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Effective Communication OZ Assignments
The word Communication is derived from the Latin word ‘Communicare’ which stands for “to share”. The communication involves transmission of information, for the better understanding communication should be effective. Effective communication is the verbal speech or other methods of relaying information that get a point across. The good quality of effective communication helps in transferring maximum necessary information in minimal period of time (Lunenburg, 2010). The health care industries are associated with high degree of risk related to patient life. Health care profession requires good team work. Teamwork requires effective communication, co-ordination and co-operation between members of a team to achieve desired outcomes. The healthcare team consist of doctors, nurses, and paramedical staff. It may include patients well as family members in few circumstances. Amongst all of these nurses plays a vital role in the team. (Cheney, et al. 2011). This article describes the leadership role of nurses in identifying and responding to changes in patient. It also shows light on the importance of effective communication, discipline-specific-knowledge and capabilities amongst health care team members.
Body of Essay
Communication is a dynamic, complex, multi-factorial, multi-dimensional, phenomenon and it depends on the environment in which individual is sharing experiences. Sender and the receiver are the two basic elements of every communication. (Figure 1) .The sender conveys an idea or concept to receiver (listener) through a medium. (Cheney, 2011). Medium can be in any form eg. case history, face-to-face conversation, telephone call or e-mail
Figure 1 Important elements of communication process.
Nurses are considered to be the major foundation of health care team. Good patient nurse relationship and effective communication are the keys in gaining patient’s cooperation, acceptance, satisfaction and compliance (Nayeri 2012). The Other contributing factors for effective treatment are discipline-specific-knowledge and capabilities of the health care profession. Discipline-specific-knowledge is the set understanding involves knowledge of the field in the broadened way. In past few decades the growth in research for nursing profession has been undertaken resulted in the advancement of knowledge & discipline for the profession (Butts, J., 2012) .
Effective communication is one of the critical factors for the safety of the patient during the countless interactions among healthcare professionals.( figure 2) In the simpler words patient safety is the avoidance of errors and prevention of adverse effects to patients related with health care. The patient’s safety and care are compromised under ineffective communication. According to the Joint Commission's Sentinel Event Database ineffective communication is the root cause in almost every sentinel event (evidence from the cases studies since 1996). Conflicting roles, Hierarchy differences, power struggles and ambiguity in responsibilities could lead to communication failures which in turn compromise patient quality of care and safety.
Figure 2: Safety goal of the patient
There are barriers to Effective Communication, they are physical (geographical considerations, time and space), noise (interruptions, physical distractions) selection of inappropriate language or medium, poor listening skills, mental attitudes, poor feedback, body language (non-verbal communication).Recognising the most common communication barriers and eliminating them is the need of an hour for the maximum benefit of patient (Lunenburg, 2010). Number of interrelated dynamics makes effective communication challenging, described as follows-
1. In health care facilities there is specific hierarchical organizational structure which creates remarkable power distances amongst health care team members. The difference in power is more likely to noticeable between the doctors and rests other team members. These differences forms a barrier amongst the team and most frequently it leads to restraint in communication.
2. The level of training as well as education varies in the members of team; they have different ways of understanding and attitude on individual basis. Further their nature, empathy, method of communication may complicate the situation and intern leads to ineffective communications.
3. Health care organization team is unpredictable and complex because it includes members having range of disciplines and priority regarding providing care to the patient. Most of the health care professionals have their own point of view about the care and meeting the patient’s demands. The priority of the investigation, diagnosis & treatment plan may vary on individual basis where they act individually as well as independently.
4. It has been seen that there is ignorance of health care providers towards working and growing as a team.
Nurses are the first person to interact with patient. They require interpersonal skills to deal with patient, their family, friends & other medical personnel. (Cosset, 2005). The nursing professionals are the mediator between the doctor and the patient, since they spend much more time with the patients so they become familiar. On the other hand they are also aware of all the medical terminologies & process. (Tay,2012). According to American Nurses Association (ANA), registered nurses (RNs) play leadership roles in providing primary health care services and implementing strategies to improve the quality of care. The nursing professions also play an essential role in improving patient outcomes, increasing access, coordinating care, and reducing health care costs. ANA place nurses at the centre of health care team. The public wants leaders they can trust — and nurses consistently rank at the top of a respected annual poll as the most trusted profession. The nurses must possess patience, must be good listeners, and must know the effective verbal as well as written communication. In addition to this emotional stability and humour is needed (Stein-Parbury, 2013).
There are various previous studies which suggest that even though nurses are well trained in establishing an effective communication they fail in developing positive interactions with the patients. The lack of efforts made by health care providers diminishes the quality of treatment outcome (Heaven, 2006).These facts are also supported by another study which suggests that in spite of knowing communication skills nurses fail to apply for the patients in clinical environments (Bridges et al., 2013).
Considering all the other aspects in nursing communication with Patients is of prime importance. It enables them to understand needs of their patients, their expectation regarding treatment or the fees. Once effective communication is established high-quality health care services can be delivered (Ward, 2012).Since communication is always two way process, It has been found that Patients lacking communication skills or the patients with communication disability are three times more likely to experience clinical complications as compared to other patients (Dingley, et. al . 2008).
Ineffective communication in the team members of health care providers is one of the major causes of serious adverse events while dealing with patient. Ineffective communication is also related to poor patient’s communication skills and lack of their knowledge of medical terminologies. Language barriers play noteworthy impact on total treatment outcome and also create a great difference in patient’s satisfaction.
Figure 3:- Communication Barriers
Barriers can compromise treatment plan for example Asians are not comfortable with revealing sexual histories in disease where it is required. Some culture considers touching of one gender to other is inappropriate even during treatment. For such kind of barriers nurses require extra efforts to modify their thought or to make them comfortable. Also the nurses have to justify the treatment plan in front of patient and their family members for their satisfaction. Since RNs are the leader as well as the centre of the health care team in case of transfer of patient from one doctor to another they play vital part in conveying records and history (Arnold, 2015).
Asking question and interpreting it correctly is also utmost important for the health care providers. Nurses should be aware of the extent of denial nature and lack knowledge of medical terminologies and the attitude of patient towards their health (Hemsley, 2012). We had a case of patient of diabetes. Patient was old and was quite ignorant toward his health. He was admitted to the hospital, for uncontrolled diabetes. Previously he was instructed to take insulin twice daily before meal. Since he didn’t have any care taker and was living alone in the home for years somehow he failed to follow the instructions. In the hospital he was given regular required doses of insulin. He himself found improvement in his health. Since improvement was very fast so we have decided to reconsider the instructions. For more effective communication we took the efforts. Along with the explanation of doses in a much simpler language, we made a special instruction chart for the patient in which we have highlighted important points. Patient was recalled after fifteen days. Drastic improvement in his health was found. His diabetes was found to be under control which was appreciable by patient himself.
From the above mentioned example it has been made clear that nurses are the first care provider and even the slightest failure in care provision or ineffective communication or laid back attitude leads unfavourable treatment outcomes (Tjia, 2009). Though the health care team consist of physicians, nurses, clinical departments, and other medical crew involving with investigation process, role of nursing staff is critical in establishing an effective communication between patient and other health care professionals. They are considered to be leader in the health care team (Mitchel, 2012 Norouziniaet al., 2016). The main aim of any health care organization is to render health care services with better quality and quantity. The combination of effective interpersonal communication skills, discipline-specific-knowledge, and capabilities are very helpful in gaining patients sconfidence and satisfaction. However the interpersonal skills are not a major part of the curriculum of nursing education institutes. It develops during the training of job. The nurses learn them with their experiences.
Based on the literature and studies it has been advised to develop good communication skills. The medical staff should be familiar with local language and culture of that region. Nursing staff should motivate to provide high-quality of health care services. Workshops on communication skills should be conducted periodically. Making instructions simpler, empathy towards patient and sincerity towards work will definitely enhances treatment outcomes.