Nursing Communication

Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all setting. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. With these nurses work in a large variety of specialties where they work independently and as part of a team to assess, plan, implement and evaluate care.

These nursing practices have been influenced by the nursing leaders in the past. Among the few of them were Clara Barton, Lavinia Dock, Lillian Wald, Margaret Sanger, Florence Nightingale and Virginia Henderson. Florence Nightingale, often considered as the first theorist, earned her title as “The Lady of Lamp” and was the Founder of Nursing while Virginia Henderson is considered as the “First Modern Nurse”. 


In this paper, we are going to discuss what is nursing, nurses’ roles and functions and the two visionary leaders and their contributions to nursing.

Communication Process

Communication is the interchange of information, thoughts and ideas between two people or group of people. Communication is the process by which a message or information is exchanged from a sender to a receiver. It can be carried out into two different modes: verbal and non-verbal.

Communication involves a sender, a message, receiver and a response or feedback.

A sender is a person or group of person who wishes to convey a message to another person or group of

person. A sender should see to it that the message she transmitted or conveyed to another person must be clear, simple and easy to understand. It is necessary to use a language that the other person is using to achieve effective communication. It is also important to note that your gesture and or body language is congruent to what you are saying. Timing and tone of voice also play an important role in communication.  It must suit to the mood of the client to obtain accurate information.

A message is the thoughts, ideas or emotions that are transmitted to the other person or group of person which is actually said or written and the body language that accompanies the words and how the message is being transmitted. In transmitting a message, a channel is used either through a face-to-face talk and recorded messages through radio or television. It is important that the channel is appropriate for the message and should serve the purpose.

A receiver is a person who perceives or receives information, ideas and thoughts transmitted by the sender. He can be a listener, observer or attendee. It is important to note that the receiver perceive or understand exactly what the messages he/she is receiving. This way communication is said to be effective.

A feedback/response is the message that the receiver returns to the sender. It can either be verbal or non-verbal or both. If the feedback or response matches to the message being relayed, then it is said that the message is interpreted correctly. This way, the sender becomes the receiver who is required to interpret and respond as well.

Importance of Effective Communication to Nurse-Client Relationship.

Effective communication is very important in nurse-client relationship. Nurse-client relationship is referred to by some as interpersonal relationship, by others as therapeutic relationship and by still others as helping relationship.

The nurse-client relationship is professional and therapeutic. It ensures the client’s needs are first and foremost. It exists to meet the needs of the client, not the needs of the nurse. It is always the nurse who is responsible for establishing and maintaining boundaries with clients, regardless of how the patient behaves (College of Registered Nurses of British Columbia).

Effective communication is used to gather assessment data, to teach and influence, and to express caring and comfort to the clients. Nurses who communicate effectively gets better information about the client’s problem and be able to identify and implement better interventions or nursing care that promotes fast recovery, health and wellness. 

There are five components to the nurse-client relationship: trust, respect, professional intimacy, empathy and power. Regardless of the context, length of interaction and whether a nurse is the primary or secondary care provider, these components are always present. 

1. Trust. Trust is critical in the nurse-client relationship because the client is in a vulnerable position. Initially, trust in a relationship is fragile, so it’s especially important that a nurse keep promises to a client. If trust is breached, it becomes difficult to re-establish.
2. Respect. Respect is the recognition of the inherent dignity, worth and uniqueness of every individual, regardless of socio-economic status, personal attributes and the nature of the health problem. 
3. Professional intimacy. Professional intimacy is inherent in the type of care and services that nurses provide. It may relate to the physical activities, such as bathing, that nurses perform for, and with, the client that creates closeness. Professional intimacy can also involve psychological, spiritual and social elements that are identified in the plan of care. Access to the client’s personal information also contributes to professional intimacy. 
4. Empathy. Empathy is the expression of understanding, validating and resonating with the meaning that the health care experience holds for the client. In nursing, empathy includes appropriate emotional distance from the client to ensure objectivity and an appropriate professional response. 
5. Power. The nurse-client relationship is one of unequal power. Although the nurse may not immediately perceive it, the nurse has more power than the client. The nurse has more authority and influence in the health care system, specialized knowledge, access to privileged information, and the ability to advocate for the client and the client’s significant others. The appropriate use of power, in a caring manner, enables the nurse to partner with the client to meet the client’s needs. A misuse of power is considered abuse.

Barriers of Communication

Barrier of communication is the difficulties faced when people attempt to communicate with each other. There are many types of barriers of communication; among the most common types are language, religion, cultural background, gender, interpersonal, physical, and emotional.

For the past four months in Diploma in Nursing in SEGI College our group has identified few barriers. Though we live in the same country yet we are different with each other in terms of religion, place we live in and we have foreigner classmates.

1. Language. This the main barrier in communication faced by our foreigner classmates. Most of our classmates does not understand and speaks English so that interaction and communication is less. Students who are able to communicate in English interacts more with each other and likewise students who only speaks in Bahasa Malaysia tends to interact with themselves too and less with non-Malaysian classmates.
2. Cultural. Malaysia is known for being a multiracial country. Chinese, Indian, Malays has their own culture which has been kept and handed down from previous generation. Though we have been living in this country since birth yet we hold our respective culture and in one way or another make us to be clannish not to mention our foreign classmates. Obviously, our foreigner classmates are trying to adapt, adjust and fit in themselves. However, from time to time we all bond each other.
3. Religion. This area is not much of an issue since in this country we highly respect each others religion. Christian, Islam, Hindu and Buddhist are free to practice their respective religious rights.
4. Interpersonal and Attitude. Though this is not included in the question, they would love to add this type of barrier because they feel that this is one of the most top barriers in communication. Each of them has different types of family upbringing, and lifestyle. We have different attitudes, likes and dislikes and some students have prejudices which affect effective communication or interaction within and outside the classroom. Students who show their bad attitudes have fewer friends in class and few only likes to communicate with them.  Others who do not like other classmates do not like to interact and communicate with them too for some other reasons.

Ways to overcome barriers of communication to make communication and interaction more effective. Our group has identified the following ways to overcome the above barriers of communication and use them in order to facilitate effective communication.

1. Work at improving English and Bahasa Malaysia languages. These take knowledge and work. Those students who less speaks English should work out hard on this. Constant reading, improves vocabulary, and or have English tutorial if necessary. Besides English is the medium of instruction in the class so it is very important. Those foreigner students should learn Bahasa Malaysia either through tutorial, seek help from other classmates for translation and or do self help study.
2. Use simple words to convey the message. Make simple sentences that are easy to understand either in writing or speaking.  Everyone hates bombastic words. So keep it simple and easy to understand.
3. Develop the skill of cross-cultural communication. Here are some skills we need to develop to have the skill in cross-cultural communication, to wit:

• Know yourself: Identify your attitudes, your opinions, your likes, your dislikes, your prejudices, your degree of personal ethnocentrism (the tendency to believe that one's ethnic or cultural group is centrally important, and that all other groups are measured in relation to one's own) and the biases that we all carry around.
• Take time: Listen to the other person and allow him or her to accomplish their purpose. Don't jump to conclusions. Some times we finish the thoughts and ideas of the other person before he or she has finished talking.
• Encourage feedback: Feedback allows communicators to correct and adjust messages. Without feedback we cannot have agreement. Don't be afraid of silence. It could be the appropriate feedback at times.
• Develop empathy: The greater the difference between us and others, the harder it is to empathize. To develop empathy we must put ourselves in the other person's place. By becoming more sensitive to the needs, values, and goals of the other person, we overcome our ethnocentric tendencies.
• Seek the commonalities among diverse cultures: Despite our cultural differences we are all alike in many ways. We need to seek that common ground to establish a bond between ourselves and the rest of humanity. Although our own ethnocentrism might have hindered us from getting to know people from other cultures, let us be more than ever committed to help ourselves and others overcome the barrier that culture creates. Let us endeavor to minimize the occurrences of cross-cultural misunderstandings as we develop the attitudes and the skills that are needed to communicate cross-culturally (Dori Kelsey).

REFERENCES

Berman, Audrey, Erb, Glenora Lea, Kozier, Barbara, and Snyder, Shirlee. 2008. Fundamentals of Nursing: Concepts, Process, and Practice. New Jersey: Pearson Education, Inc., 8th Edition, 460 – 483.

College of Registered Nurses of British Columbia. Nurse-Client Relationship. Copyright CRNBC/Nov. 2006. Available online: www.cmbc.ca (accessed November 13, 2009).

Dori Kelsey. Culture as a Barrier to Communicate. Available online: http://ezinearticles.com/?Culture-As-A-Barrier-To-Communication&id=55341 (accessed November 08, 2009).

Bernard L. Erven. Overcoming Barriers To Communication. Department of Agricultural, Environmental, and Development Economics, Ohio State University. 2002. Available online (accessed November 08, 2009).

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