Nursing Case Studies: Communication Strategies in Nursing Practice

This document presents a comprehensive analysis of nursing case studies, addressing critical aspects of patient care, communication strategies, and ethical considerations. Part A delves into three distinct case scenarios, focusing on effective verbal and non-verbal communication techniques, open disclosure principles, and the application of the SBAR (Situation, Background, Assessment, Recommendation) framework. It further examines the importance of maintaining patient confidentiality and explores the use of open-ended and closed-ended questions for gathering essential patient information. Active listening, de-escalation techniques, and the debriefing process are also discussed. Part B emphasizes the significance of communication and behavior support for nurses, highlighting the four domains of practice within the standards for the Communication and behaviour support for nurses- practice package, the importance of accurate healthcare record maintenance, and the evaluation of reliable health information sources. The document also explores group dynamics, communication strategies for effective teamwork, and the provision and reception of constructive feedback. This resource provides valuable insights for nursing students and professionals seeking to enhance their communication skills and improve patient outcomes. Desklib offers a range of similar solved assignments and past papers for students.

Running head: NURSING
Nursing
Name of student:
Name of university:
Author note:

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Table of Contents
Part A...............................................................................................................................................2
Case study 1.................................................................................................................................2
Case study 2.................................................................................................................................5
Case study 3.................................................................................................................................6
Part B...............................................................................................................................................8
References......................................................................................................................................12

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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.

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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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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)

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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.

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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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 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)

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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.

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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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 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.

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 Use of formal tone
 Maintenance of proper physical distance (Yoder-Wise, 2014)

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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?
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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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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
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Appraisal for Evidence-Based Practice. Elsevier Health Sciences. Retrieved from
https://books.google.co.in/books?
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%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

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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
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nursing and health care. Springer Publishing Company. Retrieved from
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