Introduction - Leading Empowering In Integrated Nursing Practice
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Communication is one of the major important aspects of integrated nursing practices. The daily care functions performed by these nurses for patient care, such as eating, bathing, or monitoring, are mainly based on different verbal and non-verbal communication between the patient and the nurse. Hence, a proper understanding of different communication styles and factors are important for nurses to improve their task effectiveness. On the other hand, communication also plays a major role in assisting other care providers that need to be involved in the treatment plans. The teamwork in multidisciplinary treatment aspects needs to include effective communication strategies for increasing working effectiveness. This study is mainly based on the treatment procedures and the factors affected by effective communication in the case of multidisciplinary approaches to patient care. In cases of dementia, person-based care is essential, as the symptoms and treatment-related difficulties are not similar in every patient. This is highly based on the condition and responses provided by the patient. Based on the previous experience and its analysis, effective development for the communication factors is possible.
Main body
Description of the case study
Communication with patients and team members plays an effective role in the treatment procedure. This study and analysis are based on elderly people suffering from dementia. Personal care for dementia patients is an essential factor for treatment strategies. Elderly patients mostly suffer from different lifestyles and age-related physical issues, such as lack of mobility, digestive issues, etc. In the case of dementia, physical issues are also associated with behavioural problems (van Manen et al. 2021). The major symptoms observed in the patients include memory loss, communication problems, and hand tremors. The lack of coordination is an effective and important symptom that creates hurdles in daily life. The physical activity of the patient is also decreased, which leads to creating difficulty in movement. The patient lives with his wife and son and has been cared by the home members for a long period of time. One of the major complications arrived at by the patient's carers includes a lack of co-operation of the patient with their carer (Backhouse et al. 2020). The patient is reported to refuse the care provided by his home member. On the other hand, the family members of the patient also seemed exhausted and tired from the behavioural problems faced by the patient.
Personal care and safety for the patient are one of the major threats to the patient in this case. Recently he reported having small home accidents due to lack of movement coordination and fell, leads to cutting his hand. The wound was not severe, though certain types of accidents are common and can be severe for certain patients. The patient seems to have lost words and does not intend to communicate with others. In the case of dementia patients, communication is one of the major difficulties that can be observed. This may be effective in creating an impact on the overall functional ability and treatment progress (Shaw Williams & Perkhounkova, 2018). The nursing management for dementia patients is mainly based on the application of care strategies based on the patient and the management of the symptoms and issues that are appeared during personal care for the patient.
Effectiveness of communication styles
Different kinds of communication styles are used in the case of nursing. While the patients care for dementia, a one-on-one-person communication style is an effective kind of communication. The use of different non-verbal communication skills is important in this case, such as observation, active monitoring, presentation and behaviour of the patient, and responses towards different activities. During the patient care factors, I observed that developing trust can be an effective factor in increasing the response factors of the patient. Hence, the process of communication needs to be based on the effective development of a personal connection with one carer only (Blake, Berry & Brown, 2019). This personal connection development is mainly based on effective monitoring for situations in which the patient feels anxious, confused or unsatisfied and maintaining a calm and peaceful environment to decrease their suffering. In addition, identification of patients' needs in regular lifestyle maintenance is also an important task for nurses that help to decrease their suffering and avoid overstimulation.
While planning the nursing care for the patient, I needed to depend on the observation of behavioural factors and expressions of the patient, which are known and non-verbal communication cues. This includes facial expressions, hand and facial gestures, body language and others. There are different kinds of communication styles that can be used by nurses based on the patient's case. This includes assertive type of communication, passive communication and aggressive communication (Wanko Keutchafo, Kerr & Jarvis, 2020). Assertive communication is utilised in cases when patients need to understand the importance of treatment procedures and the severity of the condition. The effectiveness of communication is important for the application of different treatment interventions and integrating them into habits and lifestyles. On the other hand, the overall analysis and understanding of the patient's conditions while making decisions in a team working is a necessary aspect. The nurses are responsible for active observations and utilise different aspects of treatment procedures and disciplines for overcoming the issues. Hence, the nurses are responsible for utilising the assertive communication style for effective decision-making procedures during teamwork.
The passive communication style is used for patients that need to take care of, have grave behaviour and physical conditions and needed o to provide a peaceful environment and avoid excessive stress. Aggressive communication is mainly used for patients who do not show a supportive attitude to treatment procedures and need force for these aspects. Also, the nurses may show certain behaviour while facing challenges to maintaining personal rights, safety and security-related concerns. Among these different communication styles application of the most effective one depends on the different identification factors for patient-related traits (Vera, 2022). The effectiveness of the communication approaches is mandatory for the symptoms and difficulties that care providers approach during the treatment procedures. Hence communication plays a major role in the person-centred treatment approaches. The effectiveness of the treatment procedures applied for this case is important. On the other hand, the evidence for the treatment interventions includes the information and observation of patients' responses and behaviour that are observed by caregivers, nurses and other care providers (Galatzan & Carrington, 2019). The evidence can be effective in analysing the current state of patients and their effectiveness in the overall analysis and understanding of the patient situation. The intervention can also be effective through active communication between the nurses and patient as personal connections are developed, and trustful approaches can be observed among them. The trust-based relationship increases the effectiveness of the therapy and other intervention procedures.
Evaluation- Personal communication style evaluation
Dementia can be observed as a progressive illness that impacts a person's cognitive abilities and results in a declination of reasoning and communication skills. As per the increasing consequence of this disease, it is estimated that dementia would increase at an exponential rate. It is expected that the prevalence of this disease would rise to 78 million in 2030 and 139 million in 2050 (Who.int, 2021). Dementia is known to have chronic nature, and it has psychological, physical, economic, and social impacts. As per the knowledge gained from my experience, I can say that dementia not only affects the individual suffering from it but also impacts society, family, and the carers in contact with the patient (Adeani, Febriani & Syafryadin, 2020). For the patient I have been providing care for, I noticed that the family members neglect the person's opinion and get frustrated with him sometimes. The reason behind this is impairment in the person's cognitive functions and thinking capabilities. Moreover, everyone in society tends to avoid the patient. This has resulted in increased loneliness of the patient. However, this kind of behaviour should be avoided with the patient, and patience should be maintained with the person.
It has been evaluated that increasing awareness is much required in this context. During my tenure of providing care, I took several strategies that can ease the communication process of the patient and help him to convey his feelings. I provide the patient with simple choices in order to avoid any complicated situations and increased confusion for the patient (Nhs.uk, 2020). As the patient has been admitted due to the accident he met, it was important to maintain patience with the patient because dementia decreases the ability to understand personal situations and participate in the healing process. I encouraged the patient to speak in short sentences and clearly and provided him with adequate time for the response to omit any feeling of pressure from the patient. This has helped in relaxing the patient largely and has also helped me in treating the wound and managing the condition of the patient effectively. I tried to maintain eye contact with the patient each time during the conversation and maintained a positive and friendly tone to ease the patient. I took the help of body language and gestures while communicating because sometimes the patient could not clearly express his feeling, and it made the situation even more complicated. However, hand gestures and rephrasing the questions have helped me a lot in understanding the need of the patient.
It is to be noted that there is an important need to be calm with the patient and avoid shouting activities with the patient. This can leads to worsening the situation even more. However, the strategies I adopted by me have helped me maintain friendly contact with the patient (Nibbelink & Brewer, 2018). Providing the patient with sufficient time to express his feelings has helped in avoiding aggression the patient. Moreover, the use of hand gestures has increased his capability of expression, and this helped me in providing better care by accomplishing the needs of the patient. Moreover, the undertaken strategies also helped the team to provide integrated care to the patient, heal the wounds, and manage the condition of the patient.
Analysis - A critical analysis of theories and evidence-based literature
It has been observed that the greater integration of health and social care services holds an important place in ensuring sustainable and long-term care is provided to dementia patients. Considering the growing population of dementia patients, it is important to provide quality and long-term care to the patient and help the families as well as patients to cope with the patient. I have observed that communication difficulties are the prime consideration of dementia patients. In this regard “Contac-d model” can be used to determine the process of effective communication with a dementia patient. This model provides factors to be involved in the communication process between staff and dementia patients (van Manen et al. 2021). Communication is an ongoing interplay and it is important to establish a relationship with the patient. However, with dementia patients, it might be challenging to establish effective communication. The use of this model has helped me understand potential targets and maintain verbal communication skills with my patient (Jennings et al. 2020). From my experience, I can sum up that the inclusion of integrated care services in dementia care can provide the utmost benefits. I have observed that the family of my patient was greatly affected due to this disease, and taking an integrated team approach has helped in supporting the family., Not only this, but it has also helped in providing the best, and the required treatment to the patient and ensuring all his needs have been met.
A “person-centred approach” has also helped me in enhancing my care. It has helped me in addressing the gaps present in recent care delivery and improving the care practices as well as the workplace culture. It has helped me as well as the team including in delivering care to the patient to understand the psychological and emotional needs of the patient (Aasmul et al. 2018). Considering the age of the patients, these factors hold the utmost importance. Collaborative interactions are known to exhibit a combination of professional cultures, and this is achieved by sharing knowledge and skills in order to upgrade the quality of care being provided to the patient (Mohr et al. 2022). While working in an inter-professional team, in order to provide the required care to the patient, it has been ensured that the confidentiality of the information of the patient was maintained by each member of the team. The team ensured that effective and proper treatment of the patient to maintain well being of the patient and without any biasness regardless of any factor.
It has been ensured while working that the values and beliefs of the patient were maintained by me as well as all the members of the team (Piercy et al. 2018). We refrained from disturbing and challenging the ethnicity of the patient. However, dealing with this dementia patient helped me to improve my interpersonal and inter-professional skills. I changed as a person and as a nurse as well. The treatment process has helped me in developing in-depth knowledge and medication. It has helped me in increasing my confidence in assessment and has also helped me to bring empathy to my behaviour. Since dementia, care involves working with the family and relatives and therefore I was able to develop communication skills, and with the help of it, I was better able to provide care while maintaining the dignity of the patient (Scerri, Innes & Scerri, 2020). However, it is to be mentioned that though our team ensured providing quality care to the patient, there was still a lack of collaboration among the team. I was unable to get the timings of the other departments frequently, which created problems while providing care. Moreover, the team also lacked presentation skills and the planning to take the right step at the right time.
Conclusion
I have learned a lot while providing care to this patient and this has improved my knowledge as a nurse. The strategies undertaken have helped me a lot in delivering my care and have helped in improving the condition of the patient. I have been able to calm down the patient and understand as well as fulfil his needs at the right time with the inclusion of appropriate techniques (Lundin & Godskesen, 2021). Though body gestures have helped me in understanding the need of the patient, still there were consequences in which I failed to determine the exact need of the patient. This restricted me from establishing effective collaboration with the team, as I was unable to convey the exact need of the patient. However, if I would have given more time to the patient, I might have been able to handle this situation in a better way. Therefore, I will create an action plan that would help me to overcome my deficiencies as a nurse and would improve my skills to deliver better care in the future.
Key skill development and critical application of theory to practice
Communication skills are considered important for the nurses, as this help to provide the treatment procedure in a certain direction. The treatment procedures are needed to b involved in the overall analysis and understanding of the procedures and patient cases for their graveness. Also, fellow supportiveness from team members, such as specialists and ogre doctors, is important for the procedures (Low et al. 2019). One of the major drawbacks of the care system has been observed in the case of understanding the non-verbal cues for the payti8net and their impact on personal needs. I have tried my best to understand the regular needs of the patient based on his reactions and responses, though I could not understand them fully due to a lack of experience in certain aspects. Hence, I plan to increase my skills, such as reading facial expressions and hand and body gestures, to improve my active listening skill for patient care. The improvement can be made through understanding the deficient behaviour for further understanding and increasing the rate of engagement in the process (Keogh, Robinson & Parnell, 2019). I need to show more mindfulness and consciousness while observing patients.
The lack of observations has also impacted the overall process of decision-making and the effective participation of the team in the treatment plan. This leads to delays in the treatment interventions and active participation of fellow team members (Johnsson et al. 2018). Hence I need to understand the effectiveness of the team working in treatment care for effective collaboration. As I could not understand all the traits and communication cues of the patient, I needed to call for help and support from senior nurses and for their factors. In addition, timing management is mandatory for patient care. Hence, the time maintenance also needs to be improved. I plan to pay more attention to different details in the behaviours and symptoms provided by the patients. Analysis of the short responses along with regular behavioural aspects and attitudes may create more sense. Developing a detailed understanding of patient choices and care is important for the overall factors that are needed to be implemented for treatment procedures. Implementation of the procedures can be effective and necessary for certain dementia patients. Furthermore, all the details are considered to be important factors.
Conclusion
The essay concludes by describing the role of communication in inter-professional working and the ways it is important to deliver better care to the patient with the help of Gibbs's reflective cycle. The essay discusses the case scenario of a dementia patient and describes the series of activities undertaken by me in order to provide effective treatment to the patient. I have described the case scenario in which the patient suffered from dementia and had recently met an accident resulting wound. I have explained the effectiveness of communication styles and the role they play in delivering care to the patient. Communication is an important factor in the development of relationships with patients and in determining their needs. I have evaluated the ways in which the communication style adopted by me has helped me in dealing with this dementia patient. I have further analysed the situation about the way in which I can improve my care delivery and have discussed “person-centred approach” and "Contac-d model."
Reference list
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