Effective Communication in Nursing Practice: Analysing Challenging Communication Scenario

Scenario 1

You are working as a registered nurse on clinical placement in the local emergency department and your colleague asks you to go out to the waiting room to speak to the family of a young man who was brought into the emergency department after falling outside the nightclub where he had been celebrating his friend's new job.  The young man sustained a serious head injury and is presently unconscious and is being prepared for transfer to the intensive care unit.  As you approach the family members (who you think are the patient's brother and sister) and introduce yourself, the family members stand really close to you and poke you on the shoulder.  In a really loud voice the say “What’s going on? We get this late night phone call saying Jim's been taken to hospital and then you leave us sitting here for hours not knowing anything! What the hell is going on?"
You feel threatened by the family member who has invaded your body space by standing so close over you and poking you in the shoulder.

Scenario 2
You are working in a day surgery unit and your patient has returned to the ward following a liver biopsy after their recent diagnosis of cancer.  Shortly after their return to the ward, you notice extensive abdominal swelling and your patient's vital signs begin to indicate signs of shock.  Shortly afterwards you press the emergency button and begin cardiopulmonary resuscitation with your colleague.  Despite the efforts of the medical emergency team and your colleagues the resuscitation was not successful and your patient dies.  
The surgeon arrives and is briefed on what has happened.  He asks you to accompany him to the interview room outside the ward to explain what has happened to the patient's wife.  After the surgeon has told the patient's wife and answered a couple of questions he leaves you alone with the wife.  She is crying and repeating "I can't understand it, how could this happen?"

Scenario 3

You are a second year student on clinical practice and your buddy RN has asked you to complete a simple wound dressing for your patient.  As you are completing the dressing, your buddy RN storms into the room and glances at what you’re doing.  She says “You’ve got  it all wrong, just stop what you’re doing!  I’m so sick of having to watch you do everything, having a student is such a pain and I really don’t have time to deal with your incompetence!”  The buddy RN then storms out of the room and leaves you to try to calm down your patient who seems very upset. As you leave the room, you try to find your buddy RN to discuss what has just happened.

For this assessment item you will need to select one of the communication scenarios.

Complete a written essay answering the following question:

Communication within nursing practice is often challenging and nurses need to be equipped with strategies to respond effectively in these situations.  Select one of the communication scenarios presented and write a 1600 word essay that draws upon communication frameworks and concepts (for example: communicating in situations of crisis/grief/loss, managing aggression, assertive communication and managing conflict) and analyses the scenario in relation to these concepts.  

The 1600- word essay should cover the points below:

•    Introduction (150 words): State an overview of the chosen scenario and the communication framework/concepts you will use in your essay. This first paragraph should provide the thesis statement and the overview of main points or brief plan for what is included in your essay.

•    Communication Framework/Concepts (200 words): Discuss your chosen communication framework/concepts.  Briefly explain how it relates or is relevant to your chosen scenario. Why it is suitable and are there any relevant positive or negative aspects of the framework/concepts that are important considerations for nurses. Write one paragraph here with the first sentence of the paragraph providing the main point – the communication framework and its relationship to the scenario. The rest of the paragraph explains why it is suitable and its positive and negative aspects for nurses, using evidence from the literature.

•    Analysis of the Communication Scenario (700 words): Analyse the communication scenario and identify the elements that reflect ineffective interpersonal communication.  Draw upon some literature to support your analysis of the communication scenario. Use at least three paragraphs here with each paragraph’s main point relating to a particular element. The rest of each paragraph will explain and support the main points by referring to the evidence and relating it to the scenario element using examples.

•    Apply your Chosen Communication Framework (400 words) Use your chosen framework/concepts to discuss effective communication within the chosen scenario and support and justify your discussion with reference to evidence based literature. Use at least 2 paragraphs here with each paragraph’s main point explaining an area of effective communication. The rest of each paragraph will explain and support the main points by referring to the evidence and relating it to the scenario using examples.

•    Conclusion (150 words): Briefly restate the case scenario and your chosen communication framework and summarise how it was relevant, your main analysis findings and the main ways you applied your framework to suggest effective communication within the chosen scenario. Use one paragraph for this conclusion, restating your thesis, providing an overview of main points and providing a concluding sentence or two that rounds out your learning from the assignment.

Effective clinical communication is an important aspect in nursing practice with good listening and interpersonal communication skills that can overcome communication barriers and promote patient safety. In the chosen scenario, on a clinical practice, a second year student was asked by a registered nurse to complete a simple wound dressing for a patient. During the dressing, the registered nurse stormed into the room and glanced at the dressing. After that, she shouted and said that the dressing process is totally wrong and was asked to stop the dressing. She also screamed saying that the she is tired of the incompetent students and they are such a pain. She showed anger on the second year student and stormed out of the room. This made the student upset and she wanted to discuss with the registered nurse about the incident. The following essay deals with the relevant communication framework and its analysis, application in the professional nursing practice.

The communication framework that is relevant to the case scenario is the SBAR framework (Cornell et al., 2014). This is highly relevant to the case scenario as there was no proper handover of the patient to the nursing student by the registered nurse. During the clinical handover, it is important to standardize the communication that allows the nurses to communicate about the important information about the patient. This ensures patient safety and quality of care. In the given case scenario, the registered nurse should have communicated and demonstrated the patient’s proper information.