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The Concept Analysis on Communication in Nursing

Introduction

The peculiarities of nursing theory and practice depend on a number of concepts which are widely discussed by scholars and practitioners. The concept of communication is one of the most significant aspects among them. Communication is the necessary part in providing different interactions, maintaining any relations, caring and fostering. Thus, the concept of communication is also the most important aspect of nursing theory and practice because it involves the elements of the interactions between patients and nurses which are required for effective care and treatment.

Nurses can influence the emotional and physical state of their patients with using the definite communication techniques. However, this impact can be either positive or negative. The fact is nurses should follow the principles of effective therapeutic communications in order to contribute to the successful care and the patients’ frequent recovery. That is why nurses should know all the aspects of the effective communication with patients, be able to overcome conflicts and treat their patients as individuals with paying much attention to their moods and psychological states. Moreover, the situations in which nurses work can be considered as rather stressful. That is why it is necessary for them to learn the peculiarities of the effective communication, of overcoming the stressful situations in their interactions with patients, and of breaking the communication barriers which can occur in their practice.

The aim of the analysis of the communication concept in the field of nursing is to provide the examination of the main aspects of the concept (attributes, antecedents, consequences), to determine the main issues which nurses can experience in their interactions with patients, and to study the major ways of overcoming these challenges as the necessary condition for providing the effective communication which is one of the main factors of nursing practice. Moreover, the paper will also focus on using the concept of communication in other disciplines (psychology and education). The aim of the work will be achieved with analyzing the current literature on the problem, determining the critical attributes, identifying the antecedents, developing the various cases, defining some empirical referents, and explaining the implications of nursing.

Literature Review

The Peculiarities of Using the Concept of Communication in Nursing

Communication is the important component of the everyday nursing practice. The effective communication forms the necessary conditions for the patients’ feeling safe and confident, ant it is closely connected with the aspects of the patient and his family’s engagement in the process of care. Moreover, the communication’s effectiveness accentuates the quality of treatment and care.

That is why many researchers concentrate on the aspects which characterize the effectiveness of communication and on those factors which can be considered as controversial or challengeable for nurses in their practice. The communication in nursing as in any other discipline refers to the complex procedure which can be described as sending and receiving definite messages which are verbal or non-verbal (Brinkert, 2010). The therapeutic communication as a concept of nursing can be considered as the way of influencing a patient in order to pass any message or an idea with the help of either non-verbal or verbal communication (Davidhizar & Eshelman, 1999).

The effectiveness of realizing this procedure influences the effectiveness of medical care and nursing practice. There are several factors which usually emphasize the benefits of communication in the nursing field. They are the commendable interviewing skills, psychosocial factors, the peculiarities of giving the information, the patient’s satisfaction, and the high quality of health care (McCabe, 2004). Thus, the results of the studies show that positive communication help nurses in meeting the patients’ psychosocial needs that can lead to the patients’ well-being and frequent recovery (Brinkert, 2010). For example, those patients who are not involved in the effective communication with their nurses while attending the therapy can take more time for recovery in comparison with those patients who have regularly positive interactions with their nurses. Thus, MacDonald bases the studies on analyzing the peculiarities of the collaboration and relationship between the nurse and the patient and provides the evidences that the care of a high quality is often the result of the commendable relationship between the nurse and the patient (MacDonald, 2007).

There are many aspects which can be discussed as influential for realizing the effective communication. They are the nurse’s ability to persuade, politeness, the use of names while interacting with patients in order to create the positive atmosphere, responsibility, sensitivity, honesty in providing the information, respect and the assertiveness. Stajduhar and the group of scholars determine these nurse’s abilities as the main principles for the effective communication with the patients with the cancer diagnosis (Stajduhar et al., 2010).

Persuasion as the important aspect of communication is accentuated by Davidhizar and Eshleman. In their research, the scholars pay attention to the fact that communication will be effective only in the situation of when the goals of the care and treatment are achieved (Davidhizar & Eshelman, 1999). Thus, nurses often experience the challenges of working with such patients who do not believe in the success of the treatment. That is why it is important to create such a communicative situation with the help of which nurses can persuade the patients to follow the doctor’s recommendations (Caris-Verhallen, 1999).

Such challenges are not rare in the work of nurses. Many researchers concentrate on the issues of nursing communication in their investigations. In her work, Tan Jia Xing Jasmine discusses the peculiarities of the use of effective therapeutic communication skills in nursing practice with focusing on the definite problems which nurses can experience “when communicating with patients, and some mistakes that they may unknowingly make” (Jasmine, 2009, p. 38). The researcher accentuates the necessity of providing the patient-centered care with paying attention to overcoming such aspects as cultural issues, listening, exploring, and barriers in communication.

The communication between nurses and patients can also be ineffective and lead to a conflict or be the result of the conflict situation. In his study, Brinkert focuses on the possible effects of conflicts in connection with nursing and the ways to overcome them (Brinkert, 2010).The main factors which are important for solving the conflict situations or their predicting are the nurse’s experience, knowledge, following the ethical principles of the interaction with patients.

Thus, the lack of experience or breaking the ethical norms can result in the development of the conflict. That is why it is significant to determine the elements of the ineffective communication which is influenced by the inappropriate nurse’s reactions. Sheldon and Ellington developed their research with paying much attention to the factor of responsiveness within the concept of communication (Sheldon & Ellington, 2008). The peculiarities of the nurse’s responses to their patients should depend on the patients’ emotional state. The work in stressful environment can result in nurses’ strict reactions to the patients’ complaints, but such behavior is inappropriate. Thus, the ineffective communication can result in such reactions as anxiety, adherence to treatments and the effective nursing communication can result in the patients’ satisfaction with the care and treatment (Sheldon & Ellington, 2008). That is why it is necessary to pay more attention to educating nurses on these aspects for contribution to their effective practice (Boschma et al., 2010).

According to the findings of the analyzed researches, the necessary attributes of the concept of communication as a complex process are the nurse’s competence, the patient’s readiness to the effective communication, verbal (the peculiarities of the language which is used, the ethical characteristics of the word choice) and non-verbal (facial expressions, jests, reactions) elements of communication. These attributes depend on such factors as the environmental features (the stressful situation, the peculiarities of communication with the members of the patient’s family), successful implementing of the necessary knowledge, and the empathic and attentive attitude toward the patients.

The Peculiarities of the Personal Experience

The work of the inexperienced nurse can be full of challenges many of which are connected with the aspects of communication with the patients. To be successful in the interactions with patients and their families, it is necessary to focus on overcoming such issues as the communicational barriers with the help of improving the skills in listening and positive reacting.

The communicational barriers are often associated with the general stressful situation in which the patient observe oneself. However, they can also involve the relations with the members of the family. Moreover, communicational barriers can be also influenced by the patients’ fears and prejudices. Successful overcoming these challenges can be the result of increasing the level of attention to the patient and his problems, effective listening and positive response according to the patient’s expectations, but depending on the medical needs (effective treatment). These methods can be efficient in combination with the individual approach to the patients.

The Peculiarities of Using the Concept of Communication in Psychology

The concept of communication is also discussed as the basis for all the professions because it determines the aspects of the people’s interactions. Communication is also the necessary part of psychology because of the fact the interactions between the psychologist and his patients occur with the help of verbal and non-verbal communication.

The psychological communication can be considered as effective when the patient and psychologist achieve the goals of their interaction. Moreover, the effective communication in psychology is based on a range of ethical aspects. Thus, the concept of communication is closely connected with the concepts of confidentiality and trust. If the principles of these two concepts are broken, the communication between the psychologist and patients cannot be discussed as successful (Craig, 1999).

The Peculiarities of Using the Concept of Communication in Education

The main processes which are associated with the field of education occur with involving the concept of communication in their realization. It is impossible to speak about the education as the process without paying attention to the aspects of verbal and non-verbal communication, different kinds of interactions which can include personal face-to-face and remote interactions (communication). Moreover, in the field of education researchers also determine several types of communication which can be effectively used for achieving the aims of teaching and learning. These types depend on the roles educators and students play while communicating with each other (Makoul, 2003).

Antecedents

The main antecedents which are connected with the aspect of communication between nurses and their patients can be discussed as the environmental influences which are important for analyzing the peculiarities of the further communication and such social and cultural influences which can be considered as the beliefs, considerations, and prejudices about the character of the further communication. The last aspect is rather influential for patients and can affect their state during the communication with nurses.

Thus, the situation of the communication between the patient and the nurse accentuates the fact that the patient’s is usually influenced by stresses and depressions as the results of his disease. That is why he often needs to be involved in the positive communication with nurses whose task is to help the patient (Sheldon & Ellington, 2008). The nurse should pay much attention to the details while dealing with a patient and his case in order to overcome his fears and prejudices.

To provide the successful communication with patients, nurses should focus on their physical, psychological and emotional states in order to assist them even in the situation when patients do not express the need for the communication with nurses (Jasmine, 2009). The main methods to overcome the negative effects which are the results of outside environmental and social factors are to realize the effective communication with patients on the principles of the mutual understanding, demonstrating care in relation to the physical and emotional state of patients, respecting the patients’ desires and inclinations, providing the necessary information, following the ethical principles, and acknowledging the patients’ fears and hesitations (MacDonald, 2007).

The other antecedent which was mentioned earlier is the setting of the environment in which the nurses interact with their patients. The environmental factors in regards to nursing communication can refer to the fellow workers’ support, the enough time of operating, and the usage of technological knowhow (MacDonald, 2007). Thus, the environment within which interactions take place must be rather conducive in order to enact the effective communication. When nurses have no time to realize the effective communication with their patients which takes a lot of time, the further interactions with these patients can be not successful because of the lack of the necessary information and the lack of understanding between the nurse and the patient (Davidhizar & Eshelman, 1999). The time and the other factors which were mentioned above are vital for the nurse to provide the communication with patients adequately. However, the lack of time should not be a hindrance to providing the communication. It is possible for nurses to manage their time in order to communicate with patients regularly (Jasmine, 2009).

Essential Attributes

To analyze the concept of communication in nursing properly, it is necessary to determine the main aspects which form it as a process. These are the attributes of nursing communication. Communication will be considered as a process when two subjects are involved in it. Thus, the main attributes are nurses and patients. However, it is necessary to focus on the nurse’s competence as the important condition for realizing the effective communication.

Moreover, verbal and non-verbal characteristics of communication are also meaningful. The language which nurses use communicating with patients can be considered as the influential factor for changing the patients’ moods and emotional states. That is why nurses should focus on the ethics of communication with patients. Such non-verbal characteristics as facial expressions and inappropriate jests can also affect in the patient’s changing the attitude to the situation (Davidhizar & Eshelman, 1999).

Consequences

According to the researchers’ findings, it is possible to determine positive and negative consequences which are associated with the advantages and disadvantages of the nursing communication (Brinkert, 2010).The effective communication between nurses and patients can contribute to the decreased level of the patients’ feeling of loneliness and the increased consciousness and hope for the future. Many studies show that the positive communication can be therapeutic in its nature.

Thus, the possible consequences of the interactions between nurses and patients can be determined in the situations of the further development of the communication between the nurse and the members of the patients’ families, the increase of the care effectiveness which can result in the successes in treatment because of the patients’ medication adherence. However, the ineffective communication can lead to the negative effects. Therefore, the consequences can be connected with the patients’ depressed emotional state and their rejection to follow the doctor’s recommendations (Jasmine, 2009).

The Model Case

An effective model case can be used as the example of using the theoretical principles in practice. This case accentuates the necessity of the effective communication between nurses and patients. When a patient receives the positive cancer test-results he needs the support and the honesty information about his situation which should be given in a positive manner in order not to confuse the patients (Davidhizar & Eshelman, 1999). For instance, John is suffering from headaches and problems with memory. He went to hospital several times. Now the doctors insist on making a head scan in order to establish the cause since the earlier medical treatment was not effective. John takes the tests and waits for the results.

When a nurse comes with the results that shows that John has a brain tumor he becomes devastated and begins to speak of dying. The nurse listens carefully to him without interrupting, but she uses the non-verbal language to show that she understands the patient’s problems. John can feel more comfortable and asks the nurse whether there can be a way out of such a dilemma. In this situation the nurse explains the possible treatment in detail accentuating the positive results. John feels quite relieved to know that chemotherapy, surgery, and radiotherapy can be used to manage the cancerous tumors. In this case the nurse and the patient are involved in the effective communication.

The Contrary case

A contrary case is the situation when a nurse comes and hands in the patient’s devastating results. She does not pay attention to the possible patient’s reactions and only does her work. In such a case John can feel upset and confused. In this situation he needs help, but the nurse is not inclined to concentrate on the patient’s needs. This nurse’s behavior contradicts the principles and criteria of the therapeutic communication. The nurse is more task-oriented in her actions than patient-oriented (Davidhizar & Eshelman, 1999).

The Borderline case

A borderline case can be described as the lack of the effective communication. For instance, a nurse just gives the results to the patient and listens to his or her complaints. Instead of offering the necessary information on how the patient can overcome his problems, this nurse can start blaming the patient for not going to the hospital when the symptoms were determined. This can be an example of the ineffective communication between the nurse and the patient. In this borderline case the nurse does not pay attention to the patient’s feelings. The patient may feel depressed and uncared for because of the nurse’s reaction (Brinkert, 2010).

The Related Case

The nurse can also use the opportunity to comfort the patient. The nurse listens to his complaints, and uses the principles of verbal effective communication. However, the results of such interaction can be considered as inappropriate because nurses can practice the therapeutic communication, but not concentrate on the patient’s real expectations and feelings (Brinkert, 2010). In such a case the nurse does not respect the patient’s feelings and cannot provide the necessary information. Nevertheless, her words can have the therapeutic effect and contribute to changing the patient’s emotional state.

Empirical Referents

Empirical referents are the classes or the categories which influence the occurrence of that concept. In the situation with the analysis of the concept of communication it is necessary to focus on such empirical referents as verbal and non-verbal aspects of communication, the factors which affect the realization of the nursing practice (Brinkert, 2010). The effectiveness of communication in the nursing field can be obtained with concentrating on the levels of patients’ satisfaction because these patients are usually involved in the positive communication. The negative impact on the communication between nurse and the patient may result in an ineffective therapy. In addition, an ineffective communication may also result in the patient’s disappointment with the health care provided.

Implications for Nursing

Communication is vital in the health care field, especially in nursing practice. The effective communication is necessary for creating the mutual understanding and positive relationship between nurses and patients (Davidhizar & Eshelman, 1999). It is always necessary for nurses to focus on the patients’ personal needs in order to provide the effective care and communication which can relieve their sufferings and give the hope for the future recovery.

To achieve the positive results in the interactions with patients, nurses should follow the complex of procedures which can contribute to their effective communication. Thus, nurses should be competent and persuasive in their work with the patients in order to convince them to follow the necessary treatment which can be considered by patients as ineffective or needless. It is also significant to communicate with patients accentuating their uniqueness. Moreover, nurses are responsible for their positive relations with the members of the patients’ families because their cooperation can contribute to the patients’ recovery significantly (Stajduhar et al., 2010).

Conclusion

This analysis of the concept of communication in nursing is developed with the help of exploring the background information on the problem, the examination of the necessary literature, determining the attributes, antecedents, consequences and the empirical referents, working out the possible model cases, and providing the overview of the implications for nursing. According to the results of the analysis, it is possible to say that communication can be discussed as a foundation for the nursing care.

To provide effective caring, nurses should pay attention to the main aspects of successful communication. There are definite attributes of this phenomenon knowing of which is necessary for nurses. Moreover, it is also significant to focus on the ways required for overcoming the conflict situations in order to realize positive interactions. Thus, nurses’ communication should be based on the principles of empathy, respect for patients, their hesitations and fears, providing the honesty information, and focusing on the positive aspects in order to encourage the patients.

References

Boschma, G., Einboden, R., Groening, M., Jackson, C., MacPhee, M., Marshall, H., Magee, K., Simpson, P., Tognazzini, P., Haney, C., Croxen, H., & Roberts, E. (2010). Strengthening communication education in an undergraduate nursing curriculum. International Journal of Nursing Education Scholarship, 7(1), 1-17.

Brinkert, R. (2010). A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of Nursing Management 18, 145–156.

Caris-Verhallen, W., Kerkstra, A., & Bensing, J.M. (1999). Non-verbal behavior in nurse-elderly patient communication. Journal of Advanced Nursing, 29(4), 28-37.

Craig, R. T. (1999). Communication theory as a field. Communication Theory, 2, 119-160.

Davidhizar, R. & Eshelman, J. (1999). The friendly art of persuasion. Health Care Manager, 18(2), 41-46.

Jasmine, T. J. X. (2009). The use of effective therapeutic communication skills in nursing practice. Singapore Nursing Journal, 36(1), 35-40.

MacDonald, M. L. (2007). Nurse talk: Features of effective verbal communication used by expert district nurses. Web.

Makoul, G. (2003). Communication skills education in medical school and beyond. The Journal of the American Medical Association, 289(1), 37-49.

McCabe, C. (2004). Nurse-patient communication: An exploration of patient’s experiences. Journal of Clinical Nursing, 13, 19-29.

Sheldon, L. K. & Ellington L. (2008). Application of a model of social information processing to nursing theory: How nurses respond to patients. Journal of Advanced Nursing 64(4), 388–398.

Stajduhar, K. J., Thorne, S. E., McGuinness, L., & Kim-Sing, C. (2010). Patient perceptions of helpful communication in the context of advanced cancer. Journal of Clinical Nursing, 19, 2039-2047.

Theobald, B., Mattthews, I., Mangini, M., Spies, I. R., Brick, T. R., Cohn, J. F., & Boker, S. M. (2009). Mapping and manipulating facial expression. Language and Speech, 52(2), 369-386.

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