Within nursing, there are aset of guidelines regulated by The Nursing and Midwifery Council (NMC), inwhich all professionals should adhere to and work within. For the purpose ofthis assignment, two topics will be explored which are thought to be paramount toNursing and that are in line with ‘The Code’ by providing safe, effective carewhilst prioritising people and promoting professionalism and trust (NMC, 2015).The topics chosen for this report are Communication and Nursing Practice andDecision Making. The work will explain and analyse these topics taking knowledgeand understanding from experience on placements. During placement, it became apparent that these two topics were fundamentalsin the day-to-day running of services and what have been noticed to bring themost challenges. Throughout thisassignment, it will focus on the importance of effective communication withinthe healthcare setting.

When might communication not be successful and how canthis be overcome? It will be discussed how important it is for patients toremain 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 whythis may not always be an easy task.  As per protocol, anyinformation shared within this writing will be vague as to not disclosepersonal information of the patient or service user. According to The NMC “as anurse or midwife, you owe a duty of confidentiality to all those who arereceiving care. This includes making sure that they are informed about theircare and that information about them is shared appropriately” (2015, p6). Inkeeping with this, it is understood that all placement names and locationsshall remain confidential and any names used within this work will be changed.    Communication Effective communication innursing is essential to excellent quality care and a fundamental in a goodrunning of care services.

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“Communication means to transmit information, ideasor feelings. This transmission may be achieved verbally, non-verbally,visually, and in the written form, and each one of these transmissions may beused singularly or collaboratively” (Talbot et al, 2011, p57). To communicatewith others can be a complex process and there are various ways in which thiscan be done. Ultimately, the main goal is for what one wishes to becommunicated, is done so successfully. To explore more about this, Talbot et alexplain 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 thecommunication is, it would be easily managed.

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

Further from the experience shared fromplacement, communicating to have influenceis a common purpose for nurses and health care staff. Many times staff willhave 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 clearexample of when the purpose is to inform,where staff are informing each other of the essential aspects of the day butalso looking to find out informationtoo. Handover is a time for the nurses to transfer all accountability and responsibilityonto 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 ofthe most perilous procedures in medicine, and when carried out improperly canbe a major contributory factor to subsequent error and harm to patients”. Thus,highlighting the importance of effective communication. Within the NMC’s Code itstates that in order to practice effectively, one must communicate clearly(NMC, 2015). When communicating using language it is imperative that we “useterms that people in your care, colleagues and the public can understand andtake reasonable steps to meet people’s language and communication needs” (NMC,2015, p7). An example here would be to not use abbreviations for medical wordsto those that do not recognise their meaning, to ensure a full understanding. Thereare also barriers with language where some patients may not speak English andmay not have access to an interpreter.

This is another example where non-verbalindicators have a huge impact in nursing practice.  Sometimes more can beexpressed non-verbally, through facial expressions and body language than thewords a patient uses. To give a definition to non-verbal communication, it isdescribed by Fearns, D and Peate, I (2006) as any use of communication thatdoes not involve speech, but most often referred to as, body language.

Whenconsidering forms of non-verbal communication, there are several skills thatneed to be established