The Potential Constraints Of Communication In Nursing

In nursing, communication is essential and needs to be effective whether it’s to the patient or other healthcare professionals. This communication can come in many forms like verbal or non-verbal (eg. Touch, body language...) and can facilitate communication but it can also inhibit it depending on the situation and in complex situations this can change between the two. There are many potential constraints for communication and some of these are shown in the case of Mrs. Romano. When working with linguistically diverse patients, these constraints can heighten and to effectively communicate with them you may need the aid of an interpreter or other external resources, as there can be very difficult language barriers to cross and work through for
effective communication to occur.

There are many factors and processes that inhibit and facilitate communication in complex situations, including verbal and non-verbal communication.
Non-verbal communication can be used positively or poorly and include touch, facial expressions, posture, gait, gestures, general physical appearance, mode of dressing and grooming, sounds and silence. (Hillege & Groome, 2009) Touch is considered an essential communication tool when trying to communicate with clients from linguistically diverse backgrounds. It is viewed as one of the most effective ways to communicate comfort, particularly in patient centred care. (Hillege & Groome, 2009) In the case of Mrs. Romano, a friendly touch on her shoulder or hand would convey comfort and show her that you are there to care for her. Touch can also communicate anger or frustration, and can be considered inappropriate in person centred care, and invades the client’s sense of privacy and personal space. (Hillege & Groome, 2009) Therefore, only touch considered appropriate should be used with Mrs. Romano. An understanding of what the client is trying to communicate verbally and non-verbally is imperative in today’s multicultural society. (McCarthy, Cassidy, Graham, & Tuohy, 2013) In the case of Mrs. Romano, there may be language barriers inhibiting verbal
communication.

A very large potential and actual restraint to communication is language barriers. With patients who do not share the same language as health care practitioners, there can be many challenges, (McCarthy, Cassidy, Graham, & Tuohy, 2013) including the use of medical terminology by health care workers that the patient may not understand, causing confusion for the patient. (Weldon, et al., 2014) A more common language barrier would be where the patient speaks a different language than the medical practitioner. Understanding the linguistically diverse patient in today’s multicultural society is imperative. (McCarthy et al, 2013) Mrs. Romano only has limited english skills, and would not understand what the nurse was asking her, the nurse would also have difficulty understanding Mrs. Romanos needs. As a patient with a special language requirement, using an interpritor (as no staff in that hospital can speak italian) is necessary. (Koutoukidis, Stainton, & Hughson, 2013)

To converse with a client from a non-English speaking background effectively, a necessary step may include using a member of the medical interpreter service to translate. (Stein-Parbury, 2009) To meet the needs of these linguistically diverse clients, there are interpreters with expertise that work in health-related areas established by the Australian Health Care system. (Stein-Parbury, 2009) In a hospital situation, it is best to use an impartial interpreter, as family members or friend may not have a necessary grasp of medical terminology, (Weldon, et al., 2014) leading to serious problems in communicating the correct message. (Weldon, et al., 2014) If you use a third person to interpret instead of a qualified, medical interpreter, the message could be misinterpreted, misunderstood or the meaning deliberately changed in interpretation. (Stein-Parbury, 2009) When an interpreter is unavailable, there are other methods of verbally conversing with linguistically diverse patients.

Where an interpreter is not available at a particular time when conversing with a linguistically diverse client, other means of verbal communication can be used.
For example the “Nurse and Patient Language Helper” book could be a valuable resource. As it is “A visual tool to assist in the provision of quality care for patients from non-English speaking backgrounds”. (Australian Nursing Federation (Victorian Branch), 2007) It has 50 different languages in it, translated to helpful sentences which can be used by medical practitioners in a hospital environment. (Australian Nursing Federation (Victorian Branch), 2007) One of the phrases in the book is “Do you have pain?” and there are responses for the patient to point at for you to understand what their answer may be. (Australian Nursing Federation (Victorian Branch), 2007) This would be a very effective way to communicate with Mrs. Romano as Italian is in the “Nurse and Patient Language Helper” (Australian Nursing Federation (Victorian Branch), 2007) making communication easier when use of an interpreter is
unavailable.
Ultimately, there are many different ways for nurses to communicate with their patients, both verbally and non-verbally with an important non-verbal form of communication being touch. Though with these different form of communication there can be constraints such as language barriers, with patients not being able to speak the same language as their health care professionals. One way to overcome these constraints can be through the use of an interpreter, making sure they are professional and not a client’s family members or friends. If an interpreter is unavailable, the use of an external source may be needed, like the use of the “Nurse and Patient Language Helper” book, to aid with communication with linguistically diverse client. (Australian Nursing Federation (Victorian Branch), 2007)