Mrs Edith Jackson is an 82-year-old lady who was recently admitted to The Golden Days Nursing Home where you work. Edith has Parkinson’s disease and early stage Parkinson’s dementia. She also has low vision and is hard of hearing and wears glasses and hearing aids in both ears. Michael is Edith’s son and her sole support person.
How would you make Mrs Jackson feel comfortable, using appropriate non-verbal communication (discuss at least three (3) points)?
Compassionate – my acts of compassion will be informed of actions such as holding her and offering assisting her while moving around, hugging the patient to show that i care and offering a listening ear and maintaining eye contact with the patient.
Caring – I will display acts of caring through always inquiring from the patient how she is fairing on every time i come to her presence.
Loving- I will display acts of love to the patient through acts such as assisting her while feeding, ensuring that they are well covered, showing love to the patient and letting them know that you will at the point of their need at his stage of life, (Gault, 2017).
How would you make Mrs Jackson feel comfortable, using appropriate verbal communication (discuss at least three (3) points)?
I will make the patient feel comfortable by:
Referring to the Core standards for nurses who provide support to people with disability, outline three (3) strategies that you could use to aid communication with Mrs Jackson giving consideration to her vision and hearing impairments.
Facial Expression- In improving this, it will involve movements of the face that expresses persons feeling touch avenues like smiling and frowning.
Touch or Contact- Physical touching of the patient through holding the hands or even placing his hand on the persons arm or shoulder.
Use of Gestures – Deliberate way of moving of the hands and expression in their concerns, utilising of signs like thumb print up t show commitment or even shaking the fist to show anger or aggression.
You are walking past Mrs Jackson’s room and discover that she has fallen out of the bed onto the floor where is crying quietly and trying to get up. You assist Mrs Jackson onto a chair as she keeps saying over and over, “I’m alright”. After following facility procedure for this incident, you are then to discuss this with the patient and the son.
Provide a definition of ‘open disclosure’ and discuss the principles of open disclosure (2013)
Open disclosure refers to open discussion of adverse events that result in harming the patient while receiving health care. The elements of open discussion which are often disclosed include expression of apology, providing factual information, giving the family members an opportunity to relate to their patient, discussing on potential consequences of the fall and explaining the steps taken to manage adverse event occurrence.
Principles of open disclosure include ; having open and timely communication ,acknowledgement, an apology or expression of interest, supporting the and meeting the needs and expectations of the patients and their family and integrating clinical risks associated with the fall and managing it through systems improvement, (Okuyama, Wagner & Bijnen, 2014).
Provide an example conversation of what you would say when communicating the incident to the patient and son.
Hello My Name is Nurse Ashley, attending Patient Jackson; I would like to speak to you regarding the patient. She had a small accident this morning and we managed to attend to het immediately. A doctor was called immediately and assessments to assess the injury were done. Good enough the patient sustained no injury and i would like to assures that the patient is okay and recuperating well. We managing the injury with the right medication with relief on the pain while showing the patience a lot love and care, in due time she will be care, but always keep visiting her as sign of support, (Anderson, Davidson & Baumeister, 2014).
Identify the key/relevant health professionals/ facility teams you are required to contact in this situation and provide a rationale.
The key professionals who will be needed in this situation include the physiotherapist to assess the situation, social teams and medical team to assist the patient medically in case there is injury.
Using SBAR provide an example of what you would document in the patient chart ensuring that you use appropriate terminology.
The SBAR being a powerful tool used to improve the effective communication between the health care practitioners. In the tool kit;
Situation analysis; The situation is that the patient fell and sustained minimal injury however we have managed to take care of her..
Background; Mrs Parkinson has Parkinson diseases and further has poor vision and hearing inability.
Assesment; Upon assessment, her vitals are stable and she affirms that she is alright and resist any assistance being offered.
Recommendation; Mrs Jackson needs to be closely monitored and help her overcome the stress symptoms being displayed. There is need for close monitoring and regular check up as the intensity of the injury and damage incurred from the fall can’t be underestimated, (De Master et al., 2013)
Michael, Edith’s son will be travelling overseas for the next few weeks and will not have telephone access. He has asked if you could email him to provide him with a progress report on his mother. Identify at least five (5) factors relating to email etiquette you will need to adhere to when emailing Michael.
In writing good email to Michael , there is need to consider the following dos and dons which include;
With the competition of numerous emails, , there is need for clear subject line , as this will enable the message being read immediately.
At times aspects of the use of hey, Hiya, or Yo, may not go well with the reader, thus to be more formal, sue formal salutation like, ‘Dear Michael…’
Use of humour in Email writing at times may not be interpreted well with the reader as it can be taken with sarcasms.
Ensure that you get the right spelling for words; the reader can be misjudged with the spelling mistakes found.
You are working as an Enrolled Nurse in a rehabilitation unit and while on your break you check your social media account and notice that one of your colleagues, who is a friend of yours, has posted some information relating to one of the patients on the unit.
What ethical principles and regulatory responsibilities do you need to consider in this situation?
Social media practice needs to adhere to organisational policies and rehabilitation guidance on confidentiality and privacy. All health care professional have the duty to protect the secrecy of their patients. Patient confidentiality is of importance. This breach can lead harmful damage and have significant consequences.
In assessing this situation, i have to consider health care professional and regulatory practices on social media usage. The guide will form a basis on ethical and legal duties not to share patient information on online platforms. The professional guidance and regulation on social media also states that no patients should be contacted through social media, so i have to take responsibility of ensuring the breach is not further circulated through advising the friend to pull down or otherwise he may face dire consequences
Provide a definition for the term ‘advocacy’ and describe how you would advocate for the patient in this situation?
Advocacy refers to activities of an individual or a group with an aim of making influencing movement within the circles of political, economic and social practice. Advocacy can involve activities which an individual or organization engages to push for change or reform. In health care practice, it is concern with advocacy and pushing for patient rights. Advocacy for patient rights deals with matters to do with confidentiality and informed consent on this issue. i will advocate for privacy of patient confidentiality, (Hurst et al., 2008). In this case study I will advocate and lobby for staff awareness on social media use and confidentiality practices, I will advocate for more friendly avenues in which the staff can express their feelings in a professional manner while protecting the confidentiality protocols of the patients.
You are asked by your supervisor to provide feedback to the colleague who has posted this information on social media. Describe at least four strategies you could use to deliver a constructive outcome when providing this feedback.
Provide an example of the feedback you could provide to your colleague, using appropriate language and a respectful manner.
Nurse Kimsley, i realize that that had done good job in managing the patient under your care and actually you did good job. However I realize that you have breach nursing code of practice by divulging patient information to unauthorised persons without patient authority. This is very wrong and it is not expected of you, in this manner you have breached our nursing standards and nursing code of practice and in general medical ethics. Please ensure that that these acts do not happen again in the near future otherwise it would land us big trouble and patient will lose trust in our service., (Balzer Riley, 2017)
David is a 58-year-old cardiac patient who had been verbally aggressive over the last two days since he has been admitted to the ward. You have been asked by the manager to have a chat with David to see how he is feeling.
What are closed ended questions and in what situations would you use closed questions with David? (provide at least two (2) examples of a closed question)
Closed ended questions often are dichotomous type of questions which often lead to answers of either yes or no. They often probe and lead to other question, and feedback is offered in few words. When used excessively, they give incomplete responses and offer incomplete conclusions. They are used when limited responses are required.
Examples include;
What are open questions and in what situations would you use open questions with David? (provide at least two (2) examples of an open question)
Open ended questions are designed to give more answers from the responder. They encourage patients to give more divulging information and explain the feelings of the patients. It if often associated with developing trust and allows free response. it used when more information is needed from the patient.
Examples of such questions include;
Discuss the term ‘Active Listening’ and provide at least one (1) example of how this could be used in this situation.
Active listening is a technique in communication skills which is used in counselling, training and conflict resolution. It often requires the listener to engage actively in active listening and respond to any response that they need to provide. It is the opposite of reflective listening where a speaker often engages himself in a repetitive talking.
An example of how this could be used ;
Nodding and giving acceptance note while the patient is providing the information, like; ‘Yes i understand,,,,,;,’ I see…’ Its cool….’
Identify what constitutes effective communication in nursing? (List at least six (6) points and provide an example of each).
Effective communication between the nurses and patients is beneficial and crucial for achieving positive outcome. In order to achieve this there is need for understanding and offering assistance to the patients. As nurse there is need to devote time in communication with the patient and building confidentiality.
To achieve this there is need for adhering to the following key points;
After a while, David becomes both verbally and physically aggressive. He says that ‘you are the worst nurse and do not care about him and he wants to leave. He pulls out his intravenous cannula in his arm and begins to throw things around the room.
Describe de-escalation and provide an example of a de-escalation strategy.
De-escalation whether verbal or aggressiveness refers to the process by which the patient is verbally engaged, and then the nurses build the collaborative relationship and it ends up the being deescalated. Verbal De-escalation is usually key to straightening the patient and assisting him in becoming a active participant in the treatment process.
A strategy to strengthen de-escalation is;
Explain the benefits of a debriefing process and explain why it would be useful following this situation.
Medical debriefings are held after significant events in the health care practice. Debriefing helps medical practitioners in order to review the process and discuss how staff can respond without stress. The purpose of reviewing process is to assess what went well and identify and what needs to be improved.
Healthcare debriefing helps to provide chance for health care practice is enabling workers to talk freely and walk through emotions. It helps staff to be able to talk and discuss about issues and traumatic events they have encountered. At times talking about one’s feelings with other individual often helps in building the relationship with others.
In this case debriefing will be essential in ensuring that the nurse overcomes this traumatic event of patent escalation and offer help incase needed to help staff by being given additional assistance if need be, Your supervisor provides you with some feedback on how you handled this situation, identify at least three (3) strategies you could use to effectively receive feedback.
Feedback is a two way approach which is aimed at giving great communication, it is natural feedback. In this case three strategies can be identified which include;
With reference to the following resource: NSW Health (2014) Communication and behaviour support for nurses- Practice Package retrieved on 3/11/2016 from: https://www.adhc.nsw.gov.au/__data/assets/file/0007/301777/Communication-Behaviour-Support-for-Nurses-Practice-Package.pdf
Communication and behaviour support for nurses- practice package was implemented for what reason?
The support system has been created to offer support to people and their families in support for their people with disability. It is geared towards supporting nurses and guides them in promoting consistent and efficient practices. It revolves around current principles which promote effective communication and behaviour practices among the disabled, (Plante & Asselin, 2014).
Identify the four domains of practice (1.2.1) within the standards for the Communication and behaviour support for nurses- practice package
The four domains which promote communication and behaviour support include;
What are the benefits of completing the “communication and behaviour support for nurses appraisal”
The appraisal tool has been developed to enhance and increase the knowledge of the nurses in completing their standards. It promotes consistent and efficient best practices. It serves as a basis for enhancing nurses knowledge and skills in developing communication and support, (NSW Government, 2014a).
Identify 2 organisational policies and procedures surrounding electronic health care records for health care personnel
Protection of confidentiality among health care staff in health care records often has privileged users and the user often assesses the information given and allows information to be shared. Assigning privileges user in health care practice has proven to be effective.
Pre established organizational privacy and security policies have been put in place to secure the confidentiality of the information given by patients and has formed part of organizational policy and regulatory framework, (Sinksy et al., 2014).
Utilising information technology to access data has become a useful tool for nurses, but must be within the organisational policies and procedures. What 3 tips are available to ensure that the web page accessed is reliable?
Tips which ensures that the sites are reliable and accurate are through professional vetting, which the sites can be cited effectively. As a nurse there is need to ensure validity, authorship, timeliness and integrity of the content.
There is need to evaluate the content of the websites, credentials and accuracy of the information provided are the key parameters in ensuring that they are reliable, (Braun et al., 2013).
Nurses may be asked to lead small group meetings and discussions; therefore they need to be aware of various procedures. List 6 procedures.
Group activities are positive engagements which assist nurses in the health care practices to focus on the tasks which are often challenging to on self. In order to realize effective group engagement, there is need to adhere to these guidelines;
What are the 3 main objectives in forming these small groups?
The importance of group tasks is meant to provide beneficial information with regard to items and activities. It is often an efficient way of learning basic cores skills in nursing and building teamwork. The main objectives of the nursing groups are;
Problem solving ability is often achieved easily with the use of group work activities. Often nurses in groups come together and share their challenges and evaluates solutions.
Time spending in group activities is aimed at enabling exposure to activities and new situation and circumstances. Nurses in the group learning activities will be engaged in modifying their behaviour. Group members can tolerate each other and share own opinions and tolerate others thus strengthening their socialization skills
Engaging in group work role of sharing information in groups is beneficial compared to individual provision. Information shred can be well internalised and analysed well in group setting compared to personal set ups.
What communication strategies are required to ensure that there is contribution from all participants in a group discussion, including providing and receiving feedback.
Communication strategies in nursing care provide prompt feedback and enhance information that is shared across the board. Effective Communication strategies are communication techniques like effective feedback, (Kasper & Kellerman, 2014).
To ensure meetings are of value, the nurse conducting the meetings need to consider at least 5 things?
Are timely, well concise and addressed key issues,
What are the 2 suggested communication strategies you can use to ensure that you understand feedback in relation to performance improvement conversations.
Positive communication strategies which can be used to effect communication techniques include being assertive and maintaining decorum. Another way is ensuring that the communication offers supportive feedback among the patients ensures that information given is relevant to the situation at hand, (Hansen, 2016).
When giving balanced feedback what 3 step communication technique is recommended?
Supportive positive feedback aims at encouraging behaviour change. While providing feedback, there are three factors to bear in mind which include, time, location, privacy t the other person influences of privacy on the other person. The three rules of engagement which ensure positive feedback include;
What are 2 strategies that demonstrate appropriate language and respectful manner when giving or receiving feedback
Applying constructive feedback information which is specific to the issue and offer positive play ground for solution. Always be direct to the point when providing feedback and avoid too much jargon and beating around the bush
There is need to avoid giving mixed messages, which don’t offer clarity to the patients. Being sincere means saying what you care and respect. Positive feedback often expresses appreciation which is needed to be direct to the point and encourages one to achieve even better.
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