Nurse-Patient Communication, Interdisciplinary Communication, and Patient Safety

For a long time, health care inconsistencies and augmented health care utilization rates have mostly been as a result of breakdowns of, or poor communication between clinicians and their patients. Clinicians have at times disregarded their patient’s understanding of the situation, their context, and preferences leading to poor health outcomes. As such to improve the quality of nursing care provided, communication between the two should be patient-centered. An effective and consistent communication between the clinician and the patient will help develop a constructive nurse-patient relationship which together with other organizational aspects will result in not only improve patient’s safety and satisfaction but also better health outcomes at relatively lower costs (McCabe, 2004). This paper is going to outline the seven principles of patient-clinician communication, the method that improves interdisciplinary communication and ethical principles that can be applied to issues in patient-clinician communication 

Principles of Communication

Despite the fact that there are many factors which can affect the clearness and quality of communication between nurses and their patients, there are basic principles if considered will lead to the achievement of expected results. These basic principles include mutual respect between the two, harmonized goals, provision of the right information, a supportive environment, full disclosure, appropriate decision partner and continuous learning (Paget et.al, 2011). Mutual respect entails that the two principles i.e. the patient and the clinician engage as full decision-making partners respecting each and everyone’s special insights brought up to solve the problem at hand. The second principle, harmonized goals, dictates that a common understanding and an agreement on the care plan between the two parties should be established to enhance harmony and common purpose. Providing the right information by the clinician such as the best available evidence at hand, some of the choices a patient have and their respective trade off is another crucial principle of patient-clinician communication. At the same time, the patient should also accurate information regarding their symptoms, perceptions, and personal practices. 

Having a supportive environment, a fostering and secure service environment where one can make a secure decision is another basic principle of patient-clinician communication. The principle of total transparency and full disclosure require patients to be open to clinicians when availing information to their clinicians and in return, the clinician should be candid in their explanation of the patient’s situation explaining the limit the medical process can reach. The principle of appropriate decision makers requires that a patient, especially those with complicated conditions have an access to other clinicians with skills in particular conditions. The last principle of communication between the patient and clinician is that of continuous learning which provides for an effective approach that is established for customary feedbacks on progress and improvements. This will help establish a periodicity for course evaluation hence allowing one to make the necessary alterations and adjustments. 

Application of the Principles

The principle of mutual respect is founded on unconditional positive regard. Since different patients face different challenges hence their response to health and illness is different, a clinician is supposed to listen and accept the patient’s beliefs without being judgmental. This principle enables patients to comfortable while dealing with a clinician. For instance, despite a patient’s unhealthy behavior such as smoking which the patient with the help of health officials have been unable to drop, a nurse should always remain respectful of the situation taking into account the patient’s values, belief, and symptoms to work with the patient to develop a care plan (Paget et. al., 2011).

Having a supportive environment is founded on confidentiality where the two principals can speak openly especially while discussing sensitive issues. Patients need to know that their information will be kept confidential bounded by the dictates of moral and legal obligation nurses have. This could mean not discussing matters with patients in public places where the conversation can be overheard. A clinician should look for an empty secure room and if there is an ambulatory roommate in the room they should be asked to leave, closing the door behind them (Gausvik et.al, 2015). 

Providing the right information is built on genuineness on both the patient and the clinician. While patients are expected to be open about their symptoms and conditions, clinicians ought to be open and genuine not hiding behind their professional façade. For instance, while crafting a treatment plan for a patient clinicians should offer facts regarding threats, benefits, values, and outlay of substitute options. During this time a nurse should not shy away from questioning some values or behavior of the patient as this is part or expressing true concern for the patient’s well-being. 

Methods of Communication

A good communication system is the cornerstone of quality nursing and developing of ways to improve communication is crucial when one wants to improve the quality of care provided to patients. Interdisciplinary communication is an approach of communication which allows improved communication among different health care professionals attending to a particular patient (Gausvik et.al, 2015). Three methods used to improve interdisciplinary communication include putting in place of unit-based care groups which brings together doctors and nurses hence increasing the chances for improved communication. The second method is the use of mandatory bedside rounds. This strategy has been found to improve effective communication between the physicians, nurses, and patients all of whom participate in the ward round receive the same information hence can properly complete their task and meet patient care goals (Flicek, 2012). The third method is the bed rounds which include all the patient’s stakeholders, nurses, physicians, the patients and their families. 

Including patients and families during bed, rounds apply best to my area of study. This method is first taken through all the confidentiality checks in accordance with the hospital’s policies. The family members in attendance must be the one identified by the patient as to be involved in the provision of care and in decision making. On top of that, the hospital should consider how to place the patient and his family in a secure room to enhance privacy. This method creates a room for direct dialogue and enables patients to be active associates of the health care team hence, help to reduce improper communication regarding the plan of care (Gausvik et. al., 2015).

Ethical Principles and Communication

As we had stated earlier, good communication forms an important pillar of nursing services. Ethical principles of communication ensure that there is trust and credibility in information shared between patients and clinicians and the decision-making process is improved for the betterment of superior outcomes. Ethics work to offer the groundwork doing things right, allowing the patients and clinicians to communicate with a basic understanding of what is required. As such ethics help to avoid either party doing harm. In communication, ethical principles help to build trust between a clinician and his patients (Paget et. al., 2011).

The patient-clinician communication and relations need to be characterized with respect, consistency, truthfulness, fairness, and empathy. Examples of ethical principles that can be applied to issues in patient-clinician communication include one that clinician should maintain accurate and truthful records of their patients. For instance, the clinician should record fabricated records or misstate diagnosis just rip off the patient and maximize reimbursement (McCabe, 2004). Another ethical principle is that patients should not twist the truth about their conditions to receive benefits. Also, they should try and compromise the physician to alter the truth on their behalf for whatever reason. The third principle is that both clinicians and patients should discern and support their relationship and its importance plus the ethical obligations of clinicians to patients. For instance, clinicians should discuss all relevant treatment alternatives with their patients while at the same time patients should feel safe in their communications with their clinicians. The last ethical principle is that patients and clinicians should be honest and truthful in their contact with each other (McCabe, 2004).

In conclusion, proper communication between nurses and physicians is very important as it can affect the direction of patients’ care outcomes. To overcome several challenges involved in the patient-clinician communication the seven basic communication principles should be followed. Clinicians plus all health providers need to invest more in interdisciplinary communication which follows the required ethical principles to improve the levels of communication. Clinicians have a liability and duty to improve their patient-clinician communication as this is the cornerstone of their professional practice.

References

Flicek, C. (2012). Nurse-physician rounds: A collaborative approach to improving communication, efficiencies, and perception of care. MEDSURG Nursing , 20(4): 194-199.

Gausvik, C., Lautar, A., Pallelra, H., Miller, L & Schlaudecker , J (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, and understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare , 8: 33–37

McCabe, C (2004). Nurse-patient communication: an exploration of patients' experiences. Journal of Clinical Nursing , 13(1):41-9

Paget, L., Han, P., Nedza, S., Kurtz, P., Racine, E., Russell, S., Santa, J., Schumann, J., Simha, J & Von Kohorn, I (2011). Patient-Clinician Communication: Basic Principles and Expectations. National Academy of Sciences. Retrieved from https://nam.edu/wp-content/uploads/2015/06/VSRT-Patient-Clinician.pdf