Improving Communication Skills
A nurse is a leader. It is, therefore, important for nurses to develop good leadership skills which include communication. Communication is a mainstay quality in nursing. Proper communication has been shown to improve nursing outcomes (Kesten, 2011). Having considered this, I thought it important to develop proper communication skills that will help me in communicating with patients and fellow health workers.
Proper communication with patients is important for the development of a therapeutic relationship. As McCabe and Timmins (2013) note, a good therapeutic relationship is an integral part of holistic patient care, which nurses are mandated to provide. In fact, just a feeling that one is wanted and appreciated in a place can help them to get well faster; as it has been said before, health starts in the mind. Good communication skills can also assist me in communicating with other health workers to ensure more collaboration and for the good of the patients. Of the communication skills that I needed to improve were speaking to large groups and how to specifically pass a nasty message like one of the demise of a loved one to a relative. Communicating to large groups was key for me as a student because sometimes we are required to present something before the entire class or members of the faculty and we are also required to speak to groups of patients as part of health education. This paper is a review of the whole process of planning, implementing, evaluation, and action in my attempt to improve my communication skills.
Plan (A)
Recent studies have shown that a good number of patients are dissatisfied by the communication by nurses (Kesten, 2011). One research even suggested that in their communication, patients find most nurses being too formal; the nurses do not smile or crack any jokes (Foronda et al., 2014). Despite it looking like such a trivial issue, it can really affect the patient’s perceptions about the individual nurse, the health facility or the entire nursing profession. I did not want to be a nurse whom patients develop an attitude and had to get a perfect plan, which will help me improve my communication skills within three weeks.
I dedicated the first two days of my three-week plan to completion of my study on the areas to be improved. I was to study about the components of effective communication and the tips that I need in order to be a good communicator as a nurse. Among the tips that I learnt would help me and I needed to work on them for the rest of the three-week period were maintaining eye contact with the crowd or individual making my audience; speaking in a slow but audible tone; developing a sense of humor; proper use of language; listening skills; and proper use of language. In the rest of the time, I decided to use three PDCA cycles to ensure my improvement. I planned to evaluate my progress at the end of every week and then an ultimate evaluation in the end.
Improving my eye contact with the audience and ability to speak in low but audible tones was easy. All I had to do was practice. This entailed preparing something to talk about every single day; I would then rehearse on the chosen item and present it to a group of friends. I would allow the friends to critique my presentation and to point out the areas that needed improvement. Use of such virtual situations has been tried and found to be effective in the past; it is even proposed as a method of teaching communication skills in institutions (Foronda et al., 2014). I also researched about how to develop a sense of humor. I had learned that developing a sense of humor, which would allow me to smile or laugh at lame jokes by patients, could effectively bring me closer to the patients. I also decided to be practicing this in my conversations with friends. I had to know how to identify a joke, how to find fun in a joke, and how to tell whenever a joke crosses the line. I also planned to do the same with my listening skills since it is key for a nurse to be a good listener. Of the strategies to improve my listening skills, I planned to practice to listen more and speak less and to let a person finish speaking before I can interrupt.
In my plan, I was to dedicate between thirty minutes to an hour every day to improving my language. In the long-term, I plan to learn an extra language which can help me to communicate with patients or their relatives who do not speak or struggle in speaking English. I plan to learn French as part of my long-term language improvement plan.
Do
I implemented my three-week plan between Wednesday the 28th of January and Tuesday the 17th of February 2017. In the first two days, I completed the extensive studies that I had been on since 22nd of January. The studies were focused on what I needed to do to improve my communication skills in accordance with my plan. I dedicated the time between 7: 30 and 8: 30 am every day to studying to improve the language. My studies revolved around mastery of grammar and learning to read people’s moods while speaking to them. The other activities that were to be done whenever interacting with my friends were done at the opportune time. I also practiced the skills I was learning while interacting with patients during this time.
Check
For evaluation, I designed weekly questionnaire, which were to be filled by nine friends who had been acting as my audience as I practiced my newly acquired communication skills. The questionnaires were to be filled anonymously and acted as a peer review. Yoo and Chae (2011) found peer reviews to be a highly effective way of improving communication skills among nursing students.
The questionnaire examined various aspects of communication that I was working on like listening skills, speaking to a group, and the sense of humor. The first evaluation was done on 29th of January. However, since I had only been reading and not practicing, the results were dismal; only one respondent thought my listening skills had improved and none of the respondents saw improvements in either my sense of humor or ability to speak before a group. At the end of the first week of practice which was the second of the whole exercise, only four of the respondents thought my listening skills had improved, three thought I could speak to a group better, and four noticed an improvement in my sense of humor. At the end of the third week, five respondents agreed that my listening skills were steadily improving while the rest did not see an improvement from the first week. Seven respondents thought my ability to speak to a group had improved while eight thought my sense of humor had improved. In the last questionnaire, all respondents noticed improvement in my listening skills and my ability to speak to a group. My sense of humor had, however, stagnated.
In the last questionnaire, there was an open question asking the respondent to say whatever area of communication they think I should improve on. Here were the nine responses:
Table 1: Responses
| SERIAL NO. | RESPONSE |
| 001 | Maintaining eye contact with the audience while speaking |
| 002 | Maintaining audibility from the beginning of a presentation to the end |
| 003 | Having a look of joyfulness or empathy while talking to one person |
| 004 | Maintaining eye contact while speaking before a large audience |
| 005 | Fluency in language |
| 006 | Use of proper language for the proper public; avoidance of medical jargon while speaking to patients |
| 007 | Audibility |
| 008 | Confidence |
| 009 | Questioning techniques |
Action
I acted on the results at the end of every week. At the end of the first week, I was particularly concerned about my ability to speak to a group. In the second week, my listening skills were stagnating. I used the week that followed to work on the skills that were seen to be problematic.
Based on the results of the last evaluation, I realized that even though I had improved my ability to talk before a group, I needed to keep more eye contact. On this, I had to just to practice. Moreover, I realized that in my attempt to speak slowly and articulate all words properly, my audibility was interfered with. As part of the action, I was to work on this. Additionally, I am still working on improving my confidence while facing people and avoidance of medical jargon wherever it is not needed. I also needed to improve on my questioning techniques. As McCabe and Timmins (2013) put it, questioning is an important communication skill for nurses who might need to take patient history on find out key information from other health workers.
Conclusion
My plan and strategies were effective. According to the results of the evaluation, my communication with patients and other staff had improved greatly. In addition, I had noted that I conversed with patients more and they seemed to be happier after the interaction. However, this improvement was not complete, the gaps that needed to be filled were clearly identified in the evaluation thereafter. Am still working on the identified gaps to try and become nearly perfect. One way in which to improve my evaluation for utmost results will be to ask for immediate feedback from my virtual audience rather than wait for feedback at the end of the exercise.
My method of evaluation also failed on the part of empathy. While interacting with patients, empathizing with them enhances the effectiveness of communication (McCabe & Timmins, 2013). However, my method of evaluation did not reveal if I had improved my ability to empathize with my audience. This is probably because my virtual audience were friends that I was used to. Interaction with real patients will help me in improving on the part of empathy.
Questions
- Communication skills
- Improvement in listening skills, ability to speak before a group, and sense of humor
- 1-5 times (precisely – 3 times)
- Personal improvement
- Very important
- Bar chart – very useful
- A significant measured improvement
- Yes
- By having improved ability to communicate with patients and colleagues effectively, am finding nursing practice a lot easier.
References
Foronda, C., Gattamorta, K., Snowden, K., & Bauman, E. B. (2014). Use of virtual clinical simulation to improve communication skills of baccalaureate nursing students: A pilot study. Nurse Education Today, 34(6), e53-e57.
Kesten, K. S. (2011). Role-play using SBAR technique to improve observed communication skills in senior nursing students. Journal of Nursing Education, 50(2), 79-87.
McCabe, C., & Timmins, F. (2013). Communication skills for nursing practice. Palgrave Macmillan.
Yoo, M. S., & Chae, S. M. (2011). Effects of peer review on communication skills and learning motivation among nursing students. Journal of Nursing Education, 50(4), 230-233.
