Video recordings spotlight poor communication between nurses and doctors
social networking sites, video sites, online Any patient information learned by the nurse during the damages the nurse/patient relationship and the general. The topic of patient advocacy is very close to my heart, so when I was more layers than ever are in place eroding the doctor-patient relationship. . Whether a doctor, nurse, clerk or phlebotomist, one employee might be .. Your browser does not currently recognize any of the video formats available. A doctor's orders will always trump a nurse's, but doctors can't do their jobs well if they across one that deals with the topic of the relationship between doctors and nurses. The nurse, who cares for the patient 8 hours of every day, might feel and coding, take a look at this informative YouTube video from CareerStep .
Be prepared to repeat yourself and express concepts in different ways so that your patient can grasp what you are trying to say. One of the most important parts of helping your elderly patients is acting as a kind of interpreter for the doctor.
Try to be on hand when the doctor talks to the patient so you can explain later what they said. They will wait and ask you later to get a better understanding. Although she is forgetful, she is still able to live a relatively independent life. She experienced an episode of fainting that was witnessed by several people at church, and she was taken to her primary care physician.
It took a great deal of talking to her to help her understand that the fainting spell was, in fact, a major problem that needed to be investigated.
In addition to restricting her driving privileges, Carolyn needed several tests to rule out different probable causes of her fainting spell.
Each test needed to be carefully explained to Carolyn and the information repeated so that she could grasp what each one required. She wrote down all the key information in a system that she had developed to keep herself from forgetting important points. It takes careful reminding to keep her from driving her car or performing other actions that may put her in danger. Include Family in the Conversation Finally, including family is a big part of communicating with older people.
You should always try to keep your older patient in the conversation, although not much of it may be understood. Often children, spouses and family friends can help the older person understand what is needed from them.
Three examples of nurse-patient interaction research | Noldus
Family and friends can help you to communicate with an older patient because they know how that person thinks. It may help to have a three-way conversation between the patient, their caregiver, and yourself. When everyone works together to help the patient understand, you stand a much better chance of putting him or her at ease with all that is happening around them. Not only are you trying to explain a difficult situation to a child, but you are trying to include the parents in the conversation as well.
It is natural for a child to be scared, unreasonable and resistant to medical treatment, and it takes a skilled nurse to work through these roadblocks to achieve understanding. As with most communication, listening and allowing the patient to be heard will serve you well in talking to children. Communicating with Children When talking to children you want to avoid medical jargon. For very young children, you have to use words that are as simple as possible. Even then, you may not get them to understand because their fear response is overriding everything else.
However, you have to use care when talking to older children. You have to make a mental note of the age of the patient and their level of understanding, and tailor your speech to meet their needs.
You need to moderate your language, get down on the level of the child, and use a soft tone of voice. Sometimes, though, you need to do something that will cause them discomfort, and you must explain this with honesty and using straightforward language.
Talking to Parents Part of communicating with children is communicating with their parents. Again, you are likely to be dealing with someone who is in a great deal of distress and fear.
It is helpful to try to allay their fears, answering all their questions as honestly as possible. Some parents may get emotional and you need to be aware of possible outbursts of anger or sorrow.
Either of these can upset your patient and that can go against what you are trying to accomplish. Try talking to parents away from the child and use active listening techniques, as you would for any other patient, family and relatives.
Case Study Daniel was a two-year-old heart patient who was preparing for his second open-heart surgery. Already, starting the IV line had been a traumatic event. Then one of the nurses from the OR came into the room the night before the operation with a bag of items. She got down on her knees with Daniel and showed him the hairnet he would wear, the tubes that would come out of him, and the mask that would be placed over his face.
Instead of being afraid, Daniel was fascinated with the new toys in front of him and played with them all.
Communication Skills for Nurses
During this time, the nurse took the time to talk to the parents about their concerns. She helped them to understand what would happen, explaining the procedure, the heart-lung machine, and the estimated time of the surgery. When the nurse prepared to leave after half an hour of talking, both Daniel and his parents were much more at ease. Although all of them were still afraid of the surgery, it helped to know a little bit about what would happen so not everything would come as a shock.
Click To Tweet Including the Child Finally, it is important to include the child when talking about procedures or their health.
It is so much easier to talk to the parents that you may have a tendency to ignore the child. Children are very sensitive to this, and they do not appreciate being ignored. You should address the child at the beginning of your explanation and try to focus your talk on them and their needs. At the end, you should also ask the child if he or she has any questions. They may not, but it helps them to feel included if you treat them like more than just a parcel to be taken here and there.
Talk to the child as much as possible, and then take the parents out of the room for more adult conversation, if needed. It is challenging and often awkward to face the person. You might be too professional and distant, or you may go the other way, and be more emotional and connected than you should be.
Remember, you have a roster of patients, and the wear and tear from becoming too emotionally involved can lead to burnout. How do you successfully balance all of the emotional roadblocks that can arise when dealing with a patient who has a poor prognosis? It is important for you to be mentally healthy when working as a nurse, but especially when working with a population of patients who are in the process of dying.
This means taking care of yourself and having ways to de-stress and unwind. When you go home you need to leave the sadness and emotion of the job at work. If you take it home you could end up becoming a victim of compassion fatigue—a syndrome that can lead to anger, depression, substance abuse, and other problems. Communicating with dying patients is difficult and taking care of yourself emotionally should always come first. Most people who are dying are aware of what is happening.
However, if you enter the room tongue tied and sad the patient could feel as if you pity them. Neither of these approaches will make your patient feel supported through this difficult time.
Instead, you should approach the patient with neutrality. You are an open, loving caregiver. You tend to their needs and answer their questions with honesty. It can be challenging to be open. When a patient asks a difficult question you may be tempted to pass the buck to other caregivers or to gloss over it. However, your patients have the right to know what their condition is. That is part of ethical nursing. Your patient may also need to open up to someone and trusts you because you are their nurse.
Although it may be difficult, always tell your patient the truth when they ask questions. Being Present Sometimes, in this situation the best communication is not saying anything at all. This is not always easy; one part of you may want to draw the person out to explore their feelings while another part of you would just like the distraction of talking to avoid awkwardness. Neither of these approaches is helpful to a dying person. You just need to be present. In some cases, silence is more helpful than talking.
Maybe your patient has been talked to so much that the quiet helps to finally give them a chance to talk. They could also be tired of talking because everyone wants to know everything about what they are feeling. Helping Families Families of dying patients are also suffering, and it can be challenging to communicate with them as well.
Honesty is always the best course of action to take with families. They will know you are hiding the truth and may resent you for telling them something false. One of the best ways to talk to families is through active listening.
Since these people may be highly emotional they have the need to be heard as much as the patient.
Evolution of Nurse/Doctor Relationships
Active listening means that you reflect back to the person what they are communicating to you. Can you tell me more about that?
Is that what you are trying to say? This can help with any emotional situation from anger to sorrow to apathy. Nurses teach and help patients communicate their needs, but something about silence is therapeutic too. Once again, openness and the willingness to be with the patient will either help them to talk or give them a much-needed rest. That is the best therapeutic gift you can give your patient.
Chances are, this strategy of communicating with doctors is not going to get you far. You have a very busy, often impatient, person listening to you. You have to make the most of your time, and the best way to do that is with organisation.
It stands for identify, situation, background, assessment, and recommendation. Merely having this structure in your head when picking up that phone to the doctor can make the call flow a bit more smoothly. The doctor on the other end will get a clear picture, you will get all of your information out concisely, and the patient will get the treatment they need.
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Identification First, identify who you are, your role and who you are talking about your patient or client. Situation The situation part of ISBAR seems self-explanatory, but it can often throw you off when dealing with a patient you are not sure about or just have a bad feeling about. It gets a little more difficult to state the situation when the patient is not presenting something black and white, so you should take some time to think about what is prompting your call to the doctor.
What exactly is it that is bothering you? What do you think the doctor can do for you? In this section of the report, state concisely whom you are calling about and what prompted the call. Background The background section of this approach has the most variability built into it. However, if the patient has been going to this doctor for 30 years, you probably wont need to give as much background.
The timeline leading up to the situation is important. What was the patient doing earlier in the day that may have an impact on the current situation? Did they have some incident or event that has some bearing on how they are acting now? Assessment All doctors will ask for them, regardless of the reason you are calling. Pathology, recent test data and any other collected information from the history can also be given at this time.
Included in this section is other data that may not fit anywhere else. You can insert how the patient looks to you personally.
Do not be afraid to let the doctor know where your concerns lie. If you do not express that your patient is worrying you, then the doctor will not know enough to be worried themselves. They are basing all of their decisions on what you are telling them.
Trust yourself and your assessment skills, and tell the doctor what you see. Recommendation Recommending a solution to a problem might feel a bit awkward to a nurse, especially newer ones, but doctors are often open to collaboration and do not mind working in tandem with a nurse.
However, you do not want to be demanding. Often phrasing your thoughts as a question can be a great way of asking for something you think might help your patient. This allows the doctor to understand your line of thinking and opens the lines of communication between the two of you.
If they agree, you got what you wanted.
It makes all the difference when a doctor introduces themselves properly
If they disagree, they will likely explain why. After all, you know your patient best because you are with them see Communicating with Patients. The doctor knows the medicine. With all of the difficult personalities that go into making up a working medical facility, nurses need to know how to navigate the waters of prickly relationships while remaining professional and retaining their sanity.
What should a nurse do when confronted with a difficult person? It is best to remain calm and cool while dealing with the person carefully. To use an apt metaphor, the skills required are akin to defusing a bomb. If you say the wrong thing, the situation with a difficult person can escalate very quickly. You need to focus on staying professional and being assertiverather than aggressive. This also means enduring personal attacks without losing your cool.
Here are just a few strategies for dealing with difficult people as a nurse. You may feel like the other person is walking all over you, but your calm, professional attitude may just show them how idiotic they are being. Professionalism is required in these situations, but what exactly does it mean? To be a professional means not to forget yourself.
You are a representative of your facility and nursing in general. They try to find ways of amicably solving the problem so that all parties are satisfied. If there is no solution, a professional finds ways to make the difficult person see that there is no other course of action. Be AssertiveNot Aggressive Some nursing schools are now teaching students how to be assertive. Reducing mealtime difficulties may result in better eating, which in turn could lead to better nutrition and healthier patients.
Researcher Andrea Gilmore-Bykovskyi observed the interaction between residents and their caregivers during breakfast or lunchtime with an average of two video observations per resident. Get an extensive view of the software See how you can seamlessly record from multiple rooms at once Experience the easy-of-use yourself Free Demo A good research method for this target group is video observations.
They allow the researcher to note behavior in detail, and review the videos as needed, including from multiple angles. Using video, no behaviors are overlooked by the researcher, as both video and audio signals can be visualized together and can be repeatedly analyzed to capture every desired behavior in great detail. Viso and Media Recorder are tools that allow for video recording in one or multiple rooms. Learn more about the study of Andrea Gilmore-Bykovskyi by reading the full blog post.
Is a patient more likely to receive, understand, and process certain messages at the beginning, or at the end of an intervention program?
To find out how this communication process works, Janneke Noordman and colleagues analyzed a large number of practicing nurse-patient consultations. To assess nurse behavior, they positioned a camera in the consultation room which enabled them to unobtrusively record each interaction.
Read the blog post to find out what kind of behaviors Noordman et al. In one study, Laura Gitlin and colleagues studied the feasibility of implementing a tailored activity program in hospitals. They observed both the reactions of the staff and the patients to the activity program. These activities varied depending on the level of cognitive functioning for the patient.