When providing emotional support, this understanding is often all that is necessary. Our readership spans scientists, professors, researchers, librarians, and students, as well as business professionals. Summary This article focuses on the definitions of cotiimiinication and an examination of their relationship to palliative care nursing. Do not however, force the patient to continue if he/she becomes anxious or seems to wish to change the subject. Effective communication practices both within and between clinical professions are essential to minimize risk in hospital settings and improve patient care, especially during the OOH period [3, 4]. The nurses therefore, decides on the purpose of the interaction before or shortly after it begins. The nurse must listen more than speak, both to what the patient is saying verbally and what is being said non-verbally. This essay will discuss how effective verbal and non-verbal communication in nursing practice will facilitate a mutually satisfying therapeutic nurse-patient relationship. Shouting down a flight of stairs doesn’t exactly make for great correspondence. In this case, it really is the best policy. The use of eye contact, touching and personal space is different in various cultures and rules about eye contact are usually complex, varying according to race, social status and gender. The roles are hard, challenging and tiring. Effective communication is a core skill for nurses and midwives. Nurses usually act as first responders to complex humanitarian crises and disasters; protectors and advocates for the community and communicators and co-ordinators within teams. Communication takes place as an interactive two-way process or interaction, involving two or more people and can occur by nonverbal, verbal, face-to-face or non-face-to-face methods. *Address all correspondence to: nokuthulas@dut.ac.za. Equipment or environmental noise impedes clear communication. This chapter explores how effective communication and interpersonal skills can enhance professional nursing practice and nursing relationships with various stakeholders. “I wasn’t sure I was the best person to be holding this conversation ... but I was called upon that day. Saying something does not necessary mean that the message has been received and understood. This essay will discuss how effective verbal and non-verbal communication in nursing practice will facilitate a mutually satisfying therapeutic nurse-patient relationship. It’s based on principles of collaboration, unobstructed discovery, and, most importantly, scientific progression. Evidence-based information on effective communication in nursing from hundreds of trustworthy sources for health and social care. Good communication plays an important role in the organization’s effective functioning [7, 8, 9]. Problem solving: If a patient discuss his/her problems with a nurse, the nurse helps the patient to analyze the problem, consider possible alternative ways of handling it and how to decide which way is the best. Try to reflect the feelings and thoughts the patient is expressing by rephrasing questions and comments using their own words. If you are asked to call another person, note the date, time, caller’s name and telephone number together with the message. Physical environment can make a huge difference for successful communication. Effective Communication in Nursing, Nursing, Nilgun Ulutasdemir, IntechOpen, DOI: 10.5772/intechopen.74995. These barriers to communication include differences in language, cultural differences and low health literacy. Validation means that you ask the patient whether your interpretation is correct or not. 6 Principles of Effective Communication. effective nursing communication skills are a critical element of patient care (Candlin & Candlin 2003). Some nurses may consider colleagues who spend time talking with patients to be avowing the ‘real’ work and lazy. Therapeutic interactions are purposeful as opposed to social. it is a methods of effective communication that is personal and has to be used more than only … *, Meyer draws on her personal and professional experiences to demonstrate the gaps in health care communication, and how to close those gaps. However, the nurse should avoid silences that last too long because they can make the patient anxious, This explains information and puts it at the patient’s disposal, “After the operation, you will have a drainage tube”, When the patient interprets something incorrectly, the nurse draws his/her attention to reality, “I am not your daughter, I am Nurse Jones”, The patient’s observation is called into question without belittling him/her, or arguing about it, Do not give social approval to wrong behavior so as not to encourage a repeat of the wrong behavior, Do not smile, nod or agree when the patient jeopardizes his/her recovery with wrong behavior, Reward behavior that promotes health to encourage a repeat of the correct behavior, Nod is approval at a patient with a weight problem who declines to eat a heavy meal, The nurse attempts to brush aside the patient’s aside the patient’s worry by acting as though it is unnecessary or inappropriate. Best Practices in Nursing Communication. Assertiveness enables a person to be honest with him/herself and in relationships with others. HealthStream: The Importance of Communication in Nursing. Emotional support alleviates the loneliness of the patient’s experience of illness and increases his/her dignity [17]. The Oxford English Dictionary defines communication as "the imparting, conveying, or exchange of ideas, knowledge and information'. Journal of Advanced Nursing 2002; 40:731-738. The critical nature of effective communication as well as accountability and the ramifications of poor communication skills can be a result of the creation of a non-harmonious rapport with the patient that results in misunderstood communication concerning the methods of care and or options open to them, as well as a host of associated factors. Care, compassion and effective communication are essential elements of nursing, which must be demonstrated by all nurses and nursing students. They bring people-centred care closer to the communities where they are needed most, thereby helping improve health outcomes and the overall cost-effectiveness of services [3]. Barriers of Communication: Thus far we have seen what we mean by the process of communication. Finding out what the patient and family know and what is most important to them. Message and data rates may apply. Linear model of communication entails a sender, a message, a receiver and noise (Figure 1). Meaningful relationships will allow nurses to carry out their clinical jobs more easily while keeping patients engaged in their care. The patient’s culture may block effective nurse–patient interactions because perceptions on health and death are different between patients [12, 13, 14]. 1. Communication is the basic element of human interactions that allows people to establish, maintain and improve contacts with others. Conflict is a common effect of two or more parties not sharing common ground. Meyer spoke about the defining moment in her life when she was a nursing student. Every step of the way, from patient intake to patient discharge and beyond, nurses must communicate well to provide comprehensive care. Rabol et al (2011) Descriptions of verbal communication errors between staff. It the means by which an individual influences the behavior of another, which leads to the successful outcome of nursing intervention. Active listening means concentrating all your senses and thoughts on the speaker. Effective Communication. However, it is recognized that such skills are not always evident and nurses do not always communicate well with patients, family members and colleagues. Our preconceived attitudes affect our ability to listen. 15 Techniques to Develop Writing Skill. Our word choice is critical. DISCUSSION 34 7.1 Discussion of results 34 7.1.1 Discussion of Results as related to theoretical concept 35 Login to your personal dashboard for more detailed statistics on your publications. Available from: Over 21,000 IntechOpen readers like this topic. A communicator creates and interprets a message with a personal field of expertise and/or a frame of reference Figure 2). The author declares that there is no conflict of interest in this chapter. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. Pausing occasionally to check the patient’s understanding and asking if there might be any questions or issues of concern. Meyer feels these conversations are positive for patients and their families, and hold great potential for a nurse’s sense of professional fulfillment and pride. How long have you been aware of this illness?”, Use of examples and comparisons to concrete objects. If you need some help with your communication skills and would like to chat to someone, you can call our confidential support line 24/7 on 1800 667 877. The factors in care setting may lead to reduction in quality of nurse–patient communication. Reassurance is not based on fact or real certainty. A desk can create physical and psychological barriers between a … Use simple, understandable phrases, not medical terms as most patients do not understand these terms. Information is “What” we share, and communication is “How” we share it. It is therefore, important for the nurse to understand and accept differences in patients’ cultures and beliefs. The way in which the pone is answered and a message is interpreted needs special skills because the body language of the person at the other end of the phone line cannot be seen.  Repetition is necessary in teaching process. Verbal and non-verbal communications are the two main types of communication used by human beings. Available from: Guidelines for successful therapeutic interactions, Counter-productive communication techniques, This gives the patient the freedom to choose what he/she wishes to talk about, This type of question allows the patient to talk about his/her views about the subject. Try to stay focused on the conversation. Are the body and face turned towards the speaker? Are the processes that make up communication congruent, in keeping with what is being said? This type of conversation can be a structured interview using an interview schedule. Many misunderstandings arise because people interpret other people’s words without checking their interpretation. Language differences between the patient and the nurse are another preventive factor in effective communication. Communication is the exchange of information between people by sending and receiving it through speaking, writing or by using any other medium. Therapeutic communication is an interpersonal interaction between the nurse and the client during which the nurse focuses on the client’s specific needs to promote an effective exchange of information. It explains principles of communication, communication process, purpose of communication, types of communication, barriers to effective communication, models of communication and strategies of improving communication and guidelines for successful therapeutic interactions. Table 2 shows counter-productive communication techniques, explains why these should be avoided and gives examples [10, 18]. … If a healthcare professional feels that the person is talking too fast, not fluently, or does not articulate clearly etc., he/she may dismiss the person. In this way, a vague or abstract concept can be more easily explained, “Does the pain feel like a sharp or a blunt object that hits you?”, This gives the patient the chance to think, and/or to his/her organize thoughts. 2. Non-verbal cues – gesture, touch, proxemics and posture – also need to reflect confidence, regard and respect for self and others. Physical contact between sexes is strictly forbidden in some cultures and can include handshakes, hugging or placing a hand on the arm or shoulder. Communication involves information being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a number of communication skills; which in a nursing context generally focuses on listening and giving information to patients (Weller 2002). Nadzam D (2009) Nurses’ role in communication and patient safety. People tend to listen uncritically to people of high status and dismiss those of low status. The TEDxLongwood Talk presentation “On Being Present, Not Perfect,’ by Elaine C. Meyer, PhD, RN, co-founder and director, Institute for Professionalism & Ethical Practice, Boston Children’s Hospital, and associate professor of psychology, department of psychiatry, Harvard Medical School, helps health care professionals build better communication skills. Provide a quiet environment without distractions. To select three techniques to use when communicating with older people. Communication is a core component of sound relationships, collaboration and co-operation, which in turn are essential aspects of professional practice. explain the blocks tocommunication in nursing.6. Yes, I do want to communicate with Benedictine University via SMS. In acute care, there are specific communication questions used in reporting quality indicators. What is acceptable for one patient may not be acceptable for another. An analysis of 84 root cause analysis-reports from Danish hospitals. With the scarecrow’s brains, practitioners seek to use their knowledge, their clinical wisdom, their experience so they can explain diagnoses and plan treatments in ways that patients understand and include patients as partners, in ways that don’t scare or frighten the patient. This leads to inconsistencies in the information given to patients making comprehension difficult for the patient and their families. It is sent through the use of one’s body rather than through speech or writing. Interaction between people is cyclic, which means that what one person says and does evokes a reaction from the other person, and this reaction again stimulates another reaction from the first person [10, 11]. That’s what stays with them.” She referred to the “other half of the medical equation or the emotional standard of care, where practice makes better.” Ways health care professionals can be present include: Meyer encourages participants to be present in conversations by: Meyer used a Wizard of Oz metaphor to highlight the necessary components of communication: courage, brains and heart: In closing, Meyer offered words of wisdom: “Dig deep and find your inspiration ... Once upon a time, you wanted to change the world. Hargis as cited by van Niekerk identifies four elements of assertive communication [8]: Content – where the rights of the people involved are embedded gently in the statement. Ask questions to clarify unclear messages. To ensure this, the message has to be adapted to the language, culture and socio-economic status of the patient. The meaning of a message depends on its literal meaning, the non-verbal indicators accompanying it and the context in which it is delivered. Fear and anxiety can affect the person’s ability to listen to what the nurse is saying. The following is a brief analysis of the important steps of the process of communication. This encourages the patient to say more and does not limit answers to a ‘yes’ or ‘no’, This shows that you are aware of what is happening to the patient and encourages him/her to talk about it, This entails confronting the patient with an observation you have made and assess his/her reaction to it. The lion’s courage reminds health care professionals to never underestimate the power of their courage, their leadership and their willingness to “go there” with a patient, a loved one. effective, it must be communicated in such a way as to motivate each individual to understand it and then to use it”. One can usually deduce whether a person is listening actively by looking at the following non-verbal indicators: Is the eye contact maintained with the person who is speaking? Remembering to have a mutual agenda that meets the needs and priorities of the patient and family, as well as the healthcare team. doi: 10.1136/bmjqs.2010.040238. The message sent may not be the message received.  Local language should be perfectly used. BMJ Quality & Safety March; 20(3): pp268-74. Help us write another book on this subject and reach those readers. Like anything else in business, it’s a skill to be learned, and methods of communication will differ from company to company. Table 1 gives an overview of therapeutic communication techniques and provides examples of each technique [10, 13]. This influence can play a very important role in areas such as patient health, education and adherence [6]. From an ethical viewpoint, patient safety takes precedence over loyalty to peers and superiors, especially when those individuals are not conforming to safety procedures. The module encourages nurses to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction. Culture is another hindrance. Do not offer your personal opinion. Effective communication within a … These requirements form the basis of the first essential skills cluster, which stipulates key skills and behaviours that must be demonstrated to meet the standards for registration with the Nursing and Midwifery Council. HeadquartersIntechOpen Limited5 Princes Gate Court,London, SW7 2QJ,UNITED KINGDOM. Respect: Always show respect for the individuality and dignity of the person you are speaking to [17]. Principles, theories and methods of effective communication (written and oral) in general, and in a management context Understanding Individuals: Principles, theories & Methods of effective communication This section covers: Principles, theories and methods of effective communication … Relevance: Make sure that your message suits the situation, the time and the person you are speaking to. Some health care organizations may still foster a culture that discourages employees from reporting negative events. Surgical Neurology International: Multidisciplinary In-Hospital Teams Improve Patient Outcomes: A Review. Clear communication means that information is conveyed effectively between the nurse, patients, family members and colleagues. To support the development of effective nursing communication in clinical practice, a good understanding of what constitutes effective communication is helpful. The sender and the receiver must both be able to concentrate on the messages they send to each other without any distraction. Nurses are critical in the delivery of essential health services and are core in strengthening the health system [1, 2]. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. I learned that [on] that day I was called upon to be present, not perfect.”. This kind of communication, called body language, can tell a great deal or can totally the wrong impression. BACKGROUND: Effective communication between nurses and physicians is central to the clinical care of nursing home residents.Anecdotal evidence suggests that communication between the groups is unsatisfactory, but no empirical data exist with which to validate assumptions. Using the terminology which the patient does not understand can also frighten the patient and make him/her think that he/she has a more serious problem than he/she originally wanted help for. The emotional or physical condition of patients may also make it difficult for them to receive long of complicated messages or even any message. While variances exist between instructors, the lecture-lab model is premised on the teachers giving, and the students passively receiving, knowledge. Some ways of improving communication are as follows: Show empathy at all times and try to understand. Use words that are non-threatening – explain what you would like to do and do not give orders to the patient. Members of the multi-disciplinary healthcare team communicate verbally with one another and with patients as well as family members. Assertiveness helps to enhance relationships, avoid power games and is a vehicle for clear outcomes. Non-verbal communication is made up of: The communication process may be explained by means of a linear model of communication, interactive model of communication or transactional model of communication [11]. You have to trust the person you are speaking with to provide the correct information in an easy to understand manner. CHAPTER 9 Communication and collaboration in nursing Learning outcomes After studying this chapter, students will be able to: • Describe therapeutic use of self. There are usually differences in age, sex, occupation, cultural background, moral and religious convictions between the nurse and the patient. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. Request information to learn more about this program and receive your free career guide. However, it is important that nurses who have the opportunity to work in other countries develop communication skills, cultural awareness and sensitivity before arriving. Your communication skills can help you avoid conflict, support relationships with colleagues, solve problems and create better outcomes and experiences for people you care for. This is particularly problematic when the advice is based on limited assessment and knowledge of the patient and the situation, These questions require only a single word as an answer when specific information is needed. Offer factual information. Continuous barriers to effective communication brings about a gradual breakdown in relationships. There is a culture to get the work done. This chapter explores how effective communication and interpersonal skills can enhance professional nursing practice and nursing relationships with various stakeholders. Nurses strive to make all their communication with patients therapeutic, that is, their communication is purposefully and consciously planned to promote the patient’s health and wellbeing. Secondly, though, effective communication methods should also be part of the training that you give to your employees. Listen to understand; not solely to respond—this is one of the best principles for … Non-verbal communication is not reliant on words. Non-therapeutic communication techniques that should be avoided. An analysis of 84 root cause analysis-reports from Danish hospitals. Learn more about howto file a complaintabout a distanceprogram or courses. It is, of course, also clear from the verbal responses: Are there regular verbal responses, even if these consist only of encouraging sounds? Adaptability: Adapt your response to the clues the patient that the patient gives you. Licensee IntechOpen. They bring people-centred care closer to the communities where they are needed most, thereby helping improve health outcomes and the overall cost-effectiveness of services. Rabol et al (2011) Descriptions of verbal communication errors between staff. Given the complexity of culture, no one can possibly know the health beliefs and practices of every culture. Interactive model of communication gives a slightly more complex explanation of the communication process.  Active involvement of nurse … Nurses aim for collaborative relationships with patients, families and colleagues. To ‘just listen’ without expressing opinions or offering advice is therefore, often not in their nature. To discuss effective communication techniques. Effective communication is an important component of quality patient care. Communication Theories in Nursing Multiple communication theories are used in nursing to help explain and guide interactions made between nurses and patients, as well as nurses and other health care professionals. Features such as time, messages, noise, fields of experience, frames of reference, meanings, shared systems of communicators and personal systems all pay a role in the process of communication. This article examines what counts as effective communication from the perspec- If this type of question is used often, the patient are less inclined to give the information and may be interpreted as an interrogation, These questions demand that the patient explains behavior, feelings or thoughts that he/she often does not understand himself or herself. The patient can then disagree with it, or confirm that your conclusions are true, “You must have been exhausted after walking a long distance from home to the hospital”, Make supportive remarks to encourage the patient to participate in the conversation. There are many different ways to communicate, each of which play an important role in sharing information. Instruct a patient: Patient instruction may vary from an informal conversation during which few facts are conveyed to an elaborate instruction session. If trust is established, patient will be willing to teach the nurse. Forging meaningful nurse-patient relationships can be accomplished by making small changes to nursing workflow.Sitting next to a patient while talking, even for a brief period, can help improve patient satisfaction score… In the modern caregiving environment, it is no longer acceptable … Every member of the healthcare team, whether they are nurses, physicians or administrators, need to be aware of the delicate nature of communications in healthcare. Nurses possess a tremendous amount of medical knowledge and clinical expertise. Nadzam D (2009) Nurses’ role in communication and patient safety. Silence also give a nurse an opportunity to observe the patient. In the interest of nurse–patient relationship, it is essential that they ascertain whether their communication has been successful. A ‘yes’ does not always mean ‘yes’. Help us write another book on this subject and reach those readers. The purpose of this conversation is always a better understanding of the patient. Past experiences can change the meaning of the message. These will present barriers to effective communication. Often non-verbal messages send stronger signals than verbal messages. By making research easy to access, and puts the academic needs of the researchers before the business interests of publishers. Honesty should be paramount in every single thing you do. Lean forward, listen intently and maintain eye contact if it culturally acceptable. Oral Communication: Oral communication consists of listening and speaking to others. If patients are embarrassed or concerned that they will not be able to speak properly or control their mouth, they could be reluctant to speak. Or by using any other medium whom he/she is conversing understands the message and make a huge difference successful... ( 2011 ) Descriptions of verbal communication, followed on by the complementary non-verbal communication in order to be successful... Of cotiimiinication and an examination of their relationship to palliative care NS321 Dunne K ( ). For great correspondence only for patients but also about their feelings nurse is saying verbally what. That result when they are applied to practice Individuals: Principles, theories & methods of effective nurse– communication! “ Hello ” or “ good morning ” to carry out their clinical jobs more easily while keeping engaged! 6.2 how effective communication show that you give to your requests and prevent! Work environment should try to understand noise ( Figure 1 ) challenge perhaps... Verbal and non-verbal communication and interpersonal skills can enhance professional nursing practice and nursing must address all of. Devising treatment plans that inhibit workflow OOH [ 4 ] over the phone or making a call: always respect. 100 million downloads Black people [ 11 ] a tendency to make judgements... 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