In Nursing, Communication Is Essential; Models of Communication, Types and Examples of Communication skills, Reflective Account using Gibb’s Reflective Model.

In Nursing, Communication Is Essential

Introduction

What is communication in nursing?

In nursing, communication is essential. Communication is the exchange of messages, and it is a process in which everyone takes part. Messages are continually conveyed between individuals or groups of people, whether by spoken word, written word, non-verbal methods, or even silence (Bach & Grant 2009). Every action conveys a message, and communication is a process that humans cannot escape (Ellis et al 1995).

Communication is crucial in nursing work, and effective communication skills are crucial in the formation of a therapeutic nurse-patient connection. The purpose of this paper is to highlight the significance of communication in nursing and to show how excellent communication helps to create a therapeutic nurse-patient connection. This will be accomplished by presenting a description of communication, referring to communication models, and describing how various kinds of communication skills may be used in practice.

Nurses must participate in the process of reflecting on how communication skills are used in practice in order to engage in meaningful communication and improve effective communication skills. Reflection helps the nurse to obtain a more in-depth understanding of their own strengths and limitations, as well as to address any areas of concern in order to enhance future practice (Taylor 2001).

A reflective narrative of a personal event that happened during placement will be offered utilizing a model. This reflective narrative will include a description of the experience, an examination of thoughts and emotions, and a conclusion. Finally, the reflective account will contain a strategy for dealing with a similar issue in the future.

Communication is defined as the sending, receiving, and decoding of information between two or more individuals (Balzer-Riley 2008), and it entails the use of a variety of communication skills, which in the nursing context mostly include listening and providing information to patients (Weller 2002).

It has been regarded as both easy and difficult to send and receive messages (Rosengren 2000 in McCabe 2006, p.4). Communication is a method that nurses use to interact with and receive information from patients, coworkers, other people they come into touch with, and the patient’s family.

Models of Communication

Which models of communication are mostly used in nursing?

The Linear Model is the most basic kind of communication, and it comprises two or more persons sending and receiving signals (McCabe 2006). While this model depicts communication in its most basic form, it neglects to account for other aspects that influence the process. When giving patients information about their care and treatment, or when delivering health promotion advice, communication in nursing practice may be sophisticated, necessitating the conveyance of huge volumes of information.

The Circular Transactional Model, on the other hand, is a two-way model that recognizes other aspects that impact communication, such as feedback and validation (McCabe 2006). A Skill Model of Interpersonal Communication by Hargie and Dickinson (2004) proposes that good communication is focused and intentional, and specifies the following skills: person-centered context, aim, mediating process, response, feedback, and perception. It also evaluates the individual’s other characteristics and how these may impact their approach to the communication process (McCabe 2006).

In order for communication to be successful, the nurse must be aware of crucial components as well as internal and extrinsic elements that may influence the process (McCabe 2006). They must think about things like prior personal experiences, personal perspectives, time, and the environment in which communication takes place. Physical, physiological, psychological, and semantic noise may all affect the communication, causing the recipient to misunderstand it (McCabe 2006).

Types and Examples of Communication skills

What are the types of communication and examples of communication skills?

There are two types of communication: verbal and nonverbal. The spoken word is referred to as verbal communication, and it may be done in person or over the phone (Docherty &McCallum 2009). Nurses speak with patients on a regular basis; verbal communication enables the nurse to provide information about the patient’s care or treatment, reassure them, and listen to and react to any concerns they may have (NMC 2008).

Effective communication benefits the patient in terms of satisfaction and comprehension of the care and treatment they have received (Arnold & Boggs 2007), while also optimizing the patient’s outcomes of care and/or treatment (Kennedy- Sheldon 2009).

The nurse may utilize open or closed questions to collect more information via questioning. Closed questions often demand a yes or no answer and are used to collect data, while open questions enable the patient to have an active part in their treatment by discussing and agreeing on possibilities as outlined in the Healthcare Standards for Wales document (2005). Probing inquiries may be used to delve further into the patient’s difficulties, enabling the nurse to address them as individuals and design a care plan tailored to their personal requirements (NMC 2008).

It is critical that the nurse communicates well with the patient, providing health information in a comprehensible manner to ensure that the patient is completely informed about their care and treatment and that permission is obtained prior to treatment (NMC 2008).

The nurse should also pay attention to the patient’s concerns and choices regarding their treatment and well-being (NMC 2008). Hearing is an important skill in nursing since it combines attention and listening (Burnard & Gill 2007). The most crucial components of being a nurse are attending; totally focused on the other person and being aware of what they are trying to express, and listening; the act of hearing what another person is saying (Burnard 1997).

Nonverbal communication is a significant aspect of communication that involves the exchange of messages without the use of words. It contains seven elements: gesture, facial expressions, gaze, posture, bodily space and closeness, touch, and clothes; it refers to emotional states and attitudes, as well as the transmission of messages via body language (Ellis et al 1995).

Each of these factors may help to reinforce the spoken word and add meaning to the message; it’s not just about what you say or how you say it; it’s also about what you’re doing with your body while you’re speaking (Oberg 2003). Patients often interpret nonverbal signs from nurses, which might suggest interest or indifference. SOLER (Sit squarely, O – open posture, L – learn towards the patient, E – eye contact, R – relax) may help you focus and pay attention to the patient (Egan 2002).

For efficient communication, there must be consistency between verbal and nonverbal signals. Nonverbal communication can contradict spoken communication, and the ability to recognize these nonverbal cues is critical in nursing practice (McCabe 2006). For example, a patient may verbally communicate that they are not in pain, but their nonverbal communication, such as their facial expression, may indicate otherwise.

The nurse should also be mindful of the consistency of their verbal and nonverbal communication. Any inconsistencies between them will have a direct impact on the message they provide to patients, thereby jeopardizing the nurse-patient relationship.

Other variables may obstruct communication, putting the process at risk, and nurses must be mindful of both internal and external obstacles (Schubert 2003). Internal elements that may impact the process include a lack of enthusiasm, poor listening skills, culture, and personal attitude. External factors including the physical surroundings, temperature, and the usage of jargon and/or technical terms may all stymie the process (Schubert 2003).

Reflection

What is reflection and what is its importance?

Reflection may be used by the nurse to completely examine the growth of communication skills and obtain a deeper grasp of their abilities (Siviter 2008). Reflection may also be used to apply theoretical knowledge to practice, bridging the gap between theory and practice (Burns & Bulman 2000) and allowing us to get a greater understanding and awareness of our behaviors in the circumstance, both conscious and unconscious.

Reflecting on events that occur in practice gives us the chance to analyze not just what we do, but also why we do it. This allows us to learn from our mistakes and improve our nursing practice in the future (Siviter 2008). Reflection is defined as either reflection in action, which occurs during the event, or reflection on action, which occurs after the event has happened (Taylor 2001). It is led by a model that provides a framework within which the nurse may operate. It’s generally a documented process, and using a reflecting model to organize and guide the process is a good idea (Siviter 2008).

Reflective Account using Gibb’s Reflective Model

As part of this placement, I assisted my mentor, a health visitor, in the provision of a baby club for parents with babies and pre-school children, which takes place on a weekly basis and involves routine checks, such as baby-weighing, in addition to opportunity, for parents to socialize and opportunity for health visitors to provide information relating to the care and health of babies and children.

During the second week of this placement, I was asked to assist in the delivery of a forthcoming health promotion session relating to dental health. I have chosen this event as a basis for my reflective account as I feel that health promotion is an important area to consider.

It enables individuals to play a pivotal role in their own health (Webster and Finch 2002 in Scriven 2005) and is a means by which positive health can be promoted and enhanced alongside the prevention of illness (Downie et al 2000). It gives clients the knowledge to make informed decisions about their health and prevention of illness and is an area in which the nurse or healthcare professional plays a key role (WHO 1989).

Description of the event.

The event occurred during a weekly session at a baby club that takes place in a community center. My mentor (Health Visitor) and I were present along with a group of ten mothers and their babies. As this event took place during a group session, I will maintain confidentiality (NMC 2008) by not referring to any one individual. Consent was gained from all clients prior to the session commencing, in line with the NMC Code of Conduct (2008) and the environment was checked to ensure it was appropriate and safe for the session to take place.

The aim of the session was to promote good dental health and oral hygiene amongst children and babies. Standard 1 of the Standards of Care for Health Visitors (RCN 1989) is to promote health, and the session aimed to provide clients with relevant, up-to-date information, thus allowing them to make informed choices about the future care of their children’s teeth.

Chairs were set out in a semi-circle with a number of playmats and various baby toys placed in the center. This allowed parents the opportunity to interact in the session, listen to the information and ask questions while at the same time being in close enough proximity to their children to respond to their needs.

The Health Visitor and I sat at the front of the semi-circle facing the group. I reintroduced myself to the group and gave a brief explanation of my role and the part I would play in the session. This was important; some of the clients were meeting me for the first time, and it is during this initial contact that judgments are made about future interactions, and the service being provided.

Positive initial interaction can provide a good foundation for a future beneficial relationship (Scriven 2005). The session was broken down into two parts: information giving, focusing on the promotion of dental health, and prevention of illness in the form of tooth decay (Robotham and Frost 2005).

Secondly, information relating to tooth brushing was given along with a demonstration undertaken by myself that showed the clients good oral hygiene could be achieved through effective tooth brushing. A question and answer session followed which allowed us to clarify any issues raised.

Feelings and thoughts.

In the week, preceding the session it was important for me to consider a systematic approach to the planning of the session. The first stage was to gather relevant, up-to-date information relating to the subject and plan how it could be incorporated into the session. The NMC Standards of Proficiency (2004a) states that nurses must engage in a continual process of learning and that evidence-based practice should be used (Bach and Grant 2009). The plan was discussed with my mentor and advice was sought about any adjustments which may be necessary.

Prior to the session, I was apprehensive about delivering a health promotion session to clients (patients). I as I felt out of my depth as a first-year student and my anxiety was exacerbated further as this was my first placement. However, support and encouragement from my mentor and other health visitors on the team helped me to relax.

I was given the opportunity to discuss the topic with my mentor and was relieved when I was able to respond to any questions asked in an appropriate manner and that my knowledge had been increased through the research I had undertaken, thus boosting my confidence.

Evaluation.

Despite my initial reservation about my knowledge of the subject and apprehension at delivering a health promotion session, I feel that my mentor’s decision to include me in the delivery of the session benefitted me greatly in the development of my knowledge and self-confidence. During the session, I feel that I communicated well verbally with clients and that my non-verbal communication was appropriate and corresponded to what I was saying.

The clients were focused on the session and seemed genuinely interested, nodding when they understood and showing attentiveness by making regular eye contact. Feedback from clients after the session also allowed me to reflect on my communication; one of the clients stated afterward that she had gained a lot from the session, particularly the demonstration relating to tooth brushing, and was now more aware of the importance of early oral hygiene to prevent problems later in the child’s life.

Analysis

Dental Health is a key Health Promotion target in Wales and is the most prevalent form of disease amongst children in Wales. Many of the participants were unaware of when and how children’s teeth should be cared for and the importance of ensuring good oral hygiene from an early age.

The aim of the session was to provide information to parents as a means of promoting good oral hygiene and preventing tooth decay in babies and young children. In order for the aim to be achieved, communication was a key element. Effective communication in a group can only be achieved if there is trust, participation, cooperation, and collaboration among its members and the belief that they as a group are able to perform effectively as a group (Balzer-Riley 2008).

The information was provided in a way that was easily understandable, a demonstration of how teeth should be brushed was given, and time was allowed for the clients to ask questions. Communication and listening skills allowed us to discover what knowledge the clients already had, and enabled us to adjust the information to meet the needs of the clients.

Throughout the session, I was aware of my non-verbal communication and attempted to show attentiveness to individuals in the group, using the principles of SOLER I made the necessary adjustments. At times, this proved difficult as trying to lean toward the clients and maintain eye contact with each individual was not possible in a group situation.

My anxiety about delivering the session was also an area in which I had some concerns. Nervousness can have an influence on how a message is delivered, and I was constantly aware of my verbal communication, particularly my paralanguage.

I have a tendency to speak at an accelerated rate when I am nervous and was aware that this may influence the way in which the message was being received. It is important to be aware of paralanguage in which the meaning of a word or phrase can change depending on the tone, pitch, or the rate at which the word(s) is spoken. Paralanguage may also include vocal sounds which may accompany speech and which can add meaning to the words being spoken (Hartley 1999).

In Nursing, Communication Is Essential
A Nurse Maintaining Eye Contact.

Throughout the session, I was aware of my verbal and non-verbal communication, and I tried to ensure that it corresponded to the information being given; I was also aware of the non-verbal communication of the participants and made appropriate adjustments to my delivery when needed

Conclusion

After the session had finished, I was given an opportunity to discuss it with my mentor. I was able to articulate what I felt had gone well, what hadn’t gone quite as well and what could be improved. I noted that I was very nervous about delivering the session despite having the knowledge and understanding of the subject and felt that this may have been noticed by the participants.

However, feedback from my mentor allowed me to realize that my nervousness was not apparent in my delivery. By undertaking this reflection, I have been able to question the experience and analyze my actions and behavior, as a means of developing my knowledge for future practice

Action plan

This session aided my learning and personal development, and I am now more confident in my ability to deliver health promotion activities to a group. I am aware, however, that speaking in front of a group is not an area in which I am particularly comfortable, but I believe that more practice will help me overcome this. I’m confident that I’ll be able to apply what I’ve learned about dental health in my future placements. I will repeat the process of thorough research in the future, as it is best practice to keep knowledge current in order to provide evidence-based care.

Summary

In a nutshell, communication is a complex process and an important skill that nurses must be aware of in all aspects of patient care and treatment. In order to develop a therapeutic relationship between nurse and patient, it is critical to be fully aware of not only the spoken word but also the impact nonverbal communication has on the messages being communicated. Reflecting on one’s own practice is also an important part of knowledge development.

In Nursing, Communication Is Essential
Gibb’s Reflective Cycle

The use of Gibb’s Reflective Cycle as a structure for creating a reflective account has proven to be beneficial in the exploration of personal thoughts and feelings in relation to a specific event, and I recognize the importance of reflection as a learning tool that can enhance knowledge and practice after considering a number of reflective frameworks.

Frequently Asked Questions (FAQs)

1. What is the best definition of communication?

Communication is defined as the sending, receiving, and decoding of information between two or more individuals (Balzer-Riley 2008), and it entails the use of a variety of communication skills, which in the nursing context mostly include listening and providing information to patients (Weller 2002).

2. What is the circular model of communication?

The Circular Transactional Model, on the other hand, is a two-way model that recognizes other aspects that impact communication, such as feedback and validation (McCabe 2006). A Skill Model of Interpersonal Communication by Hargie and Dickinson (2004) proposes that good communication is focused and intentional, and specifies the following skills: person-centered context, aim, mediating process, response, feedback, and perception.

3. What is reflective practice and why is it important in healthcare?

Reflection is defined as either reflection in action, which occurs during the event, or reflection on action, which occurs after the event has happened (Taylor 2001). It is led by a model that provides a framework within which the nurse may operate.

Reflection is important because it may be used by the nurse to completely examine the growth of communication skills and obtain a deeper grasp of their abilities (Siviter 2008). Reflection may also be used to apply theoretical knowledge to practice, bridging the gap between theory and practice (Burns & Bulman 2000) and allowing us to get a greater understanding and awareness of our behaviors in the circumstance, both conscious and unconscious.

In Nursing, Communication Is Essential

 

 

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