Nursing: Communication and Behavior Support for Nurses
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This article discusses communication and behavior support for nurses in the context of nursing practice. It covers case studies, ethical concerns, communication strategies, and more. The article also includes references and resources for further reading.
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Running head: NURSING
Nursing
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Nursing
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1NURSING
Table of Contents
Part A...............................................................................................................................................2
Case study 1.................................................................................................................................2
Case study 2.................................................................................................................................5
Case study 3.................................................................................................................................6
Part B...............................................................................................................................................8
References......................................................................................................................................12
Table of Contents
Part A...............................................................................................................................................2
Case study 1.................................................................................................................................2
Case study 2.................................................................................................................................5
Case study 3.................................................................................................................................6
Part B...............................................................................................................................................8
References......................................................................................................................................12
2NURSING
Part A
Case study 1
a.
Facial expressions- Proper facial expressions are to be used so that emotions are
conveyed in an appropriate manner.
Gestures- gestures are effective in making the patient feel comfortable and respected.
Eye contact- since the patient has impaired vision and impaired hearing ability,
maintaining constant eye contact would ensure that hostility, affection and interest is
conveyed to the her (LoBiondo-Wood & Haber, 2017).
b.
Communication is to be done clearly and slowly
The nurse must communicate with warmth and positivity
Simple words are to be used and jargons are to be avoided (Chism, 2017)
c.
The nurse must speak slowly and give pause to enable the patient process words
The nurse must present only one concept at a time
The nurse communicate in clear sentences (LoBiondo-Wood & Haber, 2017)
d.
Part A
Case study 1
a.
Facial expressions- Proper facial expressions are to be used so that emotions are
conveyed in an appropriate manner.
Gestures- gestures are effective in making the patient feel comfortable and respected.
Eye contact- since the patient has impaired vision and impaired hearing ability,
maintaining constant eye contact would ensure that hostility, affection and interest is
conveyed to the her (LoBiondo-Wood & Haber, 2017).
b.
Communication is to be done clearly and slowly
The nurse must communicate with warmth and positivity
Simple words are to be used and jargons are to be avoided (Chism, 2017)
c.
The nurse must speak slowly and give pause to enable the patient process words
The nurse must present only one concept at a time
The nurse communicate in clear sentences (LoBiondo-Wood & Haber, 2017)
d.
3NURSING
An open disclosure refers to the open discussion with a patient about any incident that has led
to harm to the individual in due course of receiving healthcare services. The principles of open
disclosure are as follows-
Timely and open communication
Acknowledgement
Apology
Supporting the expectations and needs of patients and family members
Supporting the expectations and needs of healthcare providers
Integrated clinical risk management and systems improvement
Good governance
Confidentiality (safetyandquality.gov.au , 2014)
e.
Nurse: We have taken into consideration that you had suffered a fall due to negligence on our
part and we apologize for the unfortunate incidence. We would be grateful if you kindly
elaborate on what made you suffer the fall so that such cases can be prevented in future.
Son: Are you sure such cases can be taken care of adequately in future?
Nurse: Yes certainly such incidences of falls can be prevented if appropriate steps are taken.
(Turning to the patient): If you could kindly elaborate on what cause the fall.
Patient: I was getting out of my bed and as there were no side rails I lost balance and fell.
Nurse: We would be taking appropriate measures by installing side rails in your bed and other
relevant necessities.
An open disclosure refers to the open discussion with a patient about any incident that has led
to harm to the individual in due course of receiving healthcare services. The principles of open
disclosure are as follows-
Timely and open communication
Acknowledgement
Apology
Supporting the expectations and needs of patients and family members
Supporting the expectations and needs of healthcare providers
Integrated clinical risk management and systems improvement
Good governance
Confidentiality (safetyandquality.gov.au , 2014)
e.
Nurse: We have taken into consideration that you had suffered a fall due to negligence on our
part and we apologize for the unfortunate incidence. We would be grateful if you kindly
elaborate on what made you suffer the fall so that such cases can be prevented in future.
Son: Are you sure such cases can be taken care of adequately in future?
Nurse: Yes certainly such incidences of falls can be prevented if appropriate steps are taken.
(Turning to the patient): If you could kindly elaborate on what cause the fall.
Patient: I was getting out of my bed and as there were no side rails I lost balance and fell.
Nurse: We would be taking appropriate measures by installing side rails in your bed and other
relevant necessities.
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4NURSING
f.
The infrastructure manager is to be contacted who would consider installing the side rails.
g.
S- The patient, Mrs. Edith Jackson, an 82-year-old lady has suffered a fall in her room.
B- The patient is suffering from Parkinson’s disease and early stage Parkinson’s dementia. The
patient also has low vision and is hard of hearing.
A-The patient suffers from poor balance and due to poor eyesight is not able to have clear vision.
The absence of side rails in bed led to the fall.
R- Side rails are to be installed and other fall prevention measures are to be taken.
h.
A greeting and close is to be included
Confidential information is not to be sent
A formal tone is to be maintained
The messages are to be kept concise
Emails to be written in simple language without jargons (Bladh & Van Leeuwen, 2017)
f.
The infrastructure manager is to be contacted who would consider installing the side rails.
g.
S- The patient, Mrs. Edith Jackson, an 82-year-old lady has suffered a fall in her room.
B- The patient is suffering from Parkinson’s disease and early stage Parkinson’s dementia. The
patient also has low vision and is hard of hearing.
A-The patient suffers from poor balance and due to poor eyesight is not able to have clear vision.
The absence of side rails in bed led to the fall.
R- Side rails are to be installed and other fall prevention measures are to be taken.
h.
A greeting and close is to be included
Confidential information is not to be sent
A formal tone is to be maintained
The messages are to be kept concise
Emails to be written in simple language without jargons (Bladh & Van Leeuwen, 2017)
5NURSING
Case study 2
a.
The ethical concern related to this situation is that that a nurse must not act against the
principles of patient nonmalefinence and autonomy. The regulatory responsibility relates to
adherence to legal regulation about maintaining patient confidentiality (LoBiondo-Wood &
Haber, 2017).
b.
The term ‘advocacy’ refers to pleading the cause of the patient that is supporting the
rights of the patient. Advocacy is to be done for the patient by reporting the incidence to the
higher authority (Sundqvist et al., 2016).
c.
Positive intent is to be assumed
Specific behavior is to be addressed
Formal tone is to be maintained
Personal feelings are not to be considered (Black, 2016)
d.
It has been brought to our notice that there has been a case of revealing patient
information on social media and therefore I would like to give a gentle reminder about the ethical
and legal implications of the same. It is hopeful that such instances would not be repeated in
future.
Case study 2
a.
The ethical concern related to this situation is that that a nurse must not act against the
principles of patient nonmalefinence and autonomy. The regulatory responsibility relates to
adherence to legal regulation about maintaining patient confidentiality (LoBiondo-Wood &
Haber, 2017).
b.
The term ‘advocacy’ refers to pleading the cause of the patient that is supporting the
rights of the patient. Advocacy is to be done for the patient by reporting the incidence to the
higher authority (Sundqvist et al., 2016).
c.
Positive intent is to be assumed
Specific behavior is to be addressed
Formal tone is to be maintained
Personal feelings are not to be considered (Black, 2016)
d.
It has been brought to our notice that there has been a case of revealing patient
information on social media and therefore I would like to give a gentle reminder about the ethical
and legal implications of the same. It is hopeful that such instances would not be repeated in
future.
6NURSING
Case study 3
a.
Any question which can be answered with a specific piece of information is closed ended
question. Such questions can be used for understanding presence of symptoms. Example- “Are
you feeling chest pain today”? “Are you having difficulty in breathing”?
b.
Any question which encourages a complete and meaningful answer using the subject's
own knowledge is open ended question. Such questions can be used for understanding the nature
of symptoms. Example- “Describe the nature of the chest pain you are suffering”? “how did you
feel before being admitted to the care unit” (Wite et al., 2016).
c.
Active listening is the process in nursing practice for reflecting on the patient’s messages
in a desirable manner and helping the patient develop a deeper feeling regarding the concern
being shared (Weger et al., 2014). In the present situation this can be used done for building trust
and creating rapport with the patient.
d.
Speaking slowly
Avoid using slangs
Reflecting on other’s viewpoints
Being culturally sensitive
Case study 3
a.
Any question which can be answered with a specific piece of information is closed ended
question. Such questions can be used for understanding presence of symptoms. Example- “Are
you feeling chest pain today”? “Are you having difficulty in breathing”?
b.
Any question which encourages a complete and meaningful answer using the subject's
own knowledge is open ended question. Such questions can be used for understanding the nature
of symptoms. Example- “Describe the nature of the chest pain you are suffering”? “how did you
feel before being admitted to the care unit” (Wite et al., 2016).
c.
Active listening is the process in nursing practice for reflecting on the patient’s messages
in a desirable manner and helping the patient develop a deeper feeling regarding the concern
being shared (Weger et al., 2014). In the present situation this can be used done for building trust
and creating rapport with the patient.
d.
Speaking slowly
Avoid using slangs
Reflecting on other’s viewpoints
Being culturally sensitive
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7NURSING
Using appropriate body language
Using appropriate nonverbal cues (Black 2016)
e.
De-escalation is the nursing behavior that aims to diminish or eliminate the escalations of
conflicts among nurses and patients. One example is to create a calm environment by removing
all forms of stressors (Price et al., 2015).
f.
The benefits of debriefing process are safe outcomes for the patient and enhanced patient
satisfaction. In the present case it would be useful for engaging the patient into his care delivery
process.
g.
Suspension of defensive response is required
Questions are to be asked for clarifying doubts
Reflection of feedback received is crucial (Chism, 2017)
Using appropriate body language
Using appropriate nonverbal cues (Black 2016)
e.
De-escalation is the nursing behavior that aims to diminish or eliminate the escalations of
conflicts among nurses and patients. One example is to create a calm environment by removing
all forms of stressors (Price et al., 2015).
f.
The benefits of debriefing process are safe outcomes for the patient and enhanced patient
satisfaction. In the present case it would be useful for engaging the patient into his care delivery
process.
g.
Suspension of defensive response is required
Questions are to be asked for clarifying doubts
Reflection of feedback received is crucial (Chism, 2017)
8NURSING
Part B
1.
Communication and behavior support for nurses- practice package had been implemented
for providing useful information on the Communication and Behaviour Support for Nurses to
ensure that they are guided while working with people with disability for fostering efficient and
consistent best nursing practice (dhc.nsw.gov.au, 2014).
2.
The four domains of practice within the standards for the Communication and behaviour
support for nurses- practice package are-
Person-Centred Health Care Assessments and the Development of Health Care Plans
Practice Package
Communication and Behaviour Support Practice Package
Working with People with Chronic and Complex Health Care Needs Practice Package
Mealtime Management Practice Package for Nurses
3.
The communication and behaviour support for nurses appraisal work to enhance a nurse’s
level of knowledge and practice skills in highlighting means of developing communication and
behaviour support skills contributing towards the improvement of a person’s outcome
(adhc.nsw.gov.au, 2014).
4.
Part B
1.
Communication and behavior support for nurses- practice package had been implemented
for providing useful information on the Communication and Behaviour Support for Nurses to
ensure that they are guided while working with people with disability for fostering efficient and
consistent best nursing practice (dhc.nsw.gov.au, 2014).
2.
The four domains of practice within the standards for the Communication and behaviour
support for nurses- practice package are-
Person-Centred Health Care Assessments and the Development of Health Care Plans
Practice Package
Communication and Behaviour Support Practice Package
Working with People with Chronic and Complex Health Care Needs Practice Package
Mealtime Management Practice Package for Nurses
3.
The communication and behaviour support for nurses appraisal work to enhance a nurse’s
level of knowledge and practice skills in highlighting means of developing communication and
behaviour support skills contributing towards the improvement of a person’s outcome
(adhc.nsw.gov.au, 2014).
4.
9NURSING
a. Professionals maintaining healthcare records must encompass an precise description of the
episode of care of a client with healthcare professionals in the setting.
b. Professionals must maintain confidentiality of the records and must not hand over the records
to a third party without concerned authority (Black, 2016).
5.
a. Health information from sources such as government sites, support organisation sites,
condition-specific sites, and medical journals are reliable.
b. Websites with a quality control measure such as an editorial board are reliable source of
information.
c. One must check whether the information provided is up-to-date (Fain, 2017).
6.
The three main objectives of forming groups are-
Task accomplishment
Problem solving
Proximity through effective communication
7.
Identify each of the team members
Meet with the team members on a regular basis
Agree on the set ground rules
Set a reliable meeting agenda
a. Professionals maintaining healthcare records must encompass an precise description of the
episode of care of a client with healthcare professionals in the setting.
b. Professionals must maintain confidentiality of the records and must not hand over the records
to a third party without concerned authority (Black, 2016).
5.
a. Health information from sources such as government sites, support organisation sites,
condition-specific sites, and medical journals are reliable.
b. Websites with a quality control measure such as an editorial board are reliable source of
information.
c. One must check whether the information provided is up-to-date (Fain, 2017).
6.
The three main objectives of forming groups are-
Task accomplishment
Problem solving
Proximity through effective communication
7.
Identify each of the team members
Meet with the team members on a regular basis
Agree on the set ground rules
Set a reliable meeting agenda
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10NURSING
Exchange meeting accountabilities and roles
Solve problems and resolve conflicts as a group (Yoder-Wise, 2014)
8.
Proper visual cues and showing respect towards others act as the communication
strategies required to ensure contribution from all participants in a group discussion, including
providing and receiving feedback.
9.
Punctuality is maintained
Every member has distinct participation
Each member contributes to meeting goals
Personal conflicts are resolved
Outcomes are effectively recorded (Chism, 2017)
10.
Active listening
Demonstration of emotional intelligence
11.
Feedback should be given timely and specific
Feedback should not involve effect of the other person’s personal behavior
One must maintain proper nonverbal cues
12.
Exchange meeting accountabilities and roles
Solve problems and resolve conflicts as a group (Yoder-Wise, 2014)
8.
Proper visual cues and showing respect towards others act as the communication
strategies required to ensure contribution from all participants in a group discussion, including
providing and receiving feedback.
9.
Punctuality is maintained
Every member has distinct participation
Each member contributes to meeting goals
Personal conflicts are resolved
Outcomes are effectively recorded (Chism, 2017)
10.
Active listening
Demonstration of emotional intelligence
11.
Feedback should be given timely and specific
Feedback should not involve effect of the other person’s personal behavior
One must maintain proper nonverbal cues
12.
11NURSING
Use of formal tone
Maintenance of proper physical distance (Yoder-Wise, 2014)
Use of formal tone
Maintenance of proper physical distance (Yoder-Wise, 2014)
12NURSING
References
Australian Open Disclosure Framework. (2018). Safetyandquality.gov.au. Retrieved 19 February
2018, from
https://www.safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-
Disclosure-Framework-Feb-2014.pdf
Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health
Sciences. Retrieved from https://books.google.co.in/books?
hl=en&lr=&id=ndcEDAAAQBAJ&oi=fnd&pg=PP1&dq=nursing&ots=Ly21dHNxUx&
sig=6Bl2Ytd5jBYuBUoXNcbagZCEGos#v=onepage&q=nursing&f=false
Bladh, M. L., & Van Leeuwen, A. M. (2017). Nurse-to-patient etiquette: It's more than good
manners. Nursing2017, 47(8), 52-56. DOI: 10.1097/01.NURSE.0000515508.40958.fa
Chism, L. A. (2017). The doctor of nursing practice. Jones & Bartlett Learning. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=Q8E6DwAAQBAJ&oi=fnd&pg=PR1&dq=nursing+practice&ots=q_f_a
pqDGp&sig=E2MriD7ElGLGJe1VQ1DXBut7kK8#v=onepage&q=nursing
%20practice&f=false
Communication and Behaviour Support for Nurses - Practice Package.
(2014). Adhc.nsw.gov.au. Retrieved 19 February 2018, from
http://www.adhc.nsw.gov.au/__data/assets/file/0007/301777/Communication-
Behaviour-Support-for-Nurses-Practice-Package.pdf
References
Australian Open Disclosure Framework. (2018). Safetyandquality.gov.au. Retrieved 19 February
2018, from
https://www.safetyandquality.gov.au/wp-content/uploads/2013/03/Australian-Open-
Disclosure-Framework-Feb-2014.pdf
Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health
Sciences. Retrieved from https://books.google.co.in/books?
hl=en&lr=&id=ndcEDAAAQBAJ&oi=fnd&pg=PP1&dq=nursing&ots=Ly21dHNxUx&
sig=6Bl2Ytd5jBYuBUoXNcbagZCEGos#v=onepage&q=nursing&f=false
Bladh, M. L., & Van Leeuwen, A. M. (2017). Nurse-to-patient etiquette: It's more than good
manners. Nursing2017, 47(8), 52-56. DOI: 10.1097/01.NURSE.0000515508.40958.fa
Chism, L. A. (2017). The doctor of nursing practice. Jones & Bartlett Learning. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=Q8E6DwAAQBAJ&oi=fnd&pg=PR1&dq=nursing+practice&ots=q_f_a
pqDGp&sig=E2MriD7ElGLGJe1VQ1DXBut7kK8#v=onepage&q=nursing
%20practice&f=false
Communication and Behaviour Support for Nurses - Practice Package.
(2014). Adhc.nsw.gov.au. Retrieved 19 February 2018, from
http://www.adhc.nsw.gov.au/__data/assets/file/0007/301777/Communication-
Behaviour-Support-for-Nurses-Practice-Package.pdf
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13NURSING
Core standards for nurses who support people with a disability. (2014). Adhc.nsw.gov.au.
Retrieved 19 February 2018, from
https://www.adhc.nsw.gov.au/__data/assets/file/0020/301781/Communication-and-
Behaviour-Support-for-Nurses-Appraisal.pdf
Fain, J. A. (2017). Reading, understanding, and applying nursing research. FA Davis. Retrieved
from https://books.google.co.in/books?hl=en&lr=&id=Z-
ATDgAAQBAJ&oi=fnd&pg=PR1&dq=nursing,
+research&ots=aXXSeBfPWg&sig=fO2XLr7hgrBE7-
fO_QaHWGn6UWY#v=onepage&q=nursing%2C%20research&f=false
LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical
Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=vGclDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice&ots=9ITDK
yATh_&sig=rndDqAFiLn3oW_aUSPDwvc73X4Q#v=onepage&q=nursing
%20practice&f=false
Price, O., Baker, J., Bee, P., & Lovell, K. (2015). Learning and performance outcomes of mental
health staff training in de-escalation techniques for the management of violence and
aggression. The British Journal of Psychiatry, 206(6), 447-455. DOI:
10.1192/bjp.bp.114.144576
Sundqvist, A. S., Holmefur, M., Nilsson, U., & Anderzén-Carlsson, A. (2016). Perioperative
patient advocacy: An integrative review. Journal of perianesthesia nursing, 31(5), 422-
433. DOI: https://doi.org/10.1016/j.jopan.2014.12.001
Core standards for nurses who support people with a disability. (2014). Adhc.nsw.gov.au.
Retrieved 19 February 2018, from
https://www.adhc.nsw.gov.au/__data/assets/file/0020/301781/Communication-and-
Behaviour-Support-for-Nurses-Appraisal.pdf
Fain, J. A. (2017). Reading, understanding, and applying nursing research. FA Davis. Retrieved
from https://books.google.co.in/books?hl=en&lr=&id=Z-
ATDgAAQBAJ&oi=fnd&pg=PR1&dq=nursing,
+research&ots=aXXSeBfPWg&sig=fO2XLr7hgrBE7-
fO_QaHWGn6UWY#v=onepage&q=nursing%2C%20research&f=false
LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical
Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=vGclDwAAQBAJ&oi=fnd&pg=PP1&dq=nursing+practice&ots=9ITDK
yATh_&sig=rndDqAFiLn3oW_aUSPDwvc73X4Q#v=onepage&q=nursing
%20practice&f=false
Price, O., Baker, J., Bee, P., & Lovell, K. (2015). Learning and performance outcomes of mental
health staff training in de-escalation techniques for the management of violence and
aggression. The British Journal of Psychiatry, 206(6), 447-455. DOI:
10.1192/bjp.bp.114.144576
Sundqvist, A. S., Holmefur, M., Nilsson, U., & Anderzén-Carlsson, A. (2016). Perioperative
patient advocacy: An integrative review. Journal of perianesthesia nursing, 31(5), 422-
433. DOI: https://doi.org/10.1016/j.jopan.2014.12.001
14NURSING
Weger Jr, H., Castle Bell, G., Minei, E. M., & Robinson, M. C. (2014). The relative effectiveness
of active listening in initial interactions. International Journal of Listening, 28(1), 13-31.
DOI: https://doi.org/10.1080/10904018.2013.813234
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence into
nursing and health care. Springer Publishing Company. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=vDCoCwAAQBAJ&oi=fnd&pg=PP1&dq=nursing&ots=ZZwcS78x8F&
sig=nUkN7NKXX_dlnLyp5FQ8kF5BSp0#v=onepage&q=nursing&f=false
Yoder-Wise, P. S. (2014). Leading and Managing in Nursing-E-Book. Elsevier Health Sciences.
Retrieved from https://books.google.co.in/books?
hl=en&lr=&id=Dm_XBQAAQBAJ&oi=fnd&pg=PP1&dq=nursing,
+professional+nursing,
+book&ots=Fj2CZhxPEQ&sig=iE5Nm7qLYfpRwxUXAPB4fTmVq4g#v=onepage&q=
nursing%2C%20professional%20nursing%2C%20book&f=false
Weger Jr, H., Castle Bell, G., Minei, E. M., & Robinson, M. C. (2014). The relative effectiveness
of active listening in initial interactions. International Journal of Listening, 28(1), 13-31.
DOI: https://doi.org/10.1080/10904018.2013.813234
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence into
nursing and health care. Springer Publishing Company. Retrieved from
https://books.google.co.in/books?
hl=en&lr=&id=vDCoCwAAQBAJ&oi=fnd&pg=PP1&dq=nursing&ots=ZZwcS78x8F&
sig=nUkN7NKXX_dlnLyp5FQ8kF5BSp0#v=onepage&q=nursing&f=false
Yoder-Wise, P. S. (2014). Leading and Managing in Nursing-E-Book. Elsevier Health Sciences.
Retrieved from https://books.google.co.in/books?
hl=en&lr=&id=Dm_XBQAAQBAJ&oi=fnd&pg=PP1&dq=nursing,
+professional+nursing,
+book&ots=Fj2CZhxPEQ&sig=iE5Nm7qLYfpRwxUXAPB4fTmVq4g#v=onepage&q=
nursing%2C%20professional%20nursing%2C%20book&f=false
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