Importance Of Clinical Communication In Nursing Practice

Explain Clinical Communication Is an Important Aspect?

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. She should have provided the accurate Situation, Background, Assessment and Recommendation (SBAR) regarding the type of wound and dressing along with precautions that was required for the wound dressing (Klim et al., 2013). As a second year nursing student, she lacks experience and necessary skills; it is the duty of the registered nurse to provide the appropriate information about the patient’s condition. For a safe working clinical environment, it is necessary to transmit important information to the member of a healthcare team that facilitates collection, organization and information exchange between them (Shah, Alinier & Pillay, 2016).  During the clinical handover, the registered nurse should have provided a concise statement about the wound and patient problem called Situation. The Background should have been provided where she should delivered pertinent information about the wound type and dressing. Assessment was also important where the nursing student should have properly analyzed the considerations and Recommendation where she should have demonstrated the acquired knowledge and provided proper feedback to the registered nurse. This would have helped her to know the level of understanding in her.

Analysis of the Communication Scenario

While analyzing the case scenario, it is evident that there is lack of effective interpersonal communication skills between the registered nurse and the nursing student. As there was ineffective interpersonal communication between them, it developed stress and it had a direct effect on the patient’s quality of care and safety (Kourkouta & Papathanasiou, 2014). In addition, due to this communication barrier, the nursing student was unable to understand and provide feedback on what she understood after the clinical demonstration. In a professional setting, the nurses have the responsibility to care and advocate their voices so that there is no communication barrier in providing patient safety. Interpersonal communication between the healthcare team members has a direct link with the medical errors and patient safety.  The nursing student was unable to provide feedback due to the communication gap and this annoyed the registered nurse as she considered her to be incompetent. The elements of effective communication skills comprises of the nonverbal communication, listening and personal relationships. It is an ongoing process where the gestures and facial expression are important and must comply with the verbal communication (Bach & Grant, 2015). In the scenario, registered nurse stormed into the room and then shouted and left the room in anger. This made the student and the patient upset and she wanted to discuss with the registered nurse about the incident.

Among the elements of interpersonal communication, the communication process is a tow way process, where the one person talks and the other person listens along with feedbacks. In the case scenario, it was one-way communication, where the registered nurse just advised her to perform the dressing, without even assessing the level of her understanding about the wound management. Feedback is also an important element in interpersonal communication that aids the sender to know how accurately the receiver has received the message. In the case scenario, it was not done accurately as the registered nurse just provided the message without any scope for feedback. As there was lack of good personal relationship between the student and the nurse, she was not able to provide feedback and there was knowledge gap that prevailed in the scenario hampering the patient safety (Xie et al., 2013).

Listening is also an important aspect of interpersonal communication. It is vital in nursing practice as proper attention and mobilization of all the information gathered by the nurse are emitted through the patient care ensuring safety. Through effective listening, the nursing student would have been able to understand the type of dressing and procedure that was required for the patient. It would also have ensured the patient’s needs and integrated care that was according to the evolving needs of the patients. Personal relationships are marked by compassion, kindness and empathy that help to develop good personal relationships among the nurses in a healthcare team (Burnard & Gill, 2014). If there would have been good personal relationship between the registered nurse and the nursing student, she could have asked questions with kindness and provided information that did not scare her. On a contrary, the nursing student lacked listening skills as she was not clear with the wound dressing procedure that she was advised to perform. There was also lack of acceptance and a harmonious relationship that affected the transmission of information between them. Interpersonal communication not only encompasses the transfer of information, but, also consists of emotional and mental dynamics that are required in communication (Hagemeier et al., 2014).

Application of SBAR Communication Framework

Effective interpersonal communication practice is important as asking, screening and clarifying questions helps to focus on the patient safety. The registered nurse should have been present there providing her small amounts of information at a time, checking on how she was performing the dressing and pausing where it was required. In addition, listening, paraphrasing, summarizing, empathizing and making guesses helps to demonstrate the ability of the nurse in providing the patient centered care. If the nursing student would have listened and empathized during the demonstration, it would have been able to access the level of understanding and the doubts of the student (O'Shea et al., 2013). 

SBAR stands for Situation-Background-Assessment-Recommendation that helps to facilitate prompt communication between the members of a healthcare team about a patient’s condition (Randmaat et al., 2014). It is a technique that provides concrete mechanism for the framing of conversation that requires critical attention and action plan. It is an easy way to focus on the expectations for the patient that fosters a patient safety culture. It helps to communicate pertinent information about a patient during clinical handover. In the case scenario, while advising and handing over the patient to the nursing student, she should have accurately advised and provided her with pertinent information about the patient’s wound and the dressing procedure (Chitkara et al., 2017).

The registered nurse should have explained to the student about the problem and provided her a brief description about the type of wound and dressing called Situation. During this stage, it is important to communicate providing the brief. In Background stage, it is required to provide diagnosis of the patient’s condition, medical history and current medical status. In this stage, medical-based information is conveyed to assess the data (Blom et al., 2015). In the case scenario, the registered nurse should have demonstrated her procedure of the dressing with the current medical condition and patient history. In the assessment stage, the nurse should have provided the student the appropriate action plan for the dressing with medical aspects of the patient. Impertinent information about a patient can harm the patient safety and quality of care. The vital signs of the patient and the additional concerns about the patient status are also crucial as the course of action given to the patient is determined in this stage. The nursing student should have assessed the procedure of dressing that was demonstrated to her by the registered nurse. Lastly, the recommendation or the feedback where the nursing student should have provided feedback to the registered nurse about what she had understood and the gaps in her knowledge. If feedback would have been to the nurse, she would have been able to understand her level of knowledge and this scenario would have not occurred.

Under the Standards for Practice for the enrolled nurses in the Nursing and Midwifery Board of Australia (NMBA), Standard 5 demonstrates that the enrolled nurses should collaborate with the registered nurses and with the other healthcare professionals so that it helps to develop the plan of care for the patient under their provision of care (Birks et al., 2016). For this, it is required to develop professional working relationships and clarifies the orders of the nursing care with the registered nurses.

Conclusion

In the given scenario, there is ineffective interpersonal communication between the registered nurse and the nursing student. During the clinical handover, the registered nurse did not explain the type and procedure of wound dressing and that resulted in the harm of the patient. The case scenario illustrates that there is ineffective communication and barriers prevail between them. The SBAR communication framework is relevant to the scenario as there should have been proper application of SBAR framework during patient handoffs. Effective communication encompasses the listening skills and feedback that are important to overcome the communication barriers and provide patient safety and care.

References

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Blom, L., Petersson, P., Hagell, P., & Westergren, A. (2015). The SBAR model for communication between health care professionals: a clinical intervention pilot study. International Journal of Caring Sciences, 8(3), 530-535.

Burnard, P., & Gill, P. (2014). Culture, communication and nursing. Routledge.

Chitkara, H., Dials, K., Schuh, K., Thompson, N., Wagner, C., & White, S. (2017). A Protocol to Enhance Nurse-to-Nurse Communication during Patient Handoff.

Cornell, P., Gervis, M. T., Yates, L., & Vardaman, J. M. (2014). Impact of SBAR on nurse shift reports and staff rounding. MedSurg Nursing, 23(5), 334-343.

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O'Shea, E. R., Pagano, M., Campbell, S. H., & Caso, G. (2013). A descriptive analysis of nursing student communication behaviors. Clinical Simulation in Nursing, 9(1), e5-e12.

Randmaa, M., Mårtensson, G., Swenne, C. L., & Engström, M. (2014). SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study. BMJ open, 4(1), e004268.

Shah, Y., Alinier, G., & Pillay, Y. (2016). Clinical handover between paramedics and emergency department staff: SBAR and IMIST-AMBO acronyms. International Paramedic Practice, 6(2), 37-44.

Xie, J., Ding, S., Wang, C., & Liu, A. (2013). An evaluation of nursing students' communication ability during practical clinical training. Nurse Education Today, 33(8), 823-827.