Understanding the Essentials of Nursing Communication Skills

The report explores essential communication skills for nurses during patient interviews, highlighting the significance of establishing rapport, understanding non-verbal cues, and ensuring clear interactions. It discusses specific interview techniques such as the use of open-ended questions to encourage dialogue and active listening for comprehensive data collection. The role of effective communication in reducing patient anxiety through relaxation methods like deep breathing and muscle relaxation is examined. Moreover, it emphasizes the importance of providing clear and detailed information about medications to patients before administration. By focusing on these aspects, the report underscores how skilled nursing communication contributes to better patient outcomes and more efficient healthcare delivery.

CLINICAL SCENARIO

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
ESSAY.............................................................................................................................................1
1. Discuss the communication skills you consider to be important to use in order to help
Stefan through the rest of the admission interview.....................................................................1
2. Symptoms and signs of anxiety...............................................................................................2
3. Relaxation techniques.............................................................................................................3
4. Relevant information provided to patients before medication................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
In this report communication skills required for proper interaction with patients are been
explained. Different symptoms and signs of anxiety is been identified by studying the scenario
and relaxation techniques used for reducing patient’s anxiety and relevant information provided
to patients before medication.
ESSAY
1. Discuss the communication skills you consider to be important to use in order to help Stefan
through the rest of the admission interview.
Communication is a process of interchange of verbal and non-verbal messages.
Communication in a medical field or hospital helps to take account of patient's individual
preferences, needs and values. Communication is one of the most important skills required by a
medical practitioner whether a physician or nurse with their patients in clinical practices.
Miscommunication between a patient and medical practitioner can create consequences. There is
a greater risk in hospital at time of admission or discharge due to poor communication and
unplanned change in medicines (Riley, 2015).
For effective communication with Stefan first he should be made comfortable and
relaxed. The first skill required for better communication is of being attentive and accurate
listeners. As a result of inaccurate or inattentive listening, most of the common mistakes in
hospital occurs. As a nurse interviewing patient for admission process must carefully listen to
conditions or problems that sick person is having. All required information must be asked from
the patient about his medical history such as his previous medications, surgeries, diseases,
symptoms, etc., for knowing better about his situation to make an appropriate report. For better
communication with patient’s, technical jargon's must be avoided such as use of specialized
terms or abbreviations could make it difficult for them to understand. Patient should be made
sure that the problem has been understood by nurse properly. Number of factors and special
skills are required for communicating with a sick person. Nurse should focus their attention
towards patient’s eyes and face, must speak logically, clearly and slowly so that they may
understand it clearly. Proper use of non-verbal communication skills by hand gestures, voice
tone, eye connection can help in effective communication. Eye contact is very important for
interviewing a patient as it shows that focus is on them and their words. Patient can be
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encouraged for ensuring an honest communication with nurse through greeting them with a
smile, having a personal conversation or keeping a friendly tone while interviewing them. To
understand and listen to the viewpoints of patient, nurse must be open minded and flexible in the
conversation. For ensuring what information have been asked from the patient it must be
communicated back to them to reflect what have been noted, this helps to check data collected in
order to avoid any consequences (Kinderman and Harris, 2016). Rapport and trust should be
developed before having an effective communication with patient for getting proper and
complete information or details from them regarding their medical conditions and habits.
2. Symptoms and signs of anxiety
Anxiety refers to a feeling or been unrest due to nervousness, worry or being unease
about something of unpredictable results (Barlow, Ed., 2014). Symptoms and signs of anxiety
are having nervousness, being tensed and restlessness, which can be seen in Stefan, feels nervous
as he never went for a surgery earlier and had never been admitted in a hospital before. He is
confused and don't know what to do. It can be seen that he is suffering from insomnia, which is a
type of sleep disorder and is evident from his cloths and conditions and even he himself
mentioned that. His clothes and hair are all messed up and can notice that he has been smoking
continuously. From his actions and body movements it can be easily seen that he is stressed and
filled with anxiety by the signs that he is breathing rapidly, sweating heavily and his muscle
twitching and trembling.
From conversation with his partner Mary, she provided some useful information about
his medical history required for filling the form, that he has lost his weight over past few months
which shows sign of weakness and lethargy, and have lost his job recently, which is causing
anxiety in him. As a symptom of anxiety person have a feeling of panic or danger, they feel that
something bad is going to happen, it can be evident from the words of Mary who tells that he is
afraid that he is going to die. One of the main sign of anxiety is of performing certain behaviours
over and again, here Stefan has been smoking continuously and while interviewing he wants to
get out and smoke.
There are various types of anxiety disorders, which include Agoraphobia which refers to
fear of certain situations or places that make them feel powerless, embarrassed or been trapped.
Generalized Anxiety Disorder (GAD) refers to anxiety or worry about an event or activities
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which could be normal in daily routine. Symptoms for this are trouble in sleeping, headaches,
etc. Obsessive compulsive disorder (OCD) it is a constant experience of worries and thoughts
causing anxiety which are intrusive and unwanted (Townsend and Morgan, 2017). Symptoms of
such anxiety is person performs certain tasks or behaviours regularly, such as checking on
particular things, washing hands, counting, etc. From the above types of anxiety disorder Stefan
is going through Generalized Anxiety Disorder (GAD) as he is being worried about the surgery
which is going to happen and fears of losing his life.
3. Relaxation techniques
For reducing anxiety and stress strategies like relaxation techniques are used. These
techniques are used for managing different symptoms of anxiety and help patients get through
panic attack. Due to various anxiety disorders and their different causes, for all of then no single
treatment works specifically. There is a significant psychological impact of relaxation. Specific
aspects of personality can be improved through relaxation which helps in changing unwanted
attitudes and habits and strengthening positive qualities of a person (Relaxation techniques
2017). One of the effective techniques for reducing anxiety is performing deep breathing
exercises.
These are very easy to learn and are foundation of different relaxation techniques. They
have a cleansing effect on patient's mind, making them feel refreshed and energised. Breath's
periodicity is being controlled and mind is being cleared by deep breathing as it requires
attention and focus on respiration process. Shortness of breath can be managed, reduce rapid
heart rate and improve other symptoms of panic with the help of exercises (Carver and
O’Malley, 2015). In hospitals for controlling anxiety medications are given to the patients. It
helps them to get a deep sleep and relax their body and mind. These medications help brain to
extract a chemical called serotonin which acts as a neurotransmitter which carries signals
between and along nerves. To help someone with anxiety it acts as mood regulators.
Hypnotherapy can be given by hypnotherapists who can be a doctor, psychologists,
therapists, nurses or licensed professionals. Patients having anxiety can be helped by hypnosis to
get into a relaxed state through breathing, muscle relaxing techniques or guided image. By using
simple verbal suggestions or imagery severity of symptoms of anxiety can be reduced. After few
sessions, positive results can be seen in some people.
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Counselling sessions are conducted for Stefan for removing all his fears and stress
regarding the surgery. Through counselling sense of trust and safety is been developed within
patient. Some other techniques used for relaxation while in anxiety are autogenic training where
person have to concentrate at sensations of physical warmth, relaxation and heaviness in
different body parts. Progressive relaxation technique also known as Jacobson relaxation in
which various muscle groups are tightened and relaxed combined with breathing exercises and
guided imagery (Barsky, (2017)). As a choice of treatment for reducing depression and anxiety,
progressive muscle relaxation technique is widely used and learned. Group therapy refers to the
relaxation techniques where more than one patient or participants are there in a therapeutic
environment. Where each of them shares their own experiences and stories to each other for
relaxation.
4. Relevant information provided to patients before medication.
When psychological treatments for relaxation haven't been effective for patient then
medication is being offered to them. In hospital for anxiety symptoms for only once diazepam 5
to 10 mg oral PRN can be given. For helping Stefan to make decision regarding the use of
diazepam proper description must be provided to him. He must be made aware of the common
side effects regarding medication. Diazepam is a common medication that is been given to
patients having anxiety. It helps in relieving symptoms of anxiety disorders (Khalaila, (2014)). It
can be habit forming and usually prescribed on short term. It balances chemicals in brain
unbalanced due to anxiety in people. It is used in for treating alcohol withdrawal symptoms,
muscle spasms and anxiety disorder.
Patients should be given at-least minimum information before giving medication. First of
all, the effects of drug should be explained to them. That it will help to reduce symptoms of
anxiety and will aid to sleep easily. Amount of dose for the medication would be given. Side
effects of medication is also being explained to the patient. Such as Diazepam have common side
effect of fatigue, respiratory depression, skin rash, headache, hypotension, changes in salivation,
blurred vision, etc. Whereas it also has some adverse effects like diarrhoea, somnolence, in-
coordination, carpal tunnel syndrome, jaundice, neutropenia, etc. It is also being checked
whether the patient have any reaction or allergy due to this medication.
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Proper instructions are given to the patient about how to intake drug for medication,
whether it has to be taken via injection, orally or through IV. Time when the drug would be
given for intake such as after dinner etc. For how long it would have its effect on them,
Diazepam have effect for 6 – 12 hours. Warnings regarding the medication of diazepam should
be given to them like when it should be consumed like after proper diet, at night, etc. Maximum
doses prescribed by doctors for diazepam is of about 5-10 mg.
After all relevant data is been given to the patient, he is being asked whether everything
is being understood by them and request to tell about most important information and ask if they
have any questions, which they need to ask regarding medication (Leung, 2014).
CONCLUSION
From this report it can be concluded that there are certain communication skills required
by nurse for interviewing the patients for taking important information from them. Such as
carefully and attentively listening, proper eye contact, involving body language, etc. They should
avoid the use of technical language while communicating with patients. Proper relaxation
techniques should be used for controlling and reducing anxiety. Patient must be informed
properly with relevant information before providing medication.
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REFERENCES
Books and Journals:
Barlow, D. H. (Ed.). (2014). Clinical handbook of psychological disorders: A step-by-step
treatment manual. Guilford publications.
Barsky, A. J. (2017). The iatrogenic potential of the physician’s words. Jama, 318(24), 2425-
2426.
Carver, M. L., & O’Malley, M. (2015). Progressive muscle relaxation to decrease anxiety in
clinical simulations. Teaching and Learning in Nursing, 10(2), 57-62.
Khalaila, R. (2014). Simulation in nursing education: an evaluation of students' outcomes at
their first clinical practice combined with simulations. Nurse education today, 34(2),
252-258.
Kinderman, A., & Harris, H. A. (2016). Advances in Palliative Care in Underserved Settings.
Leung, K. Y. (2014). Vergence and accommodation function of patient under medication for
anxiety or mental disorder.
Riley, J. B. (2015). Communication in nursing. Elsevier Health Sciences.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care
in evidence-based practice. FA Davis.
Online
Relaxation techniques. 2017. [online] Available through:
<https://nccih.nih.gov/health/stress/relaxation.htm>
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