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Communication is a way of life and can be considered as a basic need in life. The use of communication is very broad and spreads from one field area to another. In a general view, communication is the process of passing information through thoughts, information, messages, speech, signals, or writing. In the past, communication mostly existed between two living creatures. However, with the advancement in technology and the creation of machines, communication can now happen between a living creature and a machine (Burnard, 2008). Technology has brought about a revolution when it comes to communication making it easier and simple for people to contact each other and convey information. In the history, communication was very tiring process since there were no timely procedures that would enhance communication. The barriers were also many, so communication was difficult compared to these days.
Communication has very many definitions depending on the angle of view of an individual. The definitions for communication include:
1) Any act through which a person receives or gives information from another party concerning their needs, perceptions, desires and knowledge.
2) The act of interchanging thoughts, opinions, expressions or any other information, relevant or irrelevant between one person and another.
The history of communication can be traced back to prehistory era with no certain date of association. The change of communication has been happening over the centuries, and the factors that have caused the changes are both political and economical. Approximately 100,000 years ago, there was a revolutionary breakthrough in human communication, and that was speech. Symbols then were invented about 30,000 years ago while writing is the latest breakthrough in communication, dating 5,000 years ago. The invention of human speech made communication way easier though before it was completely developed it posed a great challenge. However, with human speech the sharing of ideas and inventions became much simpler. Other old age methods of communication include cave paintings, pictograms, alphabet, petroglyphs, ideograms, and writing.
Cave paintings are among the oldest form of communication and are a form of rock art. A pictogram is a representation of information through a symbol that stands for activity, event, object, or place. Petroglyphs were similar to cave paintings and also included carvings being drawn into the rock surface. Ideograms are a graphical representation of an idea: the art was invented after pictograms. The graphical symbols were very rigid, and every symbol could represent a certain significant item to the community. Writing can be divided into three subsections: syllabic, logographic and alphabetic. Writing developed over the centuries, and the writing that was being used in the fourth century cannot be compared to the writing being used in the world today. The countries that can be attributed to come up with the earliest forms of writings are Greece, China and Egypt.
Communication is used in almost every aspect of life and business. No business, school or any other organization can be run without the employees communicating. Communication makes life easy and brings people together, making working simpler and creating a perfect working environment (Sheldon, 2009). Communication is a key factor in all types of careers from engineering, medicine and even business. In healthcare, communication plays a very vital role. First of all, it is a channel of passing information from the patient to a doctor. A patient cannot get treated by a doctor without the doctor first finding out what is the problem. Communication also creates a link between physicians and the other workers in the hospital.
In treating psychological problems, communications are a major contributor to the patient getting better. This is because such patients are usually very fragile and, therefore, talking to them is the easiest way of accessing the impact of the problem and the progress being made by the medication. The communication skills of all workers in a hospital need to be perfect and very flexible (Van, 2009). This is because different patients are handled differently and, therefore, it is necessary to have the ability to choose what communication skill to use on a patient. This understanding makes it easier for physicians and other health workers to understand the patients better and even end up becoming good friends.
Communication plays an important role in ensuring the provision of quality health to patients. Another advantage of using communication in health is diagnosis accuracy. Diagnosis accuracy is referred to as the correct detection of the problem or disease that is disturbing the patient. Good communication skills of the physician make it easier to detect what the patient is suffering from. The benefit is that the patient receives medication for an illness they are suffering against and does not get misdiagnosed. Good communication between the patient and the doctor also makes sure that the patient adheres to the medication awarded to them. Some patients have the notorious habit of failing to listen to the doctor’s instructions.
Communication is only effective in the presence of some three key components. The three key components of communication are the sender, message and the recipient. There also needs to be a medium through which the message is sent and a medium through which the reply will pass through. The recipient of the message does not necessarily have to be present when the message is being sent. The recipient can also receive the message without being aware that the message was being sent. This means that communication can be done over long distances without the people communication not diverging at a central place.
The two communicating parties, however, have to have a common thing that brings them together. A communication process is said to have an end once the recipient receives the message and understands the intention of the sender behind the message (Sully, 2005). The process can, however, continue once a reply is sent back from the former recipient to the former sender. Communication with people also has three different primary steps which are very essential, and they are thought, encoding and decoding. Thought refers to the information that is supposed to be passed from one person to another. Encoding refers to the message or information that is sent to the recipient and can be in words or symbols. Decoding refers to the process of the recipient of the message turning the information received into a similar way making it easier to understand.
Communication can be either verbal or non-verbal communication. Non-verbal communication is very common, and examples include sign language, body language, haptic communication, and eye contact. Non-verbal communication is used to pass secretive information between two or more people especially in a group of people. Non-verbal communication can be used to seal information since, at times; it is very hard for one to understand the message behind the gestures. Sign language is used by the disabled people, and there is a globally accepted sign language with different signs with uniform meanings all over the world (Innis, 2008). However, in most cases verbal communication is preferred to non-verbal communication since it is much easier to understand.
In nursing, both verbal and non verbal communication is imperative. A health worker needs to know when to use verbal and non-verbal communication (Sheldon, 2009). In some scenarios, non-verbal communication is much effective compared to verbal communication. When administering medication or during physical practices as physiotherapy. The gestures the patient’s wear can determine how the patient is feeling. In case the patient is in pain, the facial expression would show the patient frowning. When a patient is experiencing much pain, they may lack the strength to talk and, therefore, non verbal communication works much better.
Devices and gadgets are being used in hospitals that ensure rapid response of health workers when a patient needs them. Unlike a few decades ago, when a patient had to be under the check of the doctor or nurse all the while to ensure that they do not pass away. Nowadays, there are gadgets that the patient can use to alert the doctor or nurse anytime. The devices are very effective since they need the least effort making it easy for any patient to use them. There are also machines that are used to monitor the health of the patient (Webb, 2011). In case the health of the patient goes down, the machine makes a certain sound and alerts the doctor. In case of the patient’s health getting better, it does the same routine. Such machines make it easier to attend to patients and also make the work of the doctor easy. The doctor does not have to run a million tests on a patient while the machine can detect all those changes.
Antecedents refer to the activities or incidents that must take place leading to the occurrence of the concept. Communication in the setting of healthcare has very many antecedents that are responsible. The most obvious reason for communication in a hospital is the fact that the patient is ill and seeks the help of a doctor. Therefore, the patient must open up and talk to the doctor telling him or her, what they are experiencing. In the diagnosis, the doctor must also access the signs and symptoms of the patient then come to a conclusion. The doctor should inform the patient of their problem. This communication is very important since if the patient does not adhere to the rules given by the doctor; they might probably not get well.
The antecedents for communication related to health care may include any reason as to why the patient is seeking healthcare treatment in the first place. Some of the common reasons why patients may seek healthcare are signs and symptoms of an unknown illness persisting, drastic change in health status, random check-ups, immunizations or any concern by a health worker (Burnard, 2008). All health workers need to understand the use of communication in the setting of a hospital. Communication is the key to patients getting better and in a way speeds up the rate at which patients heal. Communication also improves customer service and enhances the relationship between the health worker and the patient.
Communication plays some very vital roles when it comes to the setting of a healthcare facility. First, communication creates a link between workers and the patients, laying a common ground through which these people can talk to each other. The modes of communication are wide, but as long the involved parties understand the message, then there is progress. Communication aids in monitoring of patients, making it easier to determine when the health of an individual is deteriorating or getting better. The lack of good communication skills in a hospital is tragic, and the results may be fatal. A failure in the communication systems, in a health facility, for only a few minutes, can show this.
A good example is a life support machine which communicates the progress of the health of the individual in question (Ellis, 2003). Therefore, if the lights go off for a while and the emergency generator is faulty, what can happen? The most probable outcome would be that the patient under life support would lose their life. This is because the communication channel that was helping the monitoring of his or her health is no longer in place. Such a failure would be tragic since the number or patients on life support in a hospital are very high. It is essential for every healthcare provider or facility to maintain quality communication skills.
Communication also helps in the formation of team work between the employees especially the workers. It aids in rapid response, in case of an emergency situation that needs to be catered for immediately. With the right communication strategies, there is job satisfaction and efficiency. In this way, the patients do not complain of the services they receive and the doctors as well are contended in what they do. Patient management and safety is also better with good communication strategies (Van, 2009). Communication also enhances the mobility of the workers that make them available at the right place at the right time. This reduces the chances of doctors or other health workers paying too much focus on patients who are getting better while there are other who are in a fatal situation.
Model and additional cases
Model case: The case below is a model case of the use of communication in a healthcare setting. The case shows the use of communication skills on the side of the doctor which leaves the patient contented while leaving the hospital.
A 45 year old woman visits the hospital due to the persistence of the symptoms of her illness. The woman has been feeling unwell for the last few days and due to her stubborn nature she had been avoiding a visit to the hospital for a check-up. The woman was sure that she is suffering from flu; therefore, she took medication to visit a hospital. On arrival at the hospital, she met a doctor who had never treated her again since her personal doctor was away on official business. The doctor recorder symptoms of sudden high fever, severe headache, stiff neck, nausea and vomiting which leads to headache, lack of appetite and lack of concentration.
When the patient got in, the doctor said hey with a very relaxed tone and asked the patient to have a seat. The doctor asked the patient to feel at home and took a pen and paper to write the symptoms of the patient. All this while, the doctor, was listening keenly to the patient, and this made the patient feel relaxed. The doctor questioned the patient every time she mentioned a symptom to find out the severance of the symptoms. This was done to find out the effect of the disease on the patient. The doctor also questioned the patient whether she had taken any medication without it being administered by a doctor. The patient admitted taking syrup and some pills meant to treat flu.
At the end of the interview, the doctor closely examined the signs and the symptoms only represented two conditions, flu and meningitis. The doctor asked the patient whether she was experiencing seizures and lack of sleep. These two symptoms separate meningitis and flu and the patient happened to experience the two symptoms. The doctor then told the patient that if she had stayed a little later before reporting to hospital, she could not have survived. Therefore, the doctor calmly talked to the patient concerning her stubborn nature telling her it could have cost her, her life. The doctor gave the patient gave the patient medication and give her his business card. The use of this business card was ever if the patient feels she is not getting better while on medication or off medication, she would call him and book an appointment.
Since the doctor had a meeting to attend, he left the facility together with the patient. During the walk to the car park, the doctor engaged the patient in general talk that made the patient relax. The patient felt very contented with the service that she received from a doctor who barely knows her. On her arrival home, the patient called the doctor and thanked him for the good service. This case portrays a physician who has perfect communication skills. The doctor does not let the fact that he has a meeting elsewhere deter him from attending to his patient.
Contrary case: The case below is a contrary case of the use of communication in a healthcare setting. The case shows a lack of communication skills on the side of the doctor that causes the misdiagnosis of the patient.
The physician in the case below fails to demonstrate the use of good communication skills with the patient. The cause of the lack of good communication skills leads to the misdiagnosis of the patient for flu. However, after a week the symptoms were still persistent, and that is when she decided to visit hospital. A 45 year old woman visits the hospital due to the persistence of the symptoms of her illness. The woman has been feeling unwell for the last few days and due to her stubborn nature she had been avoiding a visit to the hospital for a check-up. The woman was sure that she is suffering from flu; therefore, she took medication to visit a hospital. On arrival at the hospital, she met a doctor who had never treated her again since her personal doctor was away on official business.
The doctor recorder symptoms of sudden high fever, severe headache, stiff neck, nausea and vomiting which leads to headache, lack of appetite and lack of concentration. All this while, the doctor, was not paying keen attention since he had an important meeting to attend after catering for this patient. Therefore, the doctor was in a hurry to finish serving the patient so that he can have time to attend his meeting without getting late. This made the doctor miss two very significant symptoms, sleepiness or lack of sleep and seizures. The doctor, therefore, diagnosed the patient with flu and gave the woman medication for flu.
The woman tried to tell the doctor that the signs and symptoms were persistent and that it could not be flu since she had already taken medication for flu. The doctor answered the woman in a rude tone telling her that he knows what he is doing. The woman, therefore, left the hospital angered by the doctor for his rude tone. Her stubborn nature helped in a way since she did not take the medication and decided to visit another hospital that her personal doctor recommended her to. The doctor in the case above lacks the necessary communication skills, and this causes a misdiagnosis.
The doctor was in a hurry, therefore, did not pay concern to the symptoms of the patient keenly. The doctor did not even think of the patient having meningitis that was the reason the patient was experiencing seizures and lack of sleep. If it, not for the nature of the patient, she could have gone home and taken the flu medication (Innis, 2008). The condition of the patient could have gotten worse, and the eventual death of the patient could be possible. A lack of communication skills in the doctor is not because the doctor is incompetent: this is as a result of the doctor putting another issue before the health of the patient.
Communication can also be referred to the skill, which every individual needs to possess. Communication is a necessity in life and no one can live without communicating with other people. Some individuals have very good communication skills and as a result, they get along with many people. However, some individuals are born with very poor communications skills. Such individuals end up leading a very difficult life since they cannot relate well with other people. Such people never get friends and can be found most of the times by themselves. They end up getting problems and since they can trust no one to talk to, the problem if big enough might consume them.
One should start developing communication skills at an early age. Failure to do so would bring about some complications maybe later. People who have low communication skills cannot work in a situation that needs interaction with the customers. Some people are born with the problem but in most cases, the upbringing of a child determines the condition. The upbringing of a child is, therefore, very determining when it comes to the communication skills (Balzer-Riley, 2012). A child brought up in a good upbringing mostly possesses good communications skills. However, if the upbringing is negative, the communication skills of a child might be poor. Parents should, therefore, try to develop the communication skills of their children. If a child shows no signs of the urgency to relate with other children, then it is necessary for such a child to be taken to visit a doctor for a checkup. The doctor might found out it is the child’s character, or there is something wrong with the child’s health.
Communication, as stated above several times is a necessity in human life and every individual needs to communicate with other people. If there were no means of communication in the world, then there would be no value for life. In the setting of a health facility, communication plays crucial roles that have been stated above. Communication makes life simple, easy and enjoyable. Communication is sometimes is used in the wrong way: like passing terror attack messages, the advantages of communication are way ahead of the little disadvantages. In conclusion, every health worker needs to know the effect of communication in the setting of a health facility. Therefore, a health worker must possess not only communication skills, but perfect communication skills that will assist in the achievement of their goals. Research and additional studies show that a health facility that has workers with good communication skills ends up producing better results than the one that does not have such.
Balzer-Riley, J. W. (2012). Communication in nursing. St. Louis, Mo: Elsevier
Burnard, P., & Gill, P. (2008). Culture, communication and nursing.
Ellis, R. B., Gates, B., & Kenworthy, N. (2003). Interpersonal communication in nursing: Theory and practice. Edinburgh: Churchill Livingstone.
Innis, H. A. (2008). The bias of communication. Toronto: University of Toronto Press.
Sheldon, L. K. (2009). Communication for nurses: Talking with patients. Sudbury, Mass: Jones and Bartlett Publishers.
Sully, P., & Dallas, J. (2005). Essential communication skills for nursing practice. St. Louis, MO: Mosby.
Van, S. G. M. (2009). Communication skills for the health care professional: Concepts, practice, and evidence. Sudbury, Mass: Jones and Bartlett Publishers.
Webb, L. (2011). Nursing: Communication skills in practice. Oxford: Oxford University Press.
Acute pain is experienced after an injury or a disease, and it is self limited. It is because of a biologic purpose, and it affects the skeletal muscle or the nervous system. On the other hand, chronic pain is one that outlasts the normal healing time. Chronic pain does not have any biological purpose, and in most cases arise due to psychological reasons (Porth, 2009). The treatment of pain depends with its severity, either acute or chronic. The various methods include the use of Non-steroidal anti-inflammatory drugs (NSAIDs), electrical stimulation, physical therapy, surgery, and relaxation techniques like deep breathing.
Somatic pain is detectable by the skin, muscles, and joints. Somatic pain is very easy to detect, and this is done by special receptors. They detect vibration, temperature, and swelling. Visceral pain arises from direct stimulation of afferent nerves due to tumor infiltration of the soft tissue or viscera. Distension and stretching at times can cause somatic pain, and the pain is often ill defined. Unlike somatic pain, visceral pain is hard to identify and locate, this is because it is more generalized (Porth, 2009). Visceral pain is usually experienced in the mid line body; that is the lower sternum or upper abdomen. In different visceral organs, patients experience pain in different areas like bladder to the perineal area, neck and the area of the left arm to the heart also at the ureter to lower quadrant. Somatic pain, on the other hand, is experienced on the skin, joints and muscles.
Manic-depressive illness is another name for the bipolar disorder. Bipolar disorder causes unusual shifts in the brain affecting someone’s moods, functioning ability and energy. Generalized anxiety disorder (GAD) is a mental condition whereby a person is anxious and worried about many things and is unable to control the anxiety. Categorically DSM-IV-TR is a machine that categorizes psychiatric disorders. The axes are divided into five axes according to the disorders. In addition, there are three more axis for common disorders.
Anxiety disorders have proved to be quite stressful in the community affecting the way of life of those affected. The most common anxiety disorders include post-traumatic stress, social phobia and obsessive compulsive disorder (Porth, 2009). In some cases, even depression is common, but this is very rare. Patients experiencing bipolar disorder happen to suffer from mood change according to their behavior. In between these elevated moods, they also experience normal moods. The five axes in the DSM-IV-TR each represent a specific disorder:
AXIS I: All psychological diagnostic categories except mental retardation and personality disorder.
AXIS II: Mental retardation and personality disorders.
AXIS III: Acute medical conditions and physical disorders.
AXIS IV: Psychosocial and environmental factors contributing to the disorder.
AXIS V: A global test for children and teenagers below the age of 18.
Porth, C.M., & Matfin, G. (2009) Pathophysiology: Concepts of altered health states. (Eight ed.) Philadelphia, PA: Lippincott Williams & Wilkins.
Quality Improvement Project: Improving Doctor-Patient Communication
Effective communication between doctors and patients is central to improving the quality of healthcare provided. Building a physician-patient relationship is fundamental to improving communication, which in turn enhances patient satisfaction. Poor communication in a healthcare setting is attributed to poor health outcomes due to misunderstandings and wrong medication. Both the physicians and patients need to improve their ability to communicate to enhance improved patient health outcomes. Advanced communication skills are central to promoting patient-centered medical care, which increases medication compliance, thereby increasing the quality of health outcomes (Chandra, Mohammadnezhad, & Ward, 2018). Physicians should facilitate the exchange of information with their patients as a manner of involving patients in decision making, which increases patient satisfaction and adherence to medical prescriptions. Non-disclosure of information is a significant problem that has affected the provision of quality healthcare because it limits the available medical choices. Improved doctor-patient communication fosters collaboration among physicians and patients, which is central to research opportunities and improved quality of medical care.
Key stakeholders in this project are the physicians, who are the healthcare providers, and the patients, who are healthcare recipients. The doctors should receive communication training to learn how to improve interpersonal and communication skills, which can be applied in understanding patient behavior in response to their meeting their needs (Boissy et al., 2016). Patients should learn communication skills from nurses, which can enable them to improve their information-sharing ability in collaboration with doctors to improve the quality of healthcare. Improving listening skills is also necessary for enhancing the increased quality of healthcare.
Several resources are required to implement the proposed project. Patients should be educated on utilizing online resources to learn how and what to ask physicians before they go to seek medical care. They can do so by visiting health-related websites, which means that healthcare organizations should provide sufficient information on their websites regarding the types of care provided. Financial resources are also needed to facilitate the training of medical professionals on how to improve their communication skills. Other resources that may be required include nursing informatics tools, which can facilitate distance learning and patient education in the promotion of patient-centered care. Nursing informatics tools enhance distant care, which requires high communication and information skills. Physicians should learn computer skills and information retrieval skills through a training program to improve remote nursing care (Mills, Francis, McLeod, & Al-Motlaq, 2015). Short, precise patient questionnaires are needed to record their experience with healthcare professionals and state their complaints. The complaints should be the area of focus in fostering improvements.
The following action plan should be precisely followed in implementing an improved patient-doctor communication system.
1. Discuss with healthcare professionals on the need to improve communication skills
2. Set goals and possible actions needed in enhancing and implementing the plan
3. Select the project implementation team and assign roles to members
4. Write a draft on the expected outcome and seek assistance from hospital leadership
5. Access the necessary resources needed in accomplishing the project
6. Implement the necessary nursing informatics tools such as e-learning tools (text chats) and Tele-nursing tools
7. Provide training to physicians concerning improving interpersonal and communication skills
8. Train patients on the importance of effective communication and how to improve communication skills
9. Review the process and check the results (Include short patient questionnaire that provides patient views after the provision of medical care to assess outcomes and check complaints)
10. Provide room for further suggestions and improvement
The proposed implementation timeline for the above project is ten months. When the relationship between patients and doctors improves, communication and sharing of information also improves, which can foster patient-centered care and nursing research.
Boissy, A., Windover, A. K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R. M., ... & Rothberg, M. B. (2016). Communication skills training for physicians improves patient satisfaction. Journal of General Internal Medicine, 31(7), 755-761.
Chandra, S., Mohammadnezhad, M., & Ward, P. (2018) Trust and communication in a doctor-patient relationship: A literature review. Journal of Healthcare Communication, 3(3:36), 1-6. DOI: 10.4172/2472-1654.100146
Mills, J., Francis, K., McLeod, M., & Al-Motlaq, M. (2015). Enhancing computer literacy and information retrieval skills: A rural and remote nursing and midwifery workforce study. Collegian, 22(3), 283-289.
This article looks at the communication elements in nursing and assesses how effective communication is a fundamental aspect of the health profession.
How should the nurse proceed with the health interview?
A crying patient signal many kinds of emotions that can range from anger, frustration, pain, and distress. In this case, Emily is clearly distressed about the prospect of being injected. This can be because she has come to associate it with pain. The nurse in this situation is required to pause, and gently probe (Bickley & Szilagyi, 2014) Emily for reasons as to why she doesn’t want to get the “boo boo shot.” She can then be given tissue to wipe away her tears and then the nurse can reassure Emily that this time the injection is not going to be painful. Her brother can be used as an example of how painless the injection was because we can gather that the brother didn’t cry during his examination.
What factors may upset communication with this patient?
Active listening is a vital component of any communication process. However, in this case, Emily is unlikely to listen because she is crying and distressed. Emily is 3 years old. In medical language, she can be referred to as patient with limited capacity. She will not be able to understand that the purpose of immunization. In essence, her decision-making capacity is not fully developed (Riley, 2017).
What are the three phases of the interview process?
Health interviews are meant to gather information about the health history of the patient. To successfully do this, health care providers fragment the interview process into three parts. Part one focuses on planning the approach to the interview. This entails self-reflection, chart, review, goal setting, reviewing your appearance and behavior, adjusting the interview environment, and taking notes. Part two is about learning about the patient. Following a sequence of steps, the nurse can gather information about his patient in the following ways – establish rapport with patient, invite patient to tell his/her story, establish interview’s agenda, expand and clarify patient’s story, generate and test diagnostic hypotheses, presenting a shared understanding of the patient’s problem, negotiating a mutual treatment plan, and follow-up. Part three is concerned with fostering a therapeutic relationship with the patient. This entails aspects like active listening, empathizing with the patient, reassurance, validation, partnering, etc. (Bickley & Szilagyi, 2014).
What communication techniques would be appropriate for gathering the information needed to complete the health history?
For effective communication in the health profession, nurses and other health care providers understand that there are two aspects to communication -verbal and non-verbal. The techniques that can be used in health interviews are assertive communication, non-assertive communication, and are mostly dependent on the type of patient being interviewed (Riley, 2017).
Bickley, L. S., & Szilagyi, P. G. (2014). Bates' Guide to Physical Examination and History Taking (11 ed.). New York: Lippincott Williams & Wilkins.
Riley, J. B. (2017). Communication in Nursing (8 ed.). St. Louis, Missouri: Elsevier.
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