Prior Research for NURS1002 Assessment 1

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The University of Newcastle *

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1002

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Nursing

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Apr 29, 2024

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Prior Research for NURS1002 Assessment 1 Communication Communication is a dynamic process whereby which individuals relay information to others, usually for the goal of eliciting a response. Communication allows individuals to relay their thoughts and feelings to others, giving way to understanding, interpersonal relationships and a sense of belonging. Communication can take the form of verbal communication which is influenced by the content of one's words, the tone used, the articulation of one's words and the speed of speech. Communication that is in the form of written media, images, diagrams, facial expressions and body language is considered to be non-verbal communication.  The development of a therapeutic relationship supports the nurse in being person centred (Bolster & Manias30). (kosher and erb)  For the therapeutic relationship to be effective in meeting the person’s goals and needs, the nurse needs to earn the person’s trust and respect, often through demonstration of sound nursing knowledge and use of effective communication skills. (kosher and erb) Effective communication is central to effective therapeutic patient-nurse relationships and the implementation of a person-centred approach to care. A holistic approach to patient care is supported by effective communication between nurse and patient; encouraging a trusting relationship whereby patient and nurse can work in collaboration for the purpose of achieving person-centred outcomes (Stein-Parbury1). The development of a trusting relationship is essential to encouraging disclosure by a patient; allowing the nurse to increase their understanding of the person’s health experiences and needs (Stein-Parbury 2018). Nurses who communicate effectively are better able to collect, share and validate assessment data, think critically, initiate interventions, evaluate intervention outcomes, initiate change and prevent unsafe practice. Therefore, effective communication is central to safe person-centred care and effective therapeutic relationships, as reflected in the Nursing and Midwifery Board of Australia (NMBA) Registered Nurse Standards for Practice, where it is stated that Registered Nurses must communicate effectively and be respectful of each person's dignity, culture, values, beliefs and rights. Emotional intelligence is a key component to the person-centred processes; emotional intellect is characterised by an ability to regulate one's own emotions and be attentive to the emotional needs of those around them/ in their care. emotional intellect is fundamental in establishing a secure sense of self and self management that the registered nurse can take foreword into their care for people. An emotionally intelligent nurse can implement reflection-for-practice whereby they consider patient beliefs, values, culture, age, past experience and medical history, among other factors, in their approach to communication and the implementation of care plans. emotional intelligence encourages regular self-reflection that allows for continuous improvement in self and interactions with patients and the care team. Self reflection is built into the Nursing and Midwifery Board of Australia's Registered Nurse Standards for Practice as observed in 3.5 Registered Nurse seeks to respond to practice review and feedback. Applying standards Standard Subheading Application and theory RN standards for practice - Standard 1- Thinks critically and analyses nursing practice 1.2 develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice. Links key concepts in nursing theory regarding the importance of reflection as an integral aspect of nursing with emotional intelligence to professional codes and guidelines that govern practice. Incorporating reflection into practice has been linked to the enhancement of professional skills (Bulman, Lathlean, & Gobbi, 2012) and ultimately, the

strengthening of identity (Chong, 2009). Nurses are encouraged and supported in this reflective process by reflective models such as 'SPROUT'; which encourages nurses and nursing students to draw upon past experience, evidence based research, and their internal and external environments to shape understanding and guide future approaches to communication. Nurses can also utilise tools such as the Johari Window that highlight the importance of being receptive to feedback both in one's personal and professional spheres. The Jahari Window can help us in the process of self reflection, coming to the final conclusion 'what about myself am I not conscious to?' , 'what is my blind area?'. It is through being open and receptive to feedback that we become more emotionally safe practitioners and collogues that implement standard 1.2 of the RN Standards for practice into daily activities. - Nurse reflects on professional values, professional values are shaped by codes and laws, to guide in the holistic treatment of the patient. - Nurse reflects on personal values (belifs, values, morals) in their own reflection process. this reflection on personal values can increase ability to nurse with empathy, compassion and kindness. - Nurses reflect on relationships-based (caring) theories such as Roger's Person-centred approach to care - stress courage, generosity, commitment and the need to nurture and maintain relationships. RN standards for practice - Standard 1 - Thinks critically and analyses nursing practice 1.3 respects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures. The standard 1.3 provides a link to Beauchamp and Childress' four essential bioethical principles - autonomy, beneficence, non-maleficence and justice as well highlighting the importance of cultural safety to fostering positive patient outcomes. 1.3 articulates the right that a person has to having their culture and experiences respected, through respecting the ancestral knowledge embedded in cultures, their histories, spiritualities and traditions that play a key role in developing self-image and personal values. Nurses are entrusted by the public to practice with within a framework that supports beneficence as seen in the ICN code of ethics a nurse's ' primary professional responsibility is to people requiring nursing care'. Nurses are expected to honour patients autonomy in a collaborative patient-nurse relationship whereby patients are the experts in the experience of their own lives. 1.3 highlights the 'role of the family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and

people of other cultures' and the expectations placed on nurses to respect this. ICN Code of Ethics 1. In providing care, the nurse promotes an environmen t in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. A holistic approach to nursing Communication techniques  SPROUT S ituation - everything involved in the situation (begin reflection when situation is still firmly in your mind/memory) P ast experience - active recollection of previous knowledge R ead and R efer - to seek knowledge of credible research and discussion with those of relevant experience (references) O ther influences - internal and external factors of self and others U nderstanding - cumulation of other stages/ seeing as a whole T ake it forward - consider what knowledge can be taken from the situation  Active listening Nurses that implement active listening into their practice communicate with the people in their care in an intentional manner, being present for the person both physically and emotionally. To foster a trusting therapeutic relationship nurses must support patient trust through actively listening to the verbal messages patients send about their personal experiences and decode the non-verbal messages that give information about their mental state/health. Active listening can give further information on the current health status of patients, how they are reacting to the health care they are receiving and the direction of the nurse in providing care, patient understanding of own health and the values and concerns of the person in care. active listening supports an approach of sympathy, empathy and compassion towards the patient. sympathetic nurses utilise communication skills to check own understanding. this mutual understanding allows connection with the patient on an empathetic level and provides information needed to take action to alleviate patient distress (compassion). Expressing empathy requires communication skills: o Paraphrasing - encourages further patient expression; nurses get ability to check their understanding; o Seeking clarification - used when paraphrasing is difficult; involves probing questions and restating what a client has said

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o Reflecting feelings - mirroring of feelings expressed by patients; nurses translate indirect feelings of patient into other words; this confirms the existence of emotions/ feelings must be accepted as valid and real o Connecting - responds to both thoughts and feelings e.g. "you feel … when…?" o Summarising - review what has been discussed to check understanding o Understanding and exploration - understanding based responses build meaning between nurse and person; brings nurse in touch with persons private and personal worlds;  Johari window Johari Window - primary dimensions  Non-verbal tuning in using SOLAR S: Face the other person squarely. This position says, ‘I am available to you’. Turning away lessens the degree of involvement. O: Adopt an open posture. This non-defensive position is one in which neither arms nor legs are crossed. It conveys that the person wishes to encourage ongoing communication and is open or receptive to what is going to be said. L: If possible, lean towards the person. People move naturally towards one another when they want to say or hear something—by moving to the front of a class, by moving a chair nearer a friend or by leaning across a table with arms propped in front. The nurse conveys involvement by leaning forward, closer to the person they are caring for. E: Maintain good eye contact. Mutual eye contact, preferably at the same level, recognises the other person and denotes willingness to maintain communication. Eye contact neither glares at nor stares down another but is natural. R: Try to be relatively relaxed and natural in the way you use your body. Total relaxation is not feasible when the nurse is listening with intensity, but the nurse can show relaxation by taking time in responding, allowing pauses as needed, balancing periods of tension with relaxation and using gestures that are natural. Extra study topics: Health Literacy Impact of English as a second language on communication and health outcomes Impact of old age on health literacy Type 2 Diabetes

Probing questions Probing: Asking broad questions that lead to or invite the person to explore, elaborate, clarify, describe, compare or illustrate thoughts or feelings. Probing can be the use of open-ended questions, closed questions, focused closed questions and multiple choice questions that specify only the topic to be discussed and invite answers that are longer than one or two words. Probing allows exploration by nurses into areas that will assist in planning and guiding patient-centred care. Question 1 a extra info Kevin M. Chun asserts in his journal article '“So We Adapt Step by Step”: Acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants' an experience of negative health outcomes among type 2 diabetics with a linguistically diverse background (CALD). In Chun's study language barriers were found to be a salient theme that negatively impacted participants ability to access health care services. It was found that low levels of English proficiency experienced by first generation Chinese immigrants hindered not only communication with health care providers, but also the ability to perform daily self-care tasks, such as scheduling medical appointments and purchasing over-the-counter health products (e.g., glucose monitor patches). For the participants understanding and adhering to care plan requirements became a source of stress and anxiety, with one participant (54 year-old male) stating that after moving to the US he feels as if he has "lost (his) leg" in regards to engaging with health literacy. Language proficiency has a myriad of impacts across all areas of individual health outcomes. Communication barriers between healthcare staff and CALD patients impacts upon the trust relationship between person and carer. For Arabic speaking diabetic patients in Melbourne, Australia it was found that non-compliance with medication and difficulties communicating with pharmacy staff about healthcare concerns where prevalent. H. Alzubaidi et al. supports this in his study 'Predictors of effective therapeutic relationships between pharmacists and patients with type 2 diabetes: Comparison between Arabic-speaking and Caucasian English-speaking patients' (2018) posted in the journal 'Research in Social and Administrative Pharmacy'. Alzubaidi finds that from a total of 701 recruited participants; 392 Arabic speaking patients and 309 English speaking patients that Of ASMs, 88.3% were non-adherent to their prescribed medication, compared with 45.1% of ESPs. In Chiyo's self-management of her diabetes it is stated that she has been taking Metformin 1000mg for her type 2 diabetes. The scenario does not state she is struggling with non-compliance and it can be assumed she has been taking her medications appropriately. If medication expectations changed however language proficiency would need to be considered as a possible barrier to maintaining health; thus I would need to utilise communication techniques such as teach back to support Chiyo in the self-management of her health.

Prior Research for NURS1002 Assessment 1

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