Introduction This assignment will cover two aspects of nursing that I believe are important components of ensuring high quality patient centred nursing care. The two components that I have decided on are communication and team working, these are two topics that I have seen demonstrated throughout my time in practice over the last 4 weeks. According to Arnold & Boggs (1995) and Balzer-Riley (1996), “communication is a reciprocal process of sending and receiving messages using a mixture of verbal and non-verbal communication skills. However, Sheppard (1993) suggests that, in the nurse, patient relationship, communication involves more than the transmission of information; it also involves transmitting feelings, recognising these feelings and letting the patient know that their feelings have been recognised”.

( McCabe, 2003). “Teamwork in health is defined as two or more people who interact interdependently with a common purpose, working toward measurable goals that benefit from leadership that maintains stability while encouraging honest discussion and problem solving”. (Librarian,1992).  Communication and teamwork are two aspects of nursing which work alongside each other no matter where the nursing care is being carried out whether it be on a ward, nursing home, community or in research. For teamwork to be effective there needs to be dynamic communication for example when one nurse is handing a patient over to another nurse during handover it is vital that all information with regards to the patient is clearly transferred to the other nurses on duty.  For there to be effective communication there needs to be an aspect of teamwork so that the information is being portrayed is done in the correct way. You must ensure that you communicate verbally with the other health care professionals on the multidisciplinary team as well as communicating through patient charts and notes can decrease any conflict which may arise or limit the amount of misinterpretations between health care professionals.

Effective communication within a team can also ensure that one nurse isn’t solely left responsible for one patient or have a large workload which requires more than one professional. Communication and team work are two aspects of nursing that are important to ensure the highest standards of possible nursing care. Within this assignment I will describe these two aspects and how they work together in relation to nursing practice. Communication Good communication does not always have to be verbal, there are many other aspects to communication especially in the nursing industry. The tone of our voice, the attention we give to the patient speaking, the messages we portray through body gestures and movement, as well as the clarity of what we put on paper are all key elements of using good communication. As a student nurse my communication methods may not be to the standard of that of a qualified nurse as they communicate on a daily basis with patients and families and have developed a rapport of what skills, tones and gestures to use while doing this. I have found from my 4 weeks out on placement that working alongside a staff nurse or ward ,amateur allows you to hear how they communicate with different patients depending on their illness and needs. Verbal communication is the main form of communication for nursing staff and students and as a student you must ensure that your verbal communication is accurate, clear, appropriate language use, and of a good pace and tone.

 Research has shows that good communication between nurses and patients provides many benefits. Firstly it allows patients to receive individualised care, it also allows nurses to take time to understand the personal challenges and concerns of their patients and allows them to address any issues their patient  may have. The more focus there is on communication between the patient and the nurse, the more likely there is to be a better patient outcome as the patients who feel like they are receiving all of the nurses attention when they are interacting they may be more likely to disclose their true extent if their feelings and symptoms, the patient may also feel more satisfied with the care they have received if the. Rise provides them with attention. “The power of creative and effective nursing care is strengthened by good communication skills.

Patients share their stories, symptoms, and concerns by talking with us. Both the spoken word and the body language convey information about the patient’s experience.Your words can do so much: put a patient at ease, set up a productive relationship, and carry out interventions. There is no other skill that is used more in nursing than communication.”(school of nursing and midwifery).

 Non verbal communication is another form of communication towards patients, especially if they themselves have communication issues.  Non verbal communication is mostly about body language but other factors such as the clothing a person is wearing, the layout of the room and someone’s appearance can all contribute to the way we non verbally communicate. “Research says our body language communicates most of what others perceive”. (Bethann Siviter, 2013, Page 97) Body language has a range of factors that contribute to non verbal communication. How we position our bodies and where we position our bodies while communicating with the patients sends messages of how intrigued we are in what they have to say.  Facial expression such as frowning or smiling or. Owing our eyebrows can inform patients whether we are interested in what they are saying or if we are confused by what has been said.

  Making eye contact with the patient allows them to feel like they are being listened to and that their feelings are being taking into consideration. If a patient is expressing concern about their condition or about other issues, by us resting a hand on their shoulder allows them to feel reassured about the situation and that the nurse is actually listening to what they have to say. British sign language is another form of non verbal communication that many nurses use when communicating with deaf patients. British sign language allows the patient and nurse to communicate without the patient becoming distressed because they are struggling to hear what the nurse says.

“Research has shown a relationship between non-verbal behaviour and patients’ perceptions of clinicians’ empathy. Montague et al (2013) found that eye contact and social touch a handshake or pat on the back made patients see health professionals as more empathetic. Other studies have also found that moderate, appropriate eye contact boosted patient ratings of rapport (Harrigan et al, 1985). Montague et al (2013) concluded that clinical environments should be designed to facilitate positive non-verbal interactions such as eye contact and social touch”.(nursing times). There are also many barriers in communication in nursing care, language differences is the main barrier.

Miscommunication in the health care sector is becoming a on going issue that can become life threatening. There is a constant rise in the number of migrant patients and foreign qualified staff, this means that there is room for communication errors between healthcare practitioners and patients, if one or both of them are speaking a second language which they are not fluent in. (BMC Health Services). It is important that in a health care setting that the qualified staff understand how to deal with language barriers effectively to reduce an errors that may arise. While on my placement I became aware of a language barrier that was in place between the staff and a patient on the ward, to me I felt there was no attention paid to this problem on the ward as the patient requested to be called a different name which allowed the nurses to bypass this problem. Problems arose when it came to medication administration, as the patient found it difficult to understand what I was asking him to do and didn’t understand what I meant when asked “can you confirm your date of birth?”.

This caused frustration for both me and the patient as I felt incompetent in dealing with a patient who struggled with a language barrier. Language barriers result in poor understanding of diagnosis, treatment, and medication instructions, poor understanding of and compliance with recommendations for treatment and follow-up; a significantly greater likelihood of a serious medical event and lower patient satisfaction. In many hospitals, they now have translators and this can be very useful when it comes to dealing with language barriers, if the patient really struggles with speaking a second language then a translator can make them feel more at ease because the patient can speak to the translator with regards to their symptoms and how they are feeling. This can be beneficial towards the health care staff as it allows them to deal with the ongoing issue and ensure that the patient is on the correct medication to deal with their illness. Having a translator in place ensures equality is shown towards the patient and ensures that the are receiving patient centered care and not being forgotten about when it comes to communicating with in a regular friendly basis.