The assignment is based upon a critical incident that occurred in clinical practice. Dimond (2008) believes critical incidents allow nurses to explore and reflect on situations in clinical practice which are good or bad, which will help them to learn and recognise what, could have been done differently. Benner (1984) argues that nurses cannot increase or develop their knowledge to its full potential unless they examine their own practice. Using Driscoll’s (2000) model of reflection the main focus of this assignment is to discuss the communication skills used in the critical incident. This will include; definition of communication, the use of non-verbal and verbal communication skills, the barriers that affected communication with the patient and how these were overcome to return the patients autonomy. Driscoll’s (2000) identifies three processes when a nurse reflects on practice. They are: ‘What’ (returning to the situation), ‘So What’ (understanding the context) and ‘Now What’ (modifying future outcomes). By applying Driscoll’s model of reflection it will enable me to link theory to practice. The Nursing and Midwifery Council (NMC, 2004), outlines the importance of reflection for nurses stating that it will enable nurses to learn and develop from their experiences in-order to be able to provide patients with necessary quality of care (Taylor, 2006). This reflective account will highlight the knowledge and understanding I have gained and how I intend to continuously improve my communication skills for future practice. As outlined in NMC Code of Conduct the patient’s real name will not be used to maintain his confidentiality (NMC, 2008).
Communication is about the reciprocal process in which messages are sent and received between two or more people (Charlton et al, 2008). The NMC stipulates that the communication skills of nurses must always be safe, effective, compassionate and respectful. They must communicate effectively using a wide range of strategies and interventions and make reasonable to ensure patients and their families experience effective communication (NMC, 2010, p24). Meddings and Haith-Cooper (2008) identified effective communication as being key to a successful relationship between patient and nurse. When a patient’s illness compromises this communication, this can leave the patient feeling anxious; unable to understand what is being said to them, or unable to express their needs and circumstances. The following incident identifies measures used to effective communicate to a patient.
Mr. Brown a 70 year old man was admitted to the adult rehabilitation ward following a severe stroke which left him paralysed on his right side. Due to the stroke Mr. Brown had dysphasia (difficulty swallowing) and had difficulty speaking (aphasia of speech). Mr. Brown was completely dependent on nursing staff to help him with all activities of living (AL). I had been informed in handover that Mr Brown had not slept very well and was occasional aggressive with the night staff. I first approached and introduced myself and asked for his consent to assist him with his AL’s. At that time Mr Brown appeared blank and looked at me without any reaction, so I touch his hand and lowered myself to maintain good eye contact. He made several attempts to produce words but I could not comprehend or understand at the time what he was trying to say.
To respect Mr Brown as an individual (NMC, 2010) I waited for a moment for him to try and communicate to me. After a further attempt to communicate he realised I did not understand and became very frustrated and knocked over his bedside table with had a glass and his breakfast plate on it. A colleague upon hearing the commotion came into the room to offer assistance. I explained what had happened because it was necessary for me to develop a rapport with Mr Brown so that he could trust me. My colleague informed me that Mr Brown had a book on his bedside locker which had pictures...
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