Communication and Nursing Care

This report analyzes the significance of communication in nursing care through a case study of Margaret, a patient with breathing difficulties admitted to Pilgrim Hospital. It explores the challenges nurses face in communicating with patients, the importance of interprofessional communication, and the involvement of relatives in patient care. The report also outlines the nursing process, including assessment, diagnosis, planning, implementation, and evaluation, as applied to Margaret's case. It concludes by reflecting on the author's development as a result of participating in patient care.

Communication 2.
Nursing care

Table of Contents
INTRODUCTION...........................................................................................................................3
PART 1............................................................................................................................................3
Nursing issues in relation to care of given patient......................................................................3
Communication of inter professional team.................................................................................4
Involvement of relative of patient in terms of communication...................................................5
PART 2............................................................................................................................................6
Identify nursing care problems....................................................................................................6
Nursing process...........................................................................................................................6
Nursing assessment.....................................................................................................................8
Goals for given patient................................................................................................................9
Care and implementation............................................................................................................9
CONCLUSION..............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Nursing care refers to encompasses an autonomous and collaborative care of sick
individuals of all ages, families and groups to make them well-being. It is a kind of medical
profession in which clinical practices and procedures in order to make them healthy. Registered
nurse is required to follow set national standards of care and legal rules at the time of providing
care services to people. However, communication plays a significant role in nursing care in
context of diagnosing correct health issue and make appropriate decision making regarding
medication for an individual (Hockenberry and Wilson, 2018). The present report is based on
case study of a patient named Margaret who was admitted with breathing difficulties in a
medical ward of Pilgrim Hospital. It was founded in 1976 and provide number of care services to
people in respect of solving various health problems in proper manner. This assignment will
focus on communication issues along with theoretical perspective and conversation between
team members for improving care of patient. It will also include involvement of relatives in
terms of communication related to sick person to gather desired information. The nursing care
problems and nursing process along with administration of selected patient is given below. I will
conclude by reflecting on my development as a results of participating in patients care while on
placement.
PART 1
Nursing issues in relation to care of given patient
Nursing staff faces number of difficulties at the time of making communication with
patient in order to gather appropriate information for analysing present symptoms. It includes
that there are number of problem which has been faced by nurses in communication for gaining
data about past medical history which is essential to make appropriate decision regarding

specific treatment procedure. However, effective communication with patient is important in to
collect information about previous allergies from medications and other suitable medications
which are accepted by immune system of an individual (Papastavrou, Andreou and Efstathiou,
2014). In context of Margaret, nursing staff face several problems such as anxiety, hearing loss
and confusion state of a sick person in Pilgrim Hospital.
Initially, hearing loss create problem to not understand the question of nursing
practitioners which results into inappropriate answer and that will generate difficulty to make
appropriate care plan. However, the factor of anxiety which consist the feeling of unease such as
fear or worry that can mild or severe. This condition of Margaret is responsible for inappropriate
thoughts or information about actual difficulties felt by patient which impacts negatively on
clinical practices of carried out by professionals for their welfare. In addition to this, confusion is
another barrier of communication between care professional and sick person in order to gain
desired information to determine particular health issue. It is necessary to identify present health
issue of difficulty in breathing to make sure about specific problem which facilitate to establish
more effective as well as efficient care plan to make Margaret well-being (Tobiano and et. al.,
2015).
At the other hand, some of theoretical perspectives are required to be considered by
nursing staff while dealing with patient and communicating with family members or relatives.
However, it consist the criteria of active listening and indicates that a nurse should listen every
thing with patience and then take their opinion about particular medication to ensure their
comfort zone for making them feeling relaxed. Furthermore, it is essential for care professionals
in Pilgrim Hospital to show empathy, respect and dignity for patients while providing treatment
to them for their well-being.
Communication of inter professional team
The communication is very important to healthcare settings while making conversation
with patients, relatives and other care professionals. It is essential to make proper communication
among inter professionals team in terms of conveying desired information about patients.
However, it is significant to make proper conversation regarding data related to sick person in
order to make correct decision about treatment or medication technique for their welfare. In
addition to this, it has been analysed that group of care professionals are associated with single
case of Margaret having breathing difficulties to conduct appropriate diagnosis for giving correct

medications to make them well-being. It is observed that number of medical professionals are
associated including nurse, specialist, pathologist and physician to deal with single case of
patient in respect to achieve their better health (Cherry and Jacob, 2016).
At the other hand, it is necessary to team of professional linked with case of Margaret to
communicate with each other for sharing related information which is useful to carrying out
treatment process effectively. Meanwhile, it consist that nurse will conduct physical examination
and provide primary medications of patient along with recording the overall the information
written form which is required to be shared with specialist and therapist which facilitate them to
make more effective as well as efficient decision regarding treatment methods. Moreover, the
nurse will provide information to pathologist to conduct few of pathological activities which is
helpful to determine actual causes of breathing difficulty in case of Margaret in Pilgrim Hospital.
Furthermore, overall information will be shared between carers in order to prepare an appropriate
care plan for well-being of given patient (Tobiano and et. al., 2015).
Involvement of relative of patient in terms of communication
The involvement of relatives and family members in communication plays an important
role in care practices as it will facilitate to gather previous information and get aware regarding
symptoms indicates by patient. However, it has been analysed that many times sick person is not
conscious as they are not capable to communicate with nursing staff then carers prefer to collect
medical information about an individual from their relatives. Meanwhile, relatives of patients are
helpful to determine actual heath problem of them among with determining requirements in
respect of completing them in accurate way. In addition to this, some times sick individuals feel
scared to share their problem with doctors them involvement of relatives provide support to
convey their real health issue to carers in order to given correct medicines and other treatment
technique to make them healthy (Kalisch, Xie and Dabney, 2014. In case of Margaret, nursing
staff involve their family and relatives to collect required knowledge because patient is not able
to talk due to breathing difficulty in Pilgrim Hospital. Moreover, involvement of relatives
facilitate to boost up comfort zone of an individual due to that they can easily convey their
difficulties which are favourable for care professionals to provide desired medial services in
accurate manner.

PART 2
Identify nursing care problems
In case of chronic obstruction pulmonary disease is major cause of death and ill health in
adults. There are various issues which nursing care faces while treating the COPD patient. This
condition can not be diagnosed easily, the signs and symptoms are quite complex which made it
hard to determine the exact condition. Economic and clinical importance, this disease remains
under diagnosed and poorly understood. This can be due to many factors such as milder COPD
asymptomatic and individual will have cough or sometimes breathlessness as which can because
of smoking. Nurse perform screening with spirometry on the risk of population due to the
inadequate resources and training (Doenges, Moorhouse and Murr, 2014). There is a little
incentive for the nurses to recognise the disease systematically, to differentiate it from the other
respiratory disorders. The prescribing formulation are influenced by social class and age of
patient as they are objective diagnostic criteria. And here remains strong belief in primary and
secondary care which nothing can be done, to these individuals other than the intake of tobacco.
These types of approaches are mostly unwelcome in case of patients who are active smokers.
Pilgrim Hospital faces major problem to solve the health condition case like Margaret. It
is not easy to treat a patient who is with COPD which is complex disease. It can also involve
problems like pyrexia, pain and sleeping problems. The patient may not be able to sleep well due
to problem with the breathing during night time and which can cause sleepless night for
individual. Patient can also suffer the pain while breathing and coughing. This problem normally
do not shows major signs and symptoms. Sometimes this health condition also raise body
temperature which is quite misleading for the treatment (Townsend and Morgan, 2017). It
resembles with normal fever, so it is hard to determine whether it is COPD and some other health
condition. Nursing care suffer with the various problem when they deal with patient who is
having such kind of disease.
Nursing process
The nursing process can be described as a scientific method that is used by nursing staff
in order to make sure about providing better quality of care to patients to make them well-being.
They put efforts to carrying out more effective as well as efficient clinical practices to provide

care services for improving health status of sick people respectively. In context of Margaret,
proper nursing process is required to be followed in Pilgrim Hospital which is given below.
Assessment phase – This can be described as an initial stage of nursing procedure in
which nursing staff collect relate data about sick person regarding physiological, psychological,
spiritual and sociological status. Meanwhile, it involves the criteria of conducting interview with
patient in order to analyse about difficulties faced by an individuals due to specific health issue.
In addition to this, physical examination involves several kinds of data such as health history of
patient, gathering history of family and general information which can be utilised to collect
assessment data (Urden, Stacy and Lough, 2017). Moreover, the interaction with patient is
usually the heaviest at the time of evaluative phase. Furthermore, Margaret is feeling difficulty in
breathing which is symptom of Chronic obstructive pulmonary disease which is required to be
ensure through diagnosing tests.
Diagnosing phase – The second step of nursing process consist the criteria of conducting
diagnosing activities in which nursing staff make an educated judgement regarding potential or
actual health issue with sick person. However, it is necessary to conduct desired diagnosing
activities in order to determine actual cause of breathing difficulty of Margaret in Pilgrim
Hospital. In addition to this, Lung (pulmonary) function tests, chest X-ray, CT Scan, arterial
blood gas analysis and laboratory tests to make sure that selected patient is suffering from
Chronic obstructive pulmonary disease (COPD). Moreover, it cam be considered as a critical
step in terms of determining the appropriate coarse of action.
Planning phase – After the diagnosis of COPD, it is required to prepare more effective
as well as nursing care plan including intervention and rationale in order to make Margaret well-
being. Meanwhile, it consist the criteria to establish appropriate interventions step-by-step along
with their important which are appropriate to sort out breathing difficulty due to chronic
obstructive pulmonary disease (Giger, 2016). However, it is important set intervention by
following nation care standards and legislations in proper manner.
Implementing phase – The next phase consist the implementation of care plan take
place by following legal norms in order to meet actual medical requirements of Margaret.
However, it is necessary take actions including in a nursing care plan consist monitoring the
patient for signs or change or improvement, directly caring for patient or performing essential
medical tasks properly. It involves to educate and instruct sick person for further health

management and referring or contacting patient follow up. Furthermore, it consist to follow
Roper–Logan–Tierney Model of Nursing to focus on related factors for ensuring betterment of
patient.
Nursing assessment
Nursing assessment of patient who is with chronic obstructive pulmonary disease is very
essential to build accurate diagnosis, measuring outcomes for clinical, determining prognosis and
assist in making decisions of therapy. Chest computed tomography scans are very useful for the
individuals who present with the airflow limitations. Distribution and amount of emphysema can
recognise outcomes from the lung volume reduction surgery. Chest CT scan is compulsory in
assessment of the patient for the surgery (Welton and Harper, 2015). Quantitative parameters
from the chest CT scan has been used to determine longitudinal progression of the particular
disease. Assessment of the person with COPD condition for research and clinical purpose has to
be incorporate variety of outcomes. There are other different assessment which are done for the
COPD patient such as making accurate diagnosis. Making exact and accurate diagnosis helps to
estimate proper condition and which helps to provide right treatment to individual. Assist in
making choice and decision of most appropriate therapeutic interventions. Measuring the
outcomes and results in response to interventions in the clinical settings and research
investigations. This also provide an information about the prognosis.
Nursing assessment require subjective and objective data which has to assist during this
condition. Subjective data include chest tightness, difficulty in breathing and asking patient
whether having some other problems related to respiration which helps in assessment of given
condition. Objective data include wheezing, oxygen saturation, shortness of breath, swelling,
tachycardia, blue or gray lips and inability to speak the full sentence because it stops the
breathing process. All signs as to be considers in such case which gives a clear clarification
about disease and also treatment (Zúñiga and et. al., 2015).
General symptoms and signs include cough, shortness of breath and excessive mucus
production in this case. Assessments are required to confirm the condition and important for such
diseases which can confuse with symptoms because these symptoms can releasable with other
disease. These assessment helps to make decision about the care and treatment so that patient can
get correct therapy. It also lead to understand the patient's condition and methods which can be
used to overcome with particular conditions. In case of Margaret these assessments helped nurse

and doctors to give accurate treatment and care so that patient could able to get good results
regarding the health condition.
Evaluation phase – This final step of nursing process including to monitor
improvements and reaction of body to given medications after applying nursing care plan
completely. Meanwhile, it consist the criteria to determine that set goals for wellness of person
have been met or not. In addition to this, it involves to analyse possible outcomes including
improvement in condition of Margaret, stabilities of patient situation and patients discharge
(Jeffreys, 2015).
Goals for given patient
The smart goals are required to be set for Margaret in order to sort out problem of chronic
obstructive pulmonary disease to make them well-being. Smart goals can be described as
specific, measurable, acceptable, realistic and time bound which are effective to make patients
healthy. Initially, the improvement in breathing pattern by conducting oxygen therapy to make
them feeling relieved. In addition to this the another goal is to maintain a respiratory rate within
normal limits of selected sick person.
Care and implementation
The nursing care for Margaret in Pilgrim hospital includes that interventions and
rationale in order to make them well-being. Firstly, it involves to conduct oxygen therapy to
improve the condition of patient having breathing difficulty. It is necessary to follow proper
guidelines of providing oxygen through using appropriate tool for the same which is best suitable
as per person situation of an individual top make them feel relaxed (Winsett and et. al., 2016).
However, patient is required to be placed in semi fowlers position and increase fluid intake
according to actual needs of a person. Secondly, change position in every two hours that
facilitate movement of secretion & drainage and perform chest physiotherapy which helps for
loosen secretions. Thirdly, it includes to place a pillow at the time when client is sleeping that
provide adequate expansion of lung while sleeping respectively. Meanwhile, it consist to
instruct about the splinting chest wall with a pillow for comfort during elevation and coughing
of head over the body as appropriate which provide support in promoting physiological ease of
maximal inspiration. In addition to this, it involves to maintain an airway of patient along with
suctioning of secretions that may be done as ordered which are important to remove secretions
which is responsible for obstruction in airway. At the other hand, it consist he criteria to provide

respiratory support and inhalation of oxygen as required which is significant because it can be
considered as an aid in relieving the patient from the issue of dyspnea. Furthermore, it involves
to conduct an administration prescribed cough suppressants, analgesics and be cautious because
opioids may depress respiration more than desired.
The implementation of nursing care plan is required to carried out in an appropriate
manner with the help of following legislations and national care standards set by authorised
agencies. However, the nursing staff is required to obey Roper-Logan-Tierney Model of Living
which is based on daily activities of living in order to make given individual healthy. It involves
number of activities such as maintaining a safe environment, communication, breathing, eating
& drinking, elimination, washing & dressing, controlling temperature, mobilisation, working &
playing, expressing sexuality, sleeping and death & dying (Jakobsen and et. al., 2014).
Moreover, it also consists several factors which should be considered by nurses including
biological, psychological, sociocultural, environmental and politico economic. Basically, it is
also mandatory to follow national care standards like person centred care, dignity & respect,
consent, safety, safeguarding from abuse, food & drink, premises & equipment, complaints, good
governance and duty of candour. Furthermore, several legislations must be followed by nurses
such as Health & social care act 2012, Equality act 2010, Social value act 2012, Care act 2014,
Data protection act 2018 and Medical act 1983.
CONCLUSION
From the above report, it has been concluded that nursing care involves number of
effective clinical care practices which are conducted for well-being of sick people. However, it
has been analysed that I have develop communication skills by developing ability of active
listening and patiently answering doubts of patients in order to remain healthy. In addition to
this, I also come know about the techniques of communicating between professionals regarding
patient including verbal and written conversation. Moreover, I have learnt that nursing care plan
can be prepared by communicating with team and making decision together in context of setting
interventions. Meanwhile, it is a great opportunity for me to learn about practical clinical
practices and models to be followed like Roper-Logan-Tierney Model of Living in nursing to
focus on daily activities for improving diseased condition of the patient. Furthermore, it is
helpful to me for enhancing my career in future appropriately.

REFERENCES
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