COMMUNICATION AND INTERPERSONAL SKILLS
Nurses employ the six core values of nursing (6C’s) which are Care, Compassion, Competence, Communication, Courage and Commitment (NHS England, 2015). The Compassion in Practice strategy for nursing, midwifery and care staff was established by the Department of Health in England in response to high profile cases of poor quality care advanced to patients (Baillie, 2017). Care, compassion and effective communication are thus essential elements of nursing which must be practised and adhered to by every health care personnel and particularly nurses due to their close contact with patients. The management of Diabetic Foot is long term and requires a multidisciplinary team to manage. Diabetic foot is a dreaded disability and has a high risk of amputation in the event of disease progression (Pendsey, 2010). Cooperation and adherence to medical advice, medications, and lifestyle modification practise by the patient is thus key in the overall prognosis of the patient.
Compassionate care entails the nurse’s desire to ease the patient’s suffering and to address individualised care needs for the patient (Su, et al., 2020). It is considered as the philosophical foundation and focal aspect of the nursing profession (Dunn & Rivas, 2014). The fundamental attributes of compassion include trust, empathy, sensitivity, advocacy, dignity and respect (Pegram, 2015). The formation of a trusting relationship with the patient is if therapeutic benefit especially in the long term management of diabetic foot. For patients to adhere to medical advice a trusting bond is needed between the nurse and the patient. The patient has to accept and trust that the nurse has his/her best interest at heart. If amputation is warranted, the trust formed between the patient and nurse will help in reducing tension and the uncertainty that is involved with amputations.
Dignity and respect is a crucial element of compassion and an integral aspect of nursing care. Diabetic patients should be treated with respect and dignity, understanding that diabetic foot is just a debilitating condition and not a representation of who the patient is. Recognizing patients with their names, rather than their condition goes a long way in building confidence in the management regimen. The psychological effect of treating a patient with respect and dignity improves their confidence and improves patient outcomes (Ludman, et al., 2013).
Communication is an integral aspect of the proper management of patients, particularly patients with long term debilitating conditions such as a diabetic foot. According to the NHS, communication is central to successful, caring relationships among nurses and patients and nurses and other medical practitioners (NHS, 2014). Every nurse should master communication as a basic pillar for effective care and management of patients (Chichirez & Purcarea, 2018). A therapeutic alliance i.e. a mutual relationship of trust between medics and patients (Chichirez & Purcarea, 2018) is established on the founding pillars of effective communication and facilitate better prognosis.
Communication facilitates the formation of personal connection with patients and offers an opportunity for patient education. It important for diabetic foot patients to understand the basics of their condition and what to expect regarding management and complications. The management involves both homestay management and hospital management. Hence communication with the patient is crucial to educate them on the strategies of home-based diabetic foot care.
The multidisciplinary approach involved in the management of diabetic foot requires effective communication between specialities to facilitate the overall management of the patient (Alexiadou & Doupis, 2012). Nursing notes should thus be written in a specific and professional manner to facilitate effective communication across all specialities.
Interpersonal skills required of every nurse include leadership skills, listening skills, communication skills, resilience, emotional intelligence, personal stress management skills, and teamwork. To attain optimal patient outcomes, effective nursing leadership skills are paramount (Hutchinson & Jackson, 2012), with transformational leadership skill recognised as the most effective model of leadership (Doody & Doody, 2013). Based on my clinical experience leadership skills are integral to facilitating the holistic management of the patient and an area that requires further improvement. Resilience and personal stress management skills are also key due to the high-stress environment that nurses are exposed to. Patient care is dependent on nurses’ capability, state of wellbeing, and overall mental, physical and emotional health. Resilience and the ability to gather internal strength to power through stressful situations is paramount for every nurse.
Communication skills facilitate proper communication with patients and other healthcare practitioners in different specialities. It involves precise communication, patience, team spirit, emotional control, and active listening. Clinical experience dictates that interpersonal communication with patients is a centrepiece in their management. Communication should be tailored to a cognitive level that can be understood by the patient. Tailoring information to fit a particular cognitive level for each set of patients we interact with is difficult and a potential area that requires improvement in upcoming placements. Active listening to the patient is essential for the formation of a tailored management regimen for patients, and thus an area that requires further development.
References
Alexiadou, K. & Douglas, J., 2012. Management of Diabetic Foot Ulcers. Diabetes THer, 3(1).
Baillie, L., 2017. An Exploration of the 6Cs as a Set of Values for Nursing Practice. Br J Nurs., 26(10), pp. 558-563.
Chichirez, C. & Purcarea, V., 2018. interpersonal communication in healthcare. Journal of Medicine and Life, 11(2), pp. 119-122.
Doody, O. & Doody, C., 2013. Transformational leadership in nursing practice. British Journal of Nursing, 21(20), pp. 1212-1217.
Dunn, D. & Rivas, D., 2014. Transforming Compassion Satisfaction. International Journal for Human Caring.
Hutchinson, M. & Jackson, D., 2012. Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 20(11), pp. 11-22.
Ludman, E. et al., 2013. Improving Confidence for Self Care in Patients with Depression and Chronic Illnesses. Behav Med, 39(1), pp. 1-6.
NHS England, 2015. Introducing the 6Cs. National Health Service( NHS), pp. 1-15.
Pegram, B., 2015. Care, compassion and Communication. Nursing Standard, 29(25), pp. 45-50.
Pendsey, S., 2010. Understanding diabetic foot. International Journal of Diabetes in Developing Countries, 30(2), pp. 75-79.
Sinclair, S. et al., 2016. Compassion: a scoping review of the healthcare literature. BMC Palliative Care, 15(6).
Su, J., Masika, G. & Redding, S., 2020. Defining compassionate nursing care. Nurse Ethics, 27(2), pp. 480-493.