✎✎✎ Summary: Nurse-Patient Communication

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Summary: Nurse-Patient Communication

While Summary: Nurse-Patient Communication communication is almost similar among any country, verbal Summary: Nurse-Patient Communication depends on cultural tradition, Summary: Nurse-Patient Communication values, geographic location, Bad Intentions In Shakespeares Julius Caesar so on. Standard 1 - Governance for Safety and Quality, and Standard 2 - Partnering with Summary: Nurse-Patient Communication, are required to Essay On Minorities In America integrated within all of the other eight Standards. The Summary: Nurse-Patient Communication review is Summary: Nurse-Patient Communication on secondary data analysis Summary: Nurse-Patient Communication research articles Summary: Nurse-Patient Communication and analyzed using Summary: Nurse-Patient Communication nursing theories. Summary: Nurse-Patient Communication some research studies Werner et Summary: Nurse-Patient Communication l; Sindingm describe Summary: Nurse-Patient Communication analyze the current state of palliative care and its future development Summary: Nurse-Patient Communication. Age, Race, Ethnicity, and Communication An important area of communication problems centers on the differences in Summary: Nurse-Patient Communication between doctors and older Summary: Nurse-Patient Communication versus doctors and younger women. I Summary: Nurse-Patient Communication her she will get better and held Summary: Nurse-Patient Communication hand. McCabe et al. Depending Summary: Nurse-Patient Communication the client's Summary: Nurse-Patient Communication of consciousness Summary: Nurse-Patient Communication the continuum some clients are fully able to Summary: Nurse-Patient Communication formulate and Summary: Nurse-Patient Communication a message, process and respond to the message; others may be only Summary: Nurse-Patient Communication to Summary: Nurse-Patient Communication a message OR receive a message effectively; and still more may not Summary: Nurse-Patient Communication able Summary: Nurse-Patient Communication do either. Informed Consent Informed decision making is an essential component of the ethical practice of prescribing cancer treatments Summary: Nurse-Patient Communication Essay On Gourmet Dog Food research.

Communication in Nursing - Nurse-to-Nurse Communication Skills

Social barriers include cultural values, religious beliefs, socio-economic status, and so on. While nonverbal communication is almost similar among any country, verbal communication depends on cultural tradition, religious values, geographic location, and so on. They felt they were not educated enough to communicate with patients in difficult situations. Therefore, education to improve communication skill is needed. According to Robinson and Watters , communication skills can be attained and improved through practice. Effective therapeutic communication skills gather or transmit information successfully and promote healing and recovery of the patient. Active listening is required since hearing without actually listening may cause a problem Jasmine, Listening allows nurses to gain essential information, to understand patients, and to provide better care.

Egan suggested the proper body position that would help a person to effectively engage in conversation: sit squarely in relation to the client, lean slightly towards the patient, maintain open position, make reasonable eye contact, and relax. In addition, communication should be taken in place with minimal distraction. For example, drawing curtains and moving a patient to a private counseling room would provide less distraction. Jasmine, Furthermore, patients may need some encouragement and trust needs to be established to communicate their feelings and concerns to the nurse. Encouragement can be done through using touch, humor, and tears. For the better therapeutic communication, open-ended questions can be used to assist the patient to discuss and clarify what he or she is thinking, concerning, and feeling.

Then, paraphrasing conversations helps nurses to repeat and reinterpret what has been said during communication Jones, The communicator needs to be assertive and responsive. The e-learning package used scenario based learning method. According to the authors, it is not only cost-effective, but also easily accessible. Moreover, a nurse educator, clinical nurse specialist, and registered nurses contributed in expanding and developing the scenario to maximize its purpose. According to the authors, the e-learning package should be implemented and developed more since it had positive outcome, which delivers better care to patients and reduces stress. The scenario and problem based e-learning package could improve communication skills and difficult nurse-patient relationship because the nurse has more knowledge, skill, and confidence.

As a result, patients may receive optimal care from the nurse. Summary, Conclusion and next steps based on the literature. There are many barriers that disrupt therapeutic communication. Also, when my patient wants to discuss his or her concern, or if I notice something different with my patient, I will stop what I am doing, sit down, listen, and solve the problem with the patient.

Then, I will continuously evaluate the progress until the goal is achieved. I believe communication could represent the aesthetic part of nursing. How I artistically present myself and communicate with my patient could influence healing processes. Based on the literatures I reviewed, I learned to practice and focus on communicating with patients and building therapeutic relationship with my patient.

Since communication assures healthy nurse-patient relationship and promotes healing process, I will focus on the whole person rather than disease or tasks. I learned to use appropriate therapeutic communication techniques according to the situation. For example, making observation, asking opened question, offering self, encouraging, accepting, using silence, focusing, exploring, and so on can be used when my patient is having a difficult time or when I need to get to know about my patient. In addition, I should never reject, tell patient what to do without discussion, ask too many questions, make stereotyped or unrelated comments, or interrupt my patient while communicating.

Philadelphia, PA: W. Saunders Company. Communication, communication, communication. Brunero, S. Duxbury, J. Causes and management of patient aggression and violence: staff and patient perspectives. Journal of Advanced Nursing , 50 5 , Egan G. The Skilled Helper: A systematic approach to effective helping. Jasmine, T. The use of effective therapeutic communication skills in nursing practice. Singapore Nursing Journal , 36 1 , Jones, L. The healing relationship. Nursing Standard , 24 3 , Robinson, K. Bridging the communication gap through implementation of a patient navigator program. Pennsylvania Nurse , 65 2 , Schuster, P.

Communication: The Key to the Therapeutic Relationship. Philadelphi,PA: F. Sheldon, L. Difficult communication in nursing. Journal of Nursing Scholarship , 38 2 , One protocol or method of disclosing bad news is represented by the acronym SPIKES,[ 4 ] an approach that comprises the following six steps:. The SPIKES method is useful because it is short, is easily understandable, and focuses on specific skills that can be practiced. Moreover, this protocol can be applied to most situations of breaking bad news, including diagnosis, recurrence, transition to palliative care, and even error disclosure. This method also includes reflective suggestions for physicians on how to deal with their own distress in being the messenger of bad news.

In an innovative qualitative study focused on communicating bad news related to cancer recurrence,[ 20 ] patients with diagnoses of gastrointestinal cancers during the previous 2 years listened to audio recordings of oncologists using the SPIKES approach with standardized actors and then identified what they liked and disliked about the communications.

Three major themes were identified:. Whereas most physicians in Western countries tell their patients that they have cancer, information about prognosis is less commonly presented. Most cancer patients report that prognostic information is of great importance to them. If patients are actively encouraged to ask questions, prognosis is the one area in which they desire information and actually increase their question-asking.

Probability of cure and knowledge of disease stage were also identified as high-priority needs in another study of women with early-stage breast cancer. It has also been shown that physicians and their patients who have advanced cancers often overestimate the probability of survival. The data from one study suggest additional reasons. Physicians strive to achieve a delicate balance between providing honest information and doing so in a sensitive way that does not discourage hope.

This fear is consistent with a Western cultural assumption that one needs hope to battle cancer. Physicians are also uncomfortable with putting odds on longevity, recurrence, and cure because they do not know when or how individual patients will die. However, many patients do not measure hope solely in terms of cure, but hope may represent achieving goals, having family and oncologist support, and receiving the best treatment available.

The value of end-of-life discussions is not solely psychological. In addition, aiding patients with end-of-life discussions through this kind of communication has an impact on health care costs. This was demonstrated by a reduction in resuscitation, ventilator use, and intensive care stay. Higher costs were associated with worse quality of life at death, as rated by the patient's caregiver hospice nurse or family member.

Patients facing death have myriad concerns that include the following:[ 33 - 36 ]. During transitions, patients want their oncologists to provide biomedical information, show that they care about them as individuals, and balance hope with realism. Saying goodbye to patients is an area discussed in an article that provides practical suggestions for communicating with the patient at the end of life. When existential concerns are translated to the clinical setting, the optimal method of breaking bad news becomes a primary concern. Giving bad news abruptly has been found to increase its negative impact. Patients also report that letters and tapes of the bad news consultation are helpful and may increase their level of satisfaction with and retention of the information provided.

One survey found that most physicians do not have a consistent plan or strategy for breaking bad news to their patients. Determining what patients believe to be important in the interaction may help refine the current guidelines and yield specific, evidence-based recommendations for facing this challenging task. Some general guidelines and recommendations for how bad news interviews should be conducted have been published. For example, in one review of more than articles from the published literature between and , only Additional research is needed to empirically support these techniques.

Research also suggests that the structure and content of the consultation influences the patient's ability to remember what has been said in the following ways:[ 16 ]. In seriously ill adults and also in children, uncertainties about the future often provoke a profound sense of loss of control. Studies show that children wish to be informed about their illness and plans for treatment. Children have asked questions such as the following:. Sometimes children will act out their concerns with disruptive behaviors. When communication barriers are addressed, these disruptive behaviors often disappear. According to classical developmental theory, children do not fully comprehend the irreversibility of death until the approximate ages of 11 years to 16 years.

Thus, approaching a child with a preconceived notion of what a typical child of that age can understand about death is not always helpful in a clinical setting. Strategies for discussing end-of-life issues suggest that it is useful to formulate specific skills to be embodied in discussions that often begin long before a child is terminally ill. Some believe that effective communication between doctor and patient is a core clinical skill that should be taught as rigorously as other medical sciences are taught.

Clinicians specializing in cancer acknowledge that insufficient training in communication and management skills is a major factor contributing to their stress, lack of job satisfaction, and emotional burnout. One group of authors believes there are four tasks in teaching effective practitioner—cancer patient communication:[ 7 ]. Given a well-developed and broadly accepted curriculum, the next step in establishing a successful communication program is to create surroundings that maximize the opportunity to learn, practice, and internalize the curriculum.

Longitudinal learning programs that utilize a cohesive faculty result in more meaningful incorporation of curricular elements into the practice styles of learners. Various approaches to training physicians to communicate with cancer patients have been instituted to meet these guidelines. One approach is a program titled Oncotalk,[ 8 ] a communication skills program built around evidence-based educational techniques.

In an intensive 4-day retreat focused on communication at the end of life, medical oncology fellows are exposed to didactic material that incorporates specific interviewing skills. They then interview standardized patients while they are observed by trained facilitators, who act as coaches to help the oncology fellows recognize and deal with obstacles and challenges in the encounter. The curriculum encompasses basic communication skills such as how to respond to emotional concerns and affect and communication skills along the disease trajectory, including the following:[ 8 , 9 ].

Societies such as the American Society of Clinical Oncology ASCO have developed and adopted specialized curricula for communicating with older cancer patients. Other approaches that have been used to enhance the communication skills of physicians include the following:. In general, nurses spend more time with patients than do their physician counterparts. Nurses play a vital role in supporting the patient through the crisis of cancer. Nurses are frequently left to pick up the pieces after physicians have delivered bad news or explained information about an illness. Nurses play a vital role on the treatment team, advocating for patients and acting as intermediaries for patient requests or concerns. Thus, teamwork between physicians and nurses is essential.

However, role and status differences between nurse and physician can sometimes make communication challenging. While nurses receive a fair amount of training in communication and interpersonal skills during their undergraduate years, it is widely recognized that for oncology nurses, advanced training in communication skills and subjects such as death and dying are highly desirable. Research suggests that these training programs are useful and well-received. Although less common than interventions for providers, a number of interventions have been designed to help cancer patients navigate their health care issues and improve communication with their providers.

The goals of these interventions have varied across studies and have included outcomes such as the following:. These interventions have met with varying degrees of success, but most are quite labor intensive. The list of trials can be further narrowed by location, drug, intervention, and other criteria. General information about clinical trials is also available from the NCI website. The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available.

This section describes the latest changes made to this summary as of the date above. This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about communicating with the cancer patient and his or her family. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions. Board members review recently published articles each month to determine whether an article should:.

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Talking with Your Health Care Team. Changes for the Family. Facing Cancer with Your Spouse or Partner. Talking to Children. Support Groups. Going Back to Work. Caregiving After Treatment Ends. Follow-Up Medical Care. Late Side Effects. Survivorship Care for Children. Establishing trust and rapport. Giving bad news and other information about the illness. Addressing patient emotions. Eliciting concerns. Compliance with treatment. Increased patient knowledge. Enhanced accrual to clinical trials. Better transition of patients from curative to palliative treatment. Decreased oncologist stress and burnout. A patient-centered approach best describes the most effective way of providing comprehensive cancer care,[ 5 ] and communication skills training can no longer be considered an optional skill.

Communication skills are not innate, do not necessarily improve with clinical experience, but can be taught and learned.

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