Reflective Assessment on Communicative Nursing Essay

In this essay communication will be defined from a general and a clinical point of view in order to point the differences, if this is the case. The aspects and channels involved in the communication process will be briefly explored in order to show their influence, studied by Kenworhty et al (2001). With all this points considered the importance of communication in nursing will be portrayed. Following this first part, the reflective cycle developed by Gibbs (1988) (see appendix 1) will be used to evaluate and analyze a nurse to client interaction during in one of the stages of the nursing process, in order to describe how communication skills were applied in practice. Furthermore, these skills will be related to the importance of a nursing practice framework and its relevance to the current nursing standards and policies.Reflective Assessment on Communicative Nursing Essay

Watzlawick et al (1968) cited by Kenworthy et al (2001) has argued that individuals have the need to interact with each other and communication is the tool to achieve. Communication defined by Collins School Dictionary (2005). “Communication is the process by which people or animals exchange information”, this definition is a very general, it does not explain the process, aim or influences that communication carries. Instead Sheldon (2005) explains it as sharing health-related data, a process where nurse and client are sources and receivers of information. Sheldon (2005) remarks different ways to communicate such as: verbal and non-verbal or written and spoken. Finally, Sheldon (2005) suggests that nurse-client communication is not only sharing information but also building a relationship. Both definitions describe the process of passing information, although the second one analyzes more in depth about how messages can be transmitted and imply that information-exchange varies in different ambits. Sheldon (2005) adds that the communication which builds relationship is an important factor in healthcare. This point raises questions about how and what factors influence a communication process.Reflective Assessment on Communicative Nursing Essay

There are 6 aspects of communication presented by White (2000): sender, receiver, message, channel, feedback and influences. The sender is the nurse and the receiver could be a client (or a colleague). The message is the information being sent. This message is dispatched through different channels, such as verbal, visual or kinaesthetic. The feedback is the reaction of the receiver to the sent message. This helps the sender to identify whether the message is being understood properly or it has to be resend. Finally, the influences are culture, education, emotion and expectations from the interaction.

This aspects can be included in 4 types of communication as explored by Craven and Hirnle (2006). The first is written. It is based on recording or informing others about a situation or an incident occurred during a workday. This is a nurse’s key role and it is very important for the patient’s care. The second type is verbal. This is sometimes a h3 alliance and other times a weapon that might cause long-lasting misjudgement regarding the health workers presented by Stulhmiller (2000) cited by Craven and Hirnle (2006). The third is non-verbal: gestures, facial expression, space, voice tone and volume play a very important role in communication. Craven and Hirnle (2006) argues that this type is as important as the verbal. Contradictorily Druckman et al (1982) found that non-verbal communication carries more weight and has a deeper influence than verbal statements. The last type communication described by Craven and Hirnle (2006) is meta-communication. It is involves everything that is happening while the communication process is taking part. It ranges from the nurse as a worker to the hospital as a building and passing through other issues such as privacy or past experiences.Reflective Assessment on Communicative Nursing Essay

While caring for a client a nurse takes up several responsibilities and roles. There are six roles that usually can be found, studied by Peplau (1952) cited by Sheldon (2005) (see appendix 2). All these roles involve working towards a patient centred philosophy, defined by the NMC code of practice (2008). Nearly every type and channel of communication is referred throughout the entire document. A nurse looks after patients’ rights and needs, making sure all information is provided before undertaking a treatment or when working in the primary care field.

A nurse belongs to a team (the healthcare workers) therefore findings should be recorded and transmitted accurately to ensure that colleagues or services are aware of any changes on the client’s situation, as reflected on the NMC code of practice (2008). All these aspects involve communication, therefore a nurse is a communicator, sometimes a sender and sometimes a receiver of the information, viewed Craven and Hirnle (2006). All the aspects of communication should be practiced during every minute of a shift, highlighted by Thomas (2004). However, Thomas (2004) points out that there is good and also bad communication. For example bad communication is when a client is given too much or misleading information or private and confidential data is shared with people not involved in the client’s care needs (in this case the client’s consent is needed before giving information to non-care professionals). This practice violates the clients’ rights. Although it is still communication, these actions break the NMC code of practice (2008) and the Fundamentals of Care (2003). For example, the client is given too much information or misleading information.Reflective Assessment on Communicative Nursing Essay

Following this explanation about the importance of communication in nursing, I will use the Gibbs reflective cycle (1988) (see appendix 1) in order to identify communication skills and their importance in practice.

Description: Focused on the admission process.

Mrs. V. arrived to the ward on Thursday morning. She was confused and a bit agitated as she believed she was going shopping and never expected to be in hospital. However, her son had brought her to the ward for a 3 weeks respite while he was on holidays.

Firstly the qualified nurse in charge introduced himself politely, extending his hand and asking: “Welcome the ward I am M., your named nurse, how would you like to be called?” Mrs. V. answered: “Everybody calls me Mrs. V..” Afterwards the nurse invited her into the office, where he was going to carry out the admission process. The nurse introduced me as a student and asked Mrs. V. whether she minded my presence during the admission. Mrs. V. did not mind and did not look unoccupied about me. The nurse closed the office door and transferred the calls to the other office making sure no one was going to interrupt the admission process. The nurse sat next to Mrs. V., kept relaxed and opened body position and showed a friendly attitude. This was achieved by smiling, making her comfortable by offering a chair, also by respecting the spacing boundaries and by showing interest. The nurse explained what was going to happen during the assessment, the importance of it and reasons why it was done. The nurse made sure that Mrs. V. was aware that if she did not feel confident answering any questions, that was not going to be a problem and it was her choice and right not to answer. Once Mrs. V. understood and agreed with the way the assessment was going to be done, the nurse started to ask question regarding her daily living activities and lifestyle. Although, the nurse had read her notes forehand, he wanted to gain further information about Mrs. V’s physical health, past treatments or any difficulties when walking or standing up and to get a general picture of her. Mrs. V. was hesitant about many answers and was unsure about some past events. During this first encounter she had said several times she thought she was going shopping. The nurse patiently re-phrased the same idea (“your son brought you here, where you will stay the next 3 weeks for a respite …”) and she kept agreeing, however she would again ask about shopping. Along the assessment the nurse had been taking some notes, he always kept eye contact and formulated open questions as well as closed ones. The nurse agreed verbally and non-verbally by nodding with the head, rephrasing what it was being said and showing interest in what Mrs. V. was saying and the way she expressed it.Reflective Assessment on Communicative Nursing Essay

Following this interaction, the nurse invited Mrs. V. to come out of the office to be introduced to the staff on-duty and to show the bedroom where she was going to spend the following 3 weeks. Once Mrs. V. was familiarized with the ward layout, the nursing staff helped her to put her cloths away and put her toiletries in a named box. Mrs. V., afterwards she happily sat in the living room and started to interact with the staff and other patients.