Communication Skills in Nursing Practice

Lucy Webb

• Publisher: SAGE Publications Ltd
• Year: 2019
• Print ISBN: 9781526489364, 9781526489371
• eBook ISBN: 9781529700534
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Written specifically for student nurses developing their communication and interpersonal skills in any field of nursing. The book addresses all the competencies for communication skills outlined in the 2018 NMC standards and features insightful contributions from experienced nurses and healthcare leaders across different clinical fields.

As communication and interpersonal skills have become essential to modern nursing, this book will focus on demonstrating how the theory behind these skills can be successfully applied in practice. Helping students to become confident, assured communicators when interacting with patients, whilst on placement and into their post-registration nursing career.

The new edition includes the following updates:

·         A new chapter on person-centred care and intercultural communication.

·         Further content on modern forms of communication such as social media and other new technologies.

·         A new theme 'Emotional intelligence' integrated throughout the book.

Part I Theories of communication

Preface to Part 1

Communication and interpersonal skills are essential for all nurses, regardless of the area of care. Whether being used for health promotion, building a trusting nurse–patient relationship or delivering a therapeutic intervention, communication and interpersonal skills are the bedrock to delivering patient-centred care, individualised care and patient-led care.

Communication Skills in Nursing Practice has been written for student nurses following pre-registration, nursing associate or apprenticeship programmes. The contributors are all nurses and experienced leaders in their different clinical fields and have years of experience guiding nursing students through education and training. The authors bring up-to-date knowledge and expertise to their topic and demonstrate how theory and practice are linked in the different practice contexts.

There are many books on communication and interpersonal skills available to nursing students. What makes this book different is that it focuses on demonstrating how the theory is applied in practice. Student nurses are taught theory in the academic setting and practice in the clinical setting. This book helps the student bridge the gap between the two. The skills and knowledge addressed here in these chapters reflect the skills expected of all qualifying nurses as detailed in the Nursing and Midwifery Council’s Future Nurse: Standards of Proficiency for Registered Nurses (NMC, 2018a).

Lucy Webb, Editor

One Introduction to communication skills

Lucy Webb

The aims of this chapter are to:

• Outline the importance of communication skills in nursing
• Explore the underpinning theories and definitions of communication
• Demonstrate theories of communication in the practice setting
• Provide context for the rest of the book

Introduction

Communication is identified as one of the essential skills students must acquire in order to become qualified nurses (NMC, 2018a). This book has been designed to help student nurses understand the underlying reasons why communication skills have become so important in nursing. In all the chapters in this book, you will find examples illustrating how communication is applied in the nursing context. In this way, the book will help you develop your knowledge and skills in order that you feel prepared for practice.

Why is communication important in nursing?

Important skills for the Nursing and Midwifery Council

The Nursing and Midwifery Council (NMC) proficiencies (NMC, 2018a) became effective in 2019 and are split into two key elements: (1) communication and management and (2) nursing procedures. This book specifically addresses the communication and management proficiencies that students will need to demonstrate in order to become registered with the NMC. You will find the full list of communication and management proficiencies in Annex A of the NMC standards document (NMC, 2018a) but, in short, they govern the key skills domains:

1. Underpinning communication skills that enable the practitioner to assess, plan and provide evidence-based practice through:
   1. active listening, non-verbal communication, open and closed questioning
   2. being aware of one’s own biases
   3. writing accurate, clear and legible records to share information
   4. analysing and using digital data
   5. recognising the need for translational services.
2. Communication for supporting people of all ages, their families and carers in preventing ill health and in managing their care through:
   1. sharing health information with service users in an understandable way
   2. recognising the need for sensory impairments adjustments and personal communication aids.
3. Use communication to deliver therapeutic interventions and:
   1. be able to use a range of therapeutic techniques where appropriate.
4. Working with professional teams through:
   1. use of effective supervision and teaching/training of staff and students
   2. management of teams through skills in managing change, conflict, negotiation and escalation.

You will find all these competencies addressed throughout this book.

Communication as an aspect of care

We could say that communication skills are linked inextricably to the professional values of nursing. Nurses frequently work the most closely with patients, having a specific position in their role as health professionals to develop and maintain a trusting professional relationship with patients, family members and carers (Fitzpatrick, 2018). Nurses are therefore in the best position to deliver patient-centred care, and to do this compassionately while maintaining the patient’s dignity and safety and, of course, effectively. Without effective communication patient care may be negatively affected. Nurses work very closely with the patient but are also heavily involved in the multi-disciplinary team. Therefore, they need to be able to adapt to interact with a wide variety of people. If nurses do not adhere to their professional values, they may put their patients at risk of serious harm. The most crucial point is that behaving and communicating like a professional at all times is vital to becoming a competent nurse. Nurses should never presume things about their patients, and they should use their communication skills to ask relevant questions even about sensitive issues. This enables the nurse to be fully informed about the patient and for them to be able to treat the patient as an individual.

The Royal College of Nursing (RCN) proposes a set of principles that define nursing practice:

1. treat everyone with dignity, humanity and compassion
2. deliver accountable care in collaboration with patients, families and carers
3. manage risk and keep people safe
4. deliver person-centred care, driven by informed choices
5. nurses are at the heart of the communication process involving patients, practitioners and carers
6. nurses have up-to-date knowledge and skills, delivered with intelligence, insight and understanding of patients
7. work with colleagues to provide best possible co-ordinated care
8. nurses lead by example, influencing care that is person-centred.

(RCN, 2018)

These are all skills developed by nurses during their pre-registration education; however, all of them demand good communication skills. It appears that this argument supports the notion that ‘nursing’, in addition to applied knowledge and caring attitude, is underpinned essentially by communication skills.

The therapeutic effect of good communication is supported by evidence. For instance, Bensing and Verheul (2010) describe communication as ‘the silent healer’ for its positive effects on how patients experience ill health. Health professionals who can deploy emotional intelligence in their communication develop more effective care relationships and make better care decisions with their patients (Raghubir, 2018). Popa-Velea and Purcărea (2014) list the practical benefits of good communication through facilitating a positive relationship between the practitioner and the patient, allowing the patient to fully explain their needs and enhancing the practitioner’s knowledge and understanding of the patient. Street et al. (2009) demonstrate that communication pathways can lead directly to improved health outcomes by delivering health education, motivation and empowerment, and treatment based more closely on the patient’s needs.

So, we can see that good communication in the nurse–patient encounter is itself a therapeutic intervention as well as being the vehicle for good care. It is as important as any other care or treatment intervention. In brief, the evidence above suggests that health communication helps patients to:

1. express their physical and emotional needs
2. ask questions and ...

Table of contents

• Cover
• Half Title
• Acknowledgements
• Title Page
• Copyright Page
• Contents
• Publisher’s acknowledgements
• Part I Theories of communication
• One Introduction to communication skills
• Two The nurse–patient relationship
• Three How to relate to others effectively
• Four Active listening and attending: communication skills and the healthcare environment
• Five Groups and teamwork
• Six Effective person-centred and intercultural communication
• Part II Applying communication skills in nursing
• Seven Theory to practice: communicating therapeutically
• Eight Facing challenges in healthcare communication
• Nine Health promotion and communication techniques
• Ten Professional communication skills for student survival: self-management, writing and presenting
• Part III Advancing application of communication skills
• Eleven Communicating in immediate and short-term care situations
• Twelve Communicating with people with chronic and long-term health needs
• Thirteen Communicating with children, young people and their families
• Fourteen Communication and the cognitively impaired patient
• Fifteen Engagement, motivation and changing behaviour
• Sixteen Communication for personal and professional development: pre-registration and post-registration
• Glossary
• Index