Literacy and Communication for Health Care

Communication within nursing practice is often challenging and nurses need to be equipped with concepts and strategies to respond effectively in these situations. Write an essay that analyses communication within nursing practice.

Introduction

Use of the person-centered care framework, the ISBAR and hand-over tool can help the nurses to manage deteriorating patients and their families effectively. Communication is a key skill for the nursing professionals. Communicating with properly with the individuals who are associated with the treatment process facilitates the nurses to execute their activities in a time efficient manner (Riley, 2015). In addition, proper communication helps the nursing professionals to explore detailed information about the patients in depth, which, in turn, is effective for better diagnosis. Communicating with patients and their families is especially important for the nurses. Lack of communication with patient can result in complex situations also which are difficult to manage. So, it is necessary for the nursing professionals to have knowledge on communication frameworks to make the information sharing process more effective.
The current research deals with analysis on the challenges nurses face to hand-over patients share information regarding the deteriorating patients, discussion on the possible ways to mitigate those. In this assignment, the proper communication frameworks and tools for the nursing professionals will be identified. The assignment will also include discussion on the issues, and how the framework can be applied in the chosen situation to prevent the issues.

Identification of concept and tools

Communication framework and nursing tool: Identification of right communication frameworks and tools is important for nurses to manage patients. Here, the person centered care framework is used for fostering effective communication among the nurses and the conflict management framework is used for handling conflict among the nursing teams.
The person centered care is an approach that enable the nurses to deal with patients on basis of people, dignity, respect and compassion, co-ordination to deliver support, care and treatment , offering personalized support, care and treatment as well as enabling people to live independently through identification and development of strengths and abilities (Arnold & Boggs, 2015).

         Figure 1: Person centered care in Nursing
                (Source: Ncbi.nlm.nih.gov, 2018)
Use of right tools and techniques, helps the nurses to mitigate the communication gaps with all parties involved with the diagnosis process (Arnold & Boggs, 2015). The person centered communication strategy framework also enables the nurses to mitigate any communication gap with any of the parties involved with the patient and also helps to handle the complex situations effectively. In addition, use of proper communication also helps the nursing professionals to prevent occurrence of complex situations and other issues. 

               Figure 2: Conflict management strategy in Nursing
                              (Source: Riley, 2015,pp-129)
The conflict management framework helps the nurses to solve the difficult situations in formal or informal way on the basis of conflict dimensions and desired outcomes. Using this framework, the nurses can mitigate conflict, either in formal or informal way. In addition, they can involve the other parties also in the conflict management process, if necessary.
ISBAR tool: The ISBAR tool helps the nurses to maintain smooth flow of communication within a multi-disciplinary team (Adams et al. 2017). The ISBAR tool assists the nurses to communicate in five phases:
Identification: This stage deals with identifying who will be communicated and what will be communicated.
Situation: This stage deals with analysis of the current situation and the issues.
Background: In this stage, the nurse assesses the current background. This stage is effective for interpreting the present situation accurately.
Assessment: The problem is identified at this stage. The nurses use the background information to identify the problem.
Recommendation: On basis of the identified issue, the recommendations are identified in this stage.
Analysis on the model indicates that it serves mainly two purposes-disclosures of a information and identification of the issue. Families of the patients need to be informed about every detail of the diagnosis. Use of the ISBAR framework ensures that every detail of the patient is shared with the families (Kourkouta & Papathanasiou, 2014). The framework shows that when an issue takes place, the nurses can analyze it on basis of background information. 
Hand-over tools: Use of hand-over tools helps the nurses to share information regarding the patients in accurate way. A structured hand-over method is effective for the nurses to share information about the patients at the time of shift change and transferring the patients to other facilities (Arnold & Boggs, 2015). The documents like hand-over forms, progress reports can be considered as communication tool for hand-over. Use of face-to-face communication is another effective technique for hand-over as it enables the nurses to clear the doubts regarding the patients immediately.

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Analysis of the chosen scenario

The current scenario indicates that the concerned nurse was not informed about presence of the family members of patient. In addition, the family was not communicated for hours regarding health status of the patient till they arrived the hospital. It made the family members agitated and they reflected their grievances in an aggressive manner while communicating with the nurse. It was evident that the situation was not favorable for the on duty nursing professional. Furthermore, the family of the patient was highly dissatisfied. It was evident that there is need of a well-defined communication framework to handle the situation. 
Effective interpersonal communication is given high importance in nursing as it results in positive patient outcomes. Peplau’s Interpersonal Relations Theory in nursing states that the nurses can develop a positive nurse-client relationship in four phases, namely, orientation, identification, exploitation and resolution. The orientation phase enables the nurse to engage patients with the treatment process whereas in the later three stages the nursing professional ensures that the healthcare professionals and the patients are working together to meet their needs (Adams et al. 2017)). Successful execution of all the stages depends on effective communication between the nurse and the patient parties. However, due to presence of several communication barriers, the nurses may not be able to develop a solid interpersonal relationship with the patients. Lack of support, time or strategies or the staff conflicts are the communication barriers that prevent the healthcare professionals to communicate with the patient and their families effectively. In this case also, lack of communication strategy among the nursing staffs created a communication gap with families of the patients. As a result, the strong interpersonal relation has not been created with such professionals and it led to creation of a conflict with family of the patient.

Application of communication tools

In the chosen scenario, lack of information disclosure and lack of interpersonal relationship created conflicts between the nursing professional and the patient’s family. Use of ISBAR tool can help the nurses to solve issues effectively on basis of situational analysis (Adams et al. 2017). In this case, not informing the family of the patient about her health condition created problem. Lack of communication between two nurses also added to the issue. Use of the hand over tool in this case can help the nursing professionals to disclose the issues with the patient’s health (O'hagan et al. 2014). 
The communication gap between the two nursing professionals generated due to the lack of collaboration and information sharing strategies. Use of the hand over tool will help the nursing professionals to report the error to the higher authority (Sprangers et al.2015). It can be useful to share the key information regarding the patient at the time of shift change. 
Finally, use of person centered care framework helps the nurse to take care of patients in a collaborative manner. It also helps the professionals to resolving communication barriers in a better way. Therefore, it can be stated that application of the person centered care framework, ISBAR and hand-over tool and identification of the communication barriers is able to provide the healthcare professionals with long-term benefits.
 Apart from fostering effective communication, it is also necessary to ensure that the repetition of such mistakes is prevented, and families of the patient are fully satisfied. Use of conflict management framework in this case will help the nursing professionals to solve the issues with family of the patient and obtain their satisfaction.

Conclusion

Analysis on the chosen scenario indicates that there was a communication gap between the two nursing professionals. As an effect of it, a communication gap with the patient’s family has been created. Lack of communication from the side of healthcare professionals made the family members of the patient annoyed.. Use of the person centered care framework, ISBAR and hand-over tool helps the nurses to manage the situation promptly through transparent information sharing. On the contrary, use of conflict management framework helps the nurses to solve issues and earn satisfaction of all the parties involved.

Reference

Adams, A. M. N., Mannix, T., & Harrington, A. (2017). Nurses' communication with families in the intensive care unit–a literature review. Nursing in critical care, 22(2), 70-80.
Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.
Ncbi.nlm.nih.gov (2018). Figure 1, [Health Care Error-Communication Strategies]. - Patient Safety and Quality - NCBI Bookshelf. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK2652/figure/ch35.f1/ [Accessed 22 Mar. 2018].
O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., ... & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355.
Riley, J. B. (2015). Communication in nursing. Elsevier Health Sciences.
Sprangers, S., Dijkstra, K., & Romijn-Luijten, A. (2015). Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides. Clinical interventions in aging, 10, 311.

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