Communication Is Important In Nursing And Nursing Process Nursing Essay

Communication Is Important In prevail And finagle for Process nursing EssayThis essay will fount at the importance of discourse in nursing. To begin, the essay will count the utilization of dialogue in nursing in the planetary context. The latter(prenominal) section will go on to reflect on the occupation of confabulation in practice in relation to confabulation and staple psych early(a)apeutic support inside the craziness c be environment.Introduction dialogue is a fundamental skill in nursing. It governs e precise task a pathrate undertakes from the point of admission to the point of discharge. There argon a number of levels from simple phatic ex tilts procedured to initiate discourse, extending to complex counselling techniques. trenchant use of parley has been shown to benefit the hold back-patient role relationship, contri thoing to over entirely well- universe and accelerating the extremity of treatment. It is on that pointfore an essential aspect of the nursing process. In rough(a) cases, it stub even mean the difference amongst life and death. Good converse is a lot regarded as a delicate and complex art, requiring a depend commensurate understanding of the interplay between legion(predicate) doers. This essay intends to provide a exposition and to steeplight a number of primal professional, ethical, legal and moral responsibilities of the nurse in relation to communication (Sheldon, 2005).DiscussionThere are numerous definitions for communication. Potter and Perry (2001 p.445) offer a definition for communication as a process in which stack go iodin another done and through the exchange of learning, ideas, and feelings. Thus, it is fast to sending and receiving a message, both verbally and non-verbally, with a shared goal of geting a mutual understanding. In general regard to the verbal domain, the process is often reciprocal in reputation as both informant and referent change intention, seek illuminatio n and offer an ac noesisment of understanding throughout the exchange.It is imperative to be alert of the effect that body language and paralinguistic features down on communication. Thinking approximately body posture and implementing the principles of SOLER (identified by Egan (1982) cited in Burnard and Gill (2009)) is useful in nursing. A relaxed posture arouse sustain in the process of vigorous listening, attentioning to convey an empathetic result to the patient. Argyle (1994) points out that volume are often unaware of their own non-verbal communication, whilst it is clearly visible to the receiver. Incongruence between what is being said verbally and what otherwise is perceived does not befriend in facilitating a positive relationship from a patients perspective. However, for a nurse who is trained to be sensitive to much(prenominal)(prenominal) cues ( specially in mental health settings), it can sometimes present useful information rough a patients mental stat e and is a possible indicator of deterioration.The Fundamentals of bang (2003) document published by the Welsh Assembly Government highlights that communication should take place using appropriate language and in a sensitive manner. rush should be taken to notify effectively with throng who are mentally impaired. In all patient communication the use of medical jargon should be limited wherever possible. As the incision of wellness Valuing People Now (DH 2007) points out, as cited in Baillie (2009), plurality with learning disabilities slang a right to health sustentation just as oft as other people and it should be just as accessible. In essence, nurses go through to be open, flexible and versatile in their approach.Stuart and Laraia (2005) cited in Riley (2008) conjure up that communication facilitates the development of a alterative relationship. maintains should adopt a competent style of questioning, using open and closed questions appropriately depending on the s ituation. It is continuously important to convey a warm and supporting attitude that is butt and value free, taking into account the different cultural variations that exist. breast feeding is more and more recognised as a holistic and someone-centred process, with so many aspects of a patients life regarded as important to the process of retrieval that communication in itself forms a significant aspect of treatment. Caris-Verhallen et al. (1999), cited in Crawford et al (2006), imply that communication promotes an increased level of self-esteem and reduces stress. These benefits to a fault promote staff wellbeing. In addition, Watkins (2002) mentions the usage of self-disclosure as a factor that helps develop therapeutic relationships with patients, take aparticularly within mental health settings.Teamwork is a factor too which relies heavily on reasoned communication. Nurses are surrounded by different types of health do by professionals and as Peate (2006) ack straightwa yledges, interdisciplinary communication can be nasty. The care for and Midwifery Council (2008) figure of Conduct states that, as a nurse you must(prenominal) work cooperatively within teams and respect the skills, expertise and contributions of your colleagues. It is often the nurse that acts as an intermediary between the patient and another healthcare professional, disseminating information and explaining it in term suitably appropriate to the understanding of the patient.Poor communication creates barriers which can often lead to patients feeling alienated and making complaints as well as often being a significant factor in cases of malpractice, neglect and negligence. at heart many clinical settings, a inadequacy of time presents toughies in utilising effective communication. Nurses often induct to take opportunities to found rapport using synchronous communication whilst carrying out other tasks and duties. As Crawford et al. (2006) point out, healthcare professiona ls are increasingly task driven and blotto with administration which prevents them from using up time lecture with patients using the ideal but time consuming counselling type communication. Therefore, in modern healthcare settings, they suggest a newer homunculus is used that encompasses Brief, Ordinary and Effective (BOE) communication Crawford et al. (2006).With regard to written communication, the NMC Code of Conduct (2008) highlights that nurses are expected to watch that accurate and up to date records are maintained, with clear information about when the entry was made together with a signature of the person making the entry. Not only is this therapeutically useful, it is also an essential legal unavoidableness and offers evidence that treatment has been carried out. Finally, Baillie (2009) explains that the telephone also forms an important, often overlooked mode of communication. As with all clinical work, it is essential for nurses to maintain professional etiquette and confidentiality, as well as acknowledge their level of competence to the caller and get a line that the call is documented where necessary (Baillie, 2009) final stageCommunication has been demonstrated to incur an important positive set on treatment outcome. Nurses as a collective group represent a substantial aspect of all clinical health care professionals. They probably spend the most standard of time with a patient. As such, thither is an enormous capacity for influence on treatment. It is at that placefore clear why thither is a direct for significant emphasis on this matter in nurse pre-registration programmes. advance in store(predicate) and present generations of nurses to communicate more effectively could have a significant influence on increasing patient satisfaction and recovery time. It is and then suggested that promoting effective communication has electromotive force cost saving implications for local anesthetic healthcare authorities too. This is impor tant given the enormous strain that the NHS is under in the current economic climate. From a wider perspective, it could be speculated that effective communication substantiatingly has some bearing on aspects of future health and sociable policy.Reflection Communication in The Dementia Care ContextThis b indian lodgeing section looks reflects on communication within a dementia care setting and utilizes a Reflective Cycle model ( addendum 1) adapted from Gibbs et al (1988) as cited in Bulman and Schutz (2008). The model begins by using a rendering about what has happened and therefore encourages the person whom is reflecting to acknowledge their feelings about the situation/event. From this, the evaluation phase encourages the reflector to make value judgements and to say what was good or bad about the experience. Next, an analysis can be made about the situation and this should hopefully generate ideas and themes about the situation. Through doing so, conclusions can be drawn b oth in the general sand and in harm of the reflectors specific personal experience. The final part of the reflection process with this model is the personal action plans stage whereby the reflector can suggest different, peradventure breach ways of doing things in a similar future situation. interpretationThe placement was a dementia care ward which was all-female bedded with people who were at various stages in terms of the development of their dementia condition. The majority of the patients were still relatively active in a physical sense and often quite blitherative.I worn out(p) a significant cadence of time sitting with various patients in the dayroom, often for observation reasons to help ensure their safety. This enabled frequent opportunity to talk to the patients and also to upgrade some insight into the nature of how dementia can affect people. There was one patient that particularly concerned me. In the interests of preserving confidentiality I will change her n ame and refer to her as Abigale. Although this reflection is predominantly focused on my interaction with Abigale, much of what I mention is relevant to the patient race at large in respect of dementia care.Abigale was an elderly lady, perchance in her early 70s, who used to be a school teacher during her working years. Her condition was such that she was often quite talkative although the conversation was very much disjointed. She conveyed a range of emotions and often talked to me as if I resembled a particular character in her former life. Sometimes she stave in a manner that suggested that she was seemingly happy about something and then for no apparent reason, she would become very upset and tearful. This happened on a frequent basis, with her emotions appearing to cycle between positive and negative affect in relatively short periods of time.FeelingsThroughout the time I spent talking with Abigale, I always tried to talk warmly to her and convey an accepting attitude along with empathy, interest and compassion, reflecting the core principles of Rogers client centred therapy. I was aware that my non-verbal communication was very important both to her and other patients. Within the dementia care setting, non-verbal communication is often even more important because it is often relied to a great extent. I always tried to pose openness in my body language, using the SOLER principles acronym outlined by Egan (1994), (see auxiliary 2). I found that she often used the mode of touch to communicate when sitting and/or talking with people and I attempted to reduplicate this in a similar, acceptable manner. I found this to be very effective which did surprise me. With a younger generation, touch tends to be a form of communication that I tend to perceive as not working very well for me. This maybe because I just havent utilized this method very much outside of friendship and family settings.I enjoyed spending time talking with Abigale. I particularly samed the way she move to speak with a degree of authority that would perhaps be capable with her former role as a teacher. Even though her conversation was markedly unfocused and incongruent, she spoke in a very feel out manner. When I was able to answer her with a response she appeared to find satisfactory, it matte up quite rewarding and it was good to see when she appeared to be happy. Sometimes she acted as if I resembled various people from her life. It was concentrated to know whether to simply accept these non-sequiturs and go along with them, or correct her and risk upsetting her.Unfortunately, there were also times when I could not give her a response that she needed. I occasionally found it knotty to determine what she was actually talking about and I didnt want to respond with something that wasnt relevant. Despite my take up efforts, it was rugged to seek clarification from her as she would often move on to some other topic. I also found it stirredly challenging at t he times where she was upset for no apparent reason and I would have resemblingd to have been able to offer more support.Sometimes, I have observed staff using diversion techniques to help distract patients from dark situations. I have tried to use these occasionally. However, I tend to be a little uncomfortable doing this and I would rather be able to help somehow by having a greater understanding of the person and addressing their questions and concerns more directly.Finally, not having access to the computerised notes system (PARIS) was very frustrating as it meant that I only had information passed verbally from staff.EvaluationWhilst communicating with Abigale and indeed, other patients within the setting, I tried to maximise my listening capacity by blocking out noises that were external to interactions. However, because I felt I had a duty to the other patients, blocking all noises was impracticable. The dayroom tended to be a difficult place to have a conversation. The tel evision appeared to be more or less continually switched on, and there were often domestic staff acting various cleaning duties. The ambient noise levels tended to be quite high and somewhat distracting both for myself and no doubt, the patients.Access to PARIS would have al measlyed me to gain a greater awareness about the patient as I would have been able to read comments and assessments made by the whole multidisciplinary team.depth psychologyGood communication forms an intrinsic part of the nursing process and is part of many nursing models. Roper et al. (1996) as cited in Peate (2006) list it as an aspect of daily living. Unfortunately, people who suffer with dementia experience a number of cognitive difficulties check to Mace (2005) as cited in Adams (2008) (see appendix 3) which make communication very difficult. The associated pathological diseases and consequences of aging also change these difficulties making effective communication even more problematic (Adams, 2008). The role of communication is therefore specially important for dementia patients as they are apt(predicate) to have difficulties with interpretation of messages (Kitwood, 1997 as cited in Adams (2008)). Indeed, I often found that what Abigale said and how she acted on the responses that I gave was often incongruent suggesting there was a problem with interpretation. However, when I attempted to seek clarification, it was very difficult or indeed impossible.According to Cheston and Bender (2003), dementia care can be improved by being evacuant and using every interaction as an potential opportunity to help and support them. The humanistic and Rogerian aspect of empathic listening is particularly important and provides clues about embedded emotional messages according to Cheston and Bender (2003). However, they go on to suggest that in order to be psychotherapeutic in an approach requires a good understanding of a persons life register. Unfortunately, the short term nature of the p lacement meant that I was likely to remain relatively naive in terms of understanding her history and condition to any useful extent, so being truly psychotherapeutic in my actions was difficult. Nevertheless, I attempted to provide a contribution to the nursing process.I found that some of the communication strategies that nurses are encouraged to use in many settings need to be changed when consideration is given to the dementia care environment. Watkins (2001) suggests that clients respond better when nurses ask open questions. However, for dementia patients, inquire open questions would appear to have a tendency to induce cognitive overload. As such, the Alzeimers Society Advice Sheet (2000) recommends that carers should ask short questions, one at a time which require only short answers.The Alzheimers Society (2000) also highlight the need to try and see the person behind the disease Interests, likes and dislikes, hopes and fears, early life, places they have lived and visite d, working life, people they love/have loved, friendships and personality. I did try to find out from Abigale aspects of her former life but in truth, I had very little understanding about these factors. Abigale tended not to respond directly to questions but rather hinted certain aspects on an adhoc basis. Therefore, hypothetically, if I was a named nurse for Abigale in the future, it would perhaps be useful to speak to her close family to gain some insight and as well as potential stimulus for conversations. Perhaps a reminiscence box containing various items such as photographs and objects would be useful in terms of triggering memories and developing conversations.I think it is important to acknowledge that it would have been better to take Abigale to someplace quieter when she was upset. This would have been more conducive to conversation as well as offering some level privacy for Abigale. However, in the reality of the situation, there were limited places that were actually a vailable on the ward. In addition, it was likely there were other patients that were also episodically distressed that made it difficult to open full time to Abigale. The other patients tended to demonstrate similar emotions which coincided with the majority hence there were good and bad days in terms of patient behaviours.Overall, I feel that on balance I offered a good level of support for Abigale. At times, I believe that I could have offered her more in terms of conversation if I had a better level of knowledge about her background. Indeed, sometimes I felt that I lacked the relevant stimulus to have a lengthy conversation. Despite it being my first placement, there were times where I would have liked to have had the knowledge to use certain basic level therapeutic approaches that are applicable to patients whom suffer from dementia. My mentor also mentioned an interest in constitution therapy and I am aware too of the existence of other forms of therapy such as pre-therapy, reminenscence therapy, resolution therapy and the person-focused approach. However, I can clearly appreciate that as a 1st year nursing student, to gain such knowledge is totally impracticable, as well as potentially unethical and unskilled if actually used without proper registered status. Indeed, under the NMC Code of Conduct (2008) I must recognise and practice within the limits of competency. As such, in order to be in a position to use many therapeutic techniques effectively, I would need significant advance cooking and/or further professional accreditation.Conclusion (General)Communication with patients who have dementia is an extremely difficult and complex process. It is absolutely essential that nurses practice effective communication to help maintain the quality of life of the patients in their care. In practice, it is very difficult to ensure that psychotherapeutic support is well provided, particularly as mental needs are more subtle and discrete. It could be argued that relatively low levels of staff and the often high levels of physical interventions often found within dementia settings kernel that the provision for effective communication regarding mental care presents a significant challenge. I think the psychotherapeutic aspect of care is a important issue, particularly with the number of cases of dementia predicted to rise to closely 1 million in the UK by 2020 (according to Alzeimers Disease International, 1999, cited by burgess, 2003).Conclusion (Specific)Overall, I feel quite positive about my experience on placement and about the use of communication. I believe that I worked to the best of my ability. Abigale and many other patients appeared to be quite advanced in terms of their dementia condition. This proved to be quite a challenge. I would like to have had more awareness about Abigales history. I can now more readily appreciate the importance of family and friends, not only in terms of direct contribution to care but also the indirect contributions that they make through providing information about the patient. Early recognition of emotional distress helps with the nursing process. It could have made it more feasible for me to talk to Abigale to provide reassurance and limit the likelyhood of her becoming upset, therefore preserving her dignity.I have gained a great deal of insight into dementia care both through the placement experience and through the process of reflection. In retrospect, I would like to have been able to offer more in terms of psychological support and this provides some insight into the psychotherapeutic aspect of care for future placements.Action PlanIn future, I would like to have acquired a higher level of therapeutic skills to enhance my ability to communicate with people who have dementia. The predicted rise in dementia cases as previously mentioned means there is a greater likely hood of coming into fill and providing nursing care for a patient who has dementia. I think it wou ld therefore be useful to develop a greater awareness into the condition, especially from a psychological perspective.I also hope to have training and therefore approved access to PARIS computerised notes system.ReferencesAdams T (2008) Dementia Care Nursing Promoting Well-Being in People with Dementia and Their Families. Hampshire Palgrave MacmillanAlzeimers Society (2010) Factsheet calciferol Communicating. Alzeimers Society capital of the United Kingdom.http//www.alzheimers.org.uk/factsheet/500Accessed 30.06.10Argyle M (1994) The Psychology of Interpersonal behavior (5th Edn). capital of the United Kingdom Penguin BooksBaillie L (2009) Developing Practical Adult Nursing Skills (3rd Edn). London Hodder Arnold.Bullman C Schutz S (2008) Reflective Practice in Nursing (4th Edition). Oxford Blackwell Publishing.Burgess L (2003) Changing attitudes in dementia care and the role of nurses. Nursing Times, 99 (38) 18.http//www.nursingtimes.net/nursing-practice-clinical-research/changing- attitudes-in-dementia-care-and-the-role-of-nurses/205196.articleAccessed 30.06.10Burnard P Gill P (2009) Culture, Communication and Nursing. Essex Pearson Education Limited.Cheston R Bender M (2003) Understanding Dementia The Man with the Worried Eyes. London Jessica Kingsley Publishers.Crawford P Brown B Bonham P (2006) Foundations in Nursing and wellness Care Communication in clinical Settings. Cheltenham Nelson Thorns Ltd.Nursing and Midwifery Council (NMC) (2008) The Code Standards of Conduct, Performance and Ethics for Nurses and Midwifes. NMC, Londonhttp//www.nmc-uk.org/aDisplayDocument.aspx?documentID=5982Accessed 12.04.2010Peate I (2006) Becoming a Nurse in the 21st Century. West Sussex Wiley.Potters P A Perry A G (2001) Fundamentals of Nursing (5th Edn). St Louis Mosby.Riley J B (2008) Communication in Nursing (6th Edn). United States of America Mosby.Sheldon L K (2005) Communication for Nurses Talking With Patients. momma Jones and Bartlett PublishersWatkins P (2002) Ment al Health Nursing The Art of tender-hearted Care. Edinburgh Butterworth-Heinemann.Welsh Assembly Government (2003) Fundamentals of Care Guidance for Health and Social Care Staff. Welsh Assembly Government Cardiff.http//www.wales.nhs.uk/documents/booklet-e.pdfAccessed 12.04.2010BibliographyEllis R B Gates B Kenworthy N (2003) Interpersonal Communication in Nursing Theory and Practice (2nd Edn). Churchill Livingstone London.Hamilton S J Martin D J (2007) Clinical Development A framework for effective communication skill. Nursing Times, 103 48, 30-31. auxiliary 1The Reflective Cycle (adapted from Gibbs et al.1988) cited in Bulman and Schutz, (2008).Appendix 2Egans solar Principles (Egan, 1994) as cited in Crawford et al. (2006)S Face people SquarelyO Maintain an Open shape to the bodyL Lean fore slightlyE Use appropriate Eye contactR Relax