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Physical Observed Assessment

Info: 2454 words (10 pages) Nursing Assignment
Published: 14th Jun 2021

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Any form of interaction is done through communication as a skill. To human interaction it is pivotal. Communication is a process which enables people to relate with those around them and to make concerns and needs know very well indeed. Communication can be verbal and non- verbal.Peate (2005) states that non- verbal communication reinforces a verbally communicated message. Building an important sustaining relationships with a patient, eye contact, smiling, touching, head nodding and leaning forward all these are recommended and have been seen as more helpful in communicating with patients on non-verbal communication. These are the signs and symbols we use, they have powerful impact in interpreting and sharing the meanings of messages.

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Non-judgemental interactions are focused on therapeutic communication, helps settle emotional conflicts and supports heart to heart talks allowing a patient to feel safe and free to share their true feelings, fears, values, hopes and ideas. This can result in healing benefits. According to Crawford et al (2006), communication is central and powerful, it helps not damage a patient’s life. Other important attributes of communication are listening and acknowledgeing.These are also essential because they raise the self –esteem of patients, thereby paving way for a therapeutic relationship.

All details that could identify any person, clinical placement or trust have been changed to protect confidentiality, in line with The Nursing and Midwifery Council (NMC) Code of Professional Conduct, Performance and Ethics (2008) the name used will be Mr. Smith.

This assignment is going to be discussed about a physical observed assessment which was observed during practice at placement. Mr. Smith came in with different medical history problems. The reason why he was admitted in hospital is because he had eye condition two months ago. On assessment, Mr. Smith was coughing, wheezy and dyspnoeic with shallow breathing accompanied by the use of accessory muscles. His hands were clammy. Mr. Smith said that he did not want to be in hospital, was tough and appeared very anxious during assessment.

Touch was the Communication tools which was used to assess him during the period he was admitted in the ward. He could not see the nurse when she was talking to him because of his vision lost. Mr. Smith suffers with an eye condition. This is a condition somewhere the optic nerve is injured next to the idea of where it will opt out. With this kind of condition that Mr. Smith has, when trying to communicate with Mr. Smith you must attempt to be at the similar eye level as him, continually examine to find if he is able to comprehend you or not.so that you will be able to achieve Mr. Smith’s courtesy and to keep his attention during the discussion, the use of touch is vital.

Establishing the health care needs, when a patient is admitted an assessment has to be done. Assessment is one of the greatest vital jobs any qualified workers can agree to. If it is done systematically by using the range of skills that is required, it can show to be most actual and authorising knowledge for everybody anxious. But it requires to be completed appropriately and to the best of your capability.

Before arriving at any decision MDT has work and achieve their set of goals effectively, communication has to take place at all levels across the various discipline.NMC (2008) specifies that nurses should make patients their first concern and treat them with compassion maintaining the individual aspects, NMC (2011) sees communication as an important skill that complements the proficiencies that nurses are required to accomplish.

Mr. Smith’s nurse has made a plan. A plan was a session which lasts 30minutes and allowed me to observe my mentor what she has been doing with Mr. Smith. When someone is sensitive to touch, they are many signs that will indicate. Facial expression, a bite reflex or grinding teeth are most visible when touching someone. The procedure which was used by the nurse reduced the relieves reaction. She started by touching Mr. Smith’s hands then slowly moving them up his arms final on his shoulders, she clarified this was beneficial to the patient, slowly developed the use of being touched.

She then engaged both hands on the side of Mr. Smith’s face slightly and started with the movements. The reason she did this was because she wanted to warm up Mr. Smith’s face muscles. The nurse now provided Mr. Smith some facial languages to attempt and transport out such as sulking, pleasure, irritation, surprise and grief. Furthermore make sure they are agreed out correctly with sufficient of time, as if they are hurried they will not be achieved correctly.

(Timby 2005) indicated that touch is the best potent non-verbal message techinique.It is a caring and calming hint shows the patients that the nurse helps. Remain confident to practice touch in this technique only if there is non –violent to patients. However( Holey and Matthews 2013) stated that touch is a cultural ,some patients prefer that you not touch them except for treatment purpose, Many feel that touch is a medical setting signals that something disagreeable is about to happen. If you feel the patient is friendly, offer a comforting touch when nothing offensive or painful is planned. ( Kowalski 2008) suggest that before touch as a means of giving concern and compassion, defined by seeing the client whether your touch is wanted without consent agreed touching implies a certain understanding and creates power to the one who is touching over the one who is touched.

There are many plans needs to be considered when communicating with a lost vision clients (Mr. Smith). It is vital to make face to face with Mr. Smith when communicating with him, if required, bow or be seated down so you remain on level where he can see you eye to eye and he can also hear your voice. (Timby ,2005) stated that eye to eye communication means eyeing straight into the eye of the other person .Absence of eye interaction has a number of meanings among cultures. Do not speak to him when you are not standing in front of him where cannot see or hear you clearly or do not go missing while cooperating. With Mr. Smith’s condition you have to speak with a tone voice since he has a vision condition.

There signs that can encourage Mr. Smith toward communicate such as touching overall comments and using his title before introduction into general discussions can help Mr. Smith to feel more relaxed to be involved in a discussion. To keep a flowing discussion the healthcare professional are required to use inquiries, encouragements and investigations as required (Stretch, 2006).

During clinical placement mentor investigated the patient, Mr. Smith assisting him by giving him a cup of tea, the nurse asked him if he would like a cup of tea….’Mr. Smith frustrated to say coffee, vocal, keeping a flowing discussion and prompts and inquiries.

The point to which we trust on non- vocal signs for example; face appearance, body actions, or sign, to maintain our verbal production is not regularly fully familiar. The patient who is very unpleasant, or in discomfort might discover these nonverbal signs difficult to produce. The nurse’s duty is to attempt to talk this with Mr. Smith and his family to look at likely choices for avoiding this possible failure in communication.

Where verbal communication is condensed through someone who cannot talk very well or intellectual changes, the non-verbal position can deliver a different and actual main approach of both meaning receiving and giving. There are changed channels in which personal communication can be conserved. Maintaining social communication, this benefits to maintain Mr. Smith’s self-esteem.

Always try to save speaking, Mr. Smith might discover some of the non-verbal movements helpful and many are understood. Use touch carefully, it is clear that Mr. Smith relaxes at comfort as soon as touch is complex even if it a finger on his shoulders. Inspire efforts to communicate and deliver other types of encouragement with Mr. Smith, touch feeling, face to face languages, body posture, space and equal amongst vulnerable and nurse

Barriers such as term practice, phrases, images and knowledge styles have an effect. Semantic obstacles perform a massive part in the program of message from the nurses to the clients or the added method round. Arguments may have a unlike significance even communicating in not in different languages.

Therefore while trying to communicate with Mr. Smith these features must be extremely measured earlier, for example no judge mental. Thompson (2003) stated that a barrier gesture is any action, behavior or physical arrangement that discourages the other person from feeling comfortable, thereby reducing their ability to communicate positively and effectively.

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However Trevithick (2005) suggests that one of the skills which occasionally works to help unlock someone’s barrier gestures is called a mirroring.Mr.Smith use to sit up in bed with his arms locked, if his vision was good mirroring would have been an good idea to him. For example if they are sitting with arms firmly crossed, you do the same for a while that is if their vision is clear, but this would be a disadvantage to him because the vision condition he has. However, the vision is not clear enough you have to talk to them, slowly they begin to unfold your arms, and you may find that they copy your actions and begin visibly to relax especially to those who can see you. It is worth an occasional try, but it needs to be done marginally, and there is no promise that it works.

However active listening can be used as well. Docherty and McCallum (2009) states that ‘Active listening’ ensures that everything that a person is trying to say is fully received and understood by the listeners. This will include trying to comprehend not just what the person is saying with their chosen words, but what some of their underlying thoughts and feelings are that may be taken as much by what they do not say and by their body language, as by the words they use. Trevithick (2005) suggest that ‘Active listening’ is often used by helping professionals to highlight the significance of the movement.

Furthermore Crawford et al (2006) states that sometimes patients just need you to be there, quiet and listening and this can also be achieved using the acronym SOLER.Consequently, a good listener will always pay attention to non-verbal cues too and this encourages the patients to open up giving more information and expressing their concerns. From this it can be deducted that respect is given to a patient’s contribution best when they are listened too.

Active listening has several layers to it, it is only hearing the words which are being spoken by people. It is easier than done, which is why such an importance is laid upon it as a core communication skill. The listening skills we need will vary according to the setting of the tasks. For an example, if you are a nurse you may need to produce vital information about a patient’s symptoms in order to reach a correct opinion. This example illustrate the complication of the listing task. The common subject, however, the type of question that can be used in active listening.

There are grouped together into two categories which is Open questions and closed questions.Open questions are used when you want to help someone to ‘open up’ about themselves, or to give you some insights into how they feeling or to explore a situation in more depth. When Mr. Smith has been assessed by the nurse on the time he came in hospital. She asked him with her manner voice and she was speaking slowly in order for the patient to hear her well and clearly. Her tone voice overwhelmed Mr. Smith and he then explained his situation to the nurse more deeply, so this helped the nurse to get more information from her patient because he was talking about the topic to the nurse. Open questions do not allow a straightforward ‘yes’ or ‘no’ response, but it will invite the patients to talk about the topic like what Mr. Smith did to my mentor.

Not everyone will feel able to open up’ easily and share their deep thoughts and feelings. Some people needs to go step by step and to be led by interviewer until they gain confidence to go deeper. This is why closed questions also have an important role to play. Closed questions invite a straightforward ‘yes’ or ‘no’ answer, they are necessary in gathering factual information in as straightforward a way as possible.

This questions can give a message to the interviewee that you are in charge, know what you are doing and where you are going, and that they can put their confidence in you. In this case it is not that open questions are good and closed questions are bad, it is a gross magnification. Each of these two has it ‘s own part to play in a well-balanced effective interview, and it is up to you to judge which will be most suitable and real as the interview explains.


However, communication is certainly a principle commanding for the real caring. Performance and communication of caring and capability at this time have a main effect on the ability of patients and relations to adjust the update, reflect choices, and adjust to anything deceptions forward. If the update is depressed the right touch, appearance, and compassionate kind terms constantly displays a change.

The main ideas that have been debated in this assignment are that of the significance of communicating in nursing and how nurses can progress their communication skills and keep their competence. We must deliver complete care for our patients and the objective is to listen to the person and offer them with concerned understanding.


Lee Thayer, (2011). COMMUNICATION A Pocket Oracle for Leaders. 1st ed. Xlibris Corporation: e.g. Houghton Mifflin.

Nursing and midwifery council.(2011).guidance on professional conduct for nursing and midwifery students. Retrieved from http://www.nmc-uk.org

Timby, B. K. (2005). Fundamental nursing skills and concepts. (9th ed). London, United Kingdom: Williams & Wilkins


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