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The primary search strategy for this literature review involved a search of the Scopus electronic journal database. Key words in the search included roles of nurses in communication. Additionally the phrase ensure effective was included. Articles were sorted using the relevance function. Despite a large number of initial results after removing articles not relevant to the topic and those considered too old to be included in contemporary literature review the number reduced to 100 articles. After reviewing abstracts for these articles a total of 10 studies were deemed to be appropriate in terms of study question, methodology and setting and were included in my review.
Introduction
Communication is a key aspect of daily living, with that it is required to be of paramount importance to nurses in the healthcare setting to have a clear understanding of ways to ensure effective communication with patients, families and other healthcare providers without barriers.
Throughout my research I have noted that everyone has a different perception, attitude, experience and perspective of communication. The aims of this paper is to discover how nursing professionals perceive the communication during clinical handover, explore differences between care staff in mental health facilities, nursing homes, and care homes with regard to knowledge about palliative care, time pressure, and self-efficacy in end-of-life communication, as well as aiming to identify determinants of high self-efficacy in end-of-life communication.
Furthermore, talk about how nurses fell underprepared when caring and communicating with people with a disability, review the literature examining the experiences and perspectives of General Practice nurses (GPN) regarding communication with patients about lifestyle risk factors and also explore how patient participation in nursing shift-to-shift bedside handover can be enacted.
Definition
Communication is a process, act, means and transfer of verbal or written message from a sender to a receiver. Nurses can be found almost everywhere in healthcare facilities because they are in the front-lines of patient care. Hence nurses act as a hub of communication, relaying and interpreting information between physicians, families and patients.
I have chosen communication as my issue because I work as a disability nurse in the community. When I used to work as disability carer and accompany my clients to clinics or hospitals, the nurses did not seem to be able to communicate effectively as they would shout or just look at me to communicate for them. At first I was understanding towards them as they were complex patients but as we became more frequent visitors of the same facilities, I expected them to have an inquiline of how to communicate with their patient.
During my placements I have noted that most nurses need to explore the concept of cultural sensitive communication as Melbourne is a multi-cultural state. Judging someone by the way they look, is not an identifier of their cultural background and may make someone uncomfortable with the nurse. Supportive communication strategies need to be implemented to create a sense of familiarity, respect, acceptance, understanding and safety for our patients.
Overview
Lewis, Gaffney & Wilson, (2017) employed a narrative literature review using electronic database searches was conducted using variants of the terms disability, nursing and acute care in the UK, Canada, Australia and Netherlands. Registered nurses (N=267) each acute care setting were asked to describe their experiences and answer research questions related to caring for patients with disabilities. The sample was drawn from main stream acute care settings in the named countries. The results demonstrated nurses were underprepared when caring for patients with disabilities, experienced challenges with communication and have ambiguous expectations of paid and unpaid caregivers. This study adds weight to the argument of this paper that nurses require strategies to communicate with patients with disabilities.
Jones, M Johnstone, (2019) used a qualitative exploratory descriptive approach with 71 registered nurses from emergency department, critical care, perioperative, rehabilitation, transitional care and neurosciences settings in Australia. Research method informed the works of (Patton, 2002), and (Sandelowski, 2002), which analyse using content and thematic analysis strategies. The techniques used were face-to-face (n=15), telephone (n=46) and email (n=10) interviewing. The questions asked specifically focused on definition, understanding, best and worst experiences, managing and personal life experiences that have influenced the discontinued communication (gap). Findings from the participants were, failure to communicate information required during handover and proper documentation made planning and delivery of care safely limited. This study provided a narrow spectrum of experiences and views of nurses while communicating with disabled patients, the sampling methodology and finite geographical sample made generalising the findings to the larger global nursing cohort difficult.
Cooper et el (2014). Conducted a descriptive survey with 111 nurses employed at two general hospitals in UK to investigate the nurses training and experience while communicating with patients and families during palliative and end of life care. The questionnaire mainly focused on nurses level of confidence, assessments tools relevant and level of trained provided. The findings were that nurses were generally confident managing symptoms, had less training and lacked formal assessment tools. Even though this study has given limited evidence of how to communicate during end of life care, the methodology was also limited to the UK which makes generalising it to the rest of the world nursing community hard.
Discussion
From the literature of Puckeridge, Terblanche & Massey, (2017) improving outcomes and achieving key performance indicators for all elderly patients who undergo surgery through effective collaboration and regular communication between a broad group of key clinical stakeholders. Results of the quality improvement project has seen a percentage of patients receiving surgery within 2 days rise from 85% to 96% and discharge to their place of residence improve from 20% to 54%. Detection of delirium rose from 22% to 34% over the reporting period enabling rapid management. This data reflects improvement to clinical documentation and appropriate communication from nurses to patients.
Student nurses require training on how to communicate safely and assertively in a clinical practice as this ensures that the student can conduct their learning in a professional manner. As a student myself I have learnt the types of tones to use in different circumstances during clinical practice e.g. during one of my placements I attended a session on how to communicate to people with Parkinsons disease. It was very confronting for me as the tone they used seemed harsh to me. Half way through it I understood the ideology behind the tone, it was a firm way get the message across to the patient as their receptors needed one to take charge and tell them exactly what to do, they informed us on how to use clear, firm and short sentences. This new model had a 90% success rate which showed that once a nurse is clear and precise the patient is able to compile. Words like Two steps forward and stop (pause) and stand straight giving on command a time.
From the literature of Omura, Levette-Jones & stone, (2019) has done an evidence-based assertive communication workshop for student nurses. The research attests to the relationship between assertive communication and patient safety. The paper
Conclusion
Given the compelling research of the importance of clear, assertive, detailed and accurate communication in healthcare. The literature provided and my opinion on communication and how to it relayed from one person to another. Nurses need supportive strategies for developing therapeutic relationships, support continuing investment in assertiveness communication training programmes for nursing students, strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the process,
References
- Lewis, Peter, Gaffney, Ryan J, & Wilson, Nathan J. (2017). A narrative review of acute care nurses experiences nursing patients with intellectual disability: Underprepared, communication barriers and ambiguity about the role of caregivers. Journal of Clinical Nursing., 26(11-12), 1473-1484.
- Omura, Mieko, LevettJones, Tracy, & Stone, Teresa E. (2019). Design and evaluation of an assertiveness communication training programme for nursing students. Journal of Clinical Nursing., 28(9-10), 1990-1998.
- James, Sharon, Halcomb, Elizabeth, Desborough, Jane, & McInnes, Susan. (2019). Lifestyle risk communication by general practice nurses: An integrative literature review. Collegian: Journal of the Royal College of Nursing, Australia. 26(1), 183-193.
- Tobiano, Georgia, Bucknall, Tracey, Sladdin, Ishtar, Whitty, Jennifer A, & Chaboyer, Wendy. (2018). Patient participation in nursing bedside handover: A systematic mixed-methods review. International Journal of Nursing Studies., 77, 243-258.
- Jones, Angela, & Johnstone, Megan-Jane. (2019). Managing gaps in the continuity of nursing care to enhance patient safety. Collegian : Journal of the Royal College of Nursing, Australia., 26(1), 151-157.
- Fossum, Mariann, Hewitt, Nicky, Weir-Phyland, Janet, Keogh, Martin, Stuart, Joshua, Fallon, Kethly, & Bucknall, Tracey. (2019). Providing timely quality care after-hours: Perceptions of a hospital model of care. Collegian : Journal of the Royal College of Nursing, Australia., 26(1), 16-21.
- Tobiano, Georgia, Bucknall, Tracey, Sladdin, Ishtar, Whitty, Jennifer A, & Chaboyer, Wendy. (2019). Reprint of: Patient participation in nursing bedside handover: A systematic mixed-methods review. International Journal of Nursing Studies. 97, 63-77.
- Manias, Elizabeth, Geddes, Fiona, Watson, Bernadette, Jones, Dorothy, & Della, Phillip. (2016). Perspectives of clinical handover processes: A multi-site survey across different health professionals. Journal of Clinical Nursing., 25(1-2), 80-91.
- Puckeridge, Gillian, Terblanche, Morné, & Massey, Debbie. (2017). The SCHHS hip fracture clinical network experienceImproving care and outcomes through an interprofessional approach. International Journal of Orthopaedic and Trauma Nursing., 26, 24-29.
- Spooner, Amy J, Booth, Natasha, Downer, Tai-Rae, Gordon, Louisa, Hudson, Adrienne P, Bradford, Natalie K, . . . Chan, Raymond J. (2019). Advanced practice profiles and work activities of nurse navigators: An early-stage evaluation. Collegian: Journal of the Royal College of Nursing, Australia.
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