Communication and its application to practice.

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Communication and its application to practice.


The aim of this essay is to describe and analyse a personal incident, involving the inner feelings experienced and the appropriateness of the interactions involved. This will include the appropriate models of communication and also show an awareness and ability to utilise effective communication skills to meet the individuals’ needs. To reflect and be more critical of what happens in practice, to gain greater awareness of strengths and weaknesses and improve upon them to provide a therapeutic relationship in which you can facilitate the discussion of the clients concerns.

Communication can be broken down into two parts, verbal and nonverbal and it is generally accepted that communication is two or more people sending and receiving messages. The use of words, voice, tone and rate of speech are classed as verbal communication, whereas Smith suggests that nonverbal signs of communication are eye contact, facial expressions and posture (Smith 1992). Nonverbal messages such as a smile, widened eyes or an anxious glance, can all be types of powerful nonverbal communication, in a situation of face to face contact, where the use of telephones and other types of electronic media can mean that, vital nonverbal communication is lost. The nurse has the advantage of face-to-face communication and should make full use of the nonverbal techniques (Blazer 2000).

On the human face the eyes are vital in sending messages and often showing feelings, therefore eye contact can portray many messages just by the length of glances and movement of eyelids. Nurses can tell a lot from the eye contact they receive from a patient, often if patients are stressed about their health they will avoid eye contact with the nurse. Bradley & Edinberg (1990) suggest that facial expressions are the most commonly used indicator of nonverbal communication. Difficulties may arise for a nurse when a patient’s facial expressions are not noticed; the danger with this is that people manage to conceal anxieties verbally. However, facial expressions hold the true message and therefore nurses should look more carefully at their patient’s expressions when communicating with them.  

Bradley & Edinberg (1992) state that posture is an area that nurses often overlook, they continue by arguing that posture can communicate a patients emotions, attitude, self-worth and anxiety. Patients with restless hand or foot movements can also be seen to be anxious, nervous or stressed. Sundeen (1998), cited in Balzer (2000), gives a summary of therapeutic communication techniques for nurses. Listening is one of the key nonverbal skills that nurses can use to demonstrate their interest in a patient, and over a period of time it can be used to gain respect and trust. The importance of good communication between health care workers and the patient, should not be under estimated when looking at the overall well being of a patient receiving medical care. The most important factor when two people communicate is to understand and to be understood. It could be suggested that one of the problems found between a patient and a health care worker, is the use of medical jargon, which most patients are unlikely to understand. Following years of study and academic reading, Klein (1979) found that it was understandable, that health care workers sometimes forgot that patients might not understand the medical terminology being used, he goes on to say that It should also be recognised that some patients may find it hard to make themselves understood and this might lead to difficulties when expressing their feelings.

Coles (1990) illustrates how people can emerge from even well intentioned interviews with health care workers still not understanding fully what has been communicated, the problem being that the patient-centeredness is superficial in that the person ends up being told what the professional assumes they need to know. In other words, actual needs are not really dealt with. Patients within a hospital environment might experience feelings of discomfort, they may become anxious about any tests or surgery that might have to be undertaken and it can therefore be suggested that good communication between patient and Health Care Worker is essential for the patent’s well being. Fairburn and Fletcher (1986), Cited in Davies and Fallowfield (1993 p.6), highlight this point when they found that the ability of doctors to communicate information about test results, diagnosis, aetiology, treatment and prognosis was very poor, even in doctors who had previously had training in interviewing skills, where the focus was on electing rather than providing information.  

It is generally accepted that communication through positive body language, could have a beneficial influence on the overall well being of a patient. It could be argued that direct patient communication is a key part of the patients experience and therefore should be addressed as a component part of the patient journey alongside clinical and other considerations. Some recent research from the NHS Learning Zone (1999) shows that patients consistently say that they need good information and clear communication. Health Care Workers may find it difficult to give good information and clear communication to patients in intensive care units (ICUs) as the patient may have an injury that would impede any conversation, or they may find it difficult to receive a communication. Hospital staff can be extremely busy and therefore give the impression that they do not have time to listen to the patients. Some patients in intensive care may feel too ill or too tired to ask appropriate questions. Turnock (1991) suggests that appropriate communication skills must be learned by the nurse in order to identify priorities between the patients’ physical/technical needs and the psychological needs, so that the person’s coping strategies can be enhanced.

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Dimbleby & Burton (1992) suggest that an individuals’ previous experience might affect how a person interoperates interactions that involve communication, either consciously or unconsciously, they go on to say that beliefs, attitudes and prejudice can influence conversations, and an individual could, without realising, reveal their emotional state through facial expressions; anger, disapproval, disgust, irritation, love and understanding are all impressions, which could be seen, just by facial gesture. Some other important factors, which play an important part in contributing to a conversation, are the use of hands, which are particularly important to body language, especially when a person is ...

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