Reflective account on practice-communication

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NU1503 Principles of Care

Reflective Account on Practice

Word Count 2,188


Elliss, Gates and Kenworthy (2003), state that good communication is fundamental to effective nursing practice.  Communication is defined by Weller (2002) as listening, reading, speaking and writing, and in the healthcare setting these are generally listening and giving information to our patients.  Weller (2002) includes verbal and non-verbal communication in his definition, whilst Becker (1991 p.126) defines non-verbal communication as “those aspects of communication of information between individuals that do not explicitly employ language.”  These include gesture, proximity, facial expression, posture and touching.  A more recent definition is provided by Timby (2009), who explains non-verbal communication is exchanging information without use of words.  She describes how a person has less control over this type of interaction, and includes techniques such as kinesics, paralanguage, proxemics and touch.  This all suggests that communication is a very important yet undervalued element of nursing care and is essential in our lives as nurses.  As part of the healthcare team we need to identify and improve interpersonal skills to efficiently understand our patients’ needs, and to make ourselves understood.  

On placement as a student nurse I observed examples of positive and negative communication skills.  I have utilized a scenario from my experience that reflects on the need for positive communication between patients and the multidisciplinary team.  I chose Gibbs (1988) reflective cycle for the assignment and to satisfy the requirements of the Data Protection Act (1998) and the NMC (2007) Code of conduct, all names and identities in the scenario have been changed.


During handover, I was informed “Betty”, who had a history of dementia, short-term memory loss, deafness, aggression and general deterioration, had been admitted for treatment of a fractured wrist, resulting from a fall at home.  Whilst handover was taking place, Betty wandered over to the nurses’ station looking upset and anxious.  The staff nurse shooed Betty back to her room, shouting “We are too busy here, now go back to bed”.  The nurses’ present exchanged knowing glances, laughing and mimicking Betty’s voice.  I had not previously met Betty so I offered to assist her with her personal hygiene needs and to make her bed.  Betty stood up defensively as I entered the room, so I explained that I had come to help her, but she was irate and said she would like some answers.  I asked Betty what was upsetting her and I would try my best to help.  She explained that she did not know the reason she was in hospital and that she did not know the whereabouts of her nephew (and caregiver).  Reviewing Betty’s care plan I found she had fell whilst living with her nephew John and Sister informed me that John was holiday for a week, so she was unable to return home without a care package in place.  I documented the discussion in Betty’s care plan so that other members of the multi-disciplinary team would acknowledge that Betty was uncertain of the situation she was in.

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More knowledgeable I returned to Betty, pulled a chair up beside her and in a calm and comforting manner I explained the reason she was in hospital, but Betty looked confused and asked me to speak into her right ear as she was deaf.  I patiently repeated the information and she looked brighter as I mentioned her nephew’s name.  Betty had a few more questions and I tried to answer them accurately and confidently as I felt she had the right to know all decisions being made in her interests.  Betty smiled then confided she knows she is forgetful ...

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