ethical dilemma in nursing

Effective Communication in Nursing

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Communication is one of the most important aspects in the nursing world because the work of nurses includes constant and intimate contact between the nurse and the patient, the patient relatives and the other members of the medical staff. The efficiency and effectiveness of a nurse depends on the ability of nurse to communicate well with the patient and all the others involved in the care of the patient for communication to occur there must be a receiver who could be the nurse or patient, the sender who could also be patient or nurse and message to be passed (Belcher, 2009). The following essay explains the importance of communication in nursing. It also describes the various ways in which communication affects the professionalism of nurses.

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According to Woodhouse, communication in nursing is not merely verbal; it involves both verbal and written forms of communication (Woodhouse 2009). The nurse should be able to acquire the required information from the patient and pass the necessary information to the patient and other members of staff. The nurse should have good listening skills. Since the care of a patient involves collaborative management, there should be good documentation of the care given to the patient. Written communication is very important for continuity of care. It helps nurses to know what has been done to a particular patient so as to plan how to continue with care. All the plans of care and the interventions should be clearly recorded. This helps the nurse to monitor the progress of the patient and evaluate whether the interventions are relevant. It also helps the nurse in self-reflection where the nurse can look at the work she has done and know her progress (Reed, 2008).

Communication is very important in building a rapport between a nurse and a patient. The most important component of communication required here is listening. The nurse should keenly listen to the patient and give the patient a comfortable environment where he can explain all the problems he has. The patient should also listen carefully to the nurse and get all the instructions given. (Taggart et al, 2009). When carrying out procedures, the nurse should carefully explain them to the patient in language that the patient can understand. The nurse should ask the patient questions to confirm whether the patient understands the procedures. Good communication is key in developing a good and trusting relationship between the nurse and the patient. This occurs when the nurse has time to listen to the patient and they have a social conversation. The nurse should make the patient feel free and assure the patient confidentiality of the information given. (McCarthy et al, 2008).

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Good communication helps to overcome cross-cultural and linguistic barriers. In some cases, the nurse and the patient may be from different ethnic groups with different languages. The nurse should ensure that she uses a good language which both the nurse and the patient can understand. Incase both cannot understand each other, an interpreter should be used. The interpreter should be someone who the patient can trust and must be fluent in both languages that the patient and the nurse can understand. (Robyn et al, 2009). The nurse should evaluate the barriers of communication to know what may hinder the patient from giving all the information or what might make the patient not to get the instructions given. The nurse should then solve the problem to ensure efficient communication. In case it is due to fear, the nurse should reassure the patient that the information will be confidential. The nurse should also ensure a good environment which is free from noise and interference. (Belcher, 2009).

According to Usher & Holmes (2010), through good communication with the patients and other members of medical staff, a nurse has self-awareness which is a very important skill in professional monitoring. When the nurse has good communication skills, the other people tell her about her strengths and weaknesses and this helps to create self-awareness (Schon, 2009). Through observations and monitoring the patients’ progress, the nurse can easily note the influence she has on the patients. The nurse should ensure vigilant and constant monitoring of the patients under care. This can also be ensured through good documentation; clearly recorded patent’s information allows the nurse to know the effect of her interventions to the patient and capitalize on the positive part. The nurses should also understand their race, sex and age attitudes and see how they affect them in care of the patients. Racism, sexism, and ageism should not be allowed to negatively affect patient’s care.

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The discovery of self is a continuous and ongoing process and sometimes it becomes very painful as one’s hidden characters are known to self and others. Nurses are expected to behave professionally when they encounter difficult situations in the environment they work. However, feelings of vulnerability and uncertainty sometimes challenge the nurse’s ability. Self-awareness, therefore, helps people to cope with the difficulties they encounter in life. It also helps us to respect our concerns and anxieties prompting questions on how we can best overcome our challenges. (Jack & Smith, 2007).

According to Tuohy, self-reflection, which is part of self-awareness, requires a nurse to identify her strengths and area of growth especially when working across cultures (Tuohy, 2010). The nurse should be well aware of her own biases and cultural values which are the first step to achieving cultural capability and it should be carried out across the different cultures. The nurse should also have critical self-reflection which includes one being aware of her own culture and value systems and trying to avoid biases or making assumptions on cultures that are different from hers. Through self-reflection, a nurse can acknowledge her own cultural beliefs and values and make adjustments where necessary.

According to Woodhouse (2009), communication is very vital in ensuring all the domains of the national competency standards. It is very necessary for ensuring professional practice. Good documentation plays a great role on legal and ethical grounds. It demonstrates a satisfactory knowledge base in practice, accountability and functioning according to the legislation affecting nursing and the protection of patients’ rights. Well-kept records can be used for future reference or in a court of law in case a patient files a case complaining about a mode of treatment. (Robyn et al, 2009). Communication through good documentation helps the nurse to fulfill all the duties of care through performing nursing interventions according to the plan of care. It also integrates the organizational guidelines and strategies with the professional standards through demonstrating awareness and understanding of the developments in nursing which have impact on the patients. Efficient communication is important in critical thinking and analysis. It helps in self-appraisal, in the professional development and show the value of research and evidence for practice. (McCarthy et al, 2008). Communication shows the analytical skills that are used in accessing and evaluating health information and the research evidence. It also supports and largely contributes to the nursing and healthcare research. Good communication participates in improving the quality of nursing activities; it seeks feedback from the many sources and this improves the quality of services offered to the patient. (Taggart et al, 2009).

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The provision and coordination of care can only be achieved through efficient and effective communication. Communication helps to coordinate, organize and provide the required nursing care through assessment, good planning, implementation and the evaluation of the care given. (Belcher, 2009). It is very important in assessment where the data is collected verbally through interviewing the patient. It is also vital in recording the findings after data collection as this data is used by all the members involved in care of the patient. Good documentation of planning and implementation helps in evaluation of the care given so that the nurse can know the effectiveness of the interventions. Good communication is very important in collaborative and therapeutic practice. Communication is very important in establishing and maintaining professional relationships during care of the patient. The nurses should understand well their role in the interdisciplinary heath care staff and since the nurse is always close to the patient, efficient communication coordinates the roles of the other members of health care team in care of the patient (Woodhouse, 2009).

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Communication is the center of care. Nurses should learn good communication skills to enable them to care for the patients efficiently and effectively. Good records should be kept for self-reflection of the nurse, collaborative management, and coordination of care.

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Belcher, M. (2009). Graduate nurses’ experiences of developing trust in the nurse–patient relationship: Contemporary Nurse, 31(2), 142 – 152.

McCarthy, B., Moira, and Twomey, A. (2008). Person-centred communication: Design, implementation and evaluation of a communication skills module for undergraduate nursing students: Contemporary Nurse, 27(2), 207 – 222.

Robyn, O., Linda, W., and Hickson, L. (2009). The number of patients with communication related impairments in acute hospital stroke units: International Journal of Speech-Language Pathology, 11(6), 438–449.

Taggart, J., et al. (2009). Facilitating teamwork in general practice: moving theory into practice: Australian Journal of Primary Health, 15, 24–28.

Woodhouse, G. (2009). Exploration of interaction and shared care arrangements of generalist community nurses and external nursing teams in a rural health setting: Australian Journal of Advanced Nursing 26 (3), 17 – 23.

Reed, J. (2008). Teaching interpersonal communication skills. London: Edwards and Arnold Inc.

Schon, D. (2009). Educating the Reflective Practitioner. San Francisco: Jossey-Bass.

Tuohy, D. (2010). Student nurse–older person communication. London: Edwards and Arnold






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