Strategies for Comfortable Communication

To make Mrs. Jackson feel comfortable using appropriate non-verbal communication I would I would ensure that Mrs. Jackson felt comfortable by my appearance. Appropriate body clothes and body scent can make a person who has dementia or Parkinson disease more relaxed and comfortable with me, because this may remind them of someone they knew. Here, in this case, the identified person can be Micheal because he takes all the responsibilities of Mrs. Jackson.  

Another way by which I will make Mrs. Jackson comfortable is through my physical contact or touch. Physical touch will give the person a sense of care and affection. I will start the treatment by holding her hands, or rubbing her shoulders or hugging her. This will provide assurance and comfort to the patient. I should always observe the non-verbal reaction of Mrs. Edith. I should still notice the signs of emotional activities of the patient like frustration, anger or fear and eventually, I will take the necessary actions to calm or sooth the person as needed 

1. How would you make Mrs Jackson feel comfortable, using appropriate verbal communication (discuss at least three (3) points)?

 I would use appropriate verbal communication such as to keep the questions basic so that the patient can answer it easily, encouraging the loved ones to speak carefully and softly and lastly with the use of intellectual creations like photos, pamphlets.(Hopkins 2017) This type of communications I will use to make Mrs. Jackson comfortable.. .

1. Referring to the Core standards for nurses who provide support to people with disability, outline three (3) strategies that you could use to aid communication with Mrs Jackson giving consideration to her vision and hearing impairments.

Referring to the core standards for nurses who provide support to people with disability, three strategies I would use to aid communication with Mrs. Jackson, considering her vision and hearing impairments would be as follows:

 I would let Mrs. Jackson to take my arm and walk slowly with me, and on the other hand, I should make sure that if any obstacles come in our path, I shall remove those obstacles. This will help me to gain faith in Mrs. Jackson.

I should speak slowly and softly to Mrs. Jackson because shouting can make hard to understand. I will talk slowly with the patient because the patient can read my lips.

I should avoid talking in a noisy environment, or I will try to reduce the background sound as much as possible because it will give her a clear hearing and the most important is that I should say my name when I enter in the patient’s room (Lewis, Gaffney and Wilson 2017) You are walking past Mrs Jackson’s room and discover that she has fallen out of the bed onto the floor where is crying quietly and trying to get up. You assist Mrs Jackson onto a chair as she keeps saying over and over, “I’m alright”. After following facility procedure for this incident, you are then to discuss this with the patient and the son.

1. Provide a definition of ‘open disclosure’ and discuss the principles of open disclosure referring to the Australian Open Disclosure Framework (2013) (min 100 words).

Open disclosure can be defined as the free exchange of episodes that outcome in damage to a patient while getting therapeutic services with the patient, carers, family members and other helpful people. The Australian Open Disclosure Framework (the structure) is planned to authorize wellbeing administration associations and clinicians to communicate with patients when social insurance does not go to intend

Effective Communication Methods

Principles of open disclosure are as follows:

Open and well-timed communication- If the incidents diverse in a wrong way, their carers and family should be provided with all the necessary informations about what has happened honestly.

Acknowledgement- The negative events should be acknowledged by the patient, their carers and families as soon as possible.

Apology or expression of regret- The patient and their family should receive an apology of regret for any harm that resulted from an unpleasant event.  

Good governance-  Open disclosure requires the governance structure and the medical risks and the advance processes. Good governance should include the performance monitoring and treatment.

1. Provide an example conversation of what you would say when communicating the incident to the patient and son (min 100 words).

Me(nurse): Madame, how are you feeling now? You are ok?

Patient: I am feeling better than before. Thank you.

Son: Has something happened to my mom? If something happened, please let me know.

Me(nurse): Madam you have a blood test so I will take you there. Sir you, please stay here for a couple of minutes.

 (After dropping Mrs. Jackson in the laboratory)

Me(nurse): Sir, last night when I was passing by I saw Mrs. Jackson lying on the floor; probably she fell from her bed.

Son: How did this happen? Is it bad or is she injured by somehow?

Me(nurse): No not that bad. Quickly after seeing her, I made her sit on a chair and asked her “Are you okay”? She replied that “Yes, I am okay.”

Son: So, where is the problem?

 Me(Nurse): I believe that she had Parkinson’s dementia, probably she forgot what has happened to her. That why she repeatedly said the same words. But no need to worry because we had great health takers around here.

Son: Thank you so much for telling me that.

The key relevant person I should contact in this situation would be my fellow nurses because fellow nurses and I have passed through the same training and both of us has the same education. The main difference that can happen between us is the presence of mind. My fellow nurse can adapt to the situation in a more friendly manner and execute the cases with his or her way of perception. 

1. Using SBAR provide an example of what you would document in the patient chart ensuring that you use appropriate terminology. (min 50 words)

S for the situation- I am a registered nurse. The reason for my calling is that Mrs. Jackson has suddenly fallen from her bed and cried softly, but I assisted her to sit on the chair. But after the incident she continuously said over and over is that ‘she is fine.’

B for background- Mrs. Jackson is an 82-year-old lady who was admitted to the nursing home. She had Parkinson’s disease.

A for assessment- I think she may have had memory loss symptoms. I am unaware of the problem, but I am worried.

R for recommendation- Memory improvement and physiotherapy is required (Weerkamp et al. 2014).

1. Michael, Edith’s son will be travelling overseas for the next few weeks and will not have telephone access. He has asked if you could email him to provide him with a progress report on his mother. Identify at least five (5) factors relating to email etiquette you will need to adhere to when emailing Michael. (min 100 words)

Five factors relating to e-mail etiquette would be:

I ought to be clear and brief: Before starting the email, I should narrate my thoughts very clearly to the person whom I am sending the email. I should think before I write. The subject of the email should be particular.    

Managing Falls and Challenging Behaviours

I should be polite and watch my tone- I should narrate the health of Mrs. Jackson politely and not too harshly. Her son Mr. Micheal should not feel offended by reading my email.

I should watch my grammar, spelling and punctuation- Punctuation should be one of my primary concern while writing any business email because it reflects my total personality and professionalism.

I should avoid sending receipts and delivery reports- There are not many people who appreciate these sending receipts and deliver reports so I should give it a miss.

I should send smaller files- It is more preferable to transmit compressed or smaller data than large attachments. Eventually, this will make it more comfortable for the recipient who is Mr. Micheal to download the data quickly.    

   Case Study 2

You are working as an Enrolled Nurse in a rehabilitation unit and while on your break you check your social media account and notice that one of your colleagues, who is a friend of yours, has posted some information relating to one of the patients on the unit.

1. What ethical principles and regulatory responsibilities do you need to consider in this situation? (min 100 words)

The ethical principles and regulatory responsibilities needed to be considered in this situation is that I should immediately contact my friend who is also my colleague, about the post. He or she may have posted the information knowingly or unknowingly; In both cases, the management group need to be informed. It is against the ethical law of patient privacy act of Australia. In Australia, it is not appropriate to share any patient’s information on any platform without the patient’s consent. The management would take strict action as this act can affect both the patient and the family. The reputation of the hospital will also be under question (Alharbi 2017).

1. Provide a definition for the term ‘advocacy’ and describe how you would advocate for the patient in this situation? (min 100 words)

Advocacy can be defined as the technique that is used by the nurses to act as a middle of a patient. Many times the patients do not agree with the way of the medical treatments. They do not try to understand the value of such treatment. Advocacy allows the nurses to work with the doctor to evaluate an alternative way for the treatment, keeping in mind the requirements of the patient and the nurse also educate the patient about the necessity of the treatment. Nurses use advocacy technique to present the criteria and objections of the patients to the doctor. Using this method the nurses can provide the best medical treatment that the patient will accept willingly.

1. You are asked by your supervisor to provide feedback to the colleague who has posted this information on social media. Describe at least four strategies you could use to deliver a constructive outcome when providing this feedback.

For strategies I could use to deliver a constructive overcome when providing this feedback would be:

1. The feedback should include authentic information. There should not be any misguided information in the feedback. The colleague who has done such type of illegal action should be escalated in the feedback in the top priority.
2. The feedback should clarify the severity of the incident to the management.
3. Feedback should also include the results of such activity, how this type of law-breaking activity can affect the patient and his or her family. This type of action can also affect the organisation in a negative way that should also mention in the feedback.
4. In the end, the feedback should also include the accused colleague’s behavioural pattern and his or her performances in the history. The incident can also occur without his or her knowledge. It will help the management to understand if the nurse is professional and well educated so that the organisation do not lose important nurse.

1. Provide an example of the feedback you could provide to your colleague, using appropriate language and a respectful manner. (min 75 words)

An example of the feedback I could provide to your colleague, using appropriate language and a respectful manner would be:

Dear Annie,

Please be informed that you have posted a patient information ethic is unethical in our law. It is not known that the post was indented or unintended. However, please remove the post from your social platform as it is raising a threat to the organization’s reputation. This type of act will also affect your professionalism in this nursing industry. It is my humble advice to you not to repeat this kind of unethical act in future. 

Open Disclosure Principles

Case Study 3

David is a 58-year-old cardiac patient who had been verbally aggressive over the last two days since he has been admitted to the ward. You have been asked by the manager to have a chat with David to see how he is feeling.

1. What are closed ended questions and in what situations would you use closed questions with David? (provide at least two (2) examples of a closed question)

Close-ended questions are those questions which are answered by no or yes.

The case study suggests that the patient is a 58-year-old cardiac patient and if any conversation that can lead to the cardiac arrest of the patient, it should be avoided. I would use closed-ended questions with David In such scenarios as the open-ended questions can lead to debate.

Two examples of closed questions will be

Q 1. Did you take your medicines today?

Q 2. Do you want the doctor to be called?

1. What are open questions and in what situations would you use open questions with David? (provide at least two (2) examples of an open question)

Open-ended questions are those questions that command an explained respond that can help to analyse the situation.

I ought to use open-ended questions in the following situations:

1. When there is no way to avoid the open-ended questions.
2. When there is a tremendous need for open-ended questions for medical emergency

Two example of open-ended questions:

Q1. How is your health today?

Q2. Do you have any questions for me to answer?

1. Discuss the term ‘Active Listening’ and provide at least one (1) example of how this could be used in this situation. (min 100 words)

Active listening is a method in nursing that can help the caregiver to make a positive bond with the patient. The active listening requires the health professionals to listen carefully throughout the times by paying attention, which shows that the nurse is listening.  Eventually, the patient can feel relaxed in the situation. The uninterrupted and without judgemental listening practise can help the nurse to make a positive bonding with the patient (Jeffs et al. 2014).   

In this scenario, David may want anyone to talk to him. Further, he may have some doubts about the treatment, by doing active listening the nurses can understand what may have irritated him in the first place. However, if the patient could talk to someone, he may feel relaxed and less arrogant.

1. Identify what constitutes effective communication in nursing? (List at least six (6) points and provide an example of each).

Effective communication is the process by which the nurses connect and communicate with their patients and eventually it will help in the growth of relationships between them (O’hagan et al. 2014).

6 points of effective communication in nursing-

Effective communication is bilateral.

Effective communication requires active listening

Effective communication is both verbal and non-verbal.

Effective communication requires correctness

Effective communication involves conflict resolution

Effective communication needs good relationships with their co-workers. 

After a while, David becomes both verbally and physically aggressive. He says that ‘you are the worst nurse and do not care about him and he wants to leave. He pulls out his intravenous cannula in his arm and begins to throw things around the room. 

1. Describe de-escalation and provide an example of a de-escalation strategy. (min 75 words)

De-escalation can be defined as a strategy to calm the patient to provide him with appropriate treatment. If the patient is not comfortable with the treatment, he may refuse to take any medical supervision. This type of situation can lead to a harmful effect on the patient.

An example of the de-escalation strategy is:

Nurses should be calm and non-threatening to the patient to de-escalate the situation. Nurses should educate the patient about the consequences of the activity. The patient should know how it could affect the health of the patient

1. Explain the benefits of a debriefing process and explain why it would be useful following this situation. (min 100 words)

Working in the hospitals and in other departments and critical care areas, nurses are exposed to violence, aggression and traumatic events. Debriefing is necessary as it enhances the nurses’ capacity to deal with the incidents. Debriefing can cut the possibility of mental harm by conversing about what has happened. Debriefing can foster relevant and suitable discussions in a non-judgemental and non-threatening fashion.

It would be useful following this situation because through the process of debriefing the nurses can understand the exact reason that why David pulls out his cannula and what is the reason that why  he is becoming so much physically and verbally aggressive.

1. Your supervisor provides you with some feedback on how you handled this situation, identify at least three (3) strategies you could use to effectively receive feedback.

Three strategies could be used to receive feedback are as follows effectively-

• I should maintain the eye contact and watch over the body language of the patient to prevent any incident before the occurrence.
• When the escalation occurs, I should try to calm the patient and educate him about the medical treatment and its necessity.
• In case if the escalation occurs, I should try to educate the patient about the consequences of the activity he has done and why the treatment is necessary. I should also try to evaluate the problem the patient is facing by active communication

PART B

1. With reference to the following resource: NSW Health (2014) Communication and behaviour support for nurses- Practice Package retrieved on 3/11/2016 from:

Communication and behaviour support for nurses- practice package was implemented for what reason?Behaviour support and effective communications are the center components of nursing practice.There is a significant link between challenging behaviour and communication difficulties.

People with disability have a problem in coversation. Nurses must be alert of the probable problems in the future.

Short of of effective communication escorts to frustration, and eventually, this can be an outcome to a challenging behaviour (Franco and Cordero 2017)

1. Identify the four domains of practice (1.2.1) within the standards for the Communication and behaviour support for nurses- practice package

The four domains of practice within the standards of Communication and behaviour support are as follows:

Person-centred health care assessment and the development of healthcare plans practice package

Behaviour support practice package and the communication with the patients.

Working with people with chronic and health care needs practice package   

Management of the mealtime practice package for nurses.

1. What are the benefits of completing the “communication and behaviour support for nurses appraisal”

The Patient Outcome is the object that improves a patient get quicker. The patient result is the object that the patient needs to accomplish before they leave the healing centre with the best care they can get. If the patient does not need the best result, then it makes it harder for them to show signs of improvement. The patient should be on the same page from the medical attendants and specialists to have the capacity to leave the doctor’s facility (Robinson et al. 2014). The advantages of information have that foundation learning of training behind you to perform on a patient. Knowing your extent of training and having that obligation of care behind us. Conduct implies having the correct manner and state of mind when taking care of patients. Being open-minded and robust when administering to patients

1. Identify 2 organisational policies and procedures surrounding electronic health care records for health care personnel

2 organisational policies are

Procedure statement- the clinic is required by the law to protect all the necessary information according to the Health Records Act

Responsibility- Everyone including the staffs and the department heads are responsible for taking the appropriate action where privacy has been broken.      

1. Utilising information technology to access data has become a useful tool for nurses, but must be within the organisational policies and procedures. What 3 tips are available to ensure that the web page accessed is reliable?

3 tips available to ensure that the web page accessed is reliable are authority, objectivity and purpose of the site should be evident in all respect.

1. Nurses may be asked to lead small group meetings and discussions; therefore they need to be aware of various procedures. List 6 procedures.

The nurses should schedule when the most people can participate

They should prepare the agenda

They should start and end the meeting on time

The nurses should set the tone during their speech

The nurses should communicate powerfully

The nurses should focus on the discussion..

1. What are the 3 main objectives in forming these small groups?

The three primary objectives in forming groups are:

To elucidate the purpose of the group meeting.

To implement the suitable meeting procedures

To check and respond appropriately to the change of group dynamics              

1. What communication strategies are required to ensure that there is contribution from all participants in a group discussion, including providing and receiving feedback.

The communication strategies that are required to ensure that there is a contribution from all participants in a group discussion, including providing and receiving feedback are as follows:

The leader must ensure that all members should participate.

There should always be one to one communication- interaction process and this process involves both verbal and non-verbal communication.

Factors that determine the communication interaction process are the status, reinforcement, structure, control problems, content and environment.

1. To ensure meetings are of value, the nurse conducting the meetings need to consider at least 5 things?

5 things to be considered when conducting a meeting are :

The nurses should prepare their points before starting the session.

The nurses should identify their roles.

The nurses should play to their strengths.

They must use a positive body language

The nurses should consider alternative locations to conduct the meeting

1. What are the 2 suggested communication strategies you can use to ensure that you understand feedback in relation to performance improvement conversations.

The 2 suggested communication strategies you can use, to ensure  that you understand feedback, in relation to performance improvement conversations are

I should keep the communication very focused if I know the other person prefers to be direct and to the point   

I should be aware of the impact of my connection to the other person           

1. When giving balanced feedback what 3 step communication technique is recommended?

The situation in the communiation should be anchored.

The specific behaviour must be highlighted.

The communication should be cleared. .

1. What are 2 strategies that demonstrate appropriate language and respectful manner when giving or receiving feedback?2 strategies that demonstrate appropriate language and respectful manner when giving or receiving feedback are as follows:

The use of appropriate language and respectful manner is required to achieve performance improvement through feedback.

The fitting utilization of procedures to convey useful results from giving and getting input.

References

Alharbi, A.Y., 2017. LEADERSHIP STYLES OF NURSE MANAGERS AND THEIR EFFECTS ON NURSE AND ORGANISATIONAL PERFORMANCE, ISSUES AND PROBLEMS.

Franco, N.P. and Cordero, M.A.W., 2017. Collaboration Effort between Physicians and Nurses: A Feedback Tool for the Review of the Hospitals. International Journal of Nursing, 4(1), pp.19-26.

Hopkins, W., 2017. Evaluating Nurses’ Self-Efficacy in Caring for Patients with Dementia.

Jeffs, L., Beswick, S., Lo, J., Lai, Y., Chhun, A. and Campbell, H., 2014. Insights from staff nurses and managers on unit-specific nursing performance dashboards: a qualitative study. BMJ Qual Saf, 23(12), pp.1001-1006.

Lewis, P., Gaffney, R.J. and Wilson, N.J., 2017. A narrative review of acute care nurses’ experiences nursing patients with intellectual disability: Underprepared, communication barriers and ambiguity about the role of caregivers. Journal of clinical nursing, 26(11-12), pp.1473-1484.

O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., Webb, G. and McColl, G., 2014. What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), pp.1344-1355.

Robinson, A., Eccleston, C., Annear, M., Elliott, K., Andrews, S., Stirling, C., Ashby, M., Donohue, C., Banks, S., Toye, C. and McInerney, F., 2014. Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia. Journal of Palliative Care, 30(3), pp.158-165.

Weerkamp, N.J., Tissingh, G., Poels, P.J., Zuidema, S.U., Munneke, M., Koopmans, R.T. and Bloem, B.R., 2014. Parkinson disease in long term care facilities: a review of the literature. Journal of the American Medical Directors Association, 15(2), pp.90-94.