Communication for Nurses: Talking with Patients

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I speak as much with the parents actually, though I always talk to the child … But I always show the plastic tube first and I show it to the parents … We have such short meetings so we need to create trust in each other first. Parents feel it [plastic tube] and the parents give it to the child. Vuković M, Gvozdenović BS, Stamatović-Gajić B, Ilić M, Gajić T. Development and evaluation of the nurse quality of communication with patient questionnaire. Srp Arh Celok Lek. 2010;138(1–2):79–4. doi: https://doi.org/10.2298/SARH1002079V. Huang L, Lei W, Xu F, Liu H, Yu L. Emotional responses and coping strategies in nurses and nursing students during Covid-19 outbreak: A comparative study. Plos one. 2020;15(8):e0237303. pmid:32764825

The NRMP included in the study were skin tests for allergy, blood sampling (venous or capillary), intravenous cannula insertion (IV), needle insertion in a central vein port, and injections into the joint. All children were given standard therapy for NRMP which includes some form of topical anesthesia, apart from capillary blood sampling and skin tests for allergy. The topical anesthesia was applied at least 1 h prior to the NRMP. Standard therapy was also used with inhalation/sedation, N 2/0 2, for children who underwent injections into the joint and for those who had a needle phobia. Crawford T, Candlin S, Roger P. (2017). New perspectives on understanding cultural diversity in nurse-patient communication. Collegian, 2017 Feb 1;24(1):63 – 9. https://doi.org/10.1016/j.colegn.2015.09.001. Forero R, Nahidi S, De Costa J, Mohsin M, Fitzgerald G, Gibson N, et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC health services research. 2018;18(1):120. pmid:29454350 Murira N, Lützen K, Lindmark G, Christensson K. Communication patterns between healthcare providers and their clients at an antenatal clinic in Zimbabwe. Health Care Women Int. 2003 Feb 1;24(2):83 – 2. https://doi.org/10.1080/07399330390170060. The intervention invites the patient to talk about whatever is important to him or her,” Allen and colleagues wrote in an articlein Family Medicine.

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Nurse-patient communication is anchored by strong interpersonal relationships. Meaningful relationships will allow nurses to carry out their clinical jobs more easily while keeping patients engaged in their care. Anderzén-Carlsson A, Kihlgren M, Skeppner G, Sørlie V. How physicians and nurses handle fear in children with cancer. Journal of Pediatric Nursing. 2007; 22(1):71–80. [ PubMed] [ Google Scholar] Blount R. L, Piira T, Cohen L. L, Cheng P. S. Pediatric procedural pain. Behavior Modification. 2006; 30(1):24–49. [ PubMed] [ Google Scholar] Digitizing patient education systems has also been helpful at streamlining and enhancing the nurse-patient relationship. And of course, dressing the part has been key to establishing that good rapport even over virtual care options.

Nurses may also refer to any available printed or digital patient education materials. Increasingly, healthcare organizations are also investing in online patient education resources to which nurses may refer patients. Navigating nurse communication and health IT, telehealth Although nursing staff shortage is a significant barrier to patient-centered care and communication that healthcare institutions and managers must know, some healthcare scholars have critique nurses’ complaints of time limitation. For instance, McCabe [ 7] argued that the quality of nurse-patient interactions is what matters and not the quantity of time spent with patients and their caregivers. McCabe maintained that “spending long periods with patients does not always result in positive nurse-patient relationships” [ 7]. He argued that implementing patient-centered care does not require additional time; hence, nurses’ perceptions of being too busy cannot excuse poor therapeutic communication during clinical interactions. Instead, nurses are encouraged to develop self-awareness, self-reflection, and a commitment to ensuring that patients receive the needed care. Etheredge HR. “Hey sister! Where’s my kidney?“ Exploring ethics and communication in organ transplantation in Gauteng, South Africa, Ph.D. dissertation, Johannesburg. University of the Witwatersrand; 2015.Liu W, Manias E, Gerdtz M. Medication communication during ward rounds on medical wards: Power relations and spatial practices. Health 2012 Mar. 2012;17(2):113–34. doi: https://doi.org/10.1177/1363459312447257. At the end of the day, this comes down to the relationship between that provider and the patient,” Dudley advised. “If they can, providers can encourage patients to turn on their camera, to say, ‘I'm here to really support you and do everything I can. And I can do that better if I can see you, if that's possible, or you show me your medications.’” Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: A scoping review. International Journal of Emergency Medicine. 2020;13(1):1–8. pmid:31931721 Nurses and patients and their caregivers have noted that limited time affects nurse-patient interactions, communication, and care quality. Besides, Yoo et al. [ 22] reported that limited visiting hours affected communications between caregivers and nurses in a tertiary hospital in Seoul, Korea. Since the caregivers had limited time to spend with patients, they had little knowledge about the intensive care unit and distrusted the nurses. Understanding patient needs and concerns allows nurses to target their communication and clinical strategies toward specific patient preferences.

Consequently, nurses have a responsibility for supporting children to cope with NRMP and any potential negative effects (Melhuish & Payne, 2006; Wood, 2002). There are a number of different strategies for helping children during NRMP and Blount et al. ( 2006) divide actions into the use of medical, psychological, and merged activities, whereas the review by Uman et al. ( 2006) shows that nurses can support children by using hypnosis, distraction, and cognitive behavioral therapy. Furthermore the findings in this study demonstrate that nurses have different opinions about restraining children during NRMP, and whether this can be supportive or not. Arguably there is an ambiguity as to how this is expressed. It is consistent with previous research by Brenner, Parahoo, and Taggart ( 2007) and Karen ( 2010). The main difference is the focus on consent and the strength used to restrain. Supportive holding requires consent and no strength is necessary, but during restraint nurses act without consent from the child and a certain amount of strength is used. The limits of this are difficult to define (Karen, 2010; Royal College of Nursing, 2003). We want to emphasize that this reasoning is only applicable if the child is not in a life-threatening condition. While the nurses prefer using the word “brave” the two concepts appear to be used randomly, without distinguishing their specific meanings. To be brave implies that the children have coped with something unpleasant: So, you were so brave, you still did it despite being sad and not wanting to do it before, and you did it anyway. I think it's important to communicate this so the principle of being good does not prevail [principles described by nurses]. Long KA. The Institute of Medicine report on health professions education: A bridge to quality. Policy Polit Nurs Pract. 2003 Nov;4(4):259–62. doi: https://doi.org/10.1177/1527154403258304. It is important for supporting children during NRMP that the nurses are sensitive to the body language expressed by children and parents as well as its meaning.Harvard Medical School. The Eight Principles of Patient Centered Care; 2015 Nov 18. Available from OneView: https://www.oneviewhealthcare.com/the-eight-principles-of-patient-centered-care/ Accessed 28 Dec 2020. Hader R, Ne-Bc R, Officer C. The power of appreciation. Nursing Management. 2013;44(3):6. pmid:23392284