NUR1102 | Nursing Assignment | University of Southern Queensland

Introduction

Therapeutic communication skills are effective for buildings trust and rapport between patient and nurse, support effective decision -making and help in avoiding medical error and ambiguity ensure quality and safe care. In this essay, we are going to discuss importance of effective communication in health care field, significance of therapeutic communication to support and understand care recipients emotional and physical wellbeing, we will discuss different aspect of communication skills and importance through a case study of Ms. Alice Holt, who age 86 and episode of confusion and disorientation, she face difficulty in finding her bed, she complains about failing memory, we will discuss about the communication difference between nurse and patient in the scenarios and themes of therapeutic communication that can be implemented to ensure better rapport between nurse and patient, building trust, ensuring better health outcome, In the end, a conclusion relevant to it will be given.

Discussion

Patient safety is prime priority for nurses to ensure their safety and wellbeing, therapeutic skills in nursing help nurses to avoid clinical error and work effectively utilising their skill and knowledge, using effective communication skills and active listening skills help in avoiding ambiguity at work place (Martin & Chanda, 2016), and help solving problem and taking accurate decision to ensure optimistic experience for the patient. In given case study scenario of Ms. Alice holt there is communication gap between the nurse and patient which has created the ambiguity and disorientation, Ms Alice age 86 has episode of confusion and disorientation and has issue of failing memory, she face difficulty in everyday task such as finding her bed, she feel frustrated and upset due her poor memory, and didn’t feel comfortable around me therefore Ms Alice asked to call the nurse who cared for her in the morning, as her daughter arrives and find her mother upset she seems angry and unsatisfied by the care provided by me, this is very tense situation to be in for both me and the patient however, i believe this situation could have been avoided by using effective communication skills to make patient comfortable by using effective communication skills such as verbal communication skills eye contact, lowering the shoulder, using soft voice tone and showing empathy to understand patient need and ensure patients share her concern with me, similarly, using effective communication skills with the daughter to explain the situation can be supportive in that situation.

Being compassionate showing understanding for patient need, implementing training knowledge and skills to ensure quality care is delivered is supportive in avoiding communication or any medical gap, talking to patient, taking support from nursing colleague who knows about Ms Alice nature will also be helpful in avoiding the ambiguity at work. Both formal and informal communication with patient and nursing colleague help in ensure quality care is delivered and especially active listening and communication skill help build trust and rapport with patient in which patient can comfortably share their taught, feelings and concern so that patient need can be identified and effective care can be delivered (Donovan & Mullen, 2019). Also, it is important that handover nurse specifically mentioned the need of patient so that new staff can continue the quality care. Both verbal and non verbal communication skills are vital in nursing practice especially when caring for patient who has dementia or Alzheimer or weak memory issue, as it will help in building trust and rapport with patient so that they feel comfortable around you, this also help in patient sharing the emotion and concern, and involve in their own care plan to ensure better health outcome (Brownie et al., 2016). When Patient share their concern or medical need it help nurses to prioritise the caring plan as per their need, and avoid things which can effect patient mental or physical wellbeing, from individualised care to ensure feeling of trust and understanding  communication is considered to be key player in delivery of patient centered care  (Conceicao et al., 2019). Similarly, effective communication skills for seeking help from nursing colleague or seniors in the tough or complicated situation is crucial in avoiding medical errors, it help nurses to work utilising their knowledge and skills, work in obligations to policy and procedure that is expected from them to meet deliverable effectively ensure patient safety and wellbeing. Active listening and both verbal and non verbal communication skills help nurses to recognise patient value and belief support and encourage patient to share their discomfort, fear, etc. So that effective patient -centered care plan can be made involving patient to ensure better outcome for the patient. For instance, in Ms Alice case writing/labelling/using visual cues to name bathroom, bed, medication etc. Can be supportive in absence of the nurse. However, nurses working in compliance to concept of care help in avoiding the communication gap on all levels.

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Concept of Care

Concern of care is moral idea in nursing which comprise idea of showing understanding, being compassionate, showing kindness and being concern about our own and patient safety to make sure efficient patient centered care is delivered through trusting and friendly relationship with both care recipient and working colleagues (Han, 2016).  In the Ms Alice scenario, i could have used therapeutic skills such as active listening and verbal or non verbal communication skills to show understanding and recognising patient strength to make Ms Alice comfortable and relaxed in that situation, so that Ms Alice can share her emotion and feeling, as a nurse reviewing patient medical history or directly communicating with other medical staff who is also carrying for Ms Alice could might have been helpful in avoiding this communication gap and conflict. Reviewing medical history and handovers details is crucial in ensuring all aspect of patient care for instance, patient safety. Medical handover or medical record help nurse to be aware of patient need so that ambiguity can be avoided during the work  (Dillard-Wright, 2019).

Concept of care has 6’C:

Compassion: demonstrating compassion help nurses to ensure patient receive quality care through effective care plan prioritising patient needs.

Confidence: using knowledge and skills help nurses to feel confident that help in implementing their knowledge to manage tough/complicated situation effectively to ensure patient safety.

Competence: this help burses to work in obligations to organization policy and procedure and be aware of what is their responsibility and scope of work practice.

Conscience: this help nurses to be aware of their ethical responsibility to understand patient concern take effective action in compliance to ethical considerations to mange patient problem.

Comportment: this help nurses to work in dignified manner and use therapeutic skills to ensure quality care.

Commitment: this help nurses to priotise their work and patient need to provide timely care.

Nurses working in obligation and considerations to this concept of care help nurses to focus on patient care. The concept of comfort could have helped in Ms Alice to feel immediately comfortable and relaxed with me and not getting upset through effective communication, spending time with the patient might be beneficial for me in easing patient in that situation (Arnold & Boggs, 2019).

Therapeutic Communication Strategies/Skills/ Approaches.

In nursing, therapeutic skills are key to deliver safe and quality care, this concept has divided into different themes such as focusing, questioning, analysing, exploring, active listening, reflection etc. This help in building ground trust between care recipient and nurse (Moosvi & Garbutt, 2020).

Focusing:  it is vital recognise and respond to patient need, therefore, focusing on patient need and priotising to ensure effective care is delivered, in nursing, effective communication skills help nurses to focus on care recipient need and pay close attention to their both verbal and non verbal cues to provide safe care. In given scenario, it is important for nurse to talk to patient family in care plan to make patient feel comfortable, this might have helped in avoiding ambiguity.

Active Listening demonstrating active listening help nurses to identify patient feeling and emotions easily, understand patient words, this help in avoiding confusion. I realised that demonstrating active listening and encouraging individuality and uniqueness help in patient feel valued and respected thus, this might have help Ms Alice feel comfortable when she was upset about her poor memory.

Questions: review handover and medical record and asking both open and closed end questions are another way to avoid uncertainty in health care.

Silence: being silent and using positive verbal body language is another therapeutic communication strategy supporting effective care.

Clarification: asking clarification of the information from working colleagues and patient help in eliminating false assumptions.

Reflection: when patient is unable to communicate their feeling, nurse reflect on what they think patient might be feeling and provides quality care.

Respecting: respecting patient belief and value support nurse to mange tough situation.

Validating Misinformation: it is vital to correct misinformation but should never argue with the care recipient. Thus, following therapeutic communication strategies can help in avoiding communication gap.

Reflection           

I have learned about importance of concept of caring and therapeutic communication skills, I understood how this tool can help in avoiding ambiguity at work and communicating process and query of patient so that effective care plan can be drafted to meet patient need. Regardless of whether it is tied in with communicating the patient need with persistent or through investigating clinical records, utilizing v both verbal and non-verbal cues to understanding quiet feelings and make the patient agreeable is significant focuses to be viewed as while conveying quality patient-focused care.

Conclusion

In Ms Alice scenario the communication gap was the big issue and i have reflected therapeutic skills are crucial in demonstrating my learning, skill and knowledge it can also help in recognising medical record of the patient and understand patient thoughts and feeling I have learned about importance of concept of caring and therapeutic communication skills, I understood how this tool can help in avoiding ambiguity at work and communicating process and query of patient so that effective care plan can be drafted to meet patient need. Concern of care is moral idea in nursing which comprise idea of showing understanding, being compassionate, showing kindness and being concern about our own and patient safety to make sure efficient patient centered care is delivered through trusting and friendly relationship with both care recipient and working colleagues.

Reference

Arnold, E. C., & Boggs, K. U. (2019). Interpersonal Relationships E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Brownie, S., Scott, R., & Rossiter, R. (2016). Therapeutic communication and relationships in chronic and complex care. Nursing Standard, 31(6), 54.

Conceição, C., Guedes, M. J., Rosa, S., Martins, V., Figueiredo, M. C., Godinho, C., & Ferreira, S. (2019). P14 Therapeutic communication in nursing centered in the informal caregiver: a scoping review. European Journal of Public Health, 29(Supplement_2), ckz095-011.

Dillard?Wright, J. (2019). Electronic health record as a panopticon: A disciplinary apparatus in nursing practice. Nursing Philosophy, 20(2), e12239.

Donovan, L. M., & Mullen, L. K. (2019). Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication. Nurse education in practice, 38, 126-131.

Han, C. J. (2016, January). A concept analysis of personalized health care in nursing. In Nursing forum (Vol. 51, No. 1, pp. 32-39).

Martin, C. T., & Chanda, N. (2016). Mental health clinical simulation: therapeutic communication. Clinical Simulation in Nursing, 12(6), 209-214.

Moosvi, K., & Garbutt, S. (2020). Shifting Strategies: Using Film to Improve Therapeutic Communication and Nursing Education. Nursing education perspectives, 41(2), 134-135.