The importance of effective communication between doctors and nurses and its impact on patient careCritical Analysis of a Clinical Incident.

Authors Avatar by sih10unibrightonacuk (student)

The importance of effective communication between doctors and nurses and its impact on patient care; Inter-professional learning from a student nurse’s perspective

        Critical Analysis of a Clinical Incident

As student nurses, throughout this nursing course, we have continuously been reminded of the numerous issues in healthcare; some ongoing and some more current. Members of the multidisciplinary team are encouraged and expected to work together and overcome these issues so they can provide patients with the care they need. Therefore, the need for Inter-professional learning (IPL) is ongoing.
Considering the limited word count allowed for this assignment, I will be reflecting on a clinical incident (see Appendix I) that took place on a cardiology ward where I worked as a third year student nurse. Although this clinical incident arises various problems that could be classed as current issues in healthcare, for the purpose of this assignment I have decided to focus on the issue of communication between nurses and doctors in the clinical setting and its’ impact on patient’s care. This assignment offers definitions on effective communication and inter-professional learning as well as it outlines certain barriers that can prevent effective communication. Gibbs’ reflective cycle (1988) is used throughout the assignment to encourage a natural flow of events and to aid a comprehensive reflection (Gibbs, 1988).

‘Information is fundamental to choice and making informed decisions. Without information, there is no choice. Information helps knowledge and understanding. It gives patients the power and confidence to engage as partners with their health service.’
                                          (Department of Health, 2004, p.2 as cited in Berry, 2007)

Communication is the way in which information is shared with others. Northouse and Northouse (1998) define communication as the transfer of information between a source and one or more receivers using a set of common rules (Berry, 2007). Berry (2007), states that communication can be verbal and non-verbal; therefore we as human beings communicate with each other even when we are not saying anything. Mc Hugh Schuster (2010) claims that: ‘communication is the use of words and behaviours to construct, send and interpret messages’. Ellis et al. (2003) state that communication is a basic human need and according to them, lack of communication can have adverse consequences on one's psychological, social and physical health (Ellis et al, 2003). Inter-professional learning (IPL) can be described as the process where two or more professionals who share a common subject, work together whilst understanding and respecting each other’s roles (Cullen et al., 2003).

As a student nurse, I consider ward round to be an excellent inter-professional learning opportunity. In my experience, this is one of the rare occasions when the medical and the nursing team, physiotherapists, pharmacists, nursing and medical student are confined to one area and expected to collaborate jointly. Zwarenstein and Bryant (2000) define collaboration as nurses and doctors working together and sharing patients’ care responsibility. They claim that for collaboration to be successful, decision making has to be joint (Zwarenstein and Bryant, 2000). However, Barnsteiner et al. (2007) claim that collaboration is much more complex than that and requires mutual commitment and mutual respect among collaborators, including face to face encounters as well as telephone and e-mail communication. Furthermore, they present evidence that doctors and nurses may define teamwork and collaboration differently; whilst nurses often describe collaboration as including shared decision making, some doctors describe it as having their directions followed and their needs anticipated (Barnsteiner et al., 2007). The nursing and midwifery code of conduct (2008) state that nurses should work co-operatively with others while respecting their knowledge, experience and contribution (Nursing and Midwifery Code of Conduct, 2008).

Reflecting back on the clinical incident (Appendix I), it was obvious that communication between the medical team, the nursing team and the patient had not been effective; the doctor had ignored the concerns raised by the nursing team on the previous day and had not read the notes properly, nor briefed his team beforehand as he had agreed to.

‘Listening is as important as what we say and do and essential for "no decision about me without me". Communication is the key to a good workplace with benefits for those in our care and staff alike.

                                                                                        (Department of Health, 2013)

This quote was coined by the Department of Health in the aftermath of the Mid-Staffordshire report (Francis, 2013). Communication is one of the 6Cs, alongside care, compassion, competence, courage and commitment, which the government has used to reinforce the values and beliefs that should underpin all nursing care                       (Department of Health, 2013).

Despite the excellent nursing care Patient X had received on the ward, the doctor’s oversight had left the whole team appear unprofessional in front of the patient. As she later pointed out to her nurse, she had begun to doubt the doctors’ expertise because they had missed out such vital informations about her on two consecutive occasions.
Nurses are in a unique position within a healthcare environment, and are often the first point of contact for patients (Sheldon et al., 2006). Nurses spend a large amount of time communicating with patients, often not only conveying information but also conveying emotion, and transmitting a reaction to a patient that shows them that their feelings are being recognised (McCabe, 2006). For example, by showing empathy towards a patient, a nurse is demonstrating an understanding of their feelings. The nurse looking after Patient X that day spent prolonged periods of time reassuring her patient that she will receive the best care possible during the procedure and after, which seemed to help the patient.

Join now!

As McCabe's (2006) study shows, communication in nursing care is an area that is largely overlooked, often because nurses within a hospital setting will tend to focus on practical tasks involving a patient, and on occasion may feel unable to communicate with patients due to lack of time. However, if the care a patient receives in hospital is to be a positive experience then the care must be more patient-centered. Peplau’s (1988) findings would also appear to support the theory that nursing, is in essence, an interpersonal process. This suggests that nurses need to be able to communicate on a ...

This is a preview of the whole essay