Communication Skills In Nursing

Analysis of Communication Skills Communication is an essential skill a nurse must have in order to be successful in understanding and connecting with patients. The ability to utilize therapeutic communication techniques while interacting with patients to build a strong foundation for the nurse-patient relationship is also very crucial. Therapeutic communication is important to the nurse because, “Nurses who are competent, honest, skilled communicators are viewed as effective and compassionate caregivers” (Taylor, 2015, p. 461). In order to practice communication skills, an interview was conducted between the student nurse and an individual with a health concern, who will be referred to as the patient. The interview was voice recorded to allow
for analysis for the communication skills used. After first listening to the voice recording of the interview, it was apparent that although communication was something that was used daily, it was something that was going to need a lot of practice in order to be good at. Firstly, the tone of voice and the pace in which the interviewer was speaking needed improvement. The interviewers tone changed throughout the interview, but especially in the beginning it was noticeably nervous which influenced the way questions were asked to the patient. As the interview proceeded, it seemed as though she became more comfortable and that was reflected in the change of her tone. Same thing applies to pace, when the interviewer seemed nervous, she would start speaking much faster.These are major flaws when attempting to communicate effectively. Tone and pacing should not reflect being nervous or rushed because this could make the patient feel as if there is a lack of concern or time (Taylor, 2015, p. 464). In addition, if a patient is feeling nervous or anxious, then a nurse who is speaking too quickly may fail to communication with that patient and could lead to confusion or misunderstanding of important information. Another essential skill for a nurse to have in order to use therapeutic communication with their patients is to allow the patient to express themselves and let the interview flow freely. The interviewer found that she was not allowing the conversation to flow due to having an idea in mind of what she was going to ask next, regardless to what the patient may be saying at the moment. Although the questions asked were relevant to what was being said, it would have improved the communication if she would have listened closer to what the patient was really saying and then encouraging them to elaborate on the topic. This may tend to happen when referencing a list of questions that had been prepared prior to the interview taking place. Communication should allow for the patient to take the lead and for the nurse to be flexible (Taylor, 2015, p.464). The interviewer was not flexible when she was focusing on the questions she had lined up, ultimately interfering with the interview process. It is important to let the patient respond in a manner that is their own, no matter what outline it may follow (Jarvis, 2015, p.28). The ability to listen is a huge skill that must be mastered in order to effectively communicate.
Listening attentively to the patient is a crucial skill and involves more than simply listening to the words that a patient is saying. Listening is defined as, “active and demanding,” and “is the route to understanding” (Jarvis, 2015, p.28). Being aware of what the patient is saying and why they may be something is an important part of the interview process. During the interview that was conducted, it was apparent that the interviewer was listening to the patient, but there was still a much deeper level of listening that needed to be reached. For example, by truly listening to the patient the interviewer could have picked up on small cues that the patient was saying that would have uncovered much more information than simply asking more questions. While a nurse is listening during the interview process, the focus should be entirely on the patient and what they are saying. A flaw that was experienced while conducting the interview was that the interviewer had moments where she was distracted by her own thoughts or the format she was attempting to follow that made her lose focus and not give the patient the attention that she should have, this was shown through short responses to that patient without any well thought out response, for example the response, “oh okay”, was commonly used before asking another question. The interview would have been improved if the interviewer would
have committed to being a skilled listener throughout the entire interview. Throughout the interview process, the interviewer should be using effective questions and comments that reflect therapeutic communication techniques to learn about the patient. For example, the use of open and closed ended questions is a technique that is commonly used by nurses during the interview with the patient. The open-ended question technique is prefered to allow the patient to express themselves and it promotes a longer answer compared to a closed question. During the recorded interview, majority of the questions asked were open-ended questions. In addition, there was a lot of clarifying questions. The clarifying questions were commonly used as a means of making sure that both people were on the same page. It may have improved the interview if more reflexive and directing questions were asked in place of some of the clarifying questions. By adding more of these types of questions, information would have been shared by the patient that may have lead to the discovery of new important topics. The overuse of clarifying questions in some circumstances lead to a patient response of agreement of the information but no elaboration, although at times it did during the recorded interview. An issue that nurses may face during the interview is to not give the patient advice when it was not warranted. Giving advice from the nurses perspective and with their own personal considerations, could become inappropriate. To avoid giving inappropriate advice, a nurse should only give their own advice when appropriate, straightforward, information can be shared. Personal opinions should not be shared with the patient. During the recorded interview, the sharing of suggestions and advice was given. Although the interviewer did ask the patient if she wanted suggestions, it would still be best to avoid giving the advice that is based around personal opinion and not relevant information that is specific to the patient. It may have been possible to give the suggestion of certain recommendations for the patient to improve and manage her health, instead of giving the advice that was given. For example, recommending that patient to see a physical therapist to learn about exercise and stretching, or mental health nurse to talk about managing stress levels. Another possible way of avoiding this error would have been to simply ask the patient what she thought would be the best plan of action or advice for herself. This would most likely to be the best way to address the issue that occurred in the recorded interview, as well as it would have been a therapeutic question that may have lead to the revealing of important patient thoughts and concepts of health. Without a doubt, communication skills is something that a nurse simply cannot lack.
By taking the time to perfect communication techniques and learning the different ways of therapeutic communication, a nurse can build an effective helping relationship with his or her patients. By analyzing the student-patient recorded interview, it was apparent that there is always room for improvement with communication and it served as a great way to find things to focus on improving. Regardless of the mistakes, there was still good communication skills used and it seems that a good foundation was laid to allow for the sharing of information in a comfortable setting but could still use improvement in some
areas.