Acute Nursing-Communication Skills Activity

Acute Nursing-Communication Skills Activity
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Introduction
Emotional processes do influence distress pain in patients, where patients are more likely to experience greater pain if they have emotional distress. Nursing communication plays a critical role towards improving quality of care in patients with distress related to pain. Pain can cause for distress where patients find it hard to communicate and cope with the symptoms of pain. Mrs. Stevens is 50 years old experiencing chronic back pain who has been readmitted, with blood pressure of 140/90. Using a PASS self report measure focused on pain on a scale of 0 (never) and 5(always). The patient had reported score of 3, with subscales related to anxiety and avoidance responses. Assistive communication strategies and materials are essential tools to improve nurse- patient communication and interaction. Timing in communication plays a crucial role in pain management in nursing assessment and intervention of pain from patients to nurses and from nurses to clinicians (Jent et al., 2004). Patient-nurse communication helps in effective implementation of evidence –based pain management (Samuels & Fetzer, 2009). This paper highlights on factors that enhance and impede communication with patients experiencing distress related to pain including: time, communication, patients’ psychological wellbeing, patient perception, intervention programs and communication barriers.
Factors influencing communication in patients with distress related to pain
In some cases, patients do not express their displeasure and emotions directly in hospital settings. They rely on indirect cues to send signals about their worries, and psychological distress is positively related to expressing cues, but negatively related with explicit expression of concerns (Uitterhoeve et al., 2009). Essentially, patients who require emotional support rely on cues rather than relay explicit concerns to nurses. Hence, to provide a more holistic healthcare approach, nurses need to understand cues that are not explicitly expressed but are relevant to facilitate patient-nurse communication. An open patient-centred approach to communication helps patients to deal with distress associated with pain (Farin et al., 2013).
Time can be a facilitator and a hindrance to communication, and interacting with patients for longer time typically results to more bonding and engagement, but insufficient time is also a barrier to nursing-patient relationships. According to Hemsley et al (2011), time constrains communication when nurses have a heavy workload and cannot adequately carry out their duties and responsibilities. The authors highlight on one study, where nurses reported that they had inadequate time and this constrained them from interacting fully with patients (Hemsley et al., 2011). According to Kraszewski and McEwen (2010), time facilitates communication with patients, when they can utilize various communication strategies and
Alasad & Ahmad (2005) conducted a study on the experiences of critical care nurses in Jordanian ICUs, whereby communication was seen as important but also involving. Even though, nurses may prefer less interaction while caring for the patients, it is counterproductive as patients with psychologic risk factors tend to focus on the behaviour of caregivers (Farin et al., 2013). According to Alasad & Ahmad (2005), nurses did not have to take a lot of effort in understanding what the patients wanted, as it easier to anticipate the patients’ needs. For patients experiencing pain, it is possible that nurses will prefer feedback or little communication, if the communication process appears overwhelming.
In particular, self- efficacy interaction between patients and clinical practitioners is associated with higher expectations for communication among the health workers (Farin et al., 2013). This also means that patients are more willing to ask questions pertaining to pain, and they also expect greater communicative behaviour from clinical practitioners. Patients typically prefer environment that fosters open communication and encourage interaction (Perry et al., 2013). In other words, perceptions affect patients’ view on the clinicians’ communicative behaviour, and if they have no much expectation on interaction they are less inclined to look at their behaviour (Farin et al., 2013). Even though, the authors focused on physicians as providers, patient-physician interaction mirrors the same pattern.
Nurses act on patient feedback to improve communication and limited communication inhibits familiarity with patients (Hemsley et al., 2012). Essentially, communication is a two- way process involving sending and receiving of information while also fostering trust between the nurse and the patient. There is no single communication strategy that is effective in all cases, but nurses need to respect the confidentiality of patients while also being empathetic and respectful (Juvé-Udina, 2014). Hence, empathetic communication has a positive effect on communication and is an integral component of nursing care delivery as this allows therapeutic relationships to flourish and enables patients to cope better with pain. In any case, patients are dissatisfied with insufficient communication and attention to their emotional well being (Juvé-Udina et al., 2014).
Hence, psychological readiness facilitates nursing-patient communication as patients are more willing to divulge information when they trust nurses. Additionally, improved communication is associated with patient satisfaction and accountability (Radtke, 2013). Nurses should also be aware about the psychological readiness of patients when communicating, awhile also respected their choices. Where possible, nurses can involve the relatives of patients experiencing distress related to pain as this facilitates social support. In any case, nurses are more confident meeting the physical needs of patients, but less certain on about emotional needs. This highlights the need for nurses to manage patient expectations through communication in a non threatening way (JBI, 2011).
Monitoring patient progress while also improving nursing communication helps in assessing patient communication and use of standardized shift reports could improve patent perception about the communication process. According to Radtke (2013), it is possible to improve patient satisfaction on the role of nursing communication through relying on patient surveys. The authors focus on a standardized bedside reporting and this influenced patient perception on nurse communication. There is also improved patient satisfaction when nurses respond to the cues and behaviours during nursing- patient communication (Uitterhoeve et al., 2009). Essentially, monitoring patient satisfaction allows nurses to pinpoint weaknesses in the communication process and reduce the risk of communication breakdown because of low patient satisfaction.
Having a communication/ education intervention tool helps to improve communication between the patient and the nurse. According to Smith et al (2010), patients with breast cancer and experiencing pain have communication barriers that inhibit communication because of barriers and misconception about pain management. Understanding the cultural and social context influences interaction between patients and nurses, and hence nurses should be aware of the role of social and cultural factors in communication (Shattell, 2004). Overall, Smith et al (2010), highlight that by addressing patient misconceptions about pain while focusing on responsible and responsive communication improves patient outcome and how they deal with pain.
According to Radtke (2013), positive patient perception also facilitates nursing communication and the nurse-patient interaction. The interpersonal competence among nurses influences the patient’s perception on whether health care is inclusive in nursing-patient interaction (Shattell, 2004). Patients tend to focus on interpersonal interaction under nursing care where establishing trust and being friendly allows participants to be more receptive of nursing intervention strategies on pain. On the other hand, when patients feel that they are excluded and their feelings are not put into consideration, they have a negative view of the nurse-patient experience (Shattell, 2004).
Factors that hinder communication
Communication is a two- way process and both the nurse and the patient have a role to play, but the patient mostly provides feedback while nurses encourage and facilitate communication. Lack of self confidence in nurses as is one of the factors hindering communication and is related to perceptions about the professional self. When nurses lack self-confidence in their roles in hospital settings, they tend to ignore nurse-patient communi...