Explaining in Health Care
Nursing is a very important element of the whole health care system because these are nurses, who spend the most time with patients in order to help them recover faster. As in any other profession, communication plays an important role in the work of nurses. Communication is important because it helps patients and medical staff understand the goals and desires of each other faster, then to recover faster. Thus, each nurse needs to develop communication skills. Me, the author of this reflection paper, is not an exception. That is why, the aim of this paper is to decide what communication skill needs to be improved in my professional activities, and then teach it to my colleagues in the workplace.
Step 1: Choosing a communications skill to explore
As a health professional, I use communication every minute during my workday. Over time, I realized that to be able to explain is an especially important skill in communicating with patients. Of course, patients in the intensive care unit may require it less than this. Yet every person who happened to be in the hospital, wants to understand what is going on with them.
The main purpose of explaining as the main object of analysis in this paper is to give patients the opportunity to calm down and be conscious of what is happening to them. Most communication problems that arise with patients are the result of an insufficient quality of explaining. To understand what is at stake, it is necessary to give a few examples from the practice. Very often patients are aggressive or irritable when they are asked to follow certain dietary restrictions for a period of treatment. Or sometimes they do not want to take painful injections. Sometimes patients become angry when they feel pain due to medical procedures. There are many examples of nursing practice, when a patient while being in the hospital feels depressed, unhappy, and frustrated. All of these symptoms are the result of improper communication. It is evident that movement from a real-life condition to the hospital is stressful itself. Moreover, very often the relatives who visit patients make them feel not better, but even worse because they stir up a negative situation with their doubts, fears and ignorance.
In all these situations, the role of nurses is huge. Nurses should possess excellent skills of explaining to reassure patients and their relatives. Moreover, the nurse should explain to them the causes of the disease, and the importance of treatment. It should be added that the nurse should use a friendly or "easy" language so that patients do not feel incompetent. Thus, the nurse needs to have an excellent explaining skill to translate medical information about treatment into understandable «human» language for patients and their relatives.
Step 2: Researching the skill
In order to prove the importance of explaining for the rehabilitation of patients, it is necessary to provide some academic evidence. In fact, many researchers emphasize the importance of communication for patient recovery. Catherine McCabe (2004) calls a lack of patient-centered communication the “number one problem”, mentioned by patients (McCabe, 2004). Patients really want to have nurse being interested in how they feel and to have a little more time for personal communication with medical staff. Of course, the patients understand that if the nurse devotes much time to personal conversations, then nobody will do all routine medical cases. Nevertheless, it is a fact that many patients feel abandoned and useless because nobody talks to them from the heart. It is important to clarify that for the patients it is important not to feel themselves just the object of treatment, as it often happens.
Many patients say that they would be happy to talk about the reasons for their illness, and possible treatments. However, they receive only medical prescriptions written in "incomprehensible" professional language, which significantly reduces the desire to speak on these topics. Moreover, many patients feel that nurses simply do not have time to leisurely explanation, so patients often try "not to bother the nurses with silly questions." Such a situation affects the health of the patient adversely, especially those vulnerable patients with hypertension. Examination by Street et al. (2009) showed that quiet conversation between the nurse and the patient adjusts the patients a positive way. And this case, patients do not feel hopeless, but are able to recover better and with a bigger will. As a result, such patients recover much faster.
There is one interesting study, which examines how should the medical staff communicate with patients with low level of literacy. It would seem that these patients are just a minority. However, the techniques that are used to communicate with those people, show high efficiency. The main objective of this dialogue is an explanation, which should be very simple and easy to understand. A group of scientists (Schwartzberg et al., 2007) offers a number of these primitive techniques that work well for explaining to all people, not only for those who are illiterate.
Speaking slowly is maybe the core thing in explaining. Each nurse should understand that the patient, even despite the literacy rate, is likely not come across with the medicine and does not understand more than half of the text. Therefore, to facilitate understanding, the medical staff should give the patient enough time to reflect on all that has been said.
Simple language has been mentioned above, but it requires more attention. Everyone has different levels of literacy. Again, patients are not required to understand medical terminology and specifics of treatment. Therefore, in order to improve confidence, understanding and thirst to recovery, nurses should use the simplest language in explaining difficult things to patients.
Reading aloud might sound rather primitive. However, when it comes to taking medication and complex treatment regimens, for most people it is difficult to understand the instructions. Therefore, it would be a big plus if the nurse explains what is written in the instruction.
Printed materials also work greatly with any patients. Most people absorb information through the eyes. Moreover, not all people are aware of how their bodies function. Therefore, drawings, diagrams and printed materials will work great in explaining. The same works for pictures.
Step 3: Planning a teaching session
All the teaching session will be divided into two parts. The first part is "Understanding the patient." The second part of the session is a "Practice for simple explanations."
Part 1. "Understanding the patient." Timing - about 20 minutes.
It is a known fact that there is a certain gap between patients and medical staff because patients often do not understand, what does the medical staff is talking about.
Thus, the next game is aimed at understanding what patients feel when they do not understand the nurses` explanations. Moreover, this game will contribute to the mini team building of the participants of the teaching session.
Rules. The game is simple and well-known. One person from the group thinks of a medical term that is often used in communication with the patient. Then that person should show the word explaining the meaning of it just with the help of gestures. The one who shows can not say a word. At this time, the audience has to guess what the term does that person wants to show. The one from the audience, who guessed the word, is entitled to think the word next.
Part 2. "Practice for simple explanations." Timing - about 40 minutes.
In this part, the participants of the session have to do two things.
1) All together, they have to write the top 20 most common phrases that they use to communicate with their patients, and that patients almost do not understand.
2) Using tips of Schwartzberg et al., (2007), they have to try to explain those “strange expressions” using paraphrasing, speaking slowly, simple language, pictures, printed materials or anything else.
At the end, it is necessary to give some consequences of developing this "explaining" communication skill. As a result of slow explanation, the gap between patients and medical staff will gradually decline. Patients will feel needed, more confident and more motivated for fast recovery. I really believe that this training of explaining communication skill will allow medical staff to help patients better.
Bibliography
McCabe, C. (2004). Nurse–patient communication: an exploration of patients’ experiences. Journal of clinical nursing, 13(1), 41-49.
Schwartzberg, J. G., Cowett, A., VanGeest, J., & Wolf, M. S. (2007). Communication techniques for patients with low health literacy: a survey of physicians, nurses, and pharmacists. American journal of health behavior, 31(Supplement 1), S96-S104.
Street, R. L., Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient education and counseling, 74(3), 295-301.
