The area chosen for this essay is communication. This essay will attempt to demonstrate an understanding of the importance of communication within nursing practice. It will attempt to define what communication is, and will explain about the different types of communication along with the barriers that can prevent effective communication from occurring. In addition, this essay will explore why communication within nursing is important and it will highlight the importance of communication between healthcare professionals, along with what can go wrong when this type of communication fails.
Journals and texts will be used to support the theory of how communication is important in patient care. Evidence and examples from the author's clinical area will also be included. There are many interpretations of what communication is, and there are several forms it can take. It can be direct, indirect, verbal, and non-verbal, in the form of body language. Communication can be defined simply as "The imparting, conveying, or exchange of ideas, knowledge, information, etc. (whether by speech, writing, or signs). " (Oxford University Press, 2008). One integral part of communication in nursing which can be overlooked, is listening.
Often this is an area where nurses assume it is something that is done automatically. However, there is a distinction between the physical function of hearing, which can be a passive activity, to listening that is an active process. When listen actively, meaning is attached on to what the patient is conveying (Dougherty & Lister, 2008). Listening can be seen a basic nursing skill, and is needed to demonstrate a fundamental understanding of the patient's needs and feelings. Verbal responses and body language when treating a patient are a major priority, and attention to how a nurse speaks and uses body language should be observed.
Certain communication factors must be considered, such as tone of voice, and pace of speech, and body language such as eye contact, nodding, and leaning slightly towards the patient. These factors can all work to enhance the nurse-patient relationship to make care more patient-centred (Dougherty & Lister, 2008). Communication within nursing is vital for numerous reasons which include; to share and relay information, to empathise and provide support, and to assist with the reassurance of a patient when completing practical tasks and it is the foundation all of nurse-patient interaction.
Nurses are in a unique position within a healthcare environment, and are often the first point of contact for patients. (Sheldon, Barrett, & Ellington, 2006). Nurses spend a large amount of time communicating with patients, often not only conveying information but also conveying emotion, and transmitting a reaction to a patient that shows the patient that their feelings are being recognised (McCabe, 2004). For example, a nurse will often show empathy towards a patient to demonstrate an understanding of their feelings.
As McCabe's (2004) study shows, communication in nursing care is an area that is largely overlooked, often because nurses within a hospital setting will tend to focus on practical tasks involving a patient, and on occasion may feel unable to communicate with patient's due to lack of time. However, if the care a patient receives in hospital is to be a positive experience then the care must be more patient-centred. Peplau's (1988) findings would also appear to support the theory that nursing, is in essence, an interpersonal process.
This suggests that nurses need to be able to communicate on a variety of levels with patients, relatives, and members of the multidisciplinary team and thus be active in developing their communication skills (Ellis, Gates, & Kenworthy, 2003). Psychologists have defined communication as a basic human need, and have identified that when there is a lack of communication, this can have adverse consequences on a person's psychological, social, and even physical health (Ellis et al 2003).
This forms the idea that how nurses communicate with patients can have a major influence on their health and wellbeing and it can help to explain why communication is so important within nursing. Poor communication can affect a patient's health and wellbeing in a number of ways. Wound management is one area where poor communication can have an adverse effect.
For example in a recent case study, poor communication occurred between a nurse and patient, with pressure ulcers, due to a language barrier, and because of this, the patient was deeply anxious and psychologically distressed as she could not understand what the nurse was explaining about her condition. This, in turn, led to a prolonged recovery rate as stress and anxiety can lead to the body producing less cytokines, which are chemicals that the body produces, and are essential to new skin cells being formed (Goode, 2004).
This type of case study highlights the need for effective communication, and highlights that barriers to communication can occur but must be overcome. Communication is not only as a tool to give patients information, instructions and to aid practical tasks, but can also be used to alleviate patient's anxieties and concerns. The case study also highlights the way that poor communication can have direct influences on a patient's physical health and wellbeing. Often poor communication is not only a problem for nurse-patient interaction but it can be a problem between health professionals.
Effective communication is vital and important for safe and efficient patient care. However, there are incidents in which poor communication between nursing colleagues can lead to unintentional patient harm. Communication failures between medical professionals can occur for a variety of reasons. Firstly, it has been theorised that the way in which nurses and doctors are trained to communicate is wholly different (Leonard, Graham, & Bonacum, 2004). It could be argued that nurses are trained to be descriptive of a patient's concerns and conditions whereas doctors are trained to be concise and to the point.
This can lead to medical colleagues misinterpreting information, and it is this, in extreme circumstances, which can lead to patient harm. Occasionally it can be that there is a hierarchy between medical professionals that can make nurses feel unable to voice concerns about a patient or even challenge information. This could be overcome with a more standardised approach to communication within the hospital care environment, for example by creating a standardised communication method in training both nurses and doctors (Leonard et al, 2004). In clinical settings, successful teamwork often results in communication that is more effective.
When this is done at a basic level, by embedding effective communication skills within the training of medical professionals, it can mean better patient outcomes and a minimised risk to patient's health (Leonard et al, 2004). Communication between medical professionals is not the only area where there can be issues and barriers to successful communication. Often patients can experience communication barriers that can affect the care and services they receive. One study has highlighted the need for more generalised language to be used when medical professionals communicate with patients, an area that would appear to be relatively unexplored.
Patients can be generally unfamiliar with medical terminology, and as a result, can feel confused by the vocabulary used by nurses. (De Haes, Hoos, Lammes, & Ong, 1995). This would support the theory that for more quality patient interaction to occur there is a need for better communication training to take place. There is also evidence to suggest that although nurses view communication as a vital and important tool within nursing, it is often overlooked due to 'lack of time'.
However, communication need not be for prolonged periods in order for more successful patient outcomes to be achieved, and patients recognise that it is quality of the interaction that is important (McCabe, 2004). One patient outcome, which is easily measured, is patient satisfaction. In McCabe's study (2004), patient satisfaction was assessed after communication with a nurse, and found the most positive patient outcomes where when the nurse had communicated in an empathetic and individualised way. Evidence of this has been witnessed in the author's clinical placement area.
When the author was attending to a patient who had been admitted for a thyroid operation, the author was able to attend to the patient's pre-operative and post-operative care, which entailed spending a prolonged amount of time with the patient. The author asked the patient if it was acceptable to interact on a first name basis, the patient preferred this, and asked the author in depth questions about training and being a student nurse - in turn the author asked the patient about her life, family, worries, and concerns.
As the patient recovered she expressed to the author how it had been a positive experience to be able to discuss not only any issues regarding treatment, but also to discuss any worries about family and life in general. The patient stated feeling that it was refreshing to treated like an individual. This would appear to support the idea that communication within nursing is of paramount importance and research regarding patient satisfaction and communication is correct - that without positive communication patient satisfaction is adversely affected.
The theory that for patient outcomes to be positive, communication must be individual and patient-centred would also appear to be valid. In conclusion, whilst researching this essay, all the information found would seem to support the theory that communication within nursing is important for a variety of reasons, and poor communication often occurs because of a lack of knowledge amongst nursing professionals. It could be argued that less emphasis is placed on communication within nursing as nursing is seen as a practical role and nurses are educated in a task-centred way, in which practical skills are the focus of training.
Whilst practical nursing skills are often paramount, evidence would seem to suggest that effective communication could have significant and beneficial effect on patient outcomes, patient recovery, and interpersonal relationships within the multi-disciplinary healthcare team. It would also appear, from the research found, that communication is a fundamental skill that forms the foundation for nurse-patient interaction, and can be used as a tool to ensure positive patient outcomes.
Research would also seem to suggest that nursing professionals would benefit from more training with regards to communication skills; for example being taught how to communicate effectively, how to listen actively and how to communicate with patients in an individualised way. This would mean nurses could have a more patient-centred approach and patients would experience a higher level of satisfaction from their interaction with nursing professionals.
Research has also highlighted the issue that often communication problems can occur because nurses feel unable to devote time to actively communicating with patients; however, patient-centred communication can be done alongside practical tasks, and during all patient interaction. Ultimately, communication is important for a variety of reasons within nursing, and it is vital that this is recognised and communication within nurse training and nursing in general is improved.
