Within nursing, there are a
set of guidelines regulated by The Nursing and Midwifery Council (NMC), in
which all professionals should adhere to and work within. For the purpose of
this assignment, two topics will be explored which are thought to be paramount to
Nursing and that are in line with ‘The Code’ by providing safe, effective care
whilst prioritising people and promoting professionalism and trust (NMC, 2015).
The topics chosen for this report are Communication and Nursing Practice and
Decision Making. The work will explain and analyse these topics taking knowledge
and understanding from experience on placements.


During placement, it became apparent that these two topics were fundamentals
in the day-to-day running of services and what have been noticed to bring the
most challenges. Throughout this
assignment, it will focus on the importance of effective communication within
the healthcare setting. When might communication not be successful and how can
this be overcome? It will be discussed how important it is for patients to
remain as independent as possible and how nurses have a great impact on this.
It will explore how and when some decisions may be made for a patient and why
this may not always be an easy task.

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As per protocol, any
information shared within this writing will be vague as to not disclose
personal information of the patient or service user. According to The NMC “as a
nurse or midwife, you owe a duty of confidentiality to all those who are
receiving care. This includes making sure that they are informed about their
care and that information about them is shared appropriately” (2015, p6). In
keeping with this, it is understood that all placement names and locations
shall remain confidential and any names used within this work will be changed.





Effective communication in
nursing is essential to excellent quality care and a fundamental in a good
running of care services. “Communication means to transmit information, ideas
or feelings. This transmission may be achieved verbally, non-verbally,
visually, and in the written form, and each one of these transmissions may be
used singularly or collaboratively” (Talbot et al, 2011, p57). To communicate
with others can be a complex process and there are various ways in which this
can be done. Ultimately, the main goal is for what one wishes to be
communicated, is done so successfully.

To explore more about this, Talbot et al
explain how “there are seven common purposes for communicating – to interact,
to inform, to find out, to influence, to regulate, to entertain, and to record”
(2011, p57). Perhaps if it were to be recognised what the purpose for the
communication is, it would be easily managed.

When the purpose of communicating is to interact, one must consider what they
are trying to say, how they are going to approach it and how it might make the
other person feel. These interactions in practice can be a small friendly conversation
with the patient or family members or chatting between staff. By interacting
with patients, nurses are able to build up a relationship with them, getting an
idea of their personality and their norms. However, sometimes interacting with
patients can become difficult for various reasons; if the patient is distressed
and agitated they may become aggressive. As it was witnessed on a clinical
placement where a patient with alcoholism decided they wanted to leave the ward
in the middle of the night, the nurses and other ward staff used their skills
and knowledge of the patient to calm them down and persuade them it was a
better idea to say. After this experience, I reflected on what I had witnessed
and how I would approach a similar situation in the future should this ever
happen. I noted the tone in which they used to calm the patient and how they
discussed what the options were. This was interesting to see, as it ultimately
became about the patient making the right decision for themselves.

Further from the experience shared from
placement, communicating to have influence
is a common purpose for nurses and health care staff. Many times staff will
have to encourage a patient with personal care or to continue to eat and drink.
The power of reassuring words is evident here.

The practise of bedside handover is a clear
example of when the purpose is to inform,
where staff are informing each other of the essential aspects of the day but
also looking to find out information
too. Handover is a time for the nurses to transfer all accountability and responsibility
onto the next team for the duration of their shift. According to the Lilleyman
(2004, cited in Department of Health, 2015, p.7) “handover of care is one of
the most perilous procedures in medicine, and when carried out improperly can
be a major contributory factor to subsequent error and harm to patients”. Thus,
highlighting the importance of effective communication.

Within the NMC’s Code it
states that in order to practice effectively, one must communicate clearly
(NMC, 2015). When communicating using language it is imperative that we “use
terms that people in your care, colleagues and the public can understand and
take reasonable steps to meet people’s language and communication needs” (NMC,
2015, p7). An example here would be to not use abbreviations for medical words
to those that do not recognise their meaning, to ensure a full understanding. There
are also barriers with language where some patients may not speak English and
may not have access to an interpreter. This is another example where non-verbal
indicators have a huge impact in nursing practice.


Sometimes more can be
expressed non-verbally, through facial expressions and body language than the
words a patient uses. To give a definition to non-verbal communication, it is
described by Fearns, D and Peate, I (2006) as any use of communication that
does not involve speech, but most often referred to as, body language. When
considering forms of non-verbal communication, there are several skills that
need to be established