As nurses, or health care professionals in general, being able to communicate effectively with patients is a major part of the job. Communication is the base structure of what shapes nursing students in today world, teaching them to be not only helpful to the patient but to be advocates for the patient. Also, as being a nurse education is a large portion of your job description, there for with out good communication skills the important topics of education may suffer. Education in nursing is not just limited to teaching patients, it is about teaching other nurses or staff, or education ones self of a particular topic that may be important in giving the patent at hand the medical care they deserve.
When first staring a conversation with a patient it may be helpful assessing their mental status or education level, to ensure that words being used are words or phrases that the patient may already understand or are easily explainable to the patient.
In health care the role of communicator typically falls on to the shoulder of the nurse, as they are the ones who spend the majority of the time with. Communication between nurse and patient needs to be clear and direct. Also the role of being a patient advocate falls in to this category. Being a nurse advocate is to help patients be able to make informed decisions about their own health care, and helping with understanding medical information. With nurses handling most of the communication, patients may be more likely to tell information to the nurse instead of the physician as physicians can be over whelming or intimidating in time of crisis.
Communication is the key to human interaction. There are three main types of communication, verbal, written and nonverbal. Verbal communication is when an individual listen and interpret what the other person is trying to say. Written communication is when the individuals read and interpret what is being said. Nonverbal communication is what a person sees instead of hearing or reading such as, body language, facial expressions, attention span, posture, eye contact, etc.. Of these types of communication, they can be broken down in to sub groups, each of which have their importance in health care. While working the healthcare setting the use of all three types of communication is vital to giving the best and most important information the patient in the most therapeutic way possible.
Having good communication with a patient in a healthcare setting is so important. Without effective communication patients’ lives could be at great risk, it is possible the wrong information may be given, or the patient may be misguided in essential information or instructions. Studies have shown that patients have reported physicians have interrupted their statements 77% of the time with approximately 18 seconds in between interruption. Physicians interrupting patient while they are trying to talk leads to lack of respect and in most cases, patients will not tell crucial information that may or may not play a large part of the plan of care. Lack of proper communication can lead to misdiagnosis, or the belief that there is no current health issue to address. While talking to a patient communication should be filled with open ended question to ensure all of the information is being given. Interrupting a person while they are talking can lead the conversation off path and can occasionally be a waist of time. However, not allowing a patient to tell their information can all be off putting, and can sometime leave out information that the patient may not feel is important but it truly is. Finding a effective balance between the two is a vey important skill to master.
Communication in healthcare may not always be between the patient and the healthcare provider, it may also be between the health care provider and the patient’s family. This may be difficult sometimes as the patient may or may not be able to interpret the conversation as the family will. Occasionally family may be asked to leave so the nurse or provider may have a one on one discussion with the patient is they are uncomfortable with the family being present.
A lot of times in health care uncomfortable topics come up such as sexual history or mental health. These uncomfortable situations may lead to either the sender or the receiver blocking the communication. Blocking communication is defined as “a situation in which communication with a patient is made difficult because of incongruent verbal and nonverbal messages and messages that contain discrepancies and inconsistencies.”. However, in certain situation blocking communication may be the key to the care some individuals needs. As an example, with the elderly, they love to cat and can often be side tracked in the conversation, leaving a nurse stuck and unable to care for the other patients they are responsible for. The use of blocking conversation may also be used when a nurse is handling a situation they may not be able to handle themselves. This can often seem as if they are off putting or interested but everyone handles things differently. Communication may also be blocked based on a patients personal or religious belief. With the nurse advocating for the patient they will help provide excellent patient-based care.
Usually simply asking the patient how they prefer to communicate, or what is the most effective form of communication for them personally, can help communication flow easier. This also shows the patient that the nurse cares for them and would like to ensure that information that needs to be given or received is done in a way that makes the patient feel comfortable or abides by their own religious beliefs. If the nurse is not familiar with the way of communication the patient would prefer, the nurse may have to seek outside sources to assist them in effective communication, such as the use of photos, diagrams, interpreter or written communication.
Of the many types of communication, therapeutic is one of the most important. Therapeutic communication is when two people are face to face speaking and focus on the physical and well-being of a patient. Using this technique, a nurse would be able to provide comfort and emotional support to a patient. Having a nurse who is not efficient in therapeutic communication, could cause the patient to not feel comfortable. Having a patient that is not comfortable can lead to being reluctant with vital information. Therapeutic communication helps build trustworthy and professional bond between the nurse and patient.
Communication between provider and patient is not the only kind of communication that is crucial. Communication between providers is a major issue in todays health care. When a patient is admitted for surgery they can see on an average of 37 different healthcare members. (CITE) With the advancement of patient medical records, communication between providers has gotten mildly better. Providers who are in the same network can access needed patient information. The only real disadvantage is that there are so many different types of electronic medical records, that unless the providers are all associated with the same network, obtaining medical records can be a nightmare.
However not all communication can be therapeutic. When topics of conversations fail, true communication has not been achieved. When either individual is rushing or being rushed therapeutic communication has not been meant. The meaning behind the would therapeutic is that it is helpful, not degrading or discouraging. Using communication that is degrading or discouraging is not comfortable to the patient, and also may lead to the hesitancy of information being given. All conversations between nurse and patient should be as therapeutic as possible to ensure a healthy patient nurse relationship.
While trying to communicate therapeutically, they nurse may use a list of different body languages to ensure the patient they are paying attention and care. The most commonly used are attentiveness or active listening which is not just listening to the patient but actually hearing and understanding their needs. Silence, by not interrupting the patient, they are able to get out their full story with-out detours. The use of open-ended questions is a easy way to have patients open up with-out putting words in their mouths. Exploring, by asking deeper questions on the pertinent topics that come up in the conversation. Also, the use of paraphrasing and restating what the patient has said to ensure all of the correct information is documented. And finally encouraging the patient that verbalizing their feels, whatever they may be, is okay and accepted. Reassuring the patient that the information given is private and that the patient nurse relationship is a nonjudgmental relationship. While the nurse may use many of these techniques, it is important that focus is made whether or not the patient is truly understanding what is trying to be done or said. Understanding the information given is just as important for the nurse as it is for the patient.
While communication in the healthcare environment is important there is also a time and place for conversations. With laws in effect protecting patients from having their medical or personal information spoken openly about, doing such nature is punishable by law. Conversations having anything to do with a patient should be held in private with only individuals who are dealing directly with this patient and only if it needed in order to provide the patient with the medical care they need.
Communication in health care is necessary and helpful but only when it can be done correctly. If conversation between a patient and a healthcare provider is not therapeutic, it can be toxic to any individual involved. Therapeutic communication is key to a healthy relation between individuals. As nurses the ability to communicate therapeutic and education effective is a skill that needs to be learned early on in order to have a healthy and successful career.
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