Effective Communication and Barriers That May Prevent Effective Communication Within the Perioperative Setting

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A new holistic emphasis on the philosophy underpinning the role of peri-opereative practitioner has emerged in recent times and Department of Health (DOH) initiatives such as The NHS Plan (DOH 2000 p.1 – 9) (appendix a) and Essence of Care (DOH 2001, p 1 - 201) places the patient’s needs firmly in the centre of care provision. In meeting the holistic and individual needs of patients it is essential that excellent communication exist between patient, theatre colleagues and other departments (Plowes 1999, p217). This is especially true within the perioperative setting due to the relatively short time that practitioners interact with patients during perioperative care (Dyke 2000, p.74).

The ability to communicate effectively with others is fundamental to all patient care and it is widely considered that effective communication is a significant determinant of patient compliance, satisfaction and recovery (Faulkner 1998, p.1). It is not surprising therefore, that the Royal College of Surgeons rank the skill of effective communication equally with technical competence within the theatre environment (Mansfield, Collins, Phillips, Ridley & Smith 2002, p.1 – 50) (appendix b).

The skills involved in providing effective communication are vast and varied, however, due to the word constraint of this essay it has not be possible to explore every aspect of communication. Therefore, only aspects deemed by the author, to be relevant to clinical practice are discussed.

There are various modes of communication, verbal, non verbal and written (Dyke 2000, p.67). Verbal communication, described as the “What” of communication, concerns the words we use to explain our feelings, ideas and emotions and integral within verbal communication is the process of effective or active listening (Ralston 1998, p8 -11).

Non verbal communication, described as the “How” of communication, relates to how we speak both unconsciously and consciously (Ralston 1998, p8 -11) and includes natural distances; proxemics, kinesics, body language facial expressions, posture, eye contact and touch (Hayes 1994, p516 -518).

Written communication can take various forms such as; policy documents, patient care plans, prescription charts, letters, memos, emails and other Information Technology (Plowes 1999, p217).

Communication is the art of imparting a message, idea or information between two or more people (Stanton 2003, p10) and is a two way process of transferring information from a source (sender) to a destination (receiver) without the information becoming scrambled on its way so that the exact meaning is understood (Bradley & Edinberg 1990, p.48). Therefore, communication is the reciprocal process of sharing information that involves a message being communicated and, with the exception of written communication, the message may be on a verbal or non-verbal level, however it is usual for the message to be communicated simultaneously on both levels (Hayes 1994, p551 - 553).

A failure to ensure effective communication may adversely affect clinical practice due to increased staff frustration and subsequently causes undue anxiety and apprehension to the patient. Pincock (2004, p 10) maintains that poor communication by health service staff is a significant cause of complaints brought against the NHS and clearly shows the importance of achieving effective communication at all times.

It is suggested that being in hospital for any surgical procedure always causes concern and anxiety to patients (Oliver 1999, p.460 - 462 & James 2000, p 472). This in turn produces an imbalance in the body’s natural homeostasis that results in an increased cardiac workload and immune system suppression (Gross 1996, p266 - 277), all of which are detrimental to postoperative recovery. Using effective communication skills ensures that patient anxieties are minimised and increases the ability of practitioners to meet the individual needs of patients, in...
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