In Nursing, Communication Is Essential

In Nursing, conference Is naturalCommunication incriminates the exchange of messages and is a act which all mortals participate in. Whether it is with utter phrase, writ ten word, non-verbal fashion or even silence, messages atomic number 18 constantly being exchanged among undivideds or convocations of tribe (Bach dole out 2009). All behaviour has a message and confabulation is a process which individuals great deal non avoid being conf utilize with (Ellis et al 1995).In nursing go for, conference is essential, and sober communication skills be paramount in the maturation of a sanative accommodate/ tolerant relationship. This convey of this bear witness is to reason the importance of communication in nursing, demonstrating how impelling communication facilitates a therapeutic nurse/patient role relationship. This will be achieved by providing a definition of communication, making reference to models of communication and explaining how different types of communication skills can be used in practise.In prep atomic number 18 to engage in meaningful communication and smash effective communication skills, nurses must(prenominal) engage in the process of reverberateing on how communication skills are utilised in practise. upbraiding allows the nurse opportunity to gain a deeper insight into somebodyal strengths and weaknesses and to lendress any areas of concern in order to improve future practise (Taylor 2001). A further aim will be to reflect on how communication skills have been utilised within nursing practise. Various models of rumination will be examined, and a reflective delineate of a individualised experience which occurred during enthronement will be take into accountd using a model. This reflective account will involve a description the incident, an analysis of thoughts and feelings and an evaluation of what has occurred. Finally, the reflective account will include an action plan for a similar situation, which w hitethorn arise, in the future.Communication involves cultivation being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a yield of communication skills which in a nursing context generally focuses on auditory sentience and giving instruction to patients (Weller 2002). This process of sending and receiving messages has been described as both simple and complex (Rosengren 2000 in McCabe 2006, p.4). It is a process which is continually utilised by nurses to convey and receive learning from the patient, co-workers, others they come into amour with and the patients family. exercises of Communication.The Linear pretense is the simplest form of communication and involves messages being sent and received by two or more people (McCabe 2006). Whilst this model demonstrates how communication occurs in its simplest form, it fails to get other instruments impacting on the process. Communication in nursing recitation can be complicated, involving the conveyance of large amounts of knowledge, for example, when providing patients with information relating to their carry off and treatment or when offering wellness promotion advice.In contrast, the Circular Transactional moulding is a two bearing approach, acknowledging other factors, which persuade communication such as feedback and validation (McCabe 2006). Elements of this model are to a fault contained in Hargie and Dickinsons (2004) A Skill Model of Interpersonal Communication which suggests that successful communication is focused, purposeful and identifies the following skills person centred context, goal, mediating process, response, feedback and perception. It also considers other aspects of the individual and the influence these may have on their approach to the process of communication (McCabe 2006).For communication to be effective it is beta for the nurse to recognise rouge components, and intrinsic and extrinsic factors, which may affect the proc ess (McCabe 2006). They must consider factors such as past personal experiences, personal perceptions, timing and the put inting in which communication occurs. Physical, physiological, psychological and semantic noise may also influence the message, resulting in misinterpreted by the receiver (McCabe 2006).Communication skills.Communication consists of verbal and non-verbal. Verbal communication relates to the spoken word and can be conducted face-to-face or over the telephone (Docherty McCallum 2009). Nurses continually communicate with patients verbal communication allows the nurse opportunity to give information to the patient about their care or treatment, to reassure the patient and to listen and respond to any concerns the patient may have (NMC 2008). Effective communication is beneficial to the patient in terms of their sit downisfaction and taste, of care and treatment they have been given (Arnold Boggs 2007), while at the same prison term optimising the outcomes or car e and/or treatment for the patient (Kennedy- Sheldon 2009).Questioning allows the nurse to gather further information and open or closed in(p) questions can be used. Closed questions usually require a yes or no response and are used to gather the necessary information, whereas open questions allow the patient, opportunity to play an active role and to discuss and agree options relating to their care as set out in the Healthcare Standards for Wales document (2005). Probing questions can be used to explore the patients problems further thus allowing the nurse to treat the patient as an individual and develop a care plan specific to their individual needs (NMC 2008).It is vital that the nurse communicates effectively, sacramental manduction information with the patient about their wellness in an understand sufficient way to ensure the patient is richly informed about their care and treatment and that consent is gained prior to this occurring (NMC 2008). The nurse should also listen to the patient and respond to their concerns and preferences about their care and well-being (NMC 2008). In nursing, earreach is an essential skill and incorporates attending and audience (Burnard Gill 2007). Attending fully focusing on the other person and being aware of what they are trying to communicate and listening the process of hearing what is being said by another person are the close important aspects of being a nurse (Burnard 1997).Non-verbal communication is a major factor in communication, involving exchange of messages without words. It relates to emotional states and attitudes and the conveyance of messages through body language body language has 7 elements gesture, facial nerve expressions, gaze, posture, body space and proximity, touch and dress (Ellis et al 1995). Each of these elements can reinforce the spoken word and add meaning to the message it isnt about what you say or how you say it entirely it also relates to what your body is doing while you are sp eaking (Oberg 2003). Patients often read cues from the nurses non-verbal behaviour, which can indicate interest or disinterest. Attentiveness and attention to the patient can be achieved through SOLER S sit squarely, O at large(p) posture, L learn towards the patient, E eye contact, R relax (Egan 2002).There must be congruency between verbal and non verbal messages for effective communication to be achieved. Non-verbal communication can contradict the spoken word and the ability to recognise these non-verbal cues is vitally important in nursing practice (McCabe 2006), for example, a patient may verbally communicate that they are not in pain, but their non-verbal communication such as facial expression may indicate otherwise. It is also important for the nurse to be aware of the congruency of their verbal and non-verbal communication. whatsoever discrepancies between the two will have a direct influence on the message they are giving to patients, and may jeopardise the nurse/p atient relationship.Other factors may affect communication in a negative way, endangering the process, and nurses must be aware of internal and external barriers (Schubert 2003). Lack of interest, poor listening skills, culture and the personal attitude are internal factors, which may affect the process. External barriers such as the physical environment, temperature, the use of jargon and/or technical words can also negatively influence the process (Schubert 2003). notice.To fully assess the development of communication skills the nurse can make use of considerateness to gain a better insight and understanding of their skills (Siviter 2008). Reflection can also be used to apply theoretical knowledge to practice, thus bridging the gap between theory and practice (Burns Bulman 2000) and allows us opportunity, to develop a better insight and awareness of our actions both conscious and unconscious in the situation. Reflecting on events that repel place in practice, allows opportunit y not only to think about what we do, but also to consider why we do things. This helps us to learn from the experience and improve our future nursing practice (Siviter 2008). Reflection can be described as either reflection in action occurring during the event, or reflection on action which happens after the event has occurred (Taylor 2001) and is manoeuvre by a model, which serves as a framework within, which the nurse is suit fit to work. It is usually a written process, and the use of a reflective model uses questions to provide a body structure and guide for the process (Siviter 2008).Reflective Models.There are numerous reflective models that may be utilised by the nursing professional, for example, Gibbs Reflective Cycle (1988), Johns Model of Structured Reflection (1994) and Driscolls Model of Reflection (2002). Gibbs model (Appendix I) has a cyclical approach, consisting of six stages per cycle that guide the user through a series of questions, providing a structure for reflection on an experience. The first stage of the process is a descriptive account of the situation what happened? Followed by an analysis of thoughts and feelings in the second stage what were your thoughts and feelings? The third and fourth stages involve an evaluation of the situation, what was good and/or bad about the experience and an analysis allowing us to make sense of the situation. The last two stages are the conclusion of the situation, what else could have been done and finally an action plan to uprise for similar situations, which may arise in the future (Gibbs 1988).Similarly to Gibbs Reflective Cycle, Johns Model of Structured Reflection (Appendix II) and Driscolls (Appendix III) model of reflection erect learning through reflection. They have similar structures, which guide the user through the reflective process. Johns Model incorporates four stages description, reflection, alternative actions and learning (Johns 1994) and Discolls model has three stages a retu rn to the situation, understanding the context and modifying future outcome (Discoll 2002). The three models described all have similarities in that the user is guided through the reflective process by describing the event, analysing their thoughts, feelings and actions and making plans for future practice. Considering the models of reflection described, the next component of this essay will make use of the Gibbs Reflective Cycle (1998) to provide a reflective account of a situation which I experienced during clinical placement in a community setting.Reflective Account.As part of this placement, I assisted my learn, a wellness visitor, in the provision of a baby auberge for parents with babies and pre-school children, which takes place on a weekly basis and involves routine checks, such as baby-weighing, in auxiliary to opportunity, for parents to socialise and opportunity for health visitors to provide information relating to the care and health of babies and children.During t he second week of this placement, I was asked to assist in the delivery of a forthcoming health promotion sitting relating to dental health. I have chosen this event as a basis for my reflective account as I feel that health promotion is an important area to consider. It enables individuals to play a pivotal role in their own health (Webster and Finch 2002 in Scriven 2005) and is a agency by which positive health can be put forwardd and enhanced alongside the prevention of illness (Downie et al 2000). It gives clients the knowledge to make informed decisions about their health and prevention of illness and is an area in which the nurse or healthcare professional plays a key role (WHO 1989).Description of the event.The event occurred during a weekly session at baby club that takes place in a community centre. My learn (Health Visitor) and I were present along with a group of ten mothers and their babies. As this event took place during a group session, I will maintain confidentia lity (NMC 2008) by not referring to any one individual. Consent was gained from all clients prior to the session commencing, in line with the NMC Code of demeanor (2008) and the environment was checked to ensure it was leave and safe for the session to take place.The aim of the session was to promote good dental health and oral hygiene amongst children and babies. Standard 1 of the Standards of Care for Health Visitors (RCN 1989) is to promote health, and the session aimed to provide clients with relevant, streetwise information, thus allowing them to make informed choices about the future care of their childrens teeth. Chairs were set out in a semi-circle with a number of play mats and various baby toys placed in the centre. This allowed parents opportunity to interact in the session, to listen to the information and ask questions while at the same time being in close enough proximity to their children to respond to their needs. The Health Visitor and I sat at the front of the s emi circle facing the group. I reintroduced myself to the group and gave a brief accounting of my role and the part I would play in the session. This was important some of the clients were meeting me for the first time, and it is during this sign contact that judgements are make about future fundamental interactions, and the service being provided. Positive initial interaction can provide a good foundation for a future beneficial relationship (Scriven 2005). The session was broken down into two parts information giving, focusing on the promotion of dental health and prevention of illness in the form of tooth decay (Robotham and Frost 2005). Secondly, information relating to tooth brushing was given along with a inference undertaken by myself that showed the clients good oral hygiene could be achieved through effective tooth brushing. A question and answer session followed which allowed us to clarify any issues raised.Feelings and thoughts.In the week, preceding the session it was important for me to consider a systematic approach to the planning of the session. The first stage was to gather relevant, up-to-date information relating to the plain and plan how it could be incorporated in the session. The NMC Standards of Proficiency (2004a) states that nurses must engage in a continual process of learning and that evidence-based practice should be used (Bach and Grant 2009). The plan was discussed with my mentor and advice was sought-after(a) about any adjustments which may be necessary.Prior to the session, I was apprehensive about delivering a health promotion session to clients (patients). I as I felt out of my depth as a first year student and my anxiety was exacerbated further as this was my first placement. However, support and encouragement from my mentor and other health visitors in the team helped me to relax. I was given the opportunity to discuss the topic with my mentor and was relieved when I was able to respond to any questions asked in an appr opriate manner and that my knowledge had been increase through the research I had undertaken, thus boosting my confidence.Evaluation.Despite my initial reservation about my knowledge of the subject and apprehension at delivering a health promotion session, I feel that my mentors decision to include me in the delivery of the session benefitted me greatly in the development of my knowledge and self confidence. During the session, I feel that I communicated well verbally with clients and that my non-verbal communication was appropriate and corresponded to what I was saying. The clients were focused on the session and seemed genuinely interested, cernuous when they understood and showed attentiveness by making regular eye contact. Feedback from clients after the session also allowed me to reflect on my communication one of the clients stated afterwards that she had gained a lot from the session particularly the demonstration relating to tooth brushing and was now more aware of the impo rtance of early oral hygiene to prevent problems afterward in the childs life.Analysis.Dental Health is a key Health Promotion target in Wales and is the most prevalent form of disease amongst children in Wales. Many of the participants were unaware of when and how childrens teeth should be cared for and the importance of ensuring good oral hygiene from an early age. The aim of the session was to provide information to parents as a means of promoting good oral hygiene and prevention of tooth decay in babies and young children. In order for the aim to be achieved, communication was a key element. Effective communication in a group can only be achieved if there is trust, participation, co-operation and collaboration among its members and the belief that they as a group are able to perform effectively as a group (Balzer-Riley 2008). The information was provided in a way that was tardily understandable, a demonstration of how teeth should be brushed was given, and time was allowed for the clients time to ask questions. Communication and listening skills allowed us to discover what knowledge the clients already had, and enabled us to adjust the information to meet the needs of the clients. throughout the session, I was aware of my non-verbal communication and attempted to show attentiveness to individuals in the group, using the principles of SOLER I made the necessary adjustments. At times, this proved difficult as trying to lean towards the clients and maintain eye contact with each individual was not possible in a group situation.My anxiety about delivering the session was also an area which I had some concerns with. Nervousness can have an influence on how a message is delivered, and I was constantly aware of my verbal communication, particularly my paralanguage. I have a movement to speak at an accelerated rate when I am nervous, and was aware that this may influence the way in which the message was being received. It is important to be aware of paralanguag e in which the meaning of a word or phrase can change depending on tone, pitch or the rate at which the word(s) is spoken. Paralanguage may also include vocal sounds which may accompany speech and which can add meaning to the words being spoken (Hartley 1999).Throughout the session, I was aware of my verbal and non-verbal communication, and I tried to ensure that it corresponded to the information being given I was also aware of non-verbal communication of the participants and made appropriate adjustments to my delivery when neededConclusion. afterwards the session had finished, I was given an opportunity to discuss it with my mentor. I was able to articulate what I felt had gone well, what hadnt gone quite as well and what could be improved. I noted that I was very nervous about delivering the session despite having the knowledge and understanding of the subject and felt that this may have been noticed by the participants. However, feedback from my mentor allowed me to realise tha t my nervousness was not unpatterned in my delivery. By undertaking this reflection, I have been able to question the experience and analyse my actions and behaviour, as a means of developing my knowledge for future practiceAction plan.This session has helped with my learning and personal development and I now feel more confident in my ability to deliver health promotion activities in a group setting. I am, however, aware that speaking in a group setting is not an area I am very comfortable with but further practice will help alleviate this. I am confident that I will be able to use the knowledge gained on the subject of dental health in my future placements. In the future, I will repeat the process of thorough research, as it is best practice to keep knowledge up-to-date in order to provide care based on evidence (NMC 2008).Summary.In summary, communication is a complex process and an essential skill which the nurse must be aware of in all(prenominal) aspect, of care and treatmen t they give to patients. A full awareness of not only the spoken word, but also the influence non-verbal communication has on the messages being communicated, is essential in the development of a therapeutic relationship between nurse and patient. The process of reflecting upon practice is also an essential element of knowledge development. After consideration of a number of reflective frameworks, the use of Gibbs Reflective Cycle as a structure for creating a reflective account has proven to be beneficial in the exploration of personal thoughts and feelings in relation to a specified event and I recognise the importance of reflection as a learning tool that can enhance knowledge and practice.