HLTENN002 Apply Communication Skills In Nursing Practice

HLTENN002 Apply Communication Skills In Nursing Practice

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HLTENN002 Apply Communication Skills In Nursing Practice

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HLTENN002 Apply Communication Skills In Nursing Practice

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Course Code: HLTENN002
University: TAFE Queensland

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Country: Australia

Case Study 1
Mrs Edith Jackson is an 82-year-old lady who was recently admitted to The Golden Days Nursing Home where you work. Edith has Parkinson’s disease and early stage Parkinson’s dementia. She also has low vision and is hard of hearing and wears glasses and hearing aids in both ears. Michael is Edith’s son and her sole support person.

How would you make Mrs Jackson feel comfortable, using appropriate non-verbal communication (discuss at least three (3) points)?
How would you make Mrs Jackson feel comfortable, using appropriate verbal communication (discuss at least three (3) points)?
Referring to the Core standards for nurses who provide support to people with disability, outline three (3) strategies that you could use to aid communication with Mrs Jackson giving consideration to her vision and hearing impairments.
You are walking past Mrs Jackson’s room and discover that she has fallen out of the bed onto the floor where is crying quietly and trying to get up. You assist Mrs Jackson onto a chair as she keeps saying over and over, “I’m alright”. After following facility procedure for this incident, you are then to discuss this with the patient and the son. Provide a definition of ‘open disclosure’ and discuss the principles of open disclosure referring to theAustralian Open Disclosure Framework (2013) (min 100 words).
Provide an example conversationof what you would say when communicating the incident to the patient and son .
Identify the key/relevant health professionals/ facility teams you are required to contact in this situation and provide a rationale..
Using SBAR provide an example of what you would document in the patient chart ensuring that you use appropriate terminology.
Michael, Edith’s son will be traveling overseas for the next few weeks and will not have telephone access. He has asked if you could email him to provide him with a progress report on his mother. Identify at least five (5) factorsrelating to email etiquette you will need to adhere to when emailing Michael.

Case Study 2
You are working as an Enrolled Nurse in a rehabilitation unit and while on your break you check your social media account and notice that one of your colleagues, who is a friend of yours, has posted some information relating to one of the patients on the unit.

What ethical principles and regulatory responsibilities do you need to consider in this situation?
Provide a definition for the term ‘advocacy’ and describe how you would advocate for the patient in this situation?
You are asked by your supervisor to provide feedback to the colleague who has posted this information on social media. Describe at least four strategies you could use to deliver a constructive outcome when providing this feedback.Provide an example of the feedback you could provide to your colleague, using appropriate language and a respectful manner.

Case Study 3
David is a 58-year-old cardiac patient who had been verbally aggressive over the last two days since he has been admitted to the ward. You have been asked by the manager to have a chat with David to see how he is feeling.

What are closed ended questions and in what situations would you use closed questions with David? (provide at least two  examples of a closed question)
What are open questions and in what situations would you use open questions with David? (provide at least two (2) examples of an open question)
Discuss the term ‘Active Listening’ and provide at least one (1) example of how this could be used in this situation.
Identify what constitutes effective communication in nursing? (List at least six (6) points and provide an example of each).

After a while, David becomes both verbally and physically aggressive. He says that ‘you are the worst nurse and do not care about him and he wants to leave. He pulls out his intravenous cannula in his arm and begins to throw things around the room.

Describe de-escalationand provide an example of a de-escalation strategy.
Explain the benefits of a debriefing process and explain why it would be useful following this situation.
Your supervisor provides you with some feedback on how you handled this situation, identify at least three (3) strategies you could use to effectively receive feedback.

Part B

 NSW Health (2014) Communication and behaviour support for nurses- Practice

Communication and behaviour support for nurses- practice package was implemented for what reason?

Identify the four domains of practice (1.2.1) within the standards for the Communication and behaviour support for nurses- practice package
What are the benefits of completing the “communication and behaviour support for nurses appraisal”
Identify 2 organisational policies and procedures surrounding electronic health care records for health care personnel
Utilising information technology to access data has become a useful tool for nurses, but must be within the organisational policies and procedures. What 3 tips are available to ensure that the web page accessed is reliable?
Nurses may be asked to lead small group meetings and discussions; therefore they need to be aware of various procedures. List 6 procedures.

What are the 3 main objectives in forming these small groups?
 What communication strategies are required to ensure that there is contribution from all participants in a   group discussion, including providing and receiving feedback.

To ensure meetings are of value, the nurse conducting the meetings need to consider at least 5 things?

What are the 2 suggested communication strategies you can use to ensure that you understand feedback in relation to performance improvement conversations.
When giving balanced feedback what 3 step communication technique is recommended?

What are 2 strategies that demonstrate appropriate language and respectful manner when giving or receiving feedback?

Answers:
Case Study 1
1. Non –verbal communication is the use of body language such as gestures, facial expression and touch to ass a message from sender to receiver. I can certainly make Mrs. Jack so feel at ease by utilizing gestures. Gestures Gestures can convey message about emotions and express ideas. When asking Mrs Jackson if she would like to eat certainly gesturing could be to endure a bottle of water and at the same point to it utilizing the other hand (ACT Government, 2013). Concurrently you could express the agreement or maybe a disagreement by either a nodding for yes or even wiggling of a head to convey a no. This is intended to give Mrs Jackson the option of simple gesture sign. Eye contact is useful to starting and maintaining conversations .It shows respect to a person. Mrs Jackson will feel like you can be listening to her and that you care and want to assist if you maintain eye contact. However, it’s always appropriate to ensure you know about your client cultural background, as a few cultures dislike making eye contact. Physical touch This is a different excellent form of non-verbal communication to use with Mrs Jackson. It is going to offer her with sense of care and comfort with touches such as holding her hand or even rubbing her shoulders. Facial expression I would also make use of facial expressions to show emotions such as intensify what am feeling , to reduce it or to hide what am feeling at that specific time ( Better Health Channel, 2015). A facial expression such as smiling is a significant tool for rapport-building with Mrs Jackson. It helps her relax and prove that your intention is to accompany her in addition to assist her. Smile may also be beneficial to calm down an aggressive person and de-escalate a confrontation situation (Core Standards for Nurses Who Support People With  A Disability, 2014).

2. Verbal communication entails how individuals deliver message as well as how you receive them. With additional of usage of words, verbal communication could also involve.
The tone as definitely as pitch in one voice has an effect on the spoken word (Core Standards for Nurses Who Support People with A Disability, 2014). The client could sometimes determine more from a nurse tone or perhaps a pitch than the words spoken, for example loud, fast speech might show intimidation or even aggression. Another way involves keeping a calm and a friendly tone or even a pitch when talking to Mrs Jackson , which might help her to feel comfortable as since she feel that they are not stressed or upset and they have everything under control . The volume as well as the amount of the dialogue may also ascertain as to whether a message continues to be received, lost or even misunderstood. The care of the nurses to their client that have hearing as well as cognitive impairment, thus utilizing volume and rate which is moderate when talking should establish therapeutic communication (Fainberg, 2014). Clear and short sentences would assist Mrs Jackson to understand what is taking place and thus, it promotes a comforting feeling. Another way would be utilization of the breaks or even pauses after making a speech to be able to allow the patient to understand clearly the message similarly enough time to convey the response . In most of the case, this is not such a conscious style of communication, but the nurses are entailed to evaluate on the way they communicate to their client to facilitate effective communication. An individual pausing after talking and listening without interruption would help to comfort Mrs Jackson.
  It would give her time to understand what would occur and be ready for steps needed to assist her without feeling rushed or even ignored.
3. Oral Communication: it is very important initially introduce yourself whenever you get into a room then the next thing could be to stand directly in from of Mrs Jackson, so that she may see your face and perhaps lips whenever you speak to her . It is very important converse evidently to her and concisely not but loud because it might distort the words from your own lips. Usage of alternative and augmentative communication: Utilizing facial expressions, system languages together with gestures which may help communication with Mrs Jackson. The utilization of the aided devices for instance written messages or perhaps digital devices of pictures , shapes might be affected and occasionally converted to speech for the Mrs Jackson to enable her communicate with ease . Sensory integration therapy: People generally prefer deeply firmer touch as compared to the softer touch. After Mrs Jackson providing consent, you should take her arm and manual her towards in which she would like to go (Mind Tools, (no date). It is also crucial that you limit the background noise and provide sufficient lighting which would assist Mrs Jackson in comprehending the message one wants to convey.
4. Open closure relation to the way wherein the health care professional communicate and support the patients, their families together with the carers who have experienced damage during a health care stay. The concepts are provided below; Acknowledgement, all the harmful events have to be admitted to the individuals, carer or perhaps their families ( NSQHS Standards , 2013). There is apology or expression of regret, significantly early as rational to the patients and their families. Promoting and meeting the requirement and expectation of these who provide the health care. Furthermore, group that provides health care have to offer their employees with an environment which encourage these to find and report unfavourable events that could arise. This offers some kind of open disclosure education and training and help to the process.

5. An Enrolled nurse would certainly state Good afternoon Mrs Jackson, Michael. I would like to examine a few things with regards to the incidence which took place on at present. Mrs Jackson is it to be able I discuss this with your Son Michael present? A occurrence took place this morning where you fell from your bed. Michael, I discovered this while I was walking past your mother and noticed her on the floor. I knowledgeable instantly to the medical officer so they performed a evaluate on her. I have also documented this incidence by writing out to a form and have also reported it to the RN who was on duty, to the medical office accountable and the risk assessment team (Halford, 2018). My recommendation depending on this occurrence is that we should provide your mother a wheel walker, together with the sensor mat. I am very sorry to this occurrence. I hope you will be able to provide some feedback on this decision. It is in the best interest that your mother is as safe as possible and we do everything possible to ensure it.
6. The key pertinent health professional to get in touch with to this predicament are the high level supervisor for example the RN that actually works with you, others are the medical officers and quality assessment team. The next pertinent people to report on the situation are the next of kin as well as perhaps councillors in the event the client takes talking to somebody else and expressing any more concerns. The reason to report the incidence would be to learn from them, and possibly prevent on any specific future event of this kind of similar incidences.
7. Situation: During the morning Mrs. Jackson fell out of the bed and she was found on the floor and he was crying silently and simultaneously she was trying to get up. With the help of the medical officer, she was helped up to a chair. Background: Mrs. Jackson is 82 years old, she has a Parkinson ailment, which initial stages is dementia, low vision and at times it is difficult to hear and she constantly wear glasses and hearing aid. Assessment: Vital observation that were performed with QADDS the score was O. She was made comfortable to her chair and her pain had subsided. Recommendation: Mrs Jackson has to follow-through review given by medical officer who will be in charge and RN who happens to be on duty (NSQHS Standards, 2013). She may be required to use mobility equipment for instance wheelie walker , or maybe Matalson slip footwear which have to be utilized , and make sure that there is a call bell that could be at her arm attain all the time.
8. Email etiquette is as follows;
Do not use all uppercases or almost all lower cases letters. The whole uppercase letters that are utilized must not be shouting and the utilization of the lowercase letters should never look like laziness. It is very important prevent sending of the junk email folder through maintaining the subject line very obvious and concise. It is very important doable check the recipient address before sending the email. This can help to reduce sending a mail to the wrong individual.
Case Study 2
You are working as an Enrolled Nurse in a rehabilitation unit and while on your break you check your social media account and notice that one of your colleagues, who is a friend of yours, has posted some information relating to one of the patients on the unit.
1. When using social media, the health practitioners have to keep in mind that National Board code of ethics along with the professional conduct along with Guidelines for the advertising managed health services apply. It is the obligations of the health care professional to protect the privacy of the patients. The registered health practioners should think about only posting information which is not in breach of the obligation which follows to the obligations of the healthcare professionals (Nursing Times, 2018). This entails complying with the reputation as well as privacy obligations
2. Advocacy is regarded as speaking in support of or maybe in support to another individual, place or even a thing . An enrolled nurse has to move beyond their abilities or personal feelings on the agreement or perhaps disagreement which is responding compassionately. Enrolled nurses advocate continues to be described as among the acted on behave of the interceded for the patient. Furthermore, based on the professional and regulation on the social media it also highlights that there should be no patient who ought to be contacted by social media, hence, as a Enrolled Nurse, it is important to make sure this does not happen.
3. Strategies to use to deliver constructive outcomes are as follows;
Remaining positive , non judgemental and ask colleague in relation to precisely what their perspective is on the situation , then it is essential to let understand how they could develop and change on their actions . Feedback provided need to be focused based, thus, when delivering feedback to colleague it is very important offer it in a timely manner and appropriate time. You will need to explain a topic without any unwanted anger or perhaps yelling and make sure that you provide constructive feedback to the employees (Nursing and Midwifery Board Australia, 2014). Whenever a negative feedback has been offered, it is important to accept it without interruption since it achieves active listening and even indicate that one is not judgemental towards others.
4. As Enrolled Nurse, I could explain to my colleagues who are involved that I have seen what they had posted on the social media. I could certainly inform them that the client has been informed on the same. I might also inquire from them if they had read and signed a health facility policy with regards to the social media and the patient privacy. What I would recommend that to them is that it is of best interest they go and think careful about what they had done and what they are feeling if it is remorse or disappointed on the same issue. Moreover, I would ask them to ask for forgiveness, and to explain to me what had resulted them to post this kind of comment about a patient.

Case Study 3
David is a 58-year-old cardiac patient who had been verbally aggressive over the last two days since he has been admitted to the ward. You have been asked by the manager to have a chat with David to see how he is feeling.
1. The nurses would use closed up questions when they want a yes or a no or even short answer question to the patient. Closed question are important since they help one to get direct information.
How are you feeling today?
How are you feeling your pain, sharp, gripping or burning?
Would you want to shower?
2. The nurses might ask open questions to the patient in order to gain their knowledge, feelings, or even opinions to their answers (NSW Government Health, 2018). It could assist a person to think as well as reflect on the questions before providing their answers. Examples of such questions are;

What seems to make you upset?
John could you tell me where you feel pain?

3. Active listening is an active process which entails collecting, recalling, assessing as well as paraphrasing. The method is circular as the reaction of one individual serves as a motivation to another individual to respond back. Instance to how active listening could be utilized in this situation could be acknowledging the message which was received through letting David to know that you are much aware which you grasp the dilemma, you recall to what seemed to be said and done and you have the situation at hand.
4. Open question: This is where there is a detailed response from the client maybe a doctor and a patient.
Active listening: it is the most effective because it reveals that the person is keen and interested in what you really are saying. For example a patient being given feedback by a doctor. Providing feedback: Doctor providing feedback to the client (Core Standards for Nurses Who Support People With A Disability, 2014). Eye contact: great for effective communication because it reveals that the patient is focusing and listening to precisely what the health care worker is highlighting (Victoria State Government, 2014). Gestures: effective in communication given that help to make the patient feel comfortable with the doctor. Empathy: it will help the patients because they feel you understand and feel their feeling.
After a while, David becomes both verbally and physically aggressive. He says that ‘you are the worst nurse and do not care about him and he wants to leave. He pulls out his intravenous cannula in his arm and begins to throw things around the room.
5. It is a behavior to which is designed to stop escalations of the conflict. An illustration of this utilization of this program would certainly entails remain calm and call for assistance. In case one overreact they it might result in the patient to become aggressive. It is very important listen to whatever they are saying even if they yell. Respond with empathy and even recognize the emotions of the patients.
6. The benefit of this process is crucial because they assist the participant to know what is involved. It would be a discussion of what might have been done better and share of the information. This is a time to lay blame or perhaps fingers to others (Taylor, 2016). The process includes a facilitator and you will discover those who are involved with emotional outburst. This process would certainly help to offer a calm environment, to ensure that there is certainly a continuous conversation in a suitable manner. The process also assists the nurse and patient to making certain they possess not received any physical or perhaps emotional injuries from an incident that have escalated.
7. strategies to effectively receive feedback would be as follows;

Ensuring that one comprehends what exactly is said via precisely understanding the feedback. One could use techniques such as clarification as well as paraphrasing. As the supervisor for several directions on the changes to render to build up a situation. • Another is to assess a feedback, take the time to consider the feedback and ascertain as to whether you will accept or simply reject it (Smith, 2017).

Part B
1. It was developed in order to help nurses that are working with people and their families who support individuals with a disability. It has been intended to offer information on the communication as well as behavior support for the nurses who guides nurses while they are working with those individuals with disability in order to promote consistent and efficient best practice.

Identify the four domains of practice (1.2.1) within the standards for the Communication and behaviour support for nurses- practice package
Person centred Health Care Assessments as well as the Development of Health Care Plans Practice Package
Communication and Behaviour Support Practice Package
Working with personal with the Chronic in addition to Complex Health Care Needs Practice Package Mealtime Management Practice Package for Nurses.

2. The appraisal tool has been established to be able to enhance and escalation the knowledge of the nurses in finalizing of their standards. It provides consistent and efficient ideal methods. It also functions as the basis to improve nurses’ knowledge along with skills in creating communication and support.
3. Protection of the confidentiality among the health care workers in the health care records frequently has privileged customers and the user does assess the information and makes sure that the information which should be shared. Assigning privileges user in the health care practice it has proved to be a lot effective. Pre established organizational privacy along with security policies have been put in place in order to secure confidentiality of the information offered the patients and it has formed part of the organizational policy and regulatory frame-work.
4. The site are usually reliable and they are accurate they can be through professional screening, which the sites could possibly be named efficiently. As a nurse there is certainly necessity to confirm the validity, timeliness, authorship and credibility of the content. There is certainly need to assess the content of websites, credential and accuracy of information that is offered. The major parameter makes sure that they are reliable.
5. Nurses may be asked to lead small group meetings and discussions; therefore they need to be aware of various procedures. List 6 procedures.

The group ns are positive engagement to which the assistant nurses in health care methods in focusing on tasks which are challenging to a person. To manage to recognize effective group involvement, there is certainly need to comply with such kind of the guidelines (Halford, 2018). Identify on the tasks which need to be accomplished. To ensure that there is certainly good timing when engaging to the group activities. The group size should matter in relation to output content provision. Duration to the group dependent activities.Building of the collective relationship.

6. Objective
Problem solving It is the capability that is more often achieved much easily with the assistance of the group work activities Socialization The time has come spent in the group activities which has been set at permitting exposure to the activities and new situation as well as circumstances Facilitating sharing of the info Performing the group work role to share information in the groups which is advantageous compared to the personal provision.
7. The communication strategies in nursing care offer a prompt feedback as well as enhancement of the information which can be shared across the board. Effective communication methods instance includes effective feedback.  To make sure meetings are of value, the nurse conducting the meetings must think about at least 5 things? • Schedule when the majority of individual could take part, maintain time and attend the meeting • Focus to the assignment might adjust by its relevancy • Good rapporteuer is vital with the participants (Nursing Times, 2018) • Communicate significantly effective and powerful and focus on the discussion Ensuring notices with regards to meeting and they are much well communicated sooner enough and in good time.
8. One is being assertive and maintenance of decorum. One more strategy is making certain communication provides supportive feedback among the patient to make sure that the information presented is related to a specific scenario.
9. For a given balanced feedback the following are the steps which are recommended
Being constructive
Positive response approach
Analytical feedback
10. Application of constructive feedback information that is specific to the issues as well as provide positive playground for the solution
There is need to avoid offering mixed messages, that do not provide clarity to the patients. It is important to offer sincere message which shows that you care about the patients.

References
ACT Government. (2013). The Art of Feedback: Giving, Seeking and Receiving. Retrieved from https://www.cmd.act.gov.au/__data/assets/pdf_file/0003/463728/art_feedback.pdf
ACTPS Performance Framework. (2017). The Art of Feedback: Giving, Seeking and Receiving. Retrieved from  https://www.cmd.act.gov.au/__data/assets/pdf_file/0003/463728/art_feedback.pdf
Aorn Journal. (2011). Know your Etiquette. Retrieved from  https://www-clinicalkey-com-au.tafeqld.idm.oclc.org/nursing/#!/content/journal
Australian Commission on safety and quality in health care, (ACSQHC). (2018). The Australian Open Disclosure Framework. Retrieved from https://www.safetyandquality.gov.au/our-work/open-disclosure/the-open-disclosure-framework/
Halford, S. (2018). 5 Steps for Giving Productive Feedback. Retrieved fromhttps://www.entrepreneur.com/article/219437
Health.gov.com.au. (2018). Debriefing activities. Retrieved from https://www2.health.vic.gov.au
Koutoukidis, G., Stainton, K. & Hughson, J. (2017). In Tabbner’s Nursing care. Chatswood. Elsevier
Mind Tools. (no date). Questioning Techniques. Retrievedfrom https://www.mindtools.com/pages/article/newTMC_88.htm
My Aged care. (2018). Caring for someone with hearing, vision and oral health difficulties. Retrieved from
https://www.myagedcare.gov.au/caring-someone-particular-need/caring-someone-hearing-vision- and-oral-health-difficulties
NSQHS Standards. (2013). Australian Open Disclosure Framework. Retrieved from https://www.safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-Disclosure- Framework-Feb-2014.pdf
Nursing and Midwifery Board Australia. (2017). Social media policy. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Policies.aspx
Nursing and midwifery board of Australia. (2017). Enrolled Nurse standards for Practice.  Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional- standards/enrolled-nurse-standards-for-practice.aspx
Public Health Nursing. (2016). Case Management. Retrieved from https://www-clinicalkey-com-au.tafeqld.idm.oclc.org/nursing/#!/content/book 
Schroeter, K. (2010) Ethics. In Infusion Nursing. Retrieved from https://www-clinicalkey-com-au.tafeqld.idm.oclc.org/nursing/#!/content/book 
Sheehy’s Manual of Emergency Care. (2013).Workplace violence and disruptive behaviour. Retrieved from https://www-clinicalkey-com-au.tafeqld.idm.oclc.org/nursing/#!/content/book
Taylor, J. (2016). Effective Communication Skills. Retrieved  from https://www.habitsforwellbeing.com/9- effective-communication-skills/
Victoria State Government. (2014). Critical Client Incident Managment Instruction. Retrieved from https://fac.dhhs.vic.gov.au/critical-client-incident-management-instruction-technical-update

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