Nursing Communication Skills: Documentation, Ethics, and Social Media

This assignment on nursing communication skills covers a wide range of essential topics for effective patient care. It begins with interview preparation, techniques, and potential barriers to communication, including the use of open and closed-ended questions, and the importance of non-verbal cues. The assignment then delves into guidelines for completing nursing documentation, including patient identification, allergy status, medication details, and safety precautions. Further sections address strategies for communicating with patients with language difficulties, and those with disabilities, emphasizing the use of interpreters and assistive devices. The assignment also explores giving and receiving feedback, open discourse, team dynamics, and ethical considerations related to social media and email etiquette. Finally, it discusses assertive communication techniques for conflict resolution and effective negotiation, providing a comprehensive guide to improving communication skills in a nursing context, supported by relevant references.

Running head: NURSING COMMUNICATION SKILLS
Nursing communication skills
Name of the Student
Name of the University
Author Note

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Answer to question 1
Conducting interview (Silverman, Kurtz & Draper, 2016)-
Make interview preparation
 Arrangement of chairs and tables
 Maintain privacy to make information confidential
 Enough time to be kept for interview
Beginning interview
 Greetings in polite manner, formally and take patient’s name
 Introduce to the interviewee, informing the background
 Explain the purpose of the interview to maintain transparency and effective
communication
During interview
 The nurse must maintain eye contact with interviewee
 Present in warm manner to build rapport
 Actively listen to patient – to identify and address concerns
End of the interview
 Summarise the whole interview to the patient to ensure preparation for the next
day surgery
 Inform the patient about the next step
 Identify and ask questions if the patient has any worries

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 Lastly thank the patient for time
Answer to question 2
Various interviewing techniques that will be used are (Shea, 2016)-
 Use of open ended questions to get in-depth information like – what is your
perception about tonsillectomy?
 Use close ended questions for precise information. Ex- Are you ready for
tonsillectomy tomorrow morning?
 Clarify the information by paraphrasing
 Enquire about general health, habits and needs
Answer to question 3
Potential barriers to communication (Shafipour et al., 2014)
1. Use of jargon-
 nurse use too many medical terms that may be difficult to interpret
 Patient cannot comprehend bodily functions or anatomical terms
2. Values and beliefs
 Patient’s negative perception about the nurses’ experience
 Belief that man cannot be nurse
 Prejudice about the nurses’ poor knowledge
3. Time constraints
 Nurse busy schedule
 Hurried communication with patient

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 Brief stating of pressing news
 Patients feel neglected
4. Patient anxiety
 Embarrassment to speak in front of nurse
 Worry about post operative outcomes
5. Environmental factors- such as noise and privacy-
 noise in background- impede communication
 patient hearing problem may impede conversation
 Patient sensitive to personal information, read or write
 Need of translator
 Withdraw information from nurse considering too private
6. Educational attainment
 Patient/low educational attainment
 Difficulty understanding care process
 Nurse lacks effective verbal skills
 Nurse lack interview technique
7. Patient perceptions-
 patient may perceive a specific important as non-essential to be
discussed
 over thinking about pain and fatigue after interview
8. professionalism
 nurses including patient decision making
 Acknowledgement of patient concerns

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 Nurse poor seeking of information
Answer to question 4
Guidelines to completing the nursing documentation (Johnson et al., 2014)-
1. Patient identification
 Use of black wrist band
 Correct spelling of name in black, date of birth, age, gender
 Check wrist band details and match with patient
2. Removal of jewellery
 As per local policy
3. Allergy status
 Patient mentions about specific drug or food allergy
4. Infection status
 Documenting patient’s existing and past infections
5. Safety precautions
 Document loose teeth, hearing aid
 Dressing information
6. Obtain consent
 Check before surgery
7. Medication
 Past use of medications- cause of drowsiness
 Premeds administered
8. Insurance information

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 Insurance details documented
 Information of Medicare/Medicaid coverage
9. Assessment of vitals
 Abnormal readings reported
10. Site of surgery marked
 Check by nurse
 Check by day units preoperative checklist
Answer to question 5
Arrange for medical interpreter- to communicate fluently with patient
Effective use nonverbal skills- to avoid misunderstanding
Speak slowly- in shorter phrases to consider the best answer
Avoid Jargons, acronyms, idioms- to address patient queries and concerns
Provide written information- for better understanding (Meuter et al., 2015)
Answer to question 6
Interview preparation
 Arrange for chairs
 Schedule sufficient time
 Maintain privacy
Beginning interview before patient arrives

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 Greet formally and introduce (nurse)
 Maintain eye contact, warm gesture
 Give patient history
 Plan about assessment tools
 Explain the role in dealing with Mrs Singh
 Explain the patient’s language difficulties and reason for interview
During interview
 Inform what data to be collected from patient and family
 Assist with immediate communication needs
Interview style
 Speak slowly for avoiding misinterpretations
 Pause after each sentence to enable better understanding
 Ask close ended- in-depth information
 Open ended- single answer
 Advocate the patient through interpreter
End of interview
 Summarise the interview
 Receive translated document
 Decide the next step for patient
 Inquire about any queries/concerns of patient
 Thank the interpreter (Well et al., 2017)

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Answer to question 7
Optimal communication with Davis include following strategies (Smeltzer, Avery &
Haynor, 2012)-
-Stand in front of the patient, use positive tone of voice
-Avoid background noise- minimise irritation
-Use natural voice- during introduction of self and other person
-Remove tripping hazards- minimise fall
-Walk slowly with patient- guiding them around the place
-Use interpreter- for emergency
-Install assistive listening for emergency contact and
-Use of Brailey format for written information screen reader that converts
information on a computer screen to audio
-Collection of information- safety skills, use of equipments and risk factors
Answer to question 8
A)
Nurse can give feedback to other (Altmiller, 2012)-
Planning in advance-
what went right/wrong, prompt reply, goal to be achieve

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One-on-one feedback
To ensue respect and dignity, privacy
Specific- gentle start
Derive discussion as planned, brief on performance and outcomes
Encourage self reflection
Open-ended questions,
Explain learning needs and self awareness
Awareness of verbal and non-verbal cues
Maintain -Tone of voice, speech, eye contact, positive gesture,
Observe nonverbal cues of other person,
Deduce emotions
Self refection after feedback
Follow up on discussion,
Evaluate further response
B)
Nurse can receive feedback on performance by (Wu et al., 2012)-

9NURSING COMMUNICATION SKILLS
Active listening
-To be approachable and feedback,
-Avoid defence
Clarification
-seek repetition
-paraphrase after feedback
Embrace feedback
-Grab learning opportunity for making changes
Soft response
-Avoid conclusions,
-take helpful hints
-Pause and think before response
Positive attitude
-Good sport, appreciate feedback, learn from mistakes
Be proactive
-Carefully make notes
Follow up with feedback

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-share any information
Answer to question 9
Open discourse can be defined as open discussion with patient and family about harm to
the patient during health care process by certain incidents (Reisenhofer & Seibold, 2013).
Elements of the open disclosure are (Birks et al., 2014)-
Open and timely communication
-Open and honest communication about what went wrong
-Provide ongoing information
Acknowledgement
-Acknowledge carers/patients/families about adverse events
Apologizing and regret
-Apologise for harm caused by incident
-Express regret
Supporting the carer, family and patient needs
-Inform patient and family about adverse event facts
-Treat with respect, empathy and consideration
-Support as per needs
Support and meet the health care provider needs

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-encourage/recognise/report adverse events
-Training/education participation open disclosure
-Support through process
Integrated clinical risk management and improvement in system
-Investigate adverse outcomes
-incorporate quality improvement activity
Good governance
-analyse and prevent adverse events
-Accountability of changes
-Internal reporting/performance monitoring
Confidentiality
-Maintain privacy and confidentiality of the health care and patient information
Answer to question 10
Clarity of the group situation and work
-Ensure clarity over the individual purpose and shared goals
-Effective for achievement
Understanding of team boundaries

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-effective to bound together by a common purpose while performing independent tasks
Consider individual roles
-allow group functioning
-Achieve common goals
Positive relationship building
-For effective conflict resolution
-Enhance communication
Positive emotional experiences
-to deal with stress and adverse events
Team dynamics
-Effective listening of team members responses
-Different perspectives improve team performance
Teaming strategy
-Effectively hold diverse group of individuals
-Dealing with conflicts and pressure
Receiving and giving feedback
-On performance or any event

13NURSING COMMUNICATION SKILLS
-Allows for effective group function
Track contributions in group
-Via effective documentation
-Responsibility and accountability
Peer assessment/Evaluation process
-redress what might be perceived as a problem (Arnold & Boggs, 2015)
Answer to question 11
(Westrick, 2016)
a) Compliance with organisation policies and procedures
-Mismanagement of patient records to be avoided
-Avoid boundary violations
-Avoid transmission of information to third party
-Maintain professional boundaries like sharing electronic media with patients
-Compliance to national board and AHPRA by NMBA
b) Ethical principles when using social media
-Maintain privacy and confidentiality of patient information
-Breach may lead to law suit

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-Avoid disparaging remarks of patient
Avoid sharing of patients video and photos
c) Email etiquette
-Effective use of passwords/Avoid sharing
-Use of encryptions for sensitive PHI via email
-Avoid wireless systems – vulnerable to unauthorised access
-enable automatic log in and log off (case sensitive)
-Avoid storage of emails on unprotected personal archives/hard drives that are not
password protected
Answer to question 12
Assertive communication can be defined as effective expression of rights, needs,
perceptions, opinions while marinating respect and dignity of others. It is the direct open and
honest communication that fosters meaningful and fulfilling environment (Pipas & Jaradat,
2010).
Assertive communication allows for effective negotiation-
 By compromising
 Active listening during negotiation
 Aim for win-win situation
 Taking positive aspect of negotiation

15NURSING COMMUNICATION SKILLS
 Concessions and compromise where needed
Assertive communication allows for conflict resolution-
 Using phrases that seek collaboration
 Identifying areas of agreement
 Able to solicit the view of others
 Self confidence and high self esteem
 Accept mistakes (Omura et al., 2016)

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References
Altmiller, G. (2012). The role of constructive feedback in patient safety and continuous quality
improvement. Nursing Clinics, 47(3), 365-374.
Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional
Communication Skills for Nurses. Elsevier Health Sciences.
Birks, Y., Harrison, R., Bosanquet, K., Hall, J., Harden, M., Entwistle, V., ... & Adamson, J.
(2014). An exploration of the implementation of open disclosure of adverse events in the
UK: a scoping review and qualitative exploration. Health Services and Delivery
Research.
Johnson, M., Sanchez, P., Suominen, H., Basilakis, J., Dawson, L., Kelly, B., & Hanlen, L.
(2014). Comparing nursing handover and documentation: forming one set of patient
information. International nursing review, 61(1), 73-81.
Meuter, R. F., Gallois, C., Segalowitz, N. S., Ryder, A. G., & Hocking, J. (2015). Overcoming
language barriers in healthcare: A protocol for investigating safe and effective
communication when patients or clinicians use a second language. BMC health services
research, 15(1), 371.
Omura, M., Maguire, J., Levett-Jones, T., & Stone, T. E. (2016). Effectiveness of assertive
communication training programs for health professionals and students: a systematic
review protocol. JBI database of systematic reviews and implementation reports, 14(10),
64-71.

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Pipas, M. D., & Jaradat, M. (2010). Assertive communication skills. Annales Universitatis
Apulensis: Series Oeconomica, 12(2), 649.
Reisenhofer, S., & Seibold, C. (2013). Emergency healthcare experiences of women living with
intimate partner violence. Journal of clinical nursing, 22(15-16), 2253-2263.
Shafipour, V., Mohammad, E., & Ahmadi, F. (2014). Barriers to nurse-patient communication in
cardiac surgery wards: a qualitative study. Global journal of health science, 6(6), 234.
Shea, S. C. (2016). Psychiatric Interviewing E-Book: The Art of Understanding: A Practical
Guide for Psychiatrists, Psychologists, Counselors, Social Workers, Nurses, and Other
Mental Health Professionals. Elsevier Health Sciences. Retrieved from:
https://books.google.co.in/books?
hl=en&lr=&id=0LgcDQAAQBAJ&oi=fnd&pg=PP1&dq=NURSE+interview+technique
s+with+patients&ots=b1ESvbM6KA&sig=Soi5ndvPWLBan1QJx1imVQQvE8o#v=onep
age&q=NURSE%20interview%20techniques%20with%20patients&f=false
Silverman, J., Kurtz, S., & Draper, J. (2016). Skills for communicating with patients. CRC Press.
Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=pRjYCwAAQBAJ&oi=fnd&pg=PP1&dq=NURSE+COMMUNICATIO
N+SKILLS+
+during+interview+with+ptients+&ots=kmyfnJHsOP&sig=T1dqMzJv7RRSUN3aLxJE-
oAKYmM#v=onepage&q=NURSE%20COMMUNICATION%20SKILLS
%20%20during%20interview%20with%20ptients&f=false

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Smeltzer, S. C., Avery, C., & Haynor, P. (2012). Interactions of people with disabilities and
nursing staff during hospitalization. AJN The American Journal of Nursing, 112(4), 30-
37.
Well, E., First, F., Dignity, P., it Out, W., & Training, C. B. (2017). Cross-cultural interview
studies using interpreters. Nursing Standard, 21(4).
Westrick, S. J. (2016). Nursing students’ use of electronic and social media: Law, ethics, and e-
professionalism. Nursing education perspectives, 37(1), 16-22.
Wu, P. H., Hwang, G. J., Milrad, M., Ke, H. R., & Huang, Y. M. (2012). An innovative concept
map approach for improving students' learning performance with an instant feedback
mechanism. British Journal of Educational Technology, 43(2), 217-232.