required to overcome some of the obstacles to effective communication. It will highlight the skills required when communicating with different age groups and the actions to be performed in challenging or complex situations.
As humans, we thrive on interaction with others. We learn to communicate at a very early age; as babies, we are able to communicate our wants and needs through cries and smiles (Grainger 2018). Those positive connections give us a sense of belonging and value. When done well, communication is a two‐way process that involves listening, observation, body language, facial expressions and speech from all parties involved. Effective communication is extremely important at times of ill health or crisis (Raphael‐Grimm 2014). Yet, communication is one of the five most common reasons for complaints in the National Health Service (NHS) in England (Parliamentary and Health Service Ombudsman 2019). It is vital for all healthcare professionals to understand the impact of their communication with the people they are caring for. Nursing associates have a legal and professional obligation to develop the skills to ensure that each interaction is effective and meaningful (Nursing and Midwifery Council 2018a).
Green Flag
Practice effectively:
1 7.0 Communicate clearly. To achieve this, you must:
2 7.1 use terms that people in your care, colleagues and the public can understand
3 7.2 take reasonable steps to meet people’s language and communication needs, providing, wherever possible, assistance to those who need help to communicate their own or other people’s needs
4 7.3 use a range of verbal and non‐verbal communication methods and consider cultural sensitivities to better understand and respond to people’s personal and health needs
5 7.4 check people’s understanding from time to time to keep misunderstanding or mistakes to a minimum
6 7.5 be able to communicate clearly and effectively in English
Every communication is important, however insignificant it may seem, especially when working in healthcare. The Royal College of Nursing (2016) identified three reasons why communication is important:
Good communication helps patients/clients feel at ease
Good communication helps patients/clients to feel in control
Good communication makes patients/clients feel valued
Richardson (2017) developed a tool to aid healthcare professionals in effective communication, the PER tool (Propose, Engage and Reflect). This advocates that prior to any conversation, the healthcare professional proposes what they are planning to discuss to ensure that they have all the information needed and are aware of who will be involved in the conversation. This also includes ensuring there is a suitable place for the conversation to happen, as it is difficult for anyone to focus in a busy, noisy environment. The engagement aspect is the professional’s opportunity to introduce themselves, gain the other person’s attention, clarify who else is there and ensure the person(s) receiving the information is/are responding appropriately. The final element is for the healthcare professionals to reflect on whether they achieved what they set out to, if it went well and what they could have done differently (Richardson 2017).
In preparing for communication, the nursing associate can consider the 5Ws and 1H, derived from Lasswell’s (1948) 5W model of communication.
What
Why
When
Where
Who
How
Careful planning of communication encounters can result in more meaningful and effective communication. See Table 2.1 for an overview of planning communication encounters.
It is important to have an awareness of the different formats of communication when proposing planned communication with patients and colleagues. There are generally four different types of communication to consider, namely verbal, non‐verbal, written and visual (Table 2.2). Each of these will be described in detail in subsequent chapters of this book.
The engagement aspect of communication is when the nursing associate will work collaboratively with patients, families and carers to develop therapeutic relationships. As nursing associates work across all four fields of nursing practice (adult, mental health, children and young people and learning disabilities), as well as with people across the lifespan, they will need to consider the target audience when engaging in communication.
The NMC’s (2018a) standards of proficiency require the nursing associate to demonstrate the skills and abilities required to develop, manage and maintain appropriate relationships with people, their families, carers and colleagues. The trainee nursing associate needs to be deemed proficient in this aspect of care provision.
When working with children and young people, family‐centred care is a key concept, and the nursing associate needs to be aware that while the child is a pivotal member within the family unit, care must extend to involve the parents and wider family (Roberts et al. 2015). Children, more than any other age group, are keen observers and easily detect when a person is being disingenuous or impatient (Edwards & Coyne 2019). The nursing associate can strive to achieve a trusting and collaborative therapeutic relationship by demonstrating a genuine interest in the child and paying attention to all aspects of verbal and non‐verbal communication.
Table 2.1 Planning communication encounters.
| What – The ‘What’ question answers: |
| What am I required to communicate? What should the message be? What action is the audience required to take as a result of the communication? |
| Why – The ‘Why’ question deals with: |
| Why communicate now? Why this audience? Why is this important? |
| When – The ‘When’ explores: |
| When is the communication required? When is the action or result required? |
| Where – The ‘Where’ question answers: |
| Where is the venue or location of communication? Where can I get more information? Where is this communication going to lead? |
| Who – The ‘Who’ question defines the audience: |
| Who is the audience? Who does it impact? Who needs to take the required action? Who is in charge? |
| How – The ‘How’ question is about: |
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