The Nursing Associate's Handbook of Clinical Skills

Identification phase: This is when the nursing associate and patient begin to work collaboratively to enable the patient to become an active recipient of treatment. The nursing associate uses knowledge, skills, attitudes and values while consistently providing compassionate, non‐judgemental care and empathy. This is an important stage during which the power shifts from the nursing associate to the patient as the patient becomes more independent. The nursing associate uses their communication skills as an educator and a leader to enable better patient outcomes.

Exploitation phase: The patient maximises wider opportunities, exploiting the nurse‐patient relationship to address treatment goals. The patient feels like an integral part of the relationship and may make requests to the nursing associate to gain a greater understanding of their own health and social care needs.

Resolution phase: As a product of effective communication, patient issues are resolved, and they become independent. The patient no longer relies on the nursing associate’s support, and the relationship ends. The skills here are for the nursing associate to enhance the patient’s ability to become more self‐reliant in leading a productive and healthier life (Fawcett 2010).

Excellent communication skills are critical in the development of effective relationships with patients, their carers and families and when working with other health and social care professionals. While it is important for nursing associates to develop the underpinning knowledge that governs communication experiences, it is equally necessary for them to develop the skills and behaviours that are prerequisite to effective communication. Chapter 2highlights key approaches and identifies common barriers to effective communication.

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3 Burgener, M. (2017) Enhancing communication to improve patient safety and to increase patient satisfaction, Health Care Management, 36(3): 238–243. doi: 10.1097/HCM.0000000000000165.

4 Bylund, C.L., Peterson, E.B. & Cameron, K.A. (2012) A practitioner’s guide to interpersonal communication theory: an overview and exploration of selected theories, Patient Education and Counseling, 87(3): 261–267. doi: 10.1016/j.pec.2011.10.006.

5 Department of Health. (2012) Compassion in practice. [online] Available: https://www.england.nhs.uk/wp‐content/uploads/2012/12/compassion‐in‐practice.pdf. Accessed 6 September 2020.

6 Fawcett, J. (2010) Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed), Philadelphia: F.A. Davies.

7 Francis, R. (2013) Report of the Mid Staffordshire NHS foundation trust public inquiry, London: The Stationery Office.

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10 Keers, R.N., Williams, S.D., Cooke, J. & Ashcroft, D.M. (2013) Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence, Drug Safety, 36(110): 1045–1067. doi: 10.1007/s40264‐013‐0090‐2.

11 Khamisa, N., Oldenburg, B., Peltzer, K. & Ilic, D. (2015) Work related stress, burnout, job satisfaction and general health of nurses, International Journal of Environmental Research and Public Health, 12(1): 652–666. doi: 10.3390/ijerph120100652.

12 Kiernan, E. (2015) Communication theory and its application in nursing and healthcare, in Lawrence, J., Perrin, C. & Keirnan, E. (eds.) Building professional nursing communication, Melbourne: Cambridge University Press.

13 NMC. (2018) Standards of proficiency for nursing associates, London: NMC.

14 Parliamentary and Health Service Ombudsman. (2019) Complaints about the NHS in England 201819, Parliamentary and Health Service Ombudsman. [online] Available: https://www.ombudsman.org.uk/publications/complaints‐about‐nhs‐england‐quarter‐4‐2018‐19. Accessed 6 September 2020.

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16 Schramm, W. (1997) The beginnings of communication study in America, Thousand Oaks, CA: Sage.

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18 Sibiya, M.N. (2018) Effective communication in nursing, London: Intechopen.

19 World Health Organization. (2009) Human factors in patient safety: review of topics and tools, Geneva: World health Organization.

20 World Health Organization. (2016) Medication errors: technical series on safer primary care, Geneva: World Health Organization.

Janine Archer1 and Joanne Greenwood2

1University of Salford, UK

2Oldham Care Organisation District Nurses, Northern Care Alliance, UK

To equip the reader with the knowledge, skills and behaviours to communicate effectively and overcome obstacles to effective communication

By the end of this chapter, the reader will be able to:

Describe a range of communication techniques

Describe common barriers to effective communication and consider the role of a nursing associate in overcoming these obstacles

1 The Royal College of Nursing identified three reasons why communication is important. These are:It helps patients feel valued, special and engagedIt helps patients feel alone, desperate and angryIt helps patients feel valued, in control and at ease

2 Richardson (2017) developed a tool to aid healthcare professionals in effective communication, which is:Personal, enhanced and requestedPropose, engage and reflectProper, elaborate and realistic

3 It is good practice for healthcare professionals to prepare prior to any meaningful conversationTrueFalse

4 According to Laswell (1948), when healthcare professionals plan communication encounters, what should they consider?3P’s, 2H’s & 1W4H’s & 2P’s5W’s & 1H6Q’s

5 The four different types of communication are:Verbal, non‐verbal, written and drawnVerbal, non‐verbal, written and observedVerbal, non‐verbal, written and visualVerbal, non‐verbal, written and picture

To be a successful nursing associate, excellent communication skills are required. Effective communication requires the nursing associate to develop and maintain the required knowledge, skills and behaviours that enable them to work effectively with a wide range of people across the lifespan and during times where there are challenges to effective communication. The Nursing and Midwifery Council (NMC) (2018a) Nursing Associate Standards of Proficiency, at the point of registration, require the registered nursing associate to have the underpinning knowledge and communication skills to provide and monitor care. The NMC standards of proficiency also require the nursing associate to communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges.