COMM 4: Strategies for Effective Communication in Palliative Care

This essay examines effective and respectful communication strategies for Aboriginal older adults and their families facing terminal illnesses within a palliative care context. It emphasizes the importance of cultural sensitivity, empathy, and active listening in building therapeutic relationships. The essay highlights the impact of historical factors, such as colonization and residential schools, on Aboriginal communities' trust in healthcare systems and the need for nurses to address these issues. It details specific communication techniques, including indirect questioning, the use of silence, and non-verbal cues, that are culturally appropriate for this patient population. Furthermore, it clarifies the crucial role of nurses as communicators, patient advocates, and facilitators of information exchange between patients, families, and other healthcare providers. The essay underscores the significance of effective communication in improving patient outcomes, managing symptoms, and maintaining the quality of life for individuals receiving palliative care.

Running Head: COMM
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Communication
student
9/17/2019

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In different health care setting nurses plays a key role in developing a healthy therapeutic
relationship with the patient. It can help in improving the recovery process and to gain the
complete support of a patient in the assessment and treatment. To be a effective nurse, effective
communication skills are necessary (Caffery et al., 2017). The ability of nurses to communicate
and connect with the patient and other healthcare provides can prevent different healthcare errors
and provide high quality health care to the patient. Effective communication allows nurses to
have enough knowledge about the different cultures of diverse communities like Aboriginal and
Torres Strait islander people (Hole et al., 2015). In this particular essay different strategies of
effective, respectful interaction with the aboriginal older adults and their family who has been
detected with terminal illness like cancer. The role of nurse in interaction with the Aboriginal
patient and their family will also be mentioned.
A terminal illness health condition which cannot be treated and is probable to lead to
patent’s death. It is occasionally termed a life-limiting illness. There are some illnesses which are
terminal for example advanced malignancy, dementia, motor neuron disease, lung illness,
neurological illness like Parkinson’s, and advanced cardiovascular disease. Older adults with this
type of illnesses may life for days, weeks, months or years (Williams et al., 2016). The patient
living with terminal illnesses is likely to get treatment and care which emphasis on managing the
disease symptoms and maintaining the quality of life, this is called palliative care. Effective and
respectful communication is the essential part of the palliative care. Individuals with terminal
illness and their families might find they require different types of practical assistance or
emotional support at different point throughout the illness course, and effective and respectful
communication can help the nurses to provide such care to them (Kelly et al., 2018).

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There are some effective and respective strategies that can be helpful are: The adverse
impacts of the racial and financial disadvantages and a series of previous government policies,
counting segregations, dislocation and children separation has contributed to the mistrust held by
the people of Aboriginal community towards the government facilities and system. Therefore
nurses must understand their condition and address their problems by showing empathy (Keech
et al., 2016). People with terminal illness experience high levels of depression, anxiety and
stress, therefore showing empathy can provide additional emotional support and enhance a
patient’s believe in the health care setting. Empathy is different form sympathy; it is about
putting yourself in patient’s shows or situation. To understand their condition and responding to
them by using some appropriate words like “Yes, I can understand your situation” (Durey et al.,
2017).
In order to understand someone’s situation more effectively, active listening is essential
as it make the patient feel that the listener really wants to hear about the situation and concerned
for him or her. The people receiving palliative care for a terminal illness often have a lot to say
about what they are feeling. The nurse must listen to the patient carefully and give them enough
time to explain their situation (Gluyas, 2015). The nurses must lean forward and make eye
contact when having conversations with the patient. Active listening includes listening with all
senses. In addition to giving complete attention to the patient, it is essential that the nurse is also
seen to be listening - or else the patient might determine that what they are speaking about is
uninteresting to the health professional. Interest can be showed to the older patient by using some
verbal and non-verbal signals for example maintaining eye contact, nodding the head and
smiling, approving by saying ‘Yes’ or just ‘Mmm hmm’ to inspire the older adults to continue
(Nayebi & Majd Teymouri, 2015).

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In Aboriginal cultures, indirect questioning is the most preferred approach. Direct
questioning might results in misunderstandings discourage contribution and make it problematic
to obtain significant information, principally when an individual is interacting in non-Standard
English (Williams et al., 2016). Nurses must elucidate if the individual understood the meanings
of their words or queries and that nurses understood their responses. Nurses and other health care
providers must avoid compound queries and use plain words like say start instead of commence.
Nurses must not ask the older adults to repeat the words continuously, as it can frustrate the
patient (Hole et al., 2015).
In the Aboriginal cultures, lengthy periods of silence throughout discussions are
deliberated the ‘norm’ and are appreciated. Silent gaps are used to listen, display respect or
accord. The favorable use of silence must not be misunderstood as lack of understanding,
agreement or crucial concerns (Caffery et al., 2017). Notice both the silence and physical
response to gauge when it is suitable to start talking. Patients who are receiving end of life care
often prefer to spend most of their time with the family members, therefore it is also important
that nurses must not start any conversation while the patient is sleeping or discussing their life
events with their family members (Williams, Kemper & Hummert, 2016).
Verbal communication skills must be applied by nurses and other health care
professionals throughout the conversation with the older adult patient. They should speak clearly,
must complete their sentences and consider their tone when speaking. Older adult people with
terminal illness often show anger and feel frustration, and they might become aggressive during
the care process. Nurses must be skilled to handle such situation and should not use hard words
and remain calm (Crawford, Candlin & Roger, 2017).

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Nonverbal communication is similarly essential like verbal communication to develop a
healthy relationship with the patient. Some of the non-verbal communication indications (like
hand movements, and facial expressions) used by the people of Aboriginal and Torres Strait
Islander community have different significances in the Western perspective. The nurses and
other healthcare providers should be mindful that their own non-verbal interaction will be
perceived and interpreted by the patients and it might have both positive and negative impact on
them. For example, nurses have busy schedule and they deal with different patient throughout the
day, this might cause them feel tired and uninterested in addressing more patient. This might be
reflected while communicating with the patient, and they develop a sense that the nurse is not
concerned about them (Nayebi & Majd Teymouri, 2015).
Nurses these days are recognized as the core member of any health care team as they play
wide range of function in a health care setting. Nurses spent most of their time with the patient
compared to other health care providers. This they can be a key member of the healthcare team.
They can be a link between the patient and physician. The nurse can develop a therapeutic
relationship with the clients, and understand their situations, preferences related to end of life
requirement, and help them to realize that the healthcare setting is concerned about their health
situation. They can communicate the patient information to the physician. They use different
ways of communication such as written, direct, and on phone called (Williams et al., 2016). The
nurses can interact with other health care providers and share the patient information, and their
cultural n and ethical needs, so that the mistakes can be avoided. Nurses as the communicator
can interact with the family members and help them to learn how to communicate with the
patient in the end of life situations. Nurses are skilled in different communication techniques
such as better listening, speaking skills, and showing respect and empathy. The nurse, as

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a communicator, understands that the effective communication skill can help progress the
healthcare environment. Barriers occurs in the effective communication process can impede the
nursing care. The nurse has to interact effectively with the diseased person and his or her family
members in addition to other members of the professional team. Furthermore, the nurse is
accountable for written communication, or preparing patient chart, which is a key constituent to
continuity of nursing care (Norouzinia et al., 2016).
In conclusion, effective communication is the essential part of the palliative nursing care
provided to a patient with terminal illness. Nurses must communicate with the Aboriginal patient
in a respectful and empathetically way. They must be skilled different strategies of effective
communication skills such as showing empathy and respect, active listening, asking questions,
maintaining the silence while communicating, and using verbal and non-verbal communication
like using appropriate words and body gestures. Nurses can play key role in communicating with
the diseased person and family. Nurses can communicate with patient and other health
professional and maintain better transportation of information. They can communicate the
information through written way, direct interaction and phone call. They reduce the
communication gap which is the main reason of medication errors in the health care setting.

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References
Caffery, L. J., Bradford, N. K., Wickramasinghe, S. I., Hayman, N., & Smith, A. C. (2017).
Outcomes of using telehealth for the provision of healthcare to Aboriginal and Torres
Strait Islander people: a systematic review. Australian and New Zealand journal of public
health, 41(1), 48-53.
Crawford, T., Candlin, S., & Roger, P. (2017). New perspectives on understanding cultural
diversity in nurse–patient communication. Collegian, 24(1), 63-69.
Durey, A., Halkett, G., Berg, M., Lester, L., & Kickett, M. (2017). Does one workshop on
respecting cultural differences increase health professionals’ confidence to improve the
care of Australian Aboriginal patients with cancer? An evaluation. BMC health services
research, 17(1), 660.
Gluyas, H. (2015). Effective communication and teamwork promotes patient safety. Nursing
Standard (2014+), 29(49), 50.
Hole, R. D., Evans, M., Berg, L. D., Bottorff, J. L., Dingwall, C., Alexis, C., & Smith, M. L.
(2015). Visibility and voice: Aboriginal people experience culturally safe and unsafe
health care. Qualitative health research, 25(12), 1662-1674.
Keech, W., Kelly, J., Dowling, A., McBride, K., & Brown, A. (2016). The Importance of
Effective Communication in Hospital Between Aboriginal Cardiac Patients and Health
Professionals. Heart, Lung and Circulation, 25, S316-S317.

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Kelly, J., Dowling, A., McBride, K., Keech, W., & Brown, A. (2018). ‘We get so task orientated
at times that we forget the people’: staff communication experiences when caring for
Aboriginal cardiac patients. Australian Health Review.
Nayebi, N., & Majd Teymouri, R. (2015). Communication skills and related factors within
patient by nursing student. Journal of Holistic Nursing and Midwifery, 25(2), 93-101.
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016). Communication
barriers perceived by nurses and patients. Global journal of health science, 8(6), 65.
Williams, K., Kemper, S., & Hummert, M. L. (2016). Enhancing communication with older
adults: overcoming elderspeak. Journal of psychosocial nursing and mental health
services, 43(5), 12-16.