Practice development in community nursing : principles and processes

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Immediate payment required for this item. Practice Development in Community Nursing : Principles Nurses include teaching in all aspects of their practices, and in their interactions with other nurses, interns, students, patients and patient families. As such, nurses influence system-wide processes.

Practice Development in Community Nursing Summary

Interdisciplinary relationships: All members of the interdisciplinary team treat each other with mutual respect and have positive relationships. It is accepted that all members of the healthcare team make essential and meaningful contributions in achieving positive clinical outcomes. Professional development: The healthcare organization values lifelong learning of employees. On boarding training, orientation, in-service education, continuing education, formal education, and career development are especially emphasized.

Adequate human and fiscal resources for all professional development programs are provided. Service Offerings at Adventist Hinsdale Hospital. Popular Links. Related Sites. Menu Search Directions Contact. Communication involves the total personality [ 5 ]. Interaction between people is cyclic, which means that what one person says and does evokes a reaction from the other person, and this reaction again stimulates another reaction from the first person [ 10 , 11 ].

Three things are needed for successful communication. They are: A sender;. The purpose of communication is to inquire, inform, persuade, entertain, request and investigate. These three primary types of messages can be combined in many ways so that they form an interaction conversation. The goals of the interaction can be comprehensive. Verbal and non-verbal communications are the two main types of communication used by human beings.

Verbal communication is associated with spoken words and is vitally important in the healthcare context. Members of the multi-disciplinary healthcare team communicate verbally with one another and with patients as well as family members. Non-verbal communication is not reliant on words. This kind of communication, called body language, can tell a great deal or can totally the wrong impression. It is worth noting that body language may indicate a different meaning to what is spoken.

Often non-verbal messages send stronger signals than verbal messages. Non-verbal communication is made up of: Accent. The communication process may be explained by means of a linear model of communication, interactive model of communication or transactional model of communication [ 11 ]. Linear model of communication entails a sender, a message, a receiver and noise Figure 1. Interactive model of communication gives a slightly more complex explanation of the communication process.

Communication is seen as a process in which the listener gives feedback or responds to a message after a process of interpretation. Transactional model of communication acknowledges and gives emphasis to the dynamic nature of interpersonal communication and the multiple roles of the communicators. Features such as time, messages, noise, fields of experience, frames of reference, meanings, shared systems of communicators and personal systems all pay a role in the process of communication.

Communicators often participate simultaneously sending, receiving and interpreting. The unique interpretive and perceptual processes of individuals thus play an essential role in the communication process. Effective communication skills and strategies are important for nurses. Clear communication means that information is conveyed effectively between the nurse, patients, family members and colleagues. However, it is recognized that such skills are not always evident and nurses do not always communicate well with patients, family members and colleagues. The message sent may not be the message received.

The meaning of a message depends on its literal meaning, the non-verbal indicators accompanying it and the context in which it is delivered. It is therefore, easy to misinterpret the message, or to interpret it correctly, but to decide not to pursue its hidden meaning this leads to obstruction to communication.

Continuous barriers to effective communication brings about a gradual breakdown in relationships. The barriers to effective communication outlined below will help nurses to understand the challenges [ 8 ]. Language differences between the patient and the nurse are another preventive factor in effective communication. When the nurse and the patient do not share a common language, interaction between them is strained and very limited [ 9 , 10 , 11 ]. Consequently, a patient may fail to understand the instructions from a nurse regarding the frequency of taking medication at home. Culture is another hindrance.

The nurse needs to be sensitive when dealing with a patient from a different culture [ 9 , 15 , 16 ].


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What is acceptable for one patient may not be acceptable for another. Given the complexity of culture, no one can possibly know the health beliefs and practices of every culture. The use of eye contact, touching and personal space is different in various cultures and rules about eye contact are usually complex, varying according to race, social status and gender. Physical contact between sexes is strictly forbidden in some cultures and can include handshakes, hugging or placing a hand on the arm or shoulder. A smile does not indicate happiness, recognition or agreement.

Whenever people communicate, there is a tendency to make value judgements regarding those perceived as being different. Past experiences can change the meaning of the message. Culture, background and bias can be good if they allow one to use past experiences to understand something new; it is when they change meaning of the message that they interfere with the communication process [ 12 ]. It is important for nurses to think about their own experiences when considering cultural differences in communication and how these can challenge health professionals and service users.

Conflict is a common effect of two or more parties not sharing common ground. Conflict can be healthy in that it offers alternative views and values. Nurses aim for collaborative relationships with patients, families and colleagues. The factors in care setting may lead to reduction in quality of nurse—patient communication. Increased workload and time constraints restrict nurses from discussing their patients concerns effectively [ 16 ]. Nurses work in busy environments where they are expected to complete a specific amount of work in a day and work with a variety of other professionals, patients and their families.

The roles are hard, challenging and tiring.

Foundations of nursing practice

There is a culture to get the work done. Nurses who might have been confident in spending time with patients in an area where this was valued, when faced with a task-orientated culture have the dilemma of fitting into the group or being outside the group and spending time engaging with patients. Lack of collaboration between the nurses and the doctors in information sharing also hinder effective communication.

This leads to inconsistencies in the information given to patients making comprehension difficult for the patient and their families. Internal noise has an impact on the communication process.

Community Development in Community Health Nursing

People with feelings of fear and anger can find it difficult to hear. Reducing the cause of anxiety, distress, and anger would be the first step to improving communication. If a healthcare professional feels that the person is talking too fast, not fluently, or does not articulate clearly etc. Our preconceived attitudes affect our ability to listen. People tend to listen uncritically to people of high status and dismiss those of low status.

People can experience difficulty in speech and hearing following conditions like stroke or brain injury. Stroke or trauma may affect brain areas that normally enable the individual to comprehend and produce speech, or the physiology that produces sound. These will present barriers to effective communication. If patients are embarrassed or concerned that they will not be able to speak properly or control their mouth, they could be reluctant to speak. Equipment or environmental noise impedes clear communication.

The sender and the receiver must both be able to concentrate on the messages they send to each other without any distraction. Some ways of improving communication are as follows: Listen without interrupting the sender.

Practice - Registered Nurse Scope of Practice

Try to stay focused on the conversation. Use the body language that indicates your interest and concern. Touch the patient if it seems appropriate. Lean forward, listen intently and maintain eye contact if it culturally acceptable. Offer factual information. This relieves anxiety. Do not offer your personal opinion. Assure the patient that you have professional discretion. Try to reflect the feelings and thoughts the patient is expressing by rephrasing questions and comments using their own words.

Be convincing wen communicating [ 17 ]. There are several points to be kept in mind when communicating with patients. The first point is that you are there to provide care and support to the patient.

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Texas Board of Nursing - Practice - Registered Nurse Scope of Practice

Use words that are non-threatening — explain what you would like to do and do not give orders to the patient. Use simple, understandable phrases, not medical terms as most patients do not understand these terms. Nurses often communicate over the phone with patients, family members and colleagues and this can lead to misunderstandings.

The way in which the pone is answered and a message is interpreted needs special skills because the body language of the person at the other end of the phone line cannot be seen. When answering the phone or making a call: Always speak clearly into the mouthpiece of the phone.

Politely listen to the message and make notes if you think you may not remember all the information. Date and sign the message [ 17 ]. The skill of assertiveness is important to nurses. Assertiveness helps to enhance relationships, avoid power games and is a vehicle for clear outcomes.