Nursing Communication for Care and Safety

Write a 1200 word essay that analyses the scenario in relation to nursing communication.
 
You are commencing your evening shift as a Registered Nurse in the local emergency department. You have just received patient handover from the morning shift. One of your patients is a woman who has had a fall outside the local supermarket and has sustained a serious head injury. She is presently unconscious and being prepared for transfer to the intensive care unit.  As you approach the family to introduce yourself, you are confronted with a very unhappy and concerned family. One of the family stands really close to you, and in a loud voice says:
“What’s going on?We received a phone call saying Mumhas been taken to hospital and then we are left sitting here for hours with no information from anyone! What is going on?"
In the handover, you did not receive any information informing you that the family were here. 

The patients’ care and safety can be achieved to the fullest if the communication is made on a persistent basis while transferring the information using clinical handovers, through a standardised tool. Effective communication through a systematic tool which creates a memory in human mind, i.e. a mnemonic device, will definitely improve the safety in the process of transferring the information. The information gets transferred from one healthcare practitioner to the other through handovers, which contains the elementals of the patient care along with the flow of work along with the quality of care so far being taken. (Australian Commission on Quality and Safety in Health Care (ACSQHC) ) ensures that the handovers must be improved so that the continuous care is maintained to the patients. In the current scenario no. 1, the clinical handover so provided, do not depict any information regarding the presence of family of the concerned patient. So, it can be well perceived that, the handout lacks the accuracy of the information so transferred.   
Communication is that action which imparts and exchanges the information by various methods which sometimes can be verbal or can also be in writing or can be through the use of any other medium, commonly called as communication tools (Arnold, 2013). The commonly used tool, in the circumstances as depicted under scenario 1, refers to HAND ME AN ISOBAR, which is a mnemonic device, which is used for transferring the information of the patients with the team within a healthcare service provider or with other healthcare workers. In human being there is a prolonged tendency to forget things, so to document the information in systematic way will ensure that the right information get passed through the necessary systems for the sole concern to maintain patient safety and care. So, the communication must be adhered to the documentation process, which will then help in facilitating the communication, followed by the promotion of safety within the healthcare environment, and thereby meeting compliance with the legal standards. In nursing and healthcare industry, effective communication is crucial for safe delivery of care, which helps in minimisation of the risks in the form of harm to the patients and it also helps in encouraging positive outcomes within the organisation along with the reflective practice which gets implanted in the healthcare practitioners (Haynes, 2011).  
As it is evident that, the medical information so passed by the patients to the nurses or any other health practitioners are confidential so, it is essential that a privacy must be maintained in the same spirit as the communication is made effective with the use of right language, i.e. the language the patient speaks. So, there exists the barrier which hinders the effectivity of the communication. In the present scenario, there is lack of understanding between the family of the patient to that of the morning shift staff. This can happen due to the several situations, like previous shift’ s nurse was overworked or there was interference from the family of the patient or may be there was some other patient who were appointed based on emergency. But, if viewed from a patient’s perspective the situation might have worse due to nurse’s reluctance or due to the gender differences. There can be innumerable situations, but, the only things which concerns is that there is barrier, which needs immediate attention. 
In the present scenario, the family of the patient is unaware of the fact, about what is going on with their mother, and it seems that they are not even about the condition or any other relevant information. So, this scenario definitely lacks the good communication between the health care practitioners and the patient or the family of the patient. The scenario also emphasises that, there is so shared decision- making. So, there is lack of understanding and also lack of communication which could have ensured proper and faster symptom reduction. It is often seen that the patients or their family are not well acquainted with the medical terminology, which is quite sane and they prefer a psychosocial model rather than a medical terminology infested communication.  
So, one has to follow an acceptable standard of communication which can then ensure effectiveness of it. But, effective communication starts at the very initiation point when handover is made to the next shift duty staff. It is important that an interdisciplinary teamwork be established within the healthcare settings, so that the outcome which evolved through it proves to be positive in the line of the very aim of the healthcare industry, i.e. the caring the patients. It is quite a normal practice that, within an hospital environment that there will be clinical handovers. The clinical handovers essentially transfer that information which are without any discrepancies and which emboldens the accuracy within it. Again, on the other hand, clinical handovers duly shift the responsibility along with the accountability on the person who is going to be in charge of the patients for the next set of hours. So, lack of any information can prove to be of fatal consequences to the patient concerned. Throughout the whole time in the nursing practice, a nurse does the multi-tasking job, and clinical handover is just a part and parcel of everyday’ s job. As it is well known that nurses are into providing the direct care to the patients, so any lack of information from one shift to another shift will render being crucial and are considered to be having the higher risks due to this gapping of information which stays within. So, a standardised tool if adopted and implemented, then this persistent gap or rather the lack of information can be controlled. (Samara R. Zavalkoff, 2011) highlights that, if an easy to use tool is implemented then the critical information so exchanged do not have any significant effect due to shift handovers. HAND ME AN ISOBAR is the technique if administered can produce the results of safe transfer of information without leaving any gap within it (Debra Kerr, 2016). It is important that the nurses and the patients maintain the good communication so that the desired outcome becomes a success. But for the fullest achievement of the results from the use of clinical handovers, it is important that the patients or the cares are involved into the process, so that they get educated about it and becomes aware of the outcome form it, since not all information can be provided by the clinicians and are available only to the patients or their carers.  
As seen from the present case scenario, that some information was transferred to the next duty shift nurse, and some other was missing. So, if the HAND ME AN ISOBAR technique (Debra Kerr, 2016) for the shift handover can be developed and incorporated, then that will cause the improvement towards a safe practice by providing quality health care, but as it is evident from the current scenario, that a standardised process or the tool was not followed, which ultimately resulted in lack of relevant information. So, an informal process must not be followed, but a standardised and disciplined approach must be implemented so as not to allow any lack of information to sustain and flourish. When the handover tools get structured it ensures that the information so shared are to the point, i.e. relevant and also concise and focussed with the information which is fully accurate.

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References

Arnold, E. C. (2013). Interpersonal relationships: Professional communication skills for nurses. Elsevier Health Sciences.
Australian Commission on Quality and Safety in Health Care (ACSQHC) . (n.d.). Retrieved from https://www.safetyandquality.gov.au/
Debra Kerr, S. K.?M. (2016). Impact of a modified nursing handover model for improving nursing care and documentation in the emergency department: A pre? and post?implementation study. International Jounal of Nursing Practice, 89-97.
Haynes, A. B. (2011). Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention. BMJ quality & safety, 20(1), 102-107.
Samara R. Zavalkoff, e. a. (2011). Handover after pediatric heart surgery: A simple tool improvesinformation exchange. Critical Care Medicine.

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