process. In the present scenario also, the healthcare nurse can establish communication by obtaining permission, developing a relationship and discussing the issue with the patient’s wife. This simple process can work as counselling process in present situation where the nurse can communicate the message to her and provide her counselling. In this manner, the plan of transactional communication can take place in provided scenario. Zarei & Shojayizade (2012) indicated that both verbal and nonverbal actions could work in transactional communication between humans. Therefore, both the verbal and nonverbal actions can be used to communicate in provided scenario. Prelock & Nelson (2012) indicated that non-verbal communications like sympathy, positivity, relaxations and soulful touching are considered as a more effective form of communication in healthcare rather than verbal messages. In the present case also, non-verbal activities can also work as a better form of communication. Lastly, implementing actions and getting the positive outcome of transactional communication in form of person’s response is the completion of transactional communication (McCabe & Timmins, 2013).

Conclusion

The provided case scenario is the situation of patient’s wife who is in the complete state of shock, grief and bereavement due to the sudden accidental death of her husband in the hospital. The day care nurse was left all alone to provide her support and reconciliation through communication. For this situation, the transactional communication framework is an appropriate solution to communicate with the person because this framework allows a goal-plan-action approach of individual communication. The individual approach with verbal and non-verbal communication strategies is adopted to establish communication. With this communication framework nurse (sender) will help patient’s wife (receiver) to develop counselling and recovery from her grief.

The possible elements that can disturb the effective communication are the absence of a physician, the physical environment of the hospital, relationship status, patient’s mental status and perception. However, application of transactional communication with the goal-plan-action approach with best possible strategies can help to overcome these elements with best possible transactions and client recovery from grief.

References

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Huber, D. (2013). Leadership and nursing care management. Elsevier Health Sciences.

McCabe, C., & Timmins, F. (2013). Communication skills for nursing practice. Palgrave Macmillan.

Schnurr, S. (2012). Exploring professional communication: Language in action. Routledge.

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Matusitz, J., & Spear, J. (2014). Effective doctor–patient communication: an updated examination. Social work in public health, 29(3), 252-266.

Nguyen, O. K., Chan, C. V., Makam, A., Stieglitz, H., & Amarasingham, R. (2015). Envisioning a social-health information exchange as a platform to support a patient-centered medical neighborhood: a feasibility study. Journal of general internal medicine, 30(1), 60-67.

Prelock, P. J., & Nelson, N. W. (2012). Language and communication in autism: an integrated view. Pediatric Clinics of North America, 59(1), 129-145.

Rogers, R. (2012). Leadership communication styles: a descriptive analysis of health care professionals. Journal of Healthcare Leadership, 4(1), 47-57.

Valenzuela, J. M., & Smith, L. (2015). Topical Review: Provider–Patient Interactions: An Important Consideration for Racial/Ethnic Health Disparities in Youth. Journal of pediatric psychology, jsv086.

Wallace, C. L. (2015). Family communication and decision making at the end of life: A literature review. Palliative and Supportive Care, 13(03), 815-825.

Wong, C., & Giallonardo, L. (2015). Leadership and its influence on patient outcomes. Leadership and Nursing: Contemporary Perspectives, 153-170.

Zarei, F., & Shojayizade, D. (2012). The effect of educational intervention based on BASNEF model to improve interpersonal communication skills of nurses. Journal of Alborz Health, 1(3), 173-178.