There are very few methods, if any, that exist around the expression of
children’s opinions and voice within healthcare settings including both
clinical and research practice. Many children demand to be heard and would take
comfort in knowing they have a say within their care, which usually is very
limited within professional practice. Traditionally questionnaires, survey
tools, and directed interviews are often centred around adults which creates a
lot of bias results and only reaches to a very small sample of society which
can cause difficulties when generalising to the wider public (Driessnack,
2005). Therefore, it is essential that no matter who a nurse is focusing their
care on, they must ensure that the patient has a say in their care and is involved
at all times to avoid seclusion and isolation.

 

There are many ways in which barriers can be overcome, for example
it is important that when you are conversing with a patient, a nurse should
select the best location that will encourage effective communication. A nurse
should be positive and supportive, especially in times of need, when the
patient may require comfort. They must ensure they are respectful and
empathetic to all circumstances, particularly when a patient may feel
vulnerable. A nurse must be culturally and socially aware with regard to those
who may live by a certain religion or those who may speak a different language,
as well as ensuring that communication is clear, concise, and courteous to
ensure that the patient is provided with all knowledge of their care and are
aware at all times of their treatment (Benbow, 2015-16, p.20-25).

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To conclude communication is essential in nursing to create a stronger
relationship between nurses and patients, it helps to provide a clear understanding
of patient care to those who are on a need to know basis and therefore helps to
provide the best possible care to the service user. It is vital for nurses to
know how to overcome barriers when conversing with a patient to furthermore
ensure effective communication during their time in care.

The 6Cs of nursing were first introduced to the public in March 2016 (NHS
England, N.D.). Originally it launched in December 2012 and it was further
reviewed in March 2014 to see how the values had integrated into the health
care system. This allowed for the current standard of professionalism to be
maintained and modified (NHS England, Health Education England, N.D.). They
were put in place by England’s Chief Nursing Officer, Jane Cummings, (Holt, L.
2001) to ensure that the best possible care is provided to all patients. The
6Cs are defined by the Royal College of Nursing as “standing
for the professional commitment to always deliver excellent care. Each value is
equal, not one is more important than the other. They focus on putting the
person being cared for at the heart of the care they are given” (Royal College
of Nursing, 2015). This shows that each individual principle is as valued as
the other and they should all be applied within a healthcare setting by nurses
to ensure an active quality of care. This essay will explore communication and aims
to assess the use of different communication methods within nursing. It will begin
by outlining what it is, how we communicate and the different types of
communication nurses use within the work place. This will all be discussed
before further reviewing the different barriers nurses may face when
communicating with their patients.

 

Communication is key when imparting information to another person. When
talking to another person, a nurse must ensure that they are being attentive,
listening and responding in a way that will make the service user feel
significant. Poor communication can cause damage to a nurse-patient
relationship, so it is vital that no matter how they are communicating, they
should always make the individual feel paramount. There are many key aspects
that a nurse should promote when conversing with a patient, for example it is
important not only for the nurse to listen to their patient but to actually
hear what they are saying. Nurses must ensure their patients feel that what
they have to say is imperative by proving that they are listening and
responding to them. There are several ways in which nurses can enhance the way
they communicate with patients, for example, using non-verbal communication
effectively through the use of body language and facial expressions, and using
clear speech in everyday language to ensure the patient understands what is
going on with their care and treatment (Field&Smith, 2011, p.41-43).

 

Communication can include anything from the use of language, observing
actions, as well as listening to another person to express any thoughts or
feelings (Field&Smith, 2011, p.41-43). It is important that no matter what
the scenario, a nurse should always make the user feel valued. Nurses must
always give their undivided attention to their patients during the
communication process and should ensure that when they are communicating
verbally they speak in a clear and honest way that is respectful to the client
(Royal College of Nursing, 2015). Patients may be able to sense when a nurse is
feeling impatient by listening to the tone of their voice; this may cause them
to hold back any concerns they may have which can further cause apprehension to
the service user, therefore it is essential that when a nurse is communicating
with their patient that they give them the  time they need and stay calm to allow the
patient to open up when they have any questions, furthermore, this will help to
build a stronger relationship between the patient and the nurse.

 

Effective
communication is imperative when understanding a patient and their experiences;
it entails different skills in conjunction with genuine intention from the
nurse to recognise what the patient is troubled about. It is essential for a
nurse to convey to their patient that their worries are acceptable and to be
concerned is an appropriate response to the situation. There must not be
judgement towards the patient’s anxieties as it will lead to isolation within
their care (Kourkouta & Papathanasiou, 2014).

 

Nurses communicate through what Shannon and Weaver (1949) describe as
the communication process, within this process there is a sender, the message,
the channel and the receiver (Benbow, 2015-16, p.20-25). This piece
of work is still widely used across nursing as a starting point when trying to
understand the communication process. In this scenario, the sender is the nurse
and the receiver is the patient. The nurse is responsible for initiating the
communication with the patient, this could be anything from an individual, a
group or an organisation. The nurse is the initial source to the process and is
“responsible for the success of the message” (Benbow, 2015-16,
p.20-25). In order to add meaning to the message the nurse must encode
information into a message to represent ideas and concepts, this can be done
through the use of symbols. Such symbols include languages, words or gestures.
It is essential that the nurse utilises symbols that are suited to the
patient’s needs, this will allow a clear understanding of the message that is
being conveyed. The channel is how the nurse decides to transmit the message to
the patient, this could be anything from verbal, non-verbal, tactile or written
communication methods. Finally, the patient. After the nurse has chosen the
appropriate channel the message will go through what is known as the decoding
stage. Once the message has been received the information is sent to the brain
for interpretation in order to apply meaning to the message provided. “All
interpretations by the receiver are influenced by their experiences, attitudes,
knowledge, skills, perceptions and culture” (Sherman, 1994; Foulger, 2004)

 

There is no perfect communication between
anyone at any time, there will always be a barrier that intrudes with
communication; the message that is being expressed may either not reach the receiver,
be misunderstood or be misinterpreted (Benbow&Jordon, 2015-16, p.20-25). Examples
of how this may occur includes negative messages via the use of body language
for example slouching, drooping your head or avoiding eye contact when
conversing with an individual, these are all known as negative non-verbal barriers.
If a nurse was to speak too quickly this may make a patient feel that their
care is being rushed and isn’t a priority, or if they speak too slowly, this
may give off the impression that the nurse is patronising the patient and this
may cause frustrations, these are otherwise known as linguistic barriers. If
there are language barriers between a nurse and a patient it may cause
difficulty within their care, the nurse may be restricted to the care they can
provide as they may not understand their language, for example if a nurse spoke
a different language to the patient it could prevent them from understanding
the care they need to provide which could furthermore lead to mistreatment of
care, this is commonly known as cultural barriers (Benbow, 2015-16,
p.20-25).

 

Non-Verbal communication is the process by which individuals portray
emotion through the use of body and voice (Field, 2011, p41-43). To
practice in non-verbal communication, a nurse must focus on how they portray
their message, for example through tone of voice, facial expressions and body
language (Field, 2011, p41-43). For non-verbal communication it is common for patients to misinterpret
body language, for example if a nurse is slouching they may come across as
uninterested and that could lead to the patient believing that the nurse isn’t
being attentive, this could cause disruption to the patient’s care, therefore
leading to an unsatisfied service user. To prevent this from becoming an issue,
when the nurse is communicating with their patient it is essential to not only
express an interest verbally but to focus on their non-verbal skills such as
sitting up and being alert to show enthusiasm to the conversation. 

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