Factors for Communication in Nursing

Communication is paramount in nursing as it plays an essential part of the nursing practice, with significant meaning (NMC, 2008). Good communication is used from nurses to obtain trust and to gain more understanding of the Service User (SU) and is important for nursing assessment and for good implementation of care plan (Wright & McKeown, 2018). In order to achieve the goal of promoting speedy recovery of the SU, effective communication is used to build a good rapport between nurses and the SU (Wright & McKeown, 2018). This assignment will discuss the different ways of non-verbal and verbal communication skills in nursing, and the benefit of, and why it is vital to communicate effectively within the healthcare setting and how this can be use in the future practice. 

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In order to communicate effectively, one will have to understand the need of communication and the importance of communicating, from verbal or non-verbal ways of communication (McCarthy, B, 2017).  Every individual has their own way of communicating, upbringing, personality and our beliefs differentiate one person to the others (Wright & McKeown, 2018; Lorié et al., 2017; Norouzinia et al., 2016). This enables individuals to shape their identity, to deal in certain situations, to engage with each other’s and to share feelings and opinion (Norouzinia et al., 2016). For example, individual beliefs and life lessons will shape the way one will cope and assimilate their feelings from such a trauma as death (Wright & McKeown, 2018; Norouzinia et al., 2016). Lorié et al. (2017) emphasises that for some the more passive or introverted an individual will tend to have a different way of communicating these feelings compared to those more outgoing and extrovert. Verbal communication combined with the physical demeanor are considered as the most important (British Medical Association, 2012).

Communication skills is paramount in nursing when dealing with different aspect of SU’s life (Wright & McKeown, 2018; NMC, 2019).  Purnell (2018) suggests that it is mostly imperative for nurses to develop effective communication skills. As nurses will have contact with a various range of individuals while delivering care; this includes the SU and their relatives, as well as, members of the multi-Disciplinary team (Gharaveis, 2018; NMC 2008).

Purnell (2018) describes communication in two parts; a verbal and a non-verbal communication. Verbal communication is linked with speech and generally heard through the person’s ears. For example, speech, inflection, pitch and volume can be related with verbal communication changing the word meaning. Lorié et al. (2017) highlighted that different cultures can find spoken language to be difficult to understand as paraverbal cues can be different from one culture to the other (Ali & Watson, 2018). Though, paraverbal cues for example, a happy friendly smile or crying with grief can be associated with diverse cultures and may help with a cultural barrier. Wright and McKeown (2018) demonstrates that the approach in which a nurse communicates and the tone of voice can be more supportive to a SU. However, a SU may also misunderstand by the tone of voice as being demeaning in resulting the SU to become frightened. Therefore, nurses should be compassionate by recognising how the SU feels, be empathetic in order to enhance delivering of care (NMC, 2019). Chan and Lai (2016) also support the argument by stated that nurse should always use words by making sure that SU will understand so that not to be confused whilst using medical jargon.

According to Norouzinia et al. (2016), there are different barriers that can prevent a nurse from communicating effectively that can impact on the development of a therapeutic relationship, and delivery of care effectively. For example, physical barriers can possibly consist of the surrounding environment, a SU with psychological barriers may consist of the emotional needs, such as personality or anxiety issues; someone being introvert or have different beliefs and social barriers may be resulted if a person feels that their own social status is characterized by hierarchy, culture beliefs or religious (Chan & Lai, 2016).  Hence, nurses should not judge SU by making assumption about the SU; they should respect SU’s fundamental values, culture, beliefs as well as the individual means of communication (British Local Association, 2018); in order to use communication skills effectively such as verbal and non-verbal communication (NMC, 2019).

Research demonstrates that using non-verbal communication in nursing can be as good as using verbal communication (Lorié et al., 2017). For example, touch is a form of non-verbal communication skills in nursing; it is an automatic reaction as a way of showing care and compassionate when delivery of care to someone who is upset or to hospitalized older adult, cognitively impaired and institutionalized (Pedrazza et al., 2017). Therefore, by using the non-verbal communication such as, the correct use of touch has the possible to significantly increase the health status of some SU, and improve comfort and communication amongst terminally ill elderly and their close relative (Bush, 2001).

Bush (2001) states that touching is not inhibit however works on a variety of stages. Not every SU will feel at ease with closeness and their personal space is being invading upon as some SU with communication difficulties touch will be an approach of showing them appreciation for the care that is delivered to them (Pedrazza et al., 2018). Although, in some cultural and religious belief touching and eye contact are unacceptable within the principles of the society, it can class as an act of adultery (Norouzinia et al., 2016). 

Wright and McKeown (2018) also demonstrates that good eyes contact while engaging with SU helps build good rapport, it shows that they are being listened to, as no good eye contact when engaging with SU can be classed as a lack of interest, attention or trustworthiness while delivering care (NMC, 2019).  Good communication skills are vital in Nursing (NMC,2019), through verbal and non-verbal communication skills it enable nurses to get to know the SU and understand them in order to help manage any barriers, by showing interest personally it enables nurses as well to build rapport the SU and their close relatives (Chan & Lai, 2016). Listening and attending to the SU, sharing experiences, engaging in conversation, and showing good body language enable communication more active and enjoyable (Bush, 2001). Wright and McKeown (2018) emphasized smallest gesture such as offering SU a cup of tea when a SU is upset can build on good relationship. Wittenberg et al. (2017) supported the argument stated that in nursing none verbal communication such as smiling can also generate an intimate atmosphere of SUs, and enable SUs and their relative feel relieve. For example, smiling to the SUs in the morning by greeting them with good morning it enables nurses to gain trust, confidence and enables SU to overcome their disease (Boles & Baddley, 2018).

Boles & Baddley (2018) highlighted that nurses communicate with SU must be smiling, as it gives a kind and warm feeling, though as well closing the sense of distance amongst SUs to nurses. Non-verbal communication skills such as body language is a step forward to verbal communication (Chan & Lai, 2016). The non-verbal expression is essential, body language translate to individual in a relationship through movements, gestures, posture or gestures touch to transfer information, express attitudes and feelings as a means of communication (Bush, 2001). Wright and McKeown (2018) states that nurses by the use of non-verbal communication, body language in the correct use can increase SU trust, help to language (Bush, 2001). SU with high fever for example, in asking about their condition, though touching their forehead to better reflect the worries of SUs, kind of emotion, reduce SU and their family anxiety (Pedrazza et al., 2018).

Nurses will come across many barriers that may affect communication mainly when working with physically impaired people, elderly and mentally. (Bush, 2001). Pedrazza et al. (2018) indicates that an individual who is suffering from pain may find it hard to communicate and nurses should assess and made use of effective communication skills to communicate with them (Pedrazza et al., 2018). A person’s environment or surrounding can as well have an impact on the way they communicate. Children may often feel shy of new faces or in unfamiliar surroundings; and this can apply to an adult as well; to be in an unknown surrounding it can intimidate and scare someone (Wright & McKeown, 2018).

On the other hand, Gharaveis et al. (2018) states that nurses also will come across barrier to communication. Nurses sometime have to ask very personal question to individual that they just met, which can also make them feel uncomfortable even though engaging to health professional (Wright & McKeown, 2018). This can also cause a barrier until they fully open up knowing the individual and building some connection with the SU (Chan & Lai, 2016).

Ali and Watson (2018) stated that nurses should also be aware of barrier to communication such as, a SU admitted to hospital will feels secure as they are looked after by health professional and may feel shy to open up. Therefore, it is essential for the SU to be made aware of that as it is a release of trust and security (Ali & Watson, 2018). Nurses should empower the SU by communicate effectively with them, being able to build a rapport with the SU helps make communication easier whilst delivering care effectively (NMC, 2019).

Wittenberg et al. (2017) highlighted that sometimes nursing duties can be stressful which can affect communication skills such as, shortage of staff on the ward or poor management; all of these have an impact on the way nurses will deliver care and uses verbal and non-verbal to the SU. Wright and McKeown (2018) maintains that this type of barrier unable the listening practice to take place as nurse may feel under pressure to have time to sit down and listen to their SU that can resulting of SU feel neglect which may impact on the delivering of care of the SU (Chan & Lai, 2016). Furthermore, Moreland and Apker (2018) demonstrates that working under pressure, being anxious and stressed and focusing on other task rather than showing empathy and warmth towards the SU can also resulting SU to be kept to themselves and hindering valid information which could impact on delivery of care (NMC, 2019).

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Reflecting on the assignments the author identified that active listening skills are important in most therapeutic relationship and nurses’ requirement is to explore how to use communication skills effectively; verbal and non-verbal to improve the relationship (Purnell, 2018). The nurse-SU relationship is a session of communications amongst the nurse and the SU in which the nurse will assists the SU to achieve a positive communicative change (Chan & Lai, 2016). The skills of open questioning, active listening, and reflection enhance better communication and evidence recommends the need for nurses and other multi-disciplinary team to improve their communication skills in order that they can simplify the method of communication with the SU (Wright & McKeown, 2018).

Communication skills play an important role in the nurse and SU relationship in the delivery of SU-focused care (NMC, 2019). It is by focusing on positive ways successfully and effective communication to ensure a good nursing outcome. It is essential to establish a rapport with SU to encourage them to participate in the exchange both verbally and non-verbally and to identify any communication barriers (Ali & Watson, 2018). In future practice an action plan of the SU’s specific needs will be arranged to ensure effective communication skills are use to the best delivering of care.

Active learning may also help to recognise the existence of barriers to communication when engaging with SUs. Active learning is listening without making any judgements; listen to SUs’ concerns or complaints as this gives nurses the opportunity to see the SUs’ perspective (Wright & McKeown, 2018; NMC, 2019). Though, it is crucial to ignore barriers that transpire in communication with the SUs and being able to identify language barriers (Pedrazza et al., 2018). This is eliminated by questioning SUs about their health and by asking them if they require any help with their everyday activities (Bush, 2001).

Another essential factor to embrace is an action plan so to take into account any disabilities SUs may have. For example, visual impairment, poor hearing or mental disability (Pedrazza et al., 2018). This can empower the SU with some control by allowing them to make the best use of body language which will enable nurses to deliver care accordingly to patient needs (NMC, 2019).

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