essay. This first paragraph should provide the thesis statement in the first sentence and the overview of main
points or brief plan for what will be included in your essay.
Identification of the concepts, communication framework and nursing tools (200 words): Select the
concepts, communication framework and nursing communication tool/s to be applied to the scenario. Explain how
they are relevant to your chosen scenario. Discuss why they are suitable, including the relevant positive or
negative aspects of the concepts, framework and nursing tools that are important considerations for nurses). Write
one paragraph here with the first sentence of the paragraph providing the main point – the concepts and the
communication framework – and their relationship to the scenario. In the rest of the paragraph, discuss their
suitability and their positive and negative aspects for nurses, using evidence from the literature.
Analysis of the Communication Scenario (300 words): Analyse the communication scenario and identify the
nursing concepts and governances that have impacted on the interpersonal communication displayed in the
scenario. Draw upon some literature to support your analysis of the communication scenario. Use two paragraphs
here with each paragraph’s main point relating to a reason why the communication in the scenario is not effective.
The rest of each paragraph will explain and support the main point by referring to the evidence and relating it to
the scenario using examples.
Application of the chosen concepts, communication framework and nursing communication tools (400
words): Discuss how the use of the concepts, framework and tools can improve communication within the chosen
scenario and support your discussion with reference to evidence based literature. Use at least 2 paragraphs here,
with each paragraph’s main point explaining an area of effective communication. The rest of each paragraph will
explain and support the main points by referring to the evidence and relating it to the scenario using examples.
Conclusion (150 words): Briefly restate the case scenario and your chosen nursing concepts, communication
framework and nursing communication tools, and summarise how they were relevant. Summarise the main ways
you applied them to enhance the communication within the chosen scenario. Use one paragraph for this
sentence or two, that rounds out your learning from the assignment.
According to the scenario one, the critically ill patient’s family members are complaining about the miscommunication from healthcare management. The designated nurse of evening shift while introducing her to the family members and providing information about their patient was aggressively confronted by stressed and anxious family members. However, during the handover, the earlier shift’s nurse was not clarifying the information regarding the presence of the family in outside. The present study will discuss the importance of family-centered care and usefulness of effective de-escalation communication skill by critical nurses to manage stressful situation outside of emergency department or intensive care unit (ICU) and to avoid further conflict; also highlights the significance of hand-over communication tool to deliver appropriate patient care to ensure patient safety by understanding and maintaining clinical priorities.
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Identification of the concepts, communication framework and nursing tools:
In this case, the concept of family-centered care (FCC) would be the most applicable approach for outlining, conveyance, and assessment of health care that concentrates on the beneficial association between the patients and healthcare providers. Research demonstrates that including family members in decision-making and giving care to the critically ill patients is a successful approach to fulfill family requirements and lessen stress. The open and objective communication and complete, timely, and accurate information sharing with patient’s family is the effective way to deliver appropriate patient care (Adams et al., 2017; Al?Mutair et al., 2013). The clinical handover is crucial to accomplish the systematic and comprehensive communication of high-quality clinical information and to ensure patient’s safety (Anderson et al., 2015). In the scenario one, the patient’s condition is critical and need to shift to the intensive care unit (ICU). The patient’s family is showing dissatisfaction and aggression regarding the approach of the care delivery. During an emergency, the family members are usually experiencing trauma and stress, which can lead to conflict, shock, fear, and anger. However, miscommunication, perceptions of unfairness regarding treatment and impatient behavior of the family members negatively impact on the nurse-family interaction (Loghmani et al., 2014). It is essential for the nurses to confront these individuals without fighting to stay away from the additionally heightening the contention (Cojoc & Ngui, 2011).
Analysis of the Communication Scenario:
The emergency department is at higher risk of experiencing nonsuccess in communication because of the criticality and analytical characterization of patients’ state, and additionally the alternating and capricious aspects of the care delivery (Klim et al., 2013). In the scenario, the emergency duty nurse just received patient handover from another shift; but, she did not receive any information regarding the presence of the family members. As the critical care environment is found to be disturbed and trident; so handovers had a tendency to be hurried, disrupted and protracted (Bost et al., 2013; Moon et al., 2016). The continuity of clinical information is utmost crucial for the safety of the patients as well as for an effective communication in family-oriented care. In this case, miscommunication is developed due to the inadequate information provided during handovers, the unawareness of nurse impacts the care delivery. Needs should be set to guarantee that the fundamental data is conveyed and comprehended (Eggins & Slade, 2015; Bruton et al., 2016).
Diversions and intrusions contrarily impact handover by creating the loss of data, imprecise handover delivery, and enhancing the period of time required for medical attendants to give handover (Devlin et al., 2014; Holly & Poletick, 2014; Thomson et al., 2017). According to the conceptual and empirical handover literature, psychological factors like occupational stress, fatigue, and time pressure can negatively influence on the handover communication and quality (Birmingham et al., 2015; Richter et al., 2016; Neill, 2011). The family-centered care requires timely, fair, and accurate information because family often feels shattered and helpless due to their inefficiency to manage patient’s outcome, and forbidding family members from decision-making makes additional stress (Shorofi et al., 2016; Olding et al., 2016). Incursions are unforeseen and disturb the delivery of care, although interruptions due to the outside condition or contending duties irrelevant to the present action can lead to incomplete or inaccurate handover communication and concentration by the outside condition or contending duties irrelevant to the present activity (Kim & Hollensbe, 2017; Patton et al., 2017). It has been reported that low quality or ineffectual shift handover can bring about negative outcomes for patients and family-centered delivery of care (Ong et al., 2011; Kerr et al., 2011).
Application of the concepts, communication framework and nursing communication tools:
In this case, encountering the family members who are verbally aggressive and showing grievance must be managed with the assertive and de-escalation communication skill. In order to avoid further conflict effective communication is crucial and which can be accomplished by listening to their complaints and then interacting with family members in a polite yet firm manner; and try them to involve in the problem-solving discussion. Staying calm and focused frequently has a positive impact of relaxing family members as well (MHPEd, G. D. E. 2010; Pich et al., 2011; Spencer & Johnson, 2016). Also, let them feel that their opinion is esteemed and will be utilized to give the best care. This approach will lessen their anxiety enable them to attain self-control certainly. The family-centered care can enhance the communication frequency, which is related to family satisfaction and positive patient outcome. Regular updating by the designated nurse who was assigned to coordinate and share information with the family members regarding the patient’s current condition is vital when they are eagerly waiting outside the ICU or emergency department (ED). Providing psychosocial support to the family members can be achieved through exchanging information regarding the patient care which helps to reduce their anxiety and stress (Almaze & de Beer, 2018; De Beer, & Brysiewicz, 2017; Clay & Parsh, 2016; Hsiao et al., 2017). During handover, the role of collaboration and situational awareness add to the quality of handovers. The verbal face to face handover and documented handover in terms of written or electronic format should include current inpatients, diagnostic test results, medication list, acknowledged and alluded patients due to be evaluated, information to pass on to the accompanying shift, operational issues specifically applicable to clinical care, patients who are precarious or whose clinical status is disintegrating, patients with foreseen issues, to formulate administration designs and assure proper analysis, remarkable duties and their estimated time for accomplishment (Wanigasinghe, 2016; Pascoe et al., 2014; Johnson et al., 2016).
In several studies, emergency nurses agreed that family members are the principal source of information, especially for the critically ill patients as they are unable to take any decision for themselves. The family-centered care allows family members to address their requirement regarding patient’s care and make decisions on behalf of the patient whenever essential (Adams et al., 2014; Coyne, 2015). It has been claimed by reports that lack of information sharing negatively impacts on the family member’s emotion, with vulnerability regarding the patient outcome, fear, and anxiety. An effective communication in a respectful and self-restraint manner and providing precise and convenient information is crucial; as, without exact data, family members feel deprived that possibly influence aggression and dissatisfaction (Wong et al., 2018; van der Klink et al., 2010). Various responsible clinical authorities like National Institute for Health and Care Excellence (NICE) and quality health service standard designed standard guidelines relevant to hand-over to ensure patient safety, also to improve and maintain effective family-centered communication. However, ineffective and incomplete handover can prompt erroneous treatment, detentions in diagnosis, antagonistic patient outcome, family member’s accusation, enhanced healthcare expenses, prolonged hospital stay, and a scope of different impacts (Matic et al., 2011; van Sluisveld et al., 2015; Spooner et al., 2013).
From analyzing the case one scenario, it can be concluded that the families of critical care patients encounter trauma and tension that negatively affects the family’s physical and emotional health, also hinders the family’s competence to bolster the patient. The family-centered patient care emphasizes the significance and effectiveness of family members’ participation in critically ill patient’s care. Critical care nurses play an important role in the implementation of effective communication tool to prompt evaluation of family requirements which not only lessen stress and anxiety of family members but also increase the satisfaction regarding patient care. It is necessary for nurses to stay assertive and use de-escalation skill to manage the aggressive behavior of family members and to overcome the stressful situation. The handover containing all critical and clinical information must be transferred precisely and efficiently in order to ensure patient’s safety and to maintain continuity of patient care.
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