In the health care profession effective communication is an essential aspect of the nurse-client relationship. Throw-out this piece the author will discuss and give examples of listening responses that can be implemented in nurse-client communication. It will also describe and give further examples of communication strategies which are used to facilitate conversations with clients while acknowledging their barriers to communication.
Efficient communication between nurse and client can result in improved health outcomes and client satisfaction (Arnold and Boggs, 2011). To make nurse-client interactions meaningful and clear, active listening strategies need to be implemented including verbal and nonverbal responses (Arnold and Boggs, 2011). Paraphrasing, reflection and summarisation are main listening responses that improve communication. Listening strategies insure the client that the nurse has committed to a professional partnership.
This reinsures the client’s confidence that the nurse will advise the most acceptable coping strategies and knowledge related to the clients’ health status (Arnold and Boggs, 2011). Mr Giuseppe Rossi is an example of a client where these responses need to be implemented. Mr Rossi is a male client of eighty four years that suffers from diabetes, poor eyesight and hearing problems. Due to his ulcer which is affecting his mobility he has also become increasingly anxious. Nurses will focus on Mr Rossi’s immediate health problems while considering and implementing strategies to resolve his anxiety.
Paraphrasing as a response strategy is used to insure the client that the intended message has been interpreted correctly (Arnold and Boggs, 2011). This involves the nurse referring to the client’s original message and creating a justified response which does not lose the intended meaning. This is best implemented in nurse-client communication though it may not be suitable if the client is from a non-English background. Different cultures can also cause misinterpretation or confusion between client and nurse (Arnold and Boggs, 2011). Paraphrasing may be used effectively if structured suitably for example in Mr Rossi’s case, “… so what you’re saying is that you are unsure of the possible outcomes if surgery is unsuccessful?” (Stein-Parbury, 2009). When paraphrasing is performed efficiently the client remains uninterrupted as the nurse processes the main focus elements of the client’s message (Berman, Snyder, Kozier, Erb, Levett-jones, Dwyer, & Stanley, 2010). If performed unsuccessfully, errors can lead to incorrect health care being performed (Berman et al., 2010).
Emotional implications of messages are the focus of the listening response reflection (Arnold & Boggs, 2011). This response is important as it allows the client to develop feelings and identify others they may not have been aware of because of their unfamiliar circumstance. Reflection is effective when used in situations where loss is imminent or existing. It may be unacceptable if used in general conversations where emotion is unnecessary (Arnold & Boggs, 2011). An example of reflection that may be used in Mr Rossi’s circumstance is “it sounds as if you are worried about the impact that the surgery will cause on your mobility” (Windle and Warren, n.d.). If reflection is implemented correctly the clients will have heard what they have stated which may lead them to fully considered expressing important feelings about their situation. Increased use of reflection may cause annoyance and irritation for clients (Lake-Sumter State College, 2012).
Summarisation is an active listening response used to review content and process information (Arnold & Boggs, 2011). As Windle and Warren, (n.d.) understand summarisation is crucial, as it involves the listener focusing on the main ideas and feelings of the speakers large amount of information. To change the topic or focus of the conversation summarisation can be used as a beneficial bridging technique however should not be used as a closing statement, as it can portray an uninterested and uncaring professional (Arnold & Boggs, 2011).
Using summarisation as a positive technique in Mr Rossi’s circumstance could be “It sounds like you feel frustration because you do not understand what the doctor said about your surgery” (Bodak, 2013). If summarisation is accomplished it will reinsure the client that the nurse has understood the conversations intended meaning. If not, it can cause the client to be resistant and uncertain of the nurse’s interest (Windle and Warren, n.d.).
Verbal and nonverbal communications are methods used to communicate with hearing impaired clients. If unassisted by communication-assisting equipment (e.g. hearing aids or a translator) clients may have skills in lip reading or sign language (Everson, Allen, Nann, Walters, 2013). The usage of visual cues such as holding the object of discussion (e.g. tablets or blankets) is a nonverbal communication technique that can lead to significant improvement within communication (Everson et al., 2013). Mr Rossi’s hearing problem and feelings need to be addressed. Three key communication strategies which can be used to communicate with Mr Rossi’s could include sign language, clear speech or the use of assistance devices (Arnold & Boggs, 2011). Sign language is effective if both nurse and client understand the technique.
If this is the situation then Mr Rossi could communicate through the nurse to others in the health profession however he could use lip reading as an alternative which might be more suitable. Mr Rossi can be informed in a clear and calm voice of new medication he has been prescribed by “Mr Rossi, this is the new pill which will help get rid of your pain.” This should be accompanied by the nurse showing the medication to Mr Rossi. If lip reading or sign language is not possible a hearing aid could be used. Hearing aids will assist the hearing loss increasing the volume of the client’s environment. These techniques will encourage social awareness of situations and with support from nurses, can motivate clients to improving their health mentally (Arnold & Boggs, 2011).
Unlike hearing impairment, vision impairment mostly uses verbal communication methods. Vision impairment is highly common in older age and can come in many different forms. Cataracts, glaucoma, diabetic retinopathy and age related macular degeneration are common disorders among older adults such as Mr Rossi (Touhy & Jett, 2012). Mr Rossi’s feelings and his physical vision deficiency need to be addressed. Three key communication strategies which could be used include clear prompt speech, analogy of a clock face or using vision enhancing devices (Arnold & Boggs, 2011, Touhy & Jett, 2012).
The nurse’s speech should be calm, clear and performed normally in close proximity so that the level of speech volume is not disrupted (Arnold & Boggs, 2011). Analogy of the clock face is a technique where the nurse relates to an objects position to a time on the clock. An example of these techniques would be when the nurse sits next to Mr Rossi and says “Your dinner is here Mr Rossi, looks like meat at three o’clock and your dessert at six o’clock” (Touhy & Jett, 2012). Vision enhancing devices such as a Tellatouch, which is a portable machine capable of punching out braille paper, can be used in other situations to communicate with Mr Rossi (Arnold & Boggs, 2011). If these strategies are implemented correctly the nurse will have promoted healthy aging and encouraged improving quality of life (Touhy & Jett, 2012).
Anxiety is a very common feeling among elder people. It is an unclear feeling of impending danger, which is caused by a real or imaginary threat (Arnold & Boggs, 2011). When a client has anxiety there are no certain listening techniques that can be identified, for each anxiety case has different levels and techniques which could be implemented (Arnold & Boggs, 2011). Firstly the nurse will need to identify if Mr Rossi has mild, moderate, severe or a panicking level of anxiety through observations of his actions and words. Communication strategies can then be understood and implemented (Arnold & Boggs, 2011).
Three key communication strategies which a nurse could use in Mr Rossi’s circumstance must be identified by firstly acknowledging Mr Rossi’s level of anxiety. As Mr Rossi communicated his anxiety about his leg ulcer, his anxiety level will most suitably be mild to moderate. Therefore the communication strategies could include encouragement, explanation and therapeutic touch. Encouragement allows clients to identify within themselves possible reasons for why the anxiety is present (Arnold & Boggs, 2011).
An open-ended reflection statement such as “you sound very worried about your leg ulcer, do you think there could be other reasons for why you feel anxious?” can be used to allow the client to express his feelings. Clear explanations of surgery, procedures and appropriate reassurance, based on true data, can further strengthen the nurse client relationship (Arnold & Boggs, 2011). Using therapeutic touch such as, placing a professional hand on the clients shoulder, can stimulate comfort, security and a sense of feeling valued (Arnold & Boggs, 2011). When these strategies are implemented correctly a client such as Mr Rossi should feel comfort and reassurance which will strengthen the client-nurse relationship (Arnold & Boggs, 2011).
Some may ask what value there is in nurse-client communication. That value is the feeling of accomplishment, when a client and nurse create a professional bond and observe growth in both health and knowledge. Every individual continues to learn how therapeutic listening responses and communication strategies encourage client’s self-esteem and promote mental ambition for shorter hospital recovery periods. A nurse in any situation should encourage the client with a positive attitude and performs listening responses and communication strategies effectively, if so high achievement of improved health and client satisfaction can be the overall result.
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