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Communication
Communication in an integral part in human life, it is a way of bringing people together as well as a means of making our concerns and needs known to others Casey, 2014. According to Sabo 2006, Kourkouta and Papathanasiou 2014, they believed, communication is not only a successful means of conveying people skills and information, but it is also a medium which allows people to interact with one another within a different environment.
In nursing, communication is another life entirely in which nurse’s lives, Royal College of Nursing, 2012, argued that ‘nurses are the heart of the communication process’. This means, nurses are the one who spent more time closely with their patient more than the other healthcare practitioners, as a result, it gives them the ability to organise the patient’s care through their communication with the as well as the other practitioners involved in their care McCabe and Timmins, 2006.
This essay will explore the virtues and excellence of good communication in the nursing profession, and channel of improving the communication skill on the part of nurses in practice. This essay will also looks into two examples experience at work of virtues of communication with service users whilst in practice. Also, the essay will reflects on the two examples of interactions between the service users and the nurses.
Communication can be describe as a process of sending and receiving verbal and non-verbal message between two or more people De Vito, 2011; Balzer Riley, 2011. Non-verbal communication can be expressed by gestures, postures physical barriers and facial expressions which are interpreted by both the sender and the receiver Hargie, 2011.
According to Williams and Davis, 2005, communication can be verbal and non- verbal communication. Verbal communication entails the use of language to deliver a message and this type of communication is used to convey the thought, ideas, desire and with non-verbal communication, which is most commonly means used in communication Riley, 2008. Non-verbal communication required conveying and collecting information via medium that do not involve codes. Non-verbal communication allows gestures, tone, postures, and pitch of the voice together with facial expression which is more simple and natural that can be improved Timby, 2009; Spouse et al. 2008.

Importantly, non-verbal communication allows spoken messages to be adjusted and reinforced, thereby gives room for flowing of information to be regulated and make it easy for the relationship between the communicators to be identified Webb, 2011.

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Furthermore, communication is a day-to-day job activity in nursing with different multi disciplinaries Hart, 2010, with that therefore, nurses must be a good communicator to achieve effectiveness. With effective communication, nurses it helps nurses to receive more information from the patients they cared for. Casey 2011 believes that nurses and other practitioners form an important part of the communication process in a healthcare industry.

This section presents my professional reflection on communication with two patients. In this reflection, the Gibbs reflective cycle will be used.
Reflection is a vital tool in nursing practice, it helps nurse memory of what they did and reflect on whether it went well or not and if not how can the do differently better net time. Reflective account allows nurses to provide the best standard of care to their patients thereby empower them to measure their communication skills Siviter, 2008.
Sully and Dallas 2010 argued that reflective account is vital to the development of nursing profession. They emphasised that reflective account is aimed to promote their efforts it will lead to individual better practice.

Reflection is a conscious, dynamic thought process in which past experiences are analysed and learnt from. The insights gained during this process help individuals to respond to similar situations in a similar way and improve upon them (Nursing Center, 2011). Boud et al, stated that ‘reflection is an important human activity in which people recapture their experience, think about it, mull over and evaluate it. It is this working with experience that is important in learning’ (Boud et al, 1985), this is, therefore, an important aspect in reflection as it allows for constant professional growth and improvements in patient care and nurses are constantly encouraged to engage in interactions which initiates reflection (Bagay 2012). There are a number of barriers to reflection, such as, time, fear of criticism and professional arrogance, however, it can enable us to avoid part mistakes, maximise learning opportunities and allows individuals to make the best use of the knowledge available (RCN, 2013).

It involves interpersonal and intrapersonal means of dissemination information Ruesch, 1961 which can be either be positive or negative depend on the feeling, thought and intention of both the receiver and the sender Catherine & Fiona, 2013. For instance, nurse A ask his colleague with gentle and friendly tone whether is free to assist him with medication checking. Yes, you need to make snappy ok said nurse B, Nurse A was confused and he said he will ask some else. However, nurse B apologise for his irritable response because he was disturbed with personal thought and he did the check with nurse A.
In addition, transmitting of message or information from sender can be effective by not only considering the clarity, tone and purpose of the message and interpretation through the feedback from the receiver Berlo, 1960; Miller & Nicholson, 1976 But put into account the intrinsic factors such values, belief, culture, roles, goal, and education and the extrinsic factor such as physical environment like loud noise and sounds that can distort the message De Vito, 2011.
Collins, 2015 described the communication in nursing profession as an on-going process of keeping a good therapeutic relationship with patients, and maintaining consistency and steadiness between professionals for a quicker recovery and quality healthcare delivery. To achieve better understanding of the importance of communication in nursing profession, this essay will focus on the report of the experiences and interactions with service users during a placement in two organisations in which alphabets X and Y will be used to denote the names of the patients as a good practice to protect their confidentiality as Nursing and Midwifery Council, 2015.
However, for a nurse to deliver a successful communication, it must be patient-centred McCabe and Timmins, 2006, thus this practice shows that we put the patient at the heart of their care by involving them in their care planning through communication process. By doing so, it creats a kind of trust relationship between the nurse and their patient leading to patient confident and empowerment which allows them to discuss their emotional and physical needs with their nurses because they feel more valued and relaxed with them Bensing, 1991.
This essay will look at the important of communication in general, as well as how vital communication is in nursing, at the same time to analysis a reflective account on my interaction with two different patients during my placement as a student. Part of this reflective account will be centred on what I did not do well that I needed to do improve on that will enable me to do things differently next time to deliver a quality of care to the patients. The essay will also stress on what I did well and why did I do it well. To maintain the patient’s confidentiality according to the Nursing and Midwifery Council 2008, the names of the patients have changed.

In nursing practice, there are many barriers that can delay the effectiveness of the communication during the process but if these barriers can be addressed, then, effective communication between nurse and the patient will be achieved according to Altman, 2009. Meanwhile, Peate 2012, embraced Egan 2009 five basic actions that involves the active listening during the so call communication. They are, sitting straight, leaning forward, open posture, maintaining eyes contact and relax with no stress.

It was during my placement as a student in one learning disability institution, after the hand-over in the morning, I was asked to assist Patient X with her personal hygiene. Patient X is a young lady with Autism Spectrum Disorder ASD Disorder and Down syndrome disease who required to be attended to for her personal hygiene in the morning. However, it was reported that she refused previous day. Having entered patient X bedroom, I could see that she was awake, laid in bed soaked and wetted, though she appeared to be happy, singing and clapping.
It was difficult to gain her attention at first, but later we started conversation, and I eventually managed to assist her to the bathroom and ensure her personal care was attended to. Though patient X is self-dependent but requires to prompt her in accomplishes all activities meanwhile I was outside the bathroom area continuing conversation with her not only to respect her dignity Milika and Lesley, 2011 but to remind her of her activities plan of the day, things she love most, various aspect of her life were conversed and sorting out her clothing.
REFLECTION:
Cognitive empathy was shown to patient x through provision of supportive interpersonal communication after better understanding of her distressed condition William J Reynolds, 2000. This resulted to linear relationship between myself and patient x which resulted to positive response of patient x’s feeling through active and continuous conversation during the process of conducting and ensuring her personal hygiene are met Mohammadreza Hojat, 2016.
In addition, I was emotionally moved with patient x physical condition, she was in bed rested in a pool of urine. I felt she need help and I put myself in the same as her in order to give her all she need as described by Rushton, 1981 in his definition of emotional empathy.
I could not leave vulnerable patient x soaked and wet alone in a pool of urine, as part of the qualities of what is meant to be a good nurse, compassion was shown to patient x using communication skill to engaged her with words of understanding, encouragement, kindness and passion to ensure she receives quality healthcare as stressed by Alistair Hewison and Yvonne Sawbridge, 2016
Patient x was a self- dependent to some extent while she also need prompt to do certain activities. However, having met patient x soaked and wetted in bed, I thought that, it would be wrong to judge her action. I therefore embraced the genuineness of her condition with unconditional positive regard Sheila L. Videbeck 2010.
In order to promote self-esteem, natural inclination to self-actualisation involve three core conditions to communication argued by Carl Roger 1951 include empathy, unconditional positive regard and congruence Carl Roger, 1951. Empathy is about the understanding of the patient’s feeling, thought and their condition by the nurse in order to respond to their needs. Unconditional positive regard is when nurses are admitting the condition without prejudice, accepting their patient with their situation, no matter what or who they are. This will allow the patient to trust their carer or nurses and feel comfortable to express their feeling and thought with respect. While congruence is the display of genuineness, unpretentious and sincerity of intention and action without showing authority over their patients. Therefore, through good communication skill, nurses can create a peaceful environment whereby the patient can feel safe, cared for and feel respected Lisa Kennedy Sheldon, 2009
The quality of communication is when information or messages are communicated and comprehend by the receiver. Listening attentively is not only the features of good quality of communication but active listening that is demonstrating total commitment by given another person absolute and complete attention either verbal or non-verbal communication Catherine McCabe, Fiona Timmins, 2013
Communication skill through active listening really useful when I was trying to access patient x and deliver good quality care. She felt valued when she realised that I paid total commitment to her, respected her thought, and listened to her with openness as a means of achieving good quality communication argued by Perry, 1996. Furthermore, I could see positive reflection in patient x when see realised that my mouth and mind are silent when she was communicating with me. This gave patient x time to think and talk while it also gave me as a nurse to respond to her need in a person centre way gibbon, 1993

IMPORTANCE OF GOOD COMMUNICATION SKILL
COMMUNICATION: With in twinkling of eye, patient can reveal most important part of their life to the nurse for assessment purpose due to the communication skill on the part of the nurse. Through good communication skill, nurses can create a peaceful environment whereby the patient can feel safe, cared for and feel respected Lisa Kennedy Sheldon, 2009
References:
1. Communication Skills for Nursing Practice Catherine ; Fiona, 2013
2. Mohammadreza Hojat, 2016, – Empathy in Health Professions Education and Patient Care
3. William J Reynolds, 2000 – The Measurement and Development of Empathy in Nursing
4. Alistair Hewison, Yvonne Sawbridge, 2016 Compassion in Nursing: Theory, Evidence and Practice
5. Sheila L. Videbeck 2010- Psychiatric-mental Health Nursing
6. Catherine McCabe, Fiona Timmins 2013 – Communication Skills for Nursing Practice

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