Assistance Writing a Communication Paper

Assistance Writing a Communication Paper

Assistance Writing a Communication Paper

Communication Assignment

As you know communication is necessary to effectively receive and offer information. Therapeutic communication: verbal and non-verbal, are techniques you will use but not limited to: to assess your patients, educate patients and families and communicate among the interdisciplinary team in any health care entity.

This assignment is a 1-2-page paper intended to provide an opportunity to research all areas of communication that you will use, be exposed to or need to know of as a health care provider. Upon your research, choose an article that is relevant to any type of communication used in health care. See examples below.

This assignment is expected to follow the rubric provided, demonstrate professionalism and critical thinking and demonstrate correct grammar, spelling and correct citation of format.

Have fun and be creative in choosing your article/communication technique so that it broadens your current knowledge base. Assistance Writing a Communication Paper

Examples of Therapeutic communication

• With patients having debilitating health conditions
• With patients mentally compromised
• With patient who have hearing deficits
• With pediatric population
• With geriatric population
• With the interdisciplinary team
• Written, digital, verbal do’s and don’t
• Therapeutic listening
• Communication equipment
• Grief communication

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RNSG 1261 Communication Assignment Rubric

Journal of Caring Sciences, 2014, 3(1), 67-82 doi:10.5681/jcs.2014.008 http:// journals.tbzmed.ac.ir/ JCS Factors Affecting the Nurse-Patients’ Family Communication in Intensive Care Unit of Kerman: a Qualitative Study Laleh Loghmani1, Fariba Borhani2*, Abbas Abbaszadeh3 1 Departemant of Nursing, Faculty of Nursing and Midwifery, Kerman paradise University of Medical Sciences, Kerman, Iran Medical Ethics and law research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Departemant of Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 ARTICLE INFO Article Type: Original Article Article History: Received: 4 Apr. 2013 Accepted: 25 May. 2013 ePublished: 27 Feb. 2014 Keywords: Communication Nurses Family Intensive Care Units Qualitative Research

ABSTRACT

Introduction: The communication between nurses and patients’ families impacts patient well-being as well as the quality and outcome of nursing care, this study aimed to demonstrated the facilitators and barriers which influence the role of communication among Iranian nurses and families member in ICU. Methods: This study is a qualitative study with content analysis. Participants were eight registered nurses and ten of patients’ families. Patients were admitted to the ICU of two large university hospitals in Kerman, Iran. We used non-structured interviews for data collection. All interviews were transcribed verbatim with a simultaneous, constant comparative analysis of the audio tapes. Assistance Writing a Communication Paper. Results: According to data analysis, facilitative factors between nurses and families’ communication consisted of spiritual care, emotional support, Participation, notification and consultation and barriers that were misunderstandings regarding treatment, job and patient difficulties. Conclusion: The findings led into the recognition of the important barriers and facilitators in communication between ICU team and the family of the patients. By identification of the barriers and facilitators of communication, establishing new rules and using creative methods in education and establishing the communication of ICU team especially using patient-based approach we can have effective communication.

Introduction

High quality family Communication is the backbone of the art and science of nursing.1 it has a significant impact on patient well-being as well as the quality and outcome of nursing care2, and is related to patients‟ family overall satisfaction with their care.3 The maintenance of high nurse- patient‟s family communication also depends on the nurse and patients‟ family. Assistance Writing a Communication Paper. The quality of care in an ICU has been shown to be influenced by several factors including: inadequate nursing staff, too much nursing documentation, too long waiting time, and lack of specialized nurses.4 There are challenges in nurse- patients‟ family communication evidence from four sources. These are personal observation, narratives from client and their families, media reports, and official health reports. There is public outcry about the behavior of nurses during communication with their patients‟ family in ICU.5 The issue of nursepatients‟ family communication remains a problem in Kerman, despite concern expressed by the public, Iran ministry of health, Iran health service, and the nurses and midwives council for Kerman.6 It is important to know that doctors do their wards rounds once per day and are available to see seriously ill patients only on call basis and so some of these poor nurse- patients‟ family communication may happen during their absence.7 It is wondered whether those * Corresponding Author: Fariba Borhani (Phd), E- mail: fborhani@msn.com. This study was extracted from PhD thesis in Kerman University of Medical Sciences ( No: 1032) Copyright © 2014 by Tabriz University of Medical Sciences Loghmani et al. training activities and programs are yielding the expected results, especially in the area of nursepatients‟ family interactions. Identifying factors believed to facilitate positive interactions between nurses and their patients‟ family or patients‟ family as well as barriers to these positive interactions will do much to promote the well-being of those seeking health care.8 The increased insight about nurse- patients‟ family experiences in this study should help nurses and other health care workers establish positive and appropriate therapeutic relationships with patients‟ family. Study findings can also be used to inform decision makers in health and nursing about what needs to be done to improve communications patterns between health providers and patients‟ family.

Areas for future research in nurse- patient‟s family communication were also identified. It would also be of help to other educational institutions especially those involved in health education, health research and health training programs. Since the relationship of a nurse and patients‟ family is the essential and effective prerequisite on the successful care results; therefore, this issue was not yet evaluated and the elements of relation in its interactive, psychic, intellectual and dynamic components were ignored.9 By considering the lack of standard pattern for patients‟ family -nurse relationship and its different communicating methods, study about the interactions of patients‟ family -nurse can increase the knowledge of nurses toward how to communicate with the patients, especial during an interaction with them, and how to understand the patients via a communication between patient family and nurse10 in Iranian context. Based on the view of mohammadzadeh et al., it is necessary to extract the experiences of patients via the relationship of patients‟ family -nurse and also determine the most valuable issue based on the view of patients during an interaction with nurses.11 Such information leads into the increase of 68 | Journal of Caring Sciences, March 2014; 3 (1), 67-82 knowledge about communication, it helps the nurses in order to change the communication skills focused on the individual.12 By considering the significance of professional relation (communication) in the care major and its vital role, studying this issue in the field of care in our context, in depth, is essential and required. Since most of developed countries in patients‟ family nurse relationship process utilize the defined standards, but there are not clear standards in appropriate to the conditions of the caring relations in our context.13 Therefore, the studies which were done in our country about the patients‟ family and nurse relation indicate a problem in this field. For example, Abedi et al., in their studies came to this conclusion that the process of patient-nurse relation is beginning to decline and it is possible to promote it (help to promote it) by presenting the educational plans and programs for the nurses.6 Aein et al., points to the interrelationships between nurse and patients‟ family.5 The view of Mohammad Zadeh et al., is based on the presence of a supporting environment and sufficient sources in order to promote the relationship between patient-nurse.11 The barriers and facilitators of patients‟ family -nurse relation based on the care-background of our country were not more addressed.

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In this regard, since it is not possible to summarize the human events in a form of mathematical equations, therefore, it is necessary to use the most appropriate guidelines in order to obtain the depth realities of humans and in this case, the qualitative studies play an important or effective role in clarifying the ambiguous pints.14 Consequently, by considering that there are limited studies about the relationship of patient family nurse and also there are various relationship styles in each society based on their social and cultural background, In general, it can be said that lack of a relationship between families – treatment teams results into stress, temper, lack of confidence, violence, dissatisfaction among the families of patients, a Copyright © 2014 by Tabriz University of Medical Sciences Factors affecting the nurse-patients’ family communication in ICU contrast and conflict between members of a family and treatment team, implementing the treatment plants (in a long time) with less success and bad decision making and as a result, the person who faces more damages and losses is the patient. Assistance Writing a Communication Paper

In a qualitative study, Morrison described nurses‟ perceptions of the concept of caring as central to nursing practice. It involves meeting needs of patients in nurse client interactions. In all 7 categories emerged from the analysis that provided a detailed description of caring. These included interpersonal approach, clinical work style, concern for others, time management, attitudes, personal qualities and level of motivation.10 Other descriptions by the nurses related to the physical aspects of care. Positive interpersonal relationships between the nurse and family were considered to be caring and caring for family was optimum when nurses were motivated in the form of rewards by managers. Caring also depended on the skill and the competence of the nurses. Competent and skilled nurses delivered high quality nursing care to clients at the right time. Caring practices of these nurses were also demonstrated by positive facial expressions and closeness to clients.15 The caring nurses were truly present with clients and families. It was noticed that they were thoughtful, considerate, empathic, and decisive and practiced holistically. They did not view the clients as being in isolated from their families, and in turn, viewed the families as part of the community. Nursing researchers generally agree that patient dignity is highly valued by family. They also agree that a lack of dignity may lead to poorer health outcomes.15 In another study nurses were asked to describe experiences where client dignity had been maintained and where it had been compromised. The interviews were unstructured and experiential in nature. In all four nurses were interviewed, it was noted that nurses need to respect clients and accord them privacy. It was also reported Copyright © 2014 by Tabriz University of Medical Sciences that clients should not be seen as an object or body alone. Patients‟ family needed to be seen to possess an innate right to be treated with dignity and respect in all situations and at all times whether the client was conscious or unconscious, alive or dead. Respect would appear to these nurses to mean treating a person with respect to their personhood, that is, the nature of the person, their feelings, their individuality and their wishes. the body and its treatment was a central theme in nurses‟ accounts. Quality care was also acknowledged when nurses showed an interest in clients as people. nursing practices, which gave clients this impression, included nurses listening to and talking with them. Knowing the client was not seen as a single process; patients appreciated nurses who shared personal details about 9 themselves and their family. Assistance Writing a Communication Paper

Nurses who got to know clients as people were seen to encourage more social contact between clients and their relatives.16 McAdam17 reported that clients and relatives were comfortable with nurses who were available, accessible, and approachable and these were demonstrated through nurses who had time for clients and relatives. Based on the importance of professional relation in nursing and its important role, this issue should be more deal. While in most of the developed countries in nurse and patients‟ family relation, defined standards are applied. However, obvious standards consistent with the conditions in Iran are not defined while the studies conducted in Iran are about the relation of nurse and patients‟ family and showed problem in this regard. For example, Abedi et al., found that the relation of the nurse and patients‟ family is not favorable and by presenting educational plans for the patients, it can be improved.6 Aein et al., discussed about the weak interpersonal relation between the nurse and patient family.5 In another study, the presence of a supporting environment and adequate resources to improve the relation between the nurse and patients‟ family is Journal of Caring Sciences, March 2014; 3 (1), 67-82| 69 Loghmani et al. emphasized.9 Based on the position of the relation of nurse and patients‟ family in the quality of nursing care, the main question in the mind of the researcher is the facilitators and barriers of the relation between the nurse and patients‟ family based on the background of nursing in Iran? As the human being relations cannot be summarized in a research, it is required to use suitable study solutions to achieve the deep reality of human being and quality researches can have important role in clarification of ambiguous fields. Assistance Writing a Communication Paper

The researchers showed that we don‟t know the relation of nurse-patient‟s family well and the previous studies didn‟t provide the required knowledge in this regard.5-7 As there is no comprehensive study regarding the relation process of the patient family and the nurse and as it is the interpersonal and cultural relation, any society based on cultural-social ground can have different communicative styles. The researcher attempted to do the qualitative study to acquire more information. The aim of the present study is determining the facilitators and barriers of the relation between the nurse and patient family in ICU in teaching hospitals of Kerman (Iran). Materials and methods.  Assistance Writing a Communication Paper. The study was conducted at intensive care units in Kerman hospital. The hospitals have 6 ICUs with a bed capacity of 60 and the total number of nurses was 45. Eight Nurses and of 10 patient‟s families participated in this study. Purposeful sampling was used for the initial interviews and, according to the emerging codes and categories data was collected by means of theoretical sampling. The purpose of the study was briefly explained to each participant. It was explained that the interviews would be recorded and that they were free to being out of the study if they did not want to continue. Consent form was then offered. Assistance Writing a Communication Paper

If the potential participant read the information 70 | Journal of Caring Sciences, March 2014; 3 (1), 67-82 letter and signed the consent form, the one was considered for the study. Upon accepting to participate in the research, and after signing the informed consent sheet, nurses and family member were given an appointment for the interview. Interviews were carried out at the time the participants felt their workload was lower or had enough time to be interviewed. Individual non-structured interviews were conducted in a private room at the hospital. The interview guide consisted of core open ended questions to allow the respondents to explain their own viewpoints and experiences as completely as possible. The interview prompts were: 1) What factors are facilitated nurse- family‟s communications? 2) What factors are as barrier to nursefamily‟s communication? Participants where then asked to explain their own experiences and perceptions of “communication”, as well as “facilitators and barriers” that affected taking on the communication. Depending on participants’ tolerance and their interest in explaining their own experiences, the interviews continued with the topic questions and probes in order to capture a deeper understanding of the phenomenon under study. All interviews were carried out by the same interviewer. Interviews were recorded by a digital sound recorder, transcribed verbatim and analyzed consecutively. Interview transcriptions were repeatedly reviewed until meaningful themes emerged. Assistance Writing a Communication Paper. The duration of interview sessions ranged from 20 to 90 minutes, with an average of one hour, and interviews were continued until data saturation was achieved. Data were collected by interviewing participants. Data collection and analysis proceeded simultaneously. After each interview, the tape was transcribed manually by the researcher. Assistance Writing a Communication Paper. The accuracy of the transcripts was checked by listening to the audiotape and reading the transcripts simultaneously. The analysis of the interview transcripts was guided by content analysis, Copyright © 2014 by Tabriz University of Medical Sciences Factors affecting the nurse-patients’ family communication in ICU which has been identified as appropriate for analysis of interviews.18 Themes as the expression of the latent content of the text were identified. Assistance Writing a Communication Paper. The data was coded by hand using different colors. Condensed meaning units were abstracted and labeled with codes. The codes were then sorted into both categories and subcategories based on comparisons between similarities and differences. A print out of these files was also made and categories were formed from them. Finally, higher-level categorization was constructed from the initial categories. That is, categories which fit into common files were also brought together to form final and major categories.

Data acceptability criteria were applied using the following methods: prolonged engagement, assigning enough time, appropriate relation to understanding real data, peer and member check, and negative case analysis and objectivity (one of the data characteristics of research). Results Nurses who were employed for a minimum of four years at the hospital and expressed willingness to discuss their experiences were eligible for inclusion in this study. Those employed for four years had ample opportunity to observe and participate in nurse- family communication in the hospital setting. Additionally, all participants were full-time registered nurses from two hospitals in Kerman, Iran. Nurses’ age ranged from 24 to 45 years. There was one male and seven female nurses. All had worked in the ICU from 4 to 20 years. All family members consisted of patients’ parents, children and spouses, whose ages ranged from 20 to 55 years. Facilitative factors and barriers to nurse, patient and family communication were included in table 1 and explanations are in continue. A. Facilitative Factors in Nurse- Patients’ Family Communication. A. 1. Spiritual considerations Copyright © 2014 by Tabriz University of Medical Sciences Spiritual considerations are one of the content items of communication between the families and ICU team.

As the patients in this department are in critical condition, premonition of the diseases is not satisfactory and all people consider the spiritual issues more than any time and ask God to get the patient better and they consider their religious actions including worship, praying or fasting and by praying to Allah get help for their patient. It is observed that the nurses asked the families to say prayer for their patients and ask for help. A. 1. 1. Giving hope If there is no hope for getting better, again the families of the patients try to be given hope from the ICU team. Even they feel they are telling lie. One of the nurses said:” giving unreal hope is not good but making the families hopeless not good… the realities should be said as the families don‟t suffer from trauma and it can be said that you should trust in God and in all your sentences, there should be God…but when it is said what God asks, the families get comfort, he is Not given hope and they are not being hopeless. A.1.2.Considering God The nurses guide the families to God and saying prayer when they thinking that there is no hope to relieve them and they can tolerate the sad moments. It can be said that they establish spiritual relation with the family. One of them said, “This department is very important and the patient is close to death and it is the last location, we should trust in God and say prayer”. One of the nurses said: ”we give information as possible, for example, we say, the patient is better now, your patient. Assistance Writing a Communication Paper