As a future healthcare professional, Communication plays a crucial role in the personal and professional world of nursing and is a skill nurses must develop. Ineffective versus effective healthcare provider communication styles can completely change a patient’s healthcare experience. having effective communication skills is an integral part of both one’s personal and professional world as a practicing nurse. Having effective communication skills is vital in a patient’s healthcare experience. Nurses have the responsibility of being able to communicate clearly and accurately every day in order to relay health information to them with interdisciplinary teams on a daily basis to relay patient health information (Sethi & Rani, 2017). In this reflective synthesis, I will share personal reflections that overviews demonstrate the importance of effective communication skills as I transition in my professional role and how having effective communication skills have impacted my personal and educational life experiences and as a learner from a student nurse to a graduate nurse. In my professional reflection, Moreover, I will describe clinical experiences that showcase show how I have grown with my developed effective strong communication skills and explore evidence-based strategies I implemented. to do so. As well, I will reflect on how having effective communication skills will impact my future nursing practice.
Personal Reflection on Communication Skills
Having effective communication skills is an essential tool that is important for me as I transition from a supervised nursing student into an independent practitioner as a graduate nurse graduate nurse. Throughout nursing school, I was taught learned about the value and importance of therapeutic communication between the nurse and patient. Effective communication can lead to positive health outcomes through more individualized and improved quality of care (Nieuwboer, et al., 2018). As well, effective communication skills are crucial for collegial interprofessional relationships. The College and Association of Registered Nurses of Alberta’s (CARNA) Practice Standards For Regulated Members states that having effective communication between fellow nursing staff and other members of the interdisciplinary healthcare team can foster a professional and therapeutic work environment that facilitates respect, mutual trust and support (CARNA, 2013). Developing my communication skills will allow me to provide better nursing care that is holistic and as well as patient and family-centered, and interact constructively with colleagues and team members. as a graduate nurse. Comment by Taneille Johnson: Pick a different word here Comment by Taneille Johnson: It’s important to mention the team members again because otherwise your reference to the nursing standards is out of place the paragraph is just about patients
Reflecting on In my nursing practice, there are a number several factors that have affected or could potentially s played a key role in affecting my nursing growth in my communication skills. communication skills growth. These factors include Some examples of these factors include: environmental challenges, items such as an unsupportive work environment, lack of time due to a high patient workload; cultural differences (cultural competency);, and staff conflict. A Constant shortage of nurses increases the patient workloads and puts added increasing stress on the nursing staff stress and me. my own stress. When caring for multiple a lot of patients, I find that there is often not enough time for me to effectively communicate and establish the patient-nurse rapport with the patient that is needed to be required for an optimal a good therapeutic relationship. Cultural aspectsCulture, including potential differences in verbal and non-verbal communication between cultures, can also be a barrier to effective communication., because with differences in spoken language, effective communication can not be readily established. As well, another challenge with effective communication is that nonverbal communication is different among various cultures and they may have different interpretations of it. Furthermore, Patients may not want to receive care from nurses who don’t speak the same language or have a different culture than them (Sethi & Rani, 2017). As well, conflict among the interdisciplinary team can also serve as a barrier to growing my communication skills. Comment by Taneille Johnson: Do you mean if the patient speaks a different language than you? Comment by Taneille Johnson: This seems thrown in at the end. Do you have an example?
My communication style has grown and changed significantly as I moved through nursing school. This journey of growth has also had a large impact on my personal life and relationships outside of my career. My journey of growth and developing effective communication skills during nursing school have both impacted me as a person and as a continuous learner. Before starting the After-Degree Nursing program at the University of Alberta, I was known for being shy and introverted. As a learner, I struggled with communicating with my peers and instructors as I found it difficult to get my thoughts across in a succinct and effective manner. convey my thoughts succinctly and effectively. Throughout During this program, I have gained more confidence in my communication abilities skills and skills in developing therapeutic relationships with my patients. I always look sought for opportunities to practice my communication, skills such as using SBAR to give reports to members of the interdisciplinary team. Developing my communication skills has impacted my personal life in that I have a better life by improving interpersonal relationships with friends and family. I am more able to clearly express my thoughts and opinions, which helps to avoid misunderstandings. and I've also worked on my non-in verbal communication, learning how to by using use appropriate engaged eye contact and having adopted a n more open, relaxed posture to encourage others to connect with me. During my nursing program, I have also improved my active listening skills outside of school by being a listener for helping peers and friends that would like to debrief after a challenging shift. My growth in effective communication skills growth have allowed me to improve on better-exchanging ideas with other people, and to better network and build connections with others personally and professionally. The difference in my confidence and how I feel from the start of my program to now underscores to me the importance of and has shown me the importance of using effective communication skills. to network and build connections as a learner and as well in my personal life. As I transition from a student nurse to a graduate nurse, I have demonstrated growth in my communication skills as shown by my ability to provide clear and effective communication when utilizing SBAR to communicate a patient’s health status and care to members of the interdisciplinary team. Comment by Taneille Johnson: Do you find that you had misunderstandings or conflicts with friends/ family? (ps: I love you Kels and you’re lovely).I ask because you mention how you have improved things below. Comment by Taneille Johnson: Does this sentence better fit in the paragraph below?
Professional Reflection and Strategies to Develop Communication Skills
During my journey through nursing school, I have shown growth showed growth in my communication skills through various experiences in my clinical placements. In my first clinical placement, in a hospital setting, I struggled and had difficulty with building therapeutic relationships when communicating with patients and reporting to nursing staff and members of the interdisciplinary team. The unit I was placed on was a nephrology medicine unit with acutely-ill patients and was a fast-paced, and heavy-workload environment. As it was my first nursing placement as a student nurse, I struggled with having confidence in my skills and how to appropriately communicate changes in patients’ health status using SBAR; I was unsure (knowing what is the what information was pertinent to communicate. pertinent information). Providing Patient teaching was also difficult and challenging at times when I forgot not to use used medical jargon and had difficulty finding ways to describe medication uses and/or mechanism of actions of medications in layman non-medical understandable terms.
As well, communication in nursing also involves a significant amount of writing as well as speaking. as well as speaking. When long-hand writing my nursing notes on a separate piece of paper and having my buddy nurse provide feedback, my buddy the nursing staff member mentioned that I needed to work on my documentation skills in charting chronologically, timely, clear, and concise, as well as relevant. Based on my charting, it was not clear to the oncoming staff exactly what was going happening with my patient’s care during my shift and what I was the patient’s current health status was.
Cultural and emotional challenges also arose in my clinical placements. In my mental health clinical placement, I was conducting a mental status assessment and asking a patient questions when suddenly the patient became quite distressed and, yelled at me for bringing up bad memories and then walked away and walked away from me. At that moment, I realized that I did not know how to effectively communicate in order to respond or how to cope with the patient’s reaction and difficult emotions. Another challenge arose Another example I have was during my placement on a neurology medicine unit and when I was caring care for a patient who was non-verbal patient, who did not understand English and had a different way from a different cultural background than my own. As the patient could not speak, I had difficulty providing care for him and I felt like I did not have sufficient knowledge of the patient’s culture, language, and customs to communicate clearly. and avoid personal biases.
While my initial placements were challenging in their own way, I found that my communication skills improved with each subsequent clinical rotation due to experience and researching strategies to improve these skills. From each clinical experience I’ve had during my nursing program, I have continued to grow and progress in my communication skills. For example, During my internal medicine placement, I had a patient who went into respiratory distress and I had to utilize effective communication to give reports to members of the interdisciplinary team. By becoming more confident in using Using SBAR, I was able to effectively and appropriately communicate relevant assessment data on my patient’s changing health status and the interventions I carried out such as raising the head of the bed, encouraging deep breathing and coughing, administering O2 via nasal cannula and checking the SpO2 reading. After the patient stabilized, I was able to completely clear, concise, timely, comprehensive, and accurate documentation in the nursing notes flowsheets about everything that occurred events occurring before and during the rapid response team’s arrival to the unit. When the oncoming staff arrived, my documentation was effective in providing provided the necessary information for easy transfer of care: the new staff to know knew the patient’s health status and interventions carried out for easy transfer of care. Another example that highlights my communication skills growth in my effective communication skills is when I worked with a patient who was hard of hearing, had dysarthria, and spoke English as a second language was not his first language. By working with this patient, I was able to practice tried different forms of communication skills, especially with non-verbal communication, and communication with learning how to understand nonverbal cues of pain. and communicate while making good eye contact. I found that using good eye contact and a different form of communication adjuncts, such as a whiteboard to write short sentences that the patient could read and answer yes or no to was effective in the help the patient being able to communicate their concerns and needs. to me. Comment by Taneille Johnson: Did you find them frustrating? Any other emotions besides difficulty? Comment by Taneille Johnson: Did you know SBAR on your earlier clinical rotations?
There are a number of evidence-based strategies I implemented to further develop my communication skills. These strategies include, such as utilizing reflection and feedback, practicing using SBAR when communicating with interdisciplinary teams, and striving to be more culturally competent. In this reflective synthesis, I will describe these three strategies in more detail.
Utilizing Reflection and Feedback Each clinical day, I made it a habit to reflect on my nursing practice and seek feedback on how well I communicated during my nurse-patient and nurse interactions as well as with the interdisciplinary team interactions. Reflection along with and feedback allows me to identify the areas of communication I struggle in that I need to improve in, learn from my mistakes, and helps me gain self-knowledge and insight into how I can improve. my communication skills. For example, I used these techniques to learn from my patient education encounters. Of there were times when my patient patients didn’t fully have trouble understanding my patient education when talking about diabetes care and how to administer insulin. By reflecting on that interaction, I realized I need to be more careful in the words I choose such as avoiding ambiguous words or medical jargon. From feedback from My preceptor gave me feedback that, I need to also make sure I verify the patient’s understanding of my teaching by using strategies such as the teach-back method. Self-reflecting on communication skills has also been shown to be important in a medical resident’s practice for resident physicians. Research shows that physicians who reflect on their communication skills better help bring clarity in identifying how the physician both y listens to and responds to their patients. As well, the literature described how through reflection, physicians were able to recognize how having effective communication supports patients with treatment options and creates a therapeutic relationship of trust, rapport, and empathy leading to better patient outcomes (Duggan, Vicini, Allen, & Shaughnessy, 2015).
Improving Clinical Communication by Using SBAR SBAR is another strategy I make sure to implement each day daily into my nursing practice to help develop my communication skills is SBARskills.. Using SBAR to develop effective communication skills goes in hand with the is consistent with the Canadian Nurses Association’s (CNA) position statement on interprofessional collaboration. This position statement highlights the importance of having effective communication skills to share information and for decision-making amongst the interprofessional team (CNA, 2019). SBAR is a tool that allows me to clarify tool that outlines what assessment information should be communicated between members of the interdisciplinary team. When using SBAR to communicate a patient’s change in health status, this tool ensures that I am communicating health information that is concise, focused, and non-repetitive. As well, when giving reports to oncoming staff, using SBAR helps to prevent miscommunication and misunderstanding from a lack of essential health information, which can cause a breakdown in continuity of care and compromise patient safety (Uhm, Ko, & Kim, 2019).
Cultural Competence Cross-cultural communication is imperative in nursing. profession and being able to communicate in different forms and have an understanding of different cultures is important for a new graduate nurse. Cultural competency can be measured in terms of knowledge of different cultures, beliefs and attitudes, and skills, including communication (Polacek & Martinez, 2009). Throughout this program, I have acquired knowledge about different cultures and beliefs that have helped me provide culturally sensitive care by developing my cross-cultural communication skills. I also make sure to strive to ensure that my own beliefs do not affect my interactions with patients from different cultures. by creating personal biases. In terms of specific communication skills for effective cross-cultural communication that I use include, I use strategies such as using simple words with no medical jargon and speaking clearly. As well, I know Nonverbal communication can also be useful in conveying and receiving information. I implement techniques such as using pictures or symbols or a whiteboard to assist in communicating with the patients.
Impact on Future Practice
As I transition from the role of a student nurse to a graduate nurse, having effective communication skills will be paramount in my future nursing practice. During my first year of independent nursing practice, I know there will be a steep learning curve and constant challenges that I will face as a new graduate nurse. Some of the challenges I anticipate as a new graduate nurse are based on reading research and communicating with practicing registered nurses. These challenges include: succeeding inappropriately delegating tasks to licensed practical nurses (LPN) and healthcare aides (HCA);, prioritizing patient care; time management; clinical judgment; advocating for patients and yourself; developing, new psychomotor skills; and performing patient education (Wardrop, Coyne, & Needham, 2019).
Continuing to work to develop and improve my communication skills s, will hopefully help me to overcome the challenges I will likely face early on i inn my independent practice. Communication is an important aspect of delegating duties, and therefore, continuing to grow in my communication skills will help prevent miscommunication and unclear instructions that could lead to errors or missed patient care. I must ensure that I use two-way communication and verify that the delegate understands and accepts the delegated task. As a new graduate, I must never be afraid of asking for help and communicating with my nursing peers when I do not know the answer to something. Also, I must effectively communicate my limitations in a professional manner to my fellow colleagues and unit manager. Growth in my communication skills will also help me in providing patient education that is easy to comprehend and is culturally sensitive.
Developing effective communication skills will impact my future nursing practice and healthcare, nursing education, and how I provide patient care and work together with my future colleagues. To In order ton navigates a complex healthcare system with increasing numbers of patients who require requiring a great amount of care, I must constantly work on optimizing my effective communication skills, especially when working together with an interdisciplinary team. Establishing effective communication between nurses and patients provides more individualized care (Nieuwboer, et al., 2018). This is so that I aim to can become a leader in my patient's care and in my profession.
In terms of patient care and nursing practice, studies have shown that establishing effective communication between nurses and patients is beneficial in that it provides more individualized care (Nieuwboer, et al., 2018). As a new graduate nurse and throughout my nursing education, taking the time I need to understand the patient’s main concerns and unique challenges will better prepare me to be an advocate for my patient’s care and be able to address any issues if they arise. By continuing to grow in my communication skills when interacting with my patients in my future practice, I hope that this will lead to better health outcomes for my patients. Furthermore, I believe that developing effective communication skills will impact how I interact with my future colleagues. I think that Having good communication between my colleagues and I will be beneficial in reducing misunderstandings and conflict by helping to build healthy work relationships where issues can be resolved collaboratively. Having clear communication will also help create a less stressful work environment and hopefully increase job satisfaction among coworkers.
Conclusion
Through my transition from a student nurse to a graduate nurse, I have shown growth in my effective communication skills, and is something I will continue to work on these skills in my future practice. Through my personal reflection, I have highlighted factors that have affected my growth in relation to my communication skills growths, how developing effective communications skills have affected me as a person and learner and discussed how I have developed confidence in accurately using SBAR to convey a patient’s health information to the interdisciplinary team. Through my professional reflection, I have provided clinical examples that have demonstrated how I have grown my communication skills and discussed three strategies that I have implemented to make this possible. In my future practice, developing effective communication skills will be important to me in a complex healthcare system by using communication to provide more individualized care to patients to improve health outcomes. As well, by developing effective communication skills, I hope I am able to work collaboratively with my future colleagues to create a positive work environment.
References
Canadian Nurses Association. (2019). Interprofessional collaboration [Position Statement] Ottawa: Author. Retrieved from https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/interprofessional-collaboration-ps-2019.pdf?la=en&hash=E840030B51F6AF43CAF6285363481594A01828ED
College and Association of Registered Nurses of Alberta. (2013). Practice standards for regulated members. Edmonton, AB: Author.
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