Discussing the importance of communication in nursing

Discussing the importance of communication in nursing To listen to another person is the most caring act of all. Listening and attending are by far the most important aspects of being a nurse (Burnard 1992). One of the basic elements of nursing is good communication skills with patients. Being unable to communicate well with a patient immediately can destroy the nurse/patient relationship and therefore the patient may not trust the nurse (Anon 2007). The purpose of this essay is to discuss the importance of communication in nursing. Without communication nurses would be unable to provide the correct care, but improving communication is a life-long developmental process (Ewles and Simnett 2005). I will draw upon my personal experience from the clinical area to show how well the theory relates to the practical side of nursing and use the process recording sheet for structure and guidance (Appendix i). In accordance with The Nursing and Midwifery Council (2008) Code of Conduct, nurses must respect peoples right to confidentiality. Therefore for the purpose of this essay I have used a pseudonym and the patient discussed is referred to as Carol Brown and any personal or identifiable information has also been altered so as to protect her privacy and dignity which are also enshrined in the Nursing and Midwifery Council (2008) Code of Conduct. I asked Carol for explicit permission to use our interpersonal relationship in my communications essay and advised her of my obligations on my professional conduct to which I am bound by the Nursing and Midwifery Council (2008), regarding professional, moral and safe practice. Carol was in agreement to be involved with my assignment and on no account was her physical care at risk during this interaction. I was nearing the end of my placement in a general medical ward within a large general hospital. The ward treat a variety of medical complaints including diabetes, gastrointestinal disorders, stroke and alcohol liver disease. A young 36 year old female was admitted to the ward, now known as Carol Brown with an increased weight loss due to non-intentional self-neglect probably caused by her chronic condition although could be deep rooted to family relationships (Day and Leahy-Warren 2008). Carol was awaiting heart surgery, replacement hips and replacement knees at major surgical hospital in another area of the country. Her health status was poor as she suffered from rheumatoid arthritis, psoriasis, and had a congenital heart defect. Carol was in need of pain management, and although it was currently being managed with a variety of powerful painkillers, these proved to have little relief. Carol spent the majority of time in bed due to her severe pain, and due to this she cried out a lo t. I thought that communication would be difficult with Carol as she was mostly in pain but I also believed that she would like someone to talk to but that person would need to be a good listener. It is important to remember that nurses have the duty to provide care holistically, for the whole person, not just for their physical needs but their mental and social needs too (Kenworthy et al. 2002). Carol liked to be washed in her bed every morning as movement for her was difficult. The bay that she was in was busy with little privacy and only the curtains for seclusion. I went into assist her to wash one morning and because of her psoriasis she needed special creams applied routinely. She spoke quietly about her illness and explained her difficulties to me. Her head was bowed and she had difficulty in making eye contact. She talked slowly and quietly and sometimes mumbled, she also appeared quite melancholy at times. Talking about her family, her illness and when she was younger made her sad and she was crying. I think this was cathartic for Carol and it could be that feelings beneath the surface may need uncovered in more detail to enable her to release her emotions (Bulman and Schutz 2008). I felt that Carols ability to communicate was linked to how she felt about herself. She was inclined to judge herself too severely and underestimated her abilities. This self-blame reflect ed her ability to communicate (Ewles and Simnett 2005). She was in so much pain, her head was bowed and she could not make eye contact. I was leaning in close to her bedside, touch was not good, her body was too sore. I tried to show empathy towards Carol by giving her time to talk, being patient and listening to her. This was an example of Egans (2007) Soler theory which is a non-verbal listening method that is used commonly in communication. Was she crying because she was in so much pain or was it because she was recalling happy memories from before she fell ill? I was keen in developing the therapeutic relationship. According to Arnold and Undermann-Boggs (2003), empathy is the ability to be sensitive to and communicate understanding of the patients feelings. Being compassionate is similar to being empathetic in a way that it is important to recognise that Carols feelings belong to her and not to me. I was interested in Carols illness, to learn more about her condition and hear about her difficulties. Getting to know your patient helps to promote dignified care (Nicholson et al. 2010). She was very independent and wanted to do as much as she could by herself. Help was minimal and she only asked when she was struggling to re-position her feet. I used active listening to allow to her speak without interrupting. Active listening is not only the act of hearing but of being able to interpretate any underlying meaning (Arnold and Undermann-Boggs (2003). I paid close attention to her facial expressions and body language and Argyle (1988 p.57) suggests facial expressions provide a running commentary on emotional states. I asked Carol open questions about her illness as I thought this would allow me to encourage her to talk and she responded to this well. Open ended questions are used to elicit the clients thoughts and perspectives without influencing the direction of an acceptable respon se (Arnold and Undermann-Boggs 2003 p.241). It also allowed Carol to describe her experiences, feelings and understandings and I felt this approach was appropriate. I wanted to try and distract her from her pain as I found it difficult to see her being so unhappy, so I commented on some magazines that were lying on her table and asked her about her taste in music. This was a good subject, her eyes lit up and she smiled. We finally made eye contact. Carol and myself were exchanging verbal and non-verbal communication in order to understand each others feelings. According to Kozier (2008) non-verbal communication can include the use of silence, facial expressions, touch and body posture. Carol was keen to talk about her taste in music and became very chatty, in fact, she became somewhat excited. I put some cds on for her to listen to and as I did this she asked me questions about my taste in music. There was now no barriers to our communication as we both shared the same taste in music. When the music was playing Carol was in a different world, she was more relaxed. Research has shown that the pain and tension of illnesses such as arthritis can be eased with music therapy (Murcott 2006). I took her hand and held it gently, her eyes were closed, she was smiling and she appeared more content. By holding her hand, I felt as though I was comforting and reassuring her. Touch is a form of non-verbal communication and can be a powerful way of communicating (le May 2004). This was an indication that I really did care and that I wanted to help her. Using touch skilfully and thoughtfully can convey that you are able to be with your patient (Benner 2001 p.57). Communication can be therapeutic and the music playing was not a barrier in communications, it was in fact beneficial. Music has the power to tap into our emotions and alleviate tension (Mallon 2000). Therefore, it is argued that effective communication is more than delivering high quality patient-centred care; but it also allows patients to feel involved in their care, which can make a significant difference to their outlook on their treatment (Collins 2009). Reflecting back I realised that I was really quite worried about the communication difficulties I was facing during my interaction. Carol was a very obstinate person who knew exactly what she needed and yet she desperately wanted to be as independent as possible. I wanted her to allow me in and for her to be comfortable with me. I am glad I eventually gained her trust and we both became more relaxed. Trust is an important element in the nurse/patient relationship and can in fact affect the patient care in practice (Bell and Duffy 2009). In fact, the impact that this interaction had on our relationship was that as the days went on we became very good friends and she was very special to me. Sully and Dallas (2005), suggests that to have an empathetic understanding of our patients needs we must recognise their need for comfort and we respond to this compassionately. It was important to be non-judgemental, I accepted Carol for who she was no matter what her circumstances were and my main concern was to care for her in a professional and beneficial way and in a manner that she preferred. The Royal College of Nursing (2003) suggests that the personal qualities of a nurse should include compassion, respect and a non-judgemental approach. Putting the interaction into perspective, I originally found Carol very demanding, always calling out and constantly pressing the call buzzer. Some staff were very reluctant to go to her because her personal care was very time consuming. It was time consuming but it was because she was in a lot of pain. Surely this was a barrier to communication as some staff did not take the time to listen to what Carol required and as health promoters, we need to develop skills of effective listening so that we can help people to talk and express their needs and feelings (Ewles and Simnett 2005). Rogers (2004) used the term unconditional positive regard, this meaning that people can be too judgemental and it is important to disregard how much of a b urden someone thinks a patient with complex needs might be and treat everyone equally. From recording and analysing my interactions I have learned to accept people for who they are as each of us have had different experiences throughout life and these experiences make us who we are. It was also important to acknowledge Carols point of view, her emotions and thoughts without judgement as being aware of these helped to appreciate her perspective and needs (Silverman et al. 2005). I have also learned to be a good listener and an active listener. Ewles and Simnett (2005) suggest that this means taking note of the non-verbal communication as well as the spoken words. It is important to maintain eye contact, observe the body language, listen properly and pick up on non-verbal signs as well as verbal signs. The environment is important too, along with being sensitive, honest and compassionate (Anon 2007). Collins (2007) argues that judgemental attitudes can stand in the way of getting to know your patient and that labels attached to individuals such as demented can act as a l anguage barrier. Effective nursing requires us to be assertive, responsible and to help our patients achieve the best possible health status (Balzer Riley 2008). In conclusion, the key points that have been discussed in this essay are that of the importance of communicating in nursing and how nurses can improve their communication skills and maintain their effectiveness. We must provide holistic care for our patients and the goal is to listen to the whole person and provide them with empathetic understanding. Another key point is that we must be non judgemental no matter what the patients circumstances are. Overall communication during this interaction was positive, therapeutic and helped to build a relationship. This essay has shown how personal experience from the clinical area relates the theory to the practical side of nursing and how it is imperative that communication is clear, understandable, appropriate and effective. 2059 words References ANON., 2007. Communication skills (essence of care benchmark). Nursing Times. http://www.nursingtimes.net/whats-new-in-nursing/communication-skills-essence-of-care-benchmark/361127.article (Accessed on 21.07.10). ARNOLD, E., and UNDERMANN-BOGGS, K., 2003. Interpersonal relationships: professional communication skills for nurses. 4th ed. Missouri: Saunders. BELL, E., and DUFFY, A., 2009. A concept analysis of nurse-patient trust. British Journal of Nursing. 18(1), pp. 46-51. BENNER, P., 2001. From novice to expert: excellence and power in clinical nursing practice. New Jersey: Prentice Hall. BLAZER-RILEY, J., 2008. Communication in nursing. 6th ed. Missouri: Elsevier. BULMAN, C., and SCHUTZ, S., 2008. Reflective practice in nursing. 4th ed. Sussex: Blackwell. BURNARD, P., 1992. Counselling: a guide to practice in nursing. Oxford: Butterworth-Heinemann. COLLINS, S., 2009. Good communication helps to build a therapeutic relationship. Nursing Times. 105(24), pp.11-12. DAY, M.R., LEAHY-WARREN, P., (2008). Self-neglect 1: recognising features and risk factors. Nursing Times. 104(24), pp.26-27. EGAN, G., 2007. The skilled helper: a problem management and opportunity development approach to helping. 8th ed. California:Thomson. EWLES, L., and SIMNETT, I., 2005. Promoting health: a practical guide. 5th ed. Edinburgh: Bailliere Tindall. KENWORTHY, N., et al., 2002. Common foundation studies in nursing. 3rd ed. Edinburgh: Churchill Livingstone. KOZIER, B., et al., 2008. Fundamentals of nursing: concepts, process and practice. Essex: Pearson Education. LE MAY, A., 2004. Building rapport through non-verbal communication. Nursing and Residental Care. 6(10), pp. 488-491. MALLON, M., 2000. Healing Sounds. The Scotsman. 12th May, p.9. MURCOTT, T., 2006. Music Therapy. The Times. 18th February, p. 17. NICHOLSON, C. et al., 2010. Everybody matters 1: how getting to know your patients helps to promote dignified care. Nursing Times. 106(20), pp. 12-14. NURSING AND MIDWIFERY COUNCIL, 2008. The NMC code of professional conduct: standards for conduct, performance and ethics. London: NMC. ROGERS, C., 2004. On becoming a person: a therapists view of psychotherapy. London: Constable. ROYAL COLLEGE OF NURSING, 2003. Defining nursing. RCN. http://www.rcn.org.uk/__data/assets/pdf_file/0008/78569/001998.pdf (Accessed on 29.07.10). SILVERMAN, J., et al., 2005. Skills for communicating with patients. 2nd ed. Oxon: Radcliffe publishing. SULLY, P., and DALLAS, J., 2005. Essential communication skills for nursing. Edinburgh: Elsevier.

Irrational and Rational Decision Making

What is irrational and rational decision making? Well first to understand what each on is individually, I believe that you should know what each word means separately. So according to meriam-webster. com, rational means, â€Å"having reason or understanding† (Rational, 2009) while irrational means, â€Å"not endowed with reason or understanding. † (Irrational, 2009). Lastly but not least, from the Encarta. msn. com/dictionary, decision making, is â€Å"the process of making choices or reaching conclusions, especially on important political or business matters. † So what do all those definitions mean to you? To me, by these definitions, rational decision making is when a person has reason or understanding in reaching a certain conclusion and just the opposite of that is irrational decision making, when a person is not able to come to a conclusion without reason or understanding. The differences are clearly stated, such as not having any reasons. versus having a reason for a conclusion For example, if the tiles are muddy, the most rational thing to do is to mop the tiles. Your reason is that the tiles are muddy. I think that an irrational thing for a person to do is to sweep the tiles. If there is mud on tiles, it’s not the same as having sand on the tiles. The mud is wet therefore you would use a mop instead of a broom. With the broom, you could pick up dry particles such as sand. It would just make more sense, rather than using a broom to sweep mud when all you will be doing is pushing around something that is wet. Decision that was Once Reviewed to be â€Å"Rational† but Now is â€Å"Irrational† Back in the early 1700 and 1800’s, arranged marriages were part of the traditional and cultural beliefs that many families went through. Though arranged marriages happened in the United States, it was most likely to take place in the Southern States. Now, in the present day, though arranged marriages still happen in some cultures around the world, it is an irrational decision. (Decision, 2008) Explanation why it Would be Considered â€Å"Irrational† Today It was considered to be rational back then because it â€Å"was the thought to keep the blood lineage of an aristocratic family line to stay pure. † In order to make marriage agreements, there is sometimes certain business arrangements that were involved. Things such as, land, money, property, and or social status were used in order to make a marriage, other than what we presently do, which is to fall in love with a person. Now, in the present, most have the ability to choose the person they want to marry. (Arranged, n. d. ) Decision Theory Used I think the decision theory that was used in the original decision making is Satisficing. â€Å"The theory postulates that decision makers compare these calculations and choose the course of action that maximizes expected utility. (Plous, 1993). In the earlier years, parents of children, made the decision to arrange their future marriages in hopes of receiving or being able to make a deal with another family. They chose a path in their lives which would then satisfy their needs and wants. When doing so, their choice is far from being actually favorable. Instead of being able to marry someone you love and of your choice, back then, there were no opinions whether or not a person wanted to marry another. It was like you were born in order for the option of your parents to be able to make a deal with another family, just to get something out of having a child. Because arranged marriage is what was ideal for certain cultures, it turned into a custom that children soon taught their children and so on. Just because you were taught and brought up learning something, doesn’t necessarily mean that it’s always favorable for both you and your parents. To your parents, it could mean getting money, or being richer in a way, and to you, it could mean having nothing at all, no option. You are just put in a situation where you, as a child had no say in. References Arranged Marriage. (n. d. ). Retrieved February 18, 2009, from http://www. youth information. com/Templates/Internal. sp? NodeID=90221 Decision Making. (2008). Retrieved February 18, 2009, from http://encarta. msn. com/ dictionary_1861688906/decision-making. html Irrational. (2009). Retrieved February 18, 2009, from http://www. merriamwebster. com/dictionary/irrational Rational. (2009). Retrieved February 18, 2009, from http://www. merriamwebster. com/dictionary /rational Plous, S. (1993). The psychology of judgment & decision making, New York, McGraw Hill The History of Arranged Marriages in America. (2008). Retrieved February 18, 2009, from http://www. associatedcontent. com/article/787875/the_history_of_arranged

Should The United States Suspend Arctic Offshore Drilling

Is developing the Arctic for oil and natural gas worth the powerful negative impact on the environment and native communities? The article published on September 20th, 2013 by Jennifer Weeks titled, â€Å"Future of the Arctic† examines the Arctic and the controversies within it. In the pro/con section of her article, Weeks asks the question, â€Å"Should the United States suspend Arctic offshore drilling?† Senator Mark Begich argues that the resources in the Arctic are too great of an opportunity to miss out on. Although Arctic drilling is a controversial topic, many people believe it should continue because of the financial and ethical circumstances; however, evidence to support this is lacking, which leads to the other side of the debate to be in†¦show more content†¦The research around that time found that the estimate of oil deposits in the Arctic was 28 billion barrels of oil. It also shows at least 50 billion barrels of oil equivalent in the Beaufort Seaà ¢â‚¬â„¢s Amerasia Basin (U.S. Energy). These facts make the point Begich is making weak. He not only fails to cite the source of his information, he also has the information incorrect. This is not the only example of Begich using information that is not cited and inaccurate. Begich writes, â€Å"Each day, Americans drive 250 million cars and trucks. While new federally mandated fuel-economy standards are leading to greater vehicle efficiency, we still burn about 7 billion barrels of oil annually† (Weeks). Again, readers have no idea where Begich got this information and whether it is accurate. Upon further research, it has been found that the information on cars and trucks on the road daily is true; however, it is not cited and the reader must do their own research to verify this. The number of oil barrels used by the United States each year was also deemed to be true, along with the percentage of that used for gasoline, again, this brings down the authors point as the information was not cited and backed up in the argument (U.S. Energy Information Administration - EIA - Independent Statistics and Analysis.). The author follows the uncited information with another crack at the issue that again lacked citation. Begich claims that, â€Å"About half of that amount (of oil) comesShow MoreRelatedThe Drilling For Oil Drilling1490 Words   |  6 PagesEnglish 1A 15 April 2015 Offshore Oil Drilling This day and age, oil is what makes the world go around. Without it, people cannot travel, be able to use fuel oils for electricity and heating, there would not be asphalt roads, and also there would not be chemicals used to make plastics, or other synthetic materials that humans use every day. Oil is a useful resource but the ways that are used to obtain it are not very appealing. One way it is obtained is by offshore drilling. According to an articleRead MoreExploring Corporate Strategy - Case164366 Words   |  658 Pagespractice. They are not intended to be a comprehensive collection of teaching material. They have been chosen (or speciï ¬ cally written) to provide readers with a core of cases which, together, cover most of the main issues in the text. As such, they should provide a useful backbone to a programme of study but could sensibly be supplemented by other material. We have provided a mixture of longer and shorter cases to increase the ï ¬â€šexibility for teachers. Combined with the illustrations and the short case

The Significance of the Letter in The Scarlet Letter Essay

The Scarlet Letter: The Significance of the Letter Adultery has been around almost as long as people. It has maintained a harsh punishment, from banishment to death, but in the Puritan world of colonial America (from about 1620-1640), its punishment may have been worse than either. In The Scarlet Letter by Nathaniel Hawthorne, Hester Prynne is a lonely Puritan woman who commits infidelity with a preacher and has a son from the untruthful union. To punish her for this act, the council of leaders forces her to wear a large â€Å"A† on her bosom, to let all know what she has done. She is not put to death immediately because her husband is missing and may or may not be alive. The letter â€Å"A† has different meanings for different†¦show more content†¦To Hester the â€Å"A† also symbolizes her falter from the path towards God. Not only does it remind her of her falter, it also teaches her not to return to her sin. Hawthorne shows this when Hester is defending her right to keep Pearl. She is responding to th e governor’s claim that she does not deserve to keep Pearl and says, â€Å"I can teach my little Pearl what I have learned from this!, answered Hester Prynne, laying her finger on the red token.† This defense by Hester shows that she has learned from the shame of the scarlet letter. The committee was worried that the sin of the letter would make teaching Pearl impossible, but Hester is claiming that it is the exact opposite. She is saying that the â€Å"A† has shown her that the sin was wrong and because of this she will avoid any further sin. As time progresses in the novel Hester comes to regard the â€Å"A† as a necessary evil. This can be seen when Chillingworth hints that the committee may have the â€Å"A† taken off of Hester and she replies that it is not up to them to decide. She says â€Å"It lies not in the pleasure of the magistrates to take off this badge, calmly replied Hester. 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