Patient Needs And Nurse Concerns

The establishment of effective communication in nursing is essential for ensuring patient safety as well as their improved health and well-being. This is because the nurses who are at the centre of the patient care through communication are able to share information regarding the way to manage complex roles and responsibilities and understand needs as well as demands of the patient for delivering quality care to them. In this essay, a recent communication established with the patient is being explained and the challenges faced by the patient and the nurses are identified along with the way it can be resolved in future is also discussed.

At my workplace, two days back a patient named A; female of 80 years suffering from dementia along with diabetes as co-morbidity was admitted. My supervisor put her under my care and to identify her needs and demands so that an effective care plan can be developed I tried to communicate with her. The communication session was executed within the ward where she was being admitted with other patients. She initially frowned on hearing the place of the communication session but still agreed to answer the questions. During this session, one patient of the ward suddenly started shouting and misbehaving with another nurse which acted as interruption to our session. As a result, patient A was seen to be disturbed and stopped to answer my question. It was also seen that patient A was not much interested to share her details during the session and avoided to show expressions to answer my questions and often ignored me. It result me to face hindrance in understanding the way the nature of interaction to be followed to make her comply and answer my questions.

I had to receive a call from the other bay to attend a patient due to which I had to interrupt the communication for brief amount of time. During the communication session with patient A, I often feared that asking her continuously to reply to the important questions about her personal health information she was avoiding to answer may make her feel forced by me to provide information. Thus, I avoided her to reply to such questions out of fear that I may be blamed later to have misbehaved with her. Patient A was seen to upset when I asked her how many times she usually goes to the toilet per day. When I asked her about the previous medication she used to take to control her diabetes and dementia she avoided to reply. Further, she avoided to interact anymore and became angry when I asked her the previous question again.

The communication session informs that different challenges were faced due to which the patient avoided complying with me to answer the question properly. The noisy environment where the communication session was executed may be regarded as the initial challenge or barrier faced which negatively affected the interaction. This is evident because the other patient was shouting while the interaction was going on with patient A in the ward. As mentioned by Bramhall (2014), noisy environment makes the patient lose concentration and face interruption in explaining their demands and needs related to health to the nurses. This results patient to avoid effective interaction with the nurses as they could not make out or remember what to speak due to be disturbed by noises. As argued by Ali (2018), noisy places make the patients, as well as nurses, raise their voices to be heard to each other. This leads to loss of control over the privacy of the patients as the information when asked or informed through raised voices can be heard by others. It results patients as seen in case of patient A to avoid answering questions asked by me as her nursing attendant creating hindered interaction and the information required to arrange proper quality of care cannot be received.

The lack of proper use of words or emotions by the patients to express their feelings acts as a barrier in communication. This is because inability to understand the emotional language of the patients during communication makes the nurses unable to change their nature of interaction to make the patient feel supported to converse further (Bramhall (2014). It is evident from the case of patient A where due to lack of proper expression of feeling and words to share her emotions I was unable to determine the way I require to further execute my communication with her to derive information needed for arranging her care. The fear and anxiety of being judged during communication act as a barrier for the service users to interact with the nurses. This is because patients feel their information would not be valued and they may be mocked by nurses for showcasing their weak feelings and helplessness Bramhall (2014). Thus, patient A may have avoided interacting with me properly by showcasing her feelings as she thought that I may not value her emotions related to her disease.

The high workload acts a barrier to create one-to-one communication as the healthcare professionals face lack of time for one patient to interact properly as they have other tasks to be done simultaneously. It results to create interruptions during interaction and makes the patient feel lack of value as the nurses are unable to focus for a longer time on one patient during interaction as they have to execute other work to control the work pressure (Bramhall (2014). A similar thing has been faced by me while communicating with patient A as I have to attend another call during the interaction as there was staff shortage in the hospital. According to NMC (2015), the nurses require to ensure all the patients are given proper care and no one is neglected under any situation. Thus, I cannot deny the call and has to create an interruption in communication which may have led the patient A to feel lack of value making here to avoid executing proper interaction any further. The fear of judgement of the nurses that they are making the patients distressed by asking question acts as a barrier in communication. This is because the nurse is unable to confidently ask important and difficult question to the patient to be answered required for ensuring their development of proper care plan (Bramhall (2014). Thus, my lack of confidence to ask repeated questions that were required to be answered for ensuring effective development of care plan for the patient acted to negatively influence the interaction. This is because I was unable to derive the information required to develop a well-organised care plan for patient A as seen in the case scenario through the interaction as many important questions related to her care were left unanswered by the patient.

The barriers in communication which has hindered my interaction with patient A can be resolved with proper implementation of communication skills in the future. In order to make patients such as patient A feel valued and ensure they are actively listened by the nurses, acknowledging them during the communication session is to be done. This is because acknowledged during communication leads to informs the communicator that the person is being heard and understood (Bramhall, 2014). Therefore, acknowledging patient A may lead her to feel that even though interruption is occurring but I am paying minute attention to the information for each question she has answered. As mentioned by Bramhall (2014), summarising the information provided by the client helps to inform they have actively listened. This is because summarisation of the key points informed by the client showcase the extent of information being remembered by the listener through active listening which makes the communicator feel valued. Thus, summarisation of the key points of information is to be mentioned to the patients while interacting with them to ensure they feel valued and understand that they are being actively listened.

In order to keep the focus on the patient, they are to be asked open questions about their feelings when information is demanded from them during interaction (Bramhall, 2014). This is because it would lead the nurses to understand the emotions of the patient regarding the questions asked in the interaction. It would help nurses to change the nature of interaction or make changes in the questions asked to ensure no negative emotions affects the client as it would make them avoid further interaction. Therefore, such a step would lead me to understand emotions of the service users like patient A to ensure they remain in proper communication with me to ensure successful interaction. Further, the noisy places are required to be avoided so that the privacy of the patient can be ensured (Ali, 2018). This is because assurance of privacy makes the patients feel free to share information without fear of being abused or harmed that may otherwise occur due to dispersion of their personal information in the public without privacy.

In order to improve interaction with patients such as patient A in future, proper pauses and minimum prompts are to be used. This is because increased prompts and pauses make the patients feel continuously interrupted and less concentrated to deliver information regarding them through the interaction (Bramhall, 2014). In order to ask personal questions to the patients such as patient A in future, it is required to take their consent before asking such queries. This is because it would lead the patients feel they are respected and valued as their consent is given priority before asking personal questions (Ali, 2018). In future, to improve communication with patient reason behind asking certain personal questions are to be informed by the nurses. This is required so that the patient do not avoid replying as they would understand the significance of answering such question through the explained reasons ensuring effective interaction between the patient and the nurse (Bramhall, 2014).

The above discussion informs that patient A faced issues with privacy, noisy environment, interruption and others which led her to avoid executing effective interaction with the nurses. The nurse faced work overload issues, lack of confidence and other as problems to execute effective communication with patient A. In future, to improve communication with the patient the nurse would ensure active listening, value to the patient, acknowledge them during interaction and focus on other factors to ensure effective conversation.

References

• Bramhall, E., 2014. Effective communication skills in nursing practice. Nursing Standard (2014+), 29(14), p.53.
• Ali M., 2018. Communication skills 6: difficult and challenging conversations. Nursing Times; 114 (4), pp.51-53.

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