The Concept of Care in Nursing Practice

Running head: NURSING
Effective Communication in Nursing Practice
Name of the Student
Name of the University
Author Note

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Introduction
According to NMC (2019) the concept of care is defined as a comprehensive care and
support to the mental and the physical health of the patients. The concept of care is guided by
the professional values and skills of nursing. Professional values and skills of nursing are
regarded as the foundation of the nursing practice. The relevance of the professional values
and skills in nursing is relevant throughout the world. The presence of the common
professionals nursing values and professional nursing skills under the cultural variants deals
with value prioritization for improving the overall level of patient’s satisfaction and quality
outcome. Nursing values are the part of the nursing ethics that attempt to prescribe the moral
behaviours. The in order to comprehensively practice the nursing values and the nursing
skills, importance of nursing skills come into consideration (Schmidt and Mcarthur, 2018). In
this essay the main focus will be on my experience in clinical emergency ward and how it can
be related with the nursing values and nursing skills. The essay will initiate with a brief
discussion of the four important nursing skills followed by the elaboration of my experience
in clinical practice and importance of the effective nursing communication under the light of
that incident. Then I will highlight importance of the effective communication in nursing and
knowledge require for practising effective communication in nursing. After discussing the
nursing skills, I will highlight the main nursing values practised during by clinical experience
and this professional values links with the nursing skills. The essay will mainly help to
understand the importance of nursing values and skills in nursing practice.
Four top nursing skills
According to the Nursing and Midwifery Council (NMC) of the UK (2019), in order
to abide by the nursing professional code of conduct and to maintain the quality of care, the
nursing professionals are require to practice certain specific skills. The four top nursing skills

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that I have taken whilst in clinical practice include assisting patient in order to maintain
personal hygiene, recording for blood pressure parameters, proper and accurate measurement
of the body fluid and effective communication. In this essay, I am going to discuss nursing
communication, a fundamental nursing skill. The discussion will be done in relation to case
study which I encountered during my tenure in clinical practice. However, while highlighting
the narrative of the case study, the name of the service users will be kept withheld. According
to the code 5 of the NMC of the UK (2019), professional practice, it is the duty of the nursing
professionals to respect people’s choice towards privacy and confidentiality.
Elaboration of the case study
While I was doing my duty in the emergency ward, I man was admitted (Mr. X) with
stomach pain. He was shivering in pain; his stomach was bloated and was unable to move. He
looked scared and was also looked scared in explaining his concern. I understood that he
might be feeling uncomfortable in the atmosphere of the emergency department. I first came
and console him that nothing serious has happened to him and we are all here to provide him
relief. This helped him to calm down. Then I gradually accessed him by checking his vital
signs, under the assistance of a trained registered nurse. Moreover, in between I also started
interacting what additional symptoms he is experiencing in addition to pain. My constant
interaction and my assurance that we can going to given him proper care for fast relief,
helped me to earn the trust of Mr. X, he gradually started co-operating with us and helped us
to make further assessment and thereby helping in smooth process transition. The assessment
finally highlighted that Mr. X is suffering from pain due to appendicitis.
Importance of effective communication
Effective communication in the therapeutic nursing practice can be defined as a
process of oral communication of the healthcare professionals and the nursing professionals

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with the patients and their family members. It is a two way process under which the patient’s
conveys their fear and concerns to the healthcare professionals and thereby helping them to
make correct diagnosis. Effective communication in the nursing profession between nurses
and the patients is important for successful outcome for the individualised nursing care for
each of the patients (Kourkouta and Papathanasiou, 2014). O'hagan et al. (2014) are of the
opinion that the quality of the communication that is the interactions between the nurses and
the patients has a significant influence over the patient outcomes. Kourkouta and
Papathanasiou (2014) stated that effective communication in the nursing practice helps in the
development of the therapeutic relationship with the patients and their immediate caregivers.
The development of the therapeutic relationship helps to earn the patient’s trust. This trust
helps the patients to discuss their health concerns and thereby helping in the development of
person-centered care plan. Moreover, effective communication between the nursing
professionals and the patients help in proper exchange of the information with the patients
and their family members and this helps to increase their overall participation in the care plan
and therapy adherence (O'hagan et al., 2014).
Knowledge required for effective communication
According to the NMC of the UK (2019), it is the duty of the nursing professional to
communicate clearly (code 7 of the professional practice). In order to communicate clearly,
through effective communication, proper knowledge about the inter-personal communication
skills is important. Interpersonal communication skills include a wide variety of skills and
this includes both verbal and non-verbal communication skills. The verbal communication
skills mean communicating in an articulate manner with proper knowledge about the
language and with distinct pronunciation and in a slow space so that it becomes easier for the
patients to understanding (Radtke, 2013). The non-verbal communication skill mainly deals

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with emotional intelligence. Under emotional intelligence, it is the duty of the nursing
professional to listen actively to the patient’s concerns via maintenance of eye-contact and
making proper body language so that the patients feels that the nursing professional is
concerned about their health. Maintenance of proper eye contact and showing concern helps
in the generation of trust and thereby increasing the provision for therapeutic relationship
(Webster, 2014). While interacting with Mr. X I ensured that I practice active listening so that
Mr. x feels that we are concerned about this health and are willing to help him readily.
According to the NMC UK (2019), it is the duty of the nursing professionals to maintain
cultural competence while communicating with the service users and thus proper knowledge
about trans-cultural nursing is important. According to Hagerty et al. (2017), the inter-
personal communication in nursing is guided by the Peplau’s theory of interpersonal
relations. It is a middle-range theory, which emphasizes patient’s experiences and the effect
it cast on the nurse-patient relationships. Peplau mainly asserted that the focus of the nursing
research should be given over the patient, their needs, their perception, and the care they
receive from the nursing professionals.
Professional values and importance
In addition to the effective communication in the nursing practice, the professional
values which are demonstrated alongside the nursing skills in order to enhance the overall
patient’s care include providing proper respect to the patients, promotion of patient’s dignity
and promoting individualised care. According to the NMC UK (2019), it is the duty of the
nursing professional to make sure that patients are treated with respect and that their rights
are upheld. NMC UK (2019) also stated that any discriminatory attitudes and behaviours
towards the service users must be prohibited. In promotion of the dignity of the individual,
NMC UK (2019) stated that it is the duty of the nursing professionals to treat the patient with

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kindness, respect and compassion it falls under the domain of prioritization of the people.
Upholding respect helps in upholding the basic human rights. In relation to the case study as
highlighted under my own experience in the clinical practice, it can be said that Mr. X the
concerns and the opinions of Mr. X was nurtured with proper dignity and respect by listening
to his preferences and concerns attentively while respecting the level to which Mr. X wants to
receive care and want to participate in the decision making process. I also responded
compassionately and politely when I found that Mr. X was stressed and anxious.
According to the study conducted by Gastmans (2013), dignity, vulnerability and care
are guided by the ethical theory of nursing. Papastavrou, Efstathiou and Andreou, (2016) are
of the opinion that respecting the dignity of the patients is the fundamental part of the nursing
care. Respecting moral dignity is the human value that must be preserved. Earlier, dignity of
the patients and respect to the patient’s rights was continuously compromised. During the
early years of hospitalization in the UK, threats to the healthcare concerns are regarded as
potential threats in comparison to the dignity. Older people endured potential threats to
dignity in favour of treating the healthcare problems (Sabatino et al., 2014). However, with
the evolution of the nursing theory, the respect to patient’s rights and dignity gradually
earned importance. Giving importance of patients’ rights and dignity through proper
emotional support and maintaining privacy help to uplift the patient’s level of satisfaction in
healthcare. Increase in patient’s satisfaction help to improve the overall health outcome of the
patients (Papastavrou, Efstathiou and Andreou, 2016).
Promotion of individualised care to the patients can alternatively defined as the
promotion of the patient centred care in nursing. The core-elements in the patient centred care
include patient participation involvement, relationship between healthcare professionals ad
the patients and context under which the care is being delivered. The core themes describing
patient-centred care have emerged from the medical, health policy and nursing literature. This

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indicates a chance of the common conceptual source. Different healthcare professional
groups tend to focus on different themes and thereby affecting the overall success of
implementation of the patient-centred care in healthcare practice (Kitson et al., 2013). Olsson
et al. (2013) conducted a systematic review of controlled trials in order to study the efficacy
of the person-centred care under the nursing settings. The analysis of the results highlighted
that the efficacy of the person centred care might lead to significant improvement in the
patient’s health. However, Olsson et al. (2013) recommended that more controlled trials with
higher sample size are required to be undertaken in order to establish the overall efficacy of
the patient centred care plan. However, Broderick and Coffey, (2013) are of the opinion that
the process of nursing documentation is a barrier towards the individualised care and support
and appropriate care planning through person centred care (PCC) approach. The
documentation in the nursing practice is at times incomplete and the information in the
psychological aspect of the patient is infrequent. It is the duty of the nursing professional to
indulge in meaningful relationship with the patients in order to practice a comprehensive
PCC.
Linking professional linking to nursing communication
The main professional values that link with the nursing skills of communication is
giving respect to the patients and promoting dignity. This can be done by the utilization of the
effective communication skills. Raee, Abedi and Shahriari, (2017) stated that respecting
human dignity and providing respect to patient’s decision making process through effective
communication is a cornerstone of nursing. According to the NMC UK (2019), effective
communication must be done as per the best interest of the patients. Moreover, effective
communication in nursing must be done in order to increase the level of patients’ knowledge
to indulge in informed decision making process. Participation of the patients in the informed

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decision making process helps to upheld the respect and rights of the patients along with his
dignity to vouch for his own opinion. Douglas et al. (2014) are of the opinion that the respect
of the patient’s dignity must be done through giving importance to the cultural thoughts and
values of that individual. The main guidelines for the implementation of the culturally
appropriate care in order to uphold the dignity and respect of the patients include taking
proper assistance by the culturally competent nurses while communicating with the patients.
This includes respecting patients dialect, language, and communication style while not
getting judgement and devising the care plan as per the cultural and spiritual beliefs of that
person.
Values and skills
Proper nursing values and proper practice of the nursing skills helps in the
improvement of the overall health outcome of the patients. According to NMC UK (2019),
the set of the nursing values and the nursing professional code of conduct provide a
consistent, clear and positive message to the patients and the service users. This positive
message helps to increase the level of the patient’s satisfaction. Moreira-Almeida, Koenig
and Lucchetti, (2014) are of the opinion that the increase in the level of the patient’s
satisfaction helps to improve the overall mental health and well-being. Improvement in the
mental health and well-being helps to accelerate positive prognosis of the disease. The
nursing values of patient’s respect, promotion of the patient’s dignity and individualised care
approach is guided by the prioritization of the service users (professional code of conduct
one) (NMC, 2019). The prioritization of the patients can be done through listening activity to
the patients and accordingly respond to their preferences and concerns. Listening actively to
the patient’s concerns and queries can be executed by effective communication skills.
Prioritizing patients needs help in drafting patient-centred care plan and thereby helping to

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improve the overall outcome of care (Ashour and Kremer, 2016). Skills like proper regulation
of the blood pressure and assistance to personal hygiene coincides with the professional code
of conduct 4 of NMC UK (2019). According to the code of conduct 4, the nursing
professional must act in best interest of the patients. In relation to the case study as
highlighted under my professional clinical practice, recording proper vital skills like blood
pressure, pulse, heart rate, body temperature and the level of pain score acted directly for the
best interest of the Mr. X as it helped in getting a clear picture of his physiological state of the
body. Getting rough over-view of physiological state of Mr. X, guided towards appropriate
diagnosis of appendicitis.
Conclusion
Thus from the above discussion, it can be concluded that in order to upheld the
concept of care in the nursing practise proper implementation of the nursing professionals
code of conduct and nursing skills are important. One of the important nursing skills which is
correlated with my personal experience in the clinical practice is effective communication.
Effective communication helped me to up hold the nursing professional values of giving
respect to the patient’s opinion, promotion of autonomy and devising patient centred care
plan. Moreover, practice of the effective nursing communication skills helped me to earn the
patient’s trust and there y helping to generate therapeutic relationship with the patients.
Development of the therapeutic relationship helped in improving the patient’s outcome by
increasing the patient’s participation in the care process. Overall proper practice of the
professional nursing values and skills help in promoting the concept of care in nursing
practice.

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References
Ashour, O.M. and Kremer, G.E.O., (2016). Dynamic patient grouping and prioritization: a
new approach to emergency department flow improvement. Health care management
science, 19(2), pp.192-205.
Broderick, M.C. and Coffey, A., (2013). Person‐centred care in nursing
documentation. International journal of older people nursing, 8(4), pp.309-318.
Douglas, M.K., Rosenkoetter, M., Pacquiao, D.F., Callister, L.C., Hattar-Pollara, M.,
Lauderdale, J., Milstead, J., Nardi, D. and Purnell, L.,(2014). Guidelines for implementing
culturally competent nursing care. Journal of Transcultural Nursing, 25(2), pp.109-121.
Gastmans, C., (2013). Dignity-enhancing nursing care: a foundational ethical
framework. Nursing ethics, 20(2), pp.142-149.
Hagerty, T.A., Samuels, W., Norcini-Pala, A. and Gigliotti, E., (2017). Peplau’s Theory of
Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?. Nursing
science quarterly, 30(2), pp.160-167.
Kitson, A., Marshall, A., Bassett, K. and Zeitz, K., (2013). What are the core elements of
patient‐centred care? A narrative review and synthesis of the literature from health policy,
medicine and nursing. Journal of advanced nursing, 69(1), pp.4-15.
Kourkouta, L. and Papathanasiou, I.V.,(2014). Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Moreira-Almeida, A., Koenig, H.G. and Lucchetti, G., (2014). Clinical implications of
spirituality to mental health: review of evidence and practical guidelines. Revista Brasileira
de Psiquiatria, 36(2), pp.176-182.

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Nursing and Midwifery Council (NMC) UK. (2019). The Code Professional standards of
practice and behaviour for nurses, midwives and nursing associates. Access date: 21st Jan
2019. Retrieved from: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-
publications/nmc-code.pdf
O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara, T., Webb, G.
and McColl, G., (2014). What counts as effective communication in nursing? Evidence from
nurse educators' and clinicians' feedback on nurse interactions with simulated
patients. Journal of advanced nursing, 70(6), pp.1344-1355.
Olsson, L.E., Jakobsson Ung, E., Swedberg, K. and Ekman, I., (2013). Efficacy of person‐
centred care as an intervention in controlled trials–a systematic review. Journal of clinical
nursing, 22(3-4), pp.456-465.
Papastavrou, E., Efstathiou, G. and Andreou, C., (2016). Nursing students’ perceptions of
patient dignity. Nursing ethics, 23(1), pp.92-103.
Radtke, K.,(2013). Improving patient satisfaction with nursing communication using bedside
shift report. Clinical Nurse Specialist, 27(1), pp.19-25.
Raee, Z., Abedi, H. and Shahriari, M., (2017). Nurses’ commitment to respecting patient
dignity. Journal of education and health promotion, 6.
Ross, H., Tod, A.M. and Clarke, A., (2015). Understanding and achieving person‐centred
care: the nurse perspective. Journal of Clinical Nursing, 24(9-10), pp.1223-1233.
Sabatino, L., Stievano, A., Rocco, G., Kallio, H., Pietila, A.M. and Kangasniemi, M.K.,
(2014). The dignity of the nursing profession: a meta-synthesis of qualitative
research. Nursing ethics, 21(6), pp.659-672.

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Schmidt, B.J. and Mcarthur, E.C., (2018), January. Professional nursing values: A concept
analysis. In Nursing forum (Vol. 53, No. 1, pp. 69-75).
Webster, D., (2014). Using standardized patients to teach therapeutic communication in
psychiatric nursing. Clinical Simulation in Nursing, 10(2), pp.e81-e86.