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Nurses largely affect society in the health care system by helping, supporting and caring for an individual, a whole family or even an entire community. While in the medical surroundings, the nurse becomes the primary contact for the patient in care and spends a lot of time with them. Before approaching a nursing care situation a nurse needs to clear all judgments and respect every individual, as there are many different religions, morals and personal beliefs in the world today. Therefore nurses need to develop the ability of quality communication skills which helps to create great interpersonal relationship skills in nursing. Communication and interviewing are both skills needed to develop interpersonal relationships within the nursing environment. Communication skills are the first skills noticed in a person.
Effective communication skills are crucial for nurses. When first greeting a patient or person the individual level of communication is most evident. Communication has two main elements, verbal and non-verbal. Verbal communication is the use of languages, words, sounds and letters and non-verbal communication is that which is only seen, such as body language, gestures and other signs of the human body (Eunson 2008: 260). While in a hospital-like environment, all aspects of communication skills are needed because of the variety of people you need to communicate with. The use of rich vocabulary is important in educating and informing patients although the nurse needs to make sure the patient understands the information given (Dallas & Sully 2005: 50). Listening is also a very important communication skill needed in nursing. Nurses need to have the ability to actively listen to doctors and patients' needs to give quality care. Through listening, nurses put aside their own perceptions and demonstrate acceptance and respect for those they are listening to (Dallas & Sully 2005: 50). An effective way to demonstrate active listening is to be aware of the body language used. By not using eye contact, fidgeting and doing other tasks which distract the nurse while with the patient may decrease effective communication. Another important communication skill is the ability to accurately record written information. This is a very important skill as without clear concise notes recording the patient's vital signs, the quality and consistency of care may be at risk. These notes are a form of communication given to the doctor to assist in determining the patient's diagnosis and continuing care. Without effective communication, the interviewing process may be dramatically affected.
The foundation of an interpersonal relationship is in the interviewing and assessment process. Interviewing is the first very important process in a nursing care plan. This process is when the nurse interviews the patient to determine details of their current health, history and personal needs and ways in which the nurse can meet the patient's needs (Crisp & Taylor 2009: 262). Before conducting an interview, multiple things must be considered such as the people present, the environment and how much time is available to the nurse. Interviewing can be very invasive for a patient; this is why we need to consider their privacy in the hospital and around family. The environment surrounding the patient can also limit the information you will get from the patient in the interviewing process and inhibit a comfortable and trusting nurse-client relationship (Dallas & Sully 2005: 80). Interviewing skills involve the use of other communication skills including questioning skills, explanation skills and also the ability to communicate with relatives of the patient (Dallas & Sully 2005: 75). There are multiple ways in which a question can be asked. A nurse must have the ability to determine how questions should be asked depending on the topic, circumstance and environment. If a question that is asked needs an elaborate answer an open question may be used, this allows the patient to answer with full detail which can lead to other answers required for the nursing assessment (Crisp & Taylor 2009: 263). Closed questions are used in a variety of situations; they allow an answer to be given specifically and limit explanation (Crisp & Taylor 2009: 263). After asking a question it is sometimes necessary to clarify with the patient the answer they have given, this is the use of explanation and paraphrasing skills (Dallas & Sully 2005: 49,79). Explanation and paraphrasing skills are also important to give information to the doctor, patient and relatives. The interviewing process enables the beginning of a nurse-client interpersonal relationship.
Therapeutic relationships with patients are essential in nursing. Communication skills and the interaction level which is given to the patient ultimately influences the comfort and trust levels which the patient will feel, this then has effect on the interpersonal relationship (Chitty 2005: 491). Interpersonal relationships in nursing have three phases; establishing the relationship, building the relationship and the ending of the relationship (Stein-Parbury 2009: 42-48). Establishing the relationship is the initial interaction between the nurse and client, and is when trust and comfort are introduced (Stein-Parbury 2009: 42-45). Building the relationship is when the nurse and patient have an understanding of each other and the expectations of care (control and power) (Stein-Parbury 2009: 46,47). Ending the relationship happens for a number of reasons for example the patient recovers, the nurse moves placement area or the death of the patient. This stage can be emotional for both the nurse and patient. The use of effective communication must be used throughout the interpersonal relationship to establish appropriate knowledge that a nurse has. Interpersonal relationships are important in the nursing environment as it enables the most possible quality care to the patient. A nurse-patient relationship enables the patient to be comfortable and allow maximum recovery while in care. A good interpersonal relationship with a patient can also develop into relationships between the nurse and the patient's family. This helps in assisting the family with information needed and assists to comfort the patient's family that their family member is being cared for at the highest standard, as expected. The relationship also establishes a good nursing rapport which gives the nurse confidence and also helps with future interpersonal relationships. A reflection piece on nursing skills exercised is an excellent way to help develop and maintain great quality skills that help the nurses' care to patients.
This reflection piece is on my interviewing process with a role played 49 year old woman with a two pack-a-day smoking habit for 35 years who has bronchitis. As this was the first time I had used the communication, interviewing and assessment skills that I had learnt I felt a little nervous and not confident to begin with. Many things were good with my overall interviewing process for example my verbal and non-verbal communication skills. I felt I was very conscious of my body language ensuring I was actively listening at all times. I also used the reviewing and paraphrasing skills to confirm I understood correctly what the patient was informing me of. This then also reassured the patient I was listening. I feel that it took a while for me to feel comfortable and confident in my communication skills therefore the patient didn't seem comfortable with me until half way through the interview. If I could've been more confident in the beginning the patient may have felt more comfortable and trusting of me, this would've also helped our further interpersonal relationship. Another skill which needs more work is my questioning skills, being conscious of what questions need to be open or closed. With more practice I think I will feel more comfortable and confident in myself, which will then help to bring out my communication skills to full potential. This will help me in the future with interviewing process and help me develop into a high quality nurse.
Nursing has many crucial elements which are necessary to ensure a good quality of care. The nursing process is developed to encourage individualised care; this then achieves meeting all patient needs in and out of the hospital setting. Effective communication skills include the use of verbal and non verbal language, vocabulary, listening and written record taking skills. The nursing interview and assessment process is a part of the nursing care plan which is a crucial process to enable a nurse to assess a patient to full potential. These both help to develop a therapeutic interpersonal relationship which is increasingly important for both the patient and their family. The relationship allows a patient to trust and feel comfortable with the people surrounding them while being cared for. These important nursing skills enable the highest quality of care for all patients in the nursing environment.