COMMUNICATION SKILLS FOR ASSESSMENT      03/05/23.

 

We looked at the learning outcomes, the definition of communication – communication – ‘all of the procedures by which one mind may affect another’ according to Argyle (1978). without communication there cannot be any person-centred care.

In building relationships and collaborative partnerships, building trust is crucial to the success of the therapeutic relationship.

Without trust this relationship may only provide superficial discussion. Communication is based on trust, respect and your own willingness to re-examine assumptions service users to be more open. We communicate with individuals based on what we know about them as people. It influences -what we say, how we say it and the language, and the communication strategies used.

In readiness for assessment, we looked at:

The preparation aspect:

Read the notes.

Set goals.

Consider how you will be perceived (behaviour and appearance)

Consider the environment.

The sequence:

Greet and establish rapport.

Set an agenda and invite patient story.

Identify and respond to clues.

Expand and clarify.

Generate hypotheses/working diagnosis.

Share decisions and treatment plan-next steps.

Thanks.

Close and reflect.

At the first impressions, your response sets the tone.

Crucial to establishing trust and dialogue.

Ask yourself: ‘what is the best way to communicate with this person?’

Introduce yourself.

Greet them appropriately, ask how they would like to be addressed.

The interview techniques are questioning(funneling), active listening, non-verbal communication, empathetic responses, summarizing, clarification, reflection, feedback, to name but a few.

We looked at the different types of questioning, which are:

The Enhancers:

Opening questions – general (speak generally about their issue/concern/reason) and specific (encourage the service user to speak in more depth about something).

Closed questions – this is used when you need a specified answer.

Probing questions – this is used to gather more details and information (what? where? when? how? why? and who?)

Rhetorical questions -this is dressed up as questions, but can be useful for engaging others, stimulating and provoking thought around a particular subject.

Guided questions.

 

The Detractors:

Multiple questions – can confuse the service user in the response that they provide.

Leading questions – it starts from the least invasive question and progresses to the more invasive ones. It should be avoided in healthcare assessment.

In listening skills, attentive listening is essential for all the assessment process. Being open, responding and reflecting are needed to help people tell their story. It helps to develop discussion.

In active listening, closely attend to what the patient is communicating. The use of verbal and nonverbal skills to encourage the service user.

In nonverbal communication, it provides important clues to our underlying feelings. Being sensitive to nonverbal cues allows you to understand the service user more effectively and send messages of your own.

Nonverbal communication includes:

Eye contact

Facial expression

Posture

Head position and movement such as shaking or nodding.

Interpersonal distance

Placement of the arms and legs.

Nonverbal communication can be culturally bound.

Empathetic Responses are responses that convey that you appreciate the way a patient is feeling.

It validates the legitimacy of his or her emotional experience.

Reassurance – identifying and acknowledging the service user’s feelings.

Nonverbal.

Verbal.

Empowering the service user: service users have many reasons to feel vulnerable during the interview process, eg they may be in pain, worried or overwhelmed.

The relationship between a service user and healthcare professional can be unequal.

Differences of gender, ethnicity, race, or socioeconomic status can contribute to feelings of vulnerability and unequal sharing of power in therapeutic relationships.

It is also important that the service user feels empowered throughout the assessment process, as this will enhance the information exchanged.

I learnt the techniques for sharing power, they are listed below:

• Evoke the patient’s perspective.
• Convey interest in the person, not just the problem.
• Follow the patient’s leads.
• Elicit and validate emotional content.
• Share information with the patient, especially at transition points during the visit.
• Make your clinic reasoning transparent to the patient.
• Reveal the limits of your knowledge.

 

In closing the interview:

• Ending the interview can be difficult.
• Let the patient know that the end of the interview is approaching.
• Allow time for any final questions.
• Ensure the service user understands any mutual plans you have developed.
• Ask if they have any questions.
• Summarise plans for future evaluation, treatments and follow up.
• Teach back – invite the patient to tell you the plan of care in their own words.

We looked at the three Dimensions of Cultural Humility:

• Self-awareness – you must recognize how culture shapes not only the service user’s beliefs, but also your own. Avoid letting personal impressions about cultural groups turn into professional stereotyping. Evaluate each service user as an individual.
• Respectful communication – let the service user be the experts on their own unique cultural perspectives. Find out about the service user’s cultural background. Maintain an open, respectful, and inquiring attitude. Learning about the service user’s culture enhances your knowledge as a nurse.
• Collaborative partnerships – build your patient relationships on respect and mutually acceptable plans.

 

 

 

 

KSB ADDRESSED.

 

K1: Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfil all registration requirements.

K4: Understand the principles of research and how research findings are used to inform evidence-based practice.

 

K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care.

 

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice.

 

K7: Understand the importance of courage and transparency and apply the Duty of Candour.

K8: Understand how discriminatory behaviour is exhibited.

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

K10: Understand the principles of epidemiology, demography and genomics and how these may influence health and well-being outcomes.

K11: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes.

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being.

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes.

 

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care.

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

K17: Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care.

 

K18:  Understand and apply the principles and processes for making reasonable adjustments.

K19: Know how and when to escalate to the appropriate professional for expert help and advice.

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met.

 

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care.

 

K22: Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health.

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity.

K24:  Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain.

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life.

 

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld.

 

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies.

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications, and adverse reactions.

K29: Understand the different ways by which medicines can be prescribed.

 

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.

 

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes.

 

K36: Understand the roles of the different providers of health and care.

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives.

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services.

 

K41: Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it.

 

 

SKILLS:

 

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements.

S2: Keep complete, clear, accurate and timely records.

S5: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018).

 

S17: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018).

 

S18: Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent.

S21: Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes.

S23: Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate.

S25: Meet people’s needs for safety, dignity, privacy, comfort and sleep.

S26: Meet people’s needs related to nutrition, hydration and bladder and bowel health.

S27: Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity.

S28: Support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

S30:  when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed.

S32: Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams.

 

S35: Accurately undertake risk assessments, using contemporary assessment tools.

 

BEHAVIOUR:

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences.

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice.

B3: Be adaptable, reliable and consistent, show discretion, resilience and self-awareness.