This reflective essay seeks to demonstrate the role of advocacy and effective communication in nursing practice. I will use a case study of a patient I met while on placement. I will refer to the patient using the pseudonym Margaret to maintain confidentiality as required by the Nursing and Midwifery (NMC 2018b). I will also not reveal the name of the NHS setting or nurses responsible for her care (NMC 2018b). I will structure my reflection using the Driscoll model (2007) to integrate theory into practice. Driscoll (2007) was chosen since it is simple to use or follow, especially for novice students (Nicol and Dosser 2016). The Driscoll (2007) model has three questions describing the event, explaining its importance, and how it informs future practice.

I was allocated to work in an NHS Trust during placement. On my first day at the acute ward, I came across Margaret, a 76 years-old woman of African origin. Margaret had come to me complaining that she could not understand the prescriptions for her medication. She stated facing difficulties understanding her care plan because a staff nurse spoke to her in a dark accent or language. I apologized to Margaret for the poor care. Consequently, I looked for the concerned nurse and asked her to clarify Margaret’s instructions. Moreover, I listened to her instructions, which I repeated with Margaret until she was satisfied.

Margaret’s case made me upset and embarrassed about the initial care. As part of the nursing team, I felt I had failed to give her effective care. NMC (2016) standards of medicine management state that a staff nurse must ensure that a patient or family member understands all medical prescriptions. The nurse can ask the patient whether they understood all the instructions (Kim and Park 2017). However, in Margaret’s case, the staff nurse did none of these, which caused the patient to come to my aid.

Moreover, NMC (2018b) holds that communication skills are essential for nursing practice. Lotfi et al. (2019) conceptualise communication in nursing as exchanging information between a patient and a clinician. Although communication can be either verbal or non-verbal, nurses should communicate clearly nonetheless (Oliveira and Tariman 2017; NMC 2018b). In this case, nurses should ensure their patients understand or are actively involved in their case (Oliveira and Tariman 2017). The essence of effective communication is that the speaker receives the recipient’s correct feedback. (Lotfi et al., 2019). Furthermore, it is important that nurses understand the patient’s level of education and ability to understand visual signs (NMC 2018a).

However, as Lotfi et al. (2019) noted, communication can be hindered by factors such as education level, language use, accent, and attitude. Therefore, nurses should use language that a patient can understand. Effective communication ensures the patient understands and can follow what has been stated as part of their treatment plan (NMC 2018b). Moreover, nurses should relate well with patients to create a positive attitude so that a patient can be compliant with the medication recommendations (Kim and Park 2017). In Margaret’s case, the staff nurse failed to recognize that her accent was barring her communication with Margaret.

In person-centred care, the nurse combines individual expertise and evidence with the patient’s values, opinions, and culture to arrive at a treatment plan (Ghane and Esmaeili, 2020). Patient- Centre care places the individual at the Centre of their care (Oliveira and Tariman 2017). Therefore, any decision arrived at or implemented is one that the patient approves or agrees with, as opposed to one implemented without their knowledge or contribution (Abbasinia et al., 2020). However, in Margaret’s case, she was not involved in planning her treatment; hence she could not understand her care plan (Oliveira and Tariman 2017). Nonetheless, I acted as Margaret’s advocate by consulting the nurse to ensure Margaret understood her prescription.

Advocacy in nursing refers to a situation where a nurse agitates for a patient’s rights whenever they are violated (Jarpe et al., 2019). NMC (2018a) outlines that nurses can represent a patient in search of justice, especially when the patient lacks capacity or is absent from family members. This can occur in courts or by voicing a patient’s concern to the hospital management for action. Jarpe et al. (2019) noted that a nurse advocate helps patients get quality care and be protected from staff mistreatment. Although I did not report Margert’s case to any authority, the action I took to ensure that the nurse concerned clarified the instructions qualifies me to be an advocate.

This reflection experience has enabled me to understand the need to integrate essential nursing skills into practice. It has taught me the practical application of theoretical strategies for mitigating communication barriers. Moreover, I have appreciated the role of advocacy in improving patient safety and satisfaction. As part of my action plan, I will strive to understand more about the common barriers that hinder nursing care communication (Ghane and Esmaeili 2020) to improve my future practice. Similarly, I will study more on the principles of person-centred care as outlined by NMC. This will ensure I can always assess whether the care complies with them. Lastly, I will study the NMC (2016) standards of medicine management guidelines and understand the procedure of drug prescriptions to ensure I can administer medicines better.

In conclusion, this essay has reflected on the importance of effective communication and advocacy in nursing practice. Accordingly, I have used a case study of Margaret to show how accent (a communication barrier) can affect service delivery, especially if a nurse does not confirm whether a patient has understood the prescriptions. Similarly, I have outlined various approaches as articulated by the NMC that underpin medicine management, nursing communication, and person-centred care. I have always learnt to enquire whether a patient is comfortable with my way of communicating with her.