Download full Interpersonal relationships e-book: professional communication skills for nurses ebook
Visit to download the full and correct content document: https://ebookmass.com/product/interpersonal-relationships-e-book-professional-com munication-skills-for-nurses/
More products digital (pdf, epub, mobi) instant download maybe you interests ...
Interpersonal Relationships: Professional Communication Skills for Nurses 7th Edition Elizabeth Arnold
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Content Development Specialist: Diane Chatman and Luke Held
Publishing Services Manager: Deepthi Unni
Project Manager: Nayagi Athmanathan
Designer: Ryan Cook
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication
To the memory of my husband George Arnold, who believed in me and supported me unconditionally, to my parents, for their support and love, and to all the students I have had the privilege of teaching.
Elizabeth C. Arnold
For Michael, the love of my life.
Kathleen Underman Boggs
Reviewers and Contributors
Reviewers
Karan S. Kverno, PhD, PMHCNS-BC, PMHNPBC, Assistant Professor, Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD
Margaret Blanka Huml, RN, BSN, MN, Professor, Bachelor of Science in Nursing, Vancouver Island University, Nanaimo, British Columbia, Canada
Katharine A. Hungerford, RN, BScN, MEd, Professor of Nursing, Health Sciences, Lambton College of Applied Arts, Sarnia, Ontario, Canada
Contributors
Kim Siarkowski Amer, PhD, APRN, Associate professor, School of Nursing, Depaul University, Chicago, IL
Shari Kist, PhD, RN, CNE, Assistant Professor, Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO
Pamela E. Marcus, MS, APRN, Associate Professor, Prince George’s Community College, Largo, MD
Eileen O’Brien, PhD, RN, Undergraduate Program Director Psychology Department, University of Maryland, Baltimore County Campus, Baltimore, MD
Acknowledgements
We acknowledge our heartfelt appreciation for the contributions of the many professional nurses and other practitioners who helped us deepen and clarify our evolving thinking and understanding of communication over the past years.
We would like to thank Laura Holbrook, MSN, RN, consultant and educator in Health Team Communication, staff nurse in cardiology, Medical College of South Carolina for Contributing Chapter 26.
We are very grateful to the Elsevier editorial staff, particularly Tina Kaemmerer, Senior Content Development specialist, Diane Chatman, Content Development Specialist and Yvonne Alexopoulos, Senior Content Strategist. Their guidance, tangible support, and suggestions were invaluable in the content development of this 8th edition. Finally, we want to sincerely thank Nayagi Athmanathan and Karthikeyan Murthy, Senior Project Managers from Elsevier for their painstaking, precise copy-editing, and editorial support during the production process.
Elizabeth C. Arnold
Kathleen Underman Boggs
Preface
In 1989, Elsevier published the first edition of Interpersonal Relationships: Communication Skills for Nurses. It was originally developed at the University of Maryland School of Nursing to accompany a communication seminar course on interpersonal communication skills for nurses. Subsequent editions reinforced its salience as a key resource on nurse-patient relationships. This text has been twice recognized as an American Journal of Nursing book of the year (2004; 2007). Technology was in its infancy, and chronic disorders had not yet emerged as a primary focus of attention in focus health care. The latter is no longer the case.
The eighth edition is designed as a key interactive reference for nursing students and professional nurses. It has been updated and expanded to include new understandings of patient-centered communication and the support for self-management strategies needed in contemporary health care environments. New simulation exercises with reflective analysis discussions allow students to the pros and cons of various approaches and modern practice issues across clinical settings. Patient-centered relationships, selfmanagement of chronic disorders, collaborative interprofessional communication, and team-based approaches are new content additions in the eighth edition. Just as the world has so has the scope of nursing practice, fueled by several intersecting factors. Nurses are educationally prepared to function at a higher level than ever before. They are expected to play a key role in promoting and supporting healthy behavior change.
The health care system possesses stronger diagnostic capabilities and better-targeted treatments for many acute health diseases. The
nation’s population is more culturally diverse at many different levels psychosocial, educational, with multiple resource availability. This means that there are explanatory models for the same illness, and varied underlying principles about treatment.
Technology is an established part of virtually every health care endeavor. Our nation is part of a complex global community, increasingly interconnected through technology. Patients have more access to health information through the Internet, and this change means that patients are better able to self-manage their own health care. Attention has shifted from acute to chronic disorders as major causes of morbidity and mortality. By contrast with acute disorders, chronic conditions usually last a long time, sometimes a lifetime. Many people have to cope with more than one chronic condition, sometimes with competing care needs. Currently, health care is as much a public health issue as it is a general health concern.
About the Content
Interpersonal Relationships: Communication Skills for Nurses consists of 26 chapters. The range of health care applications includes preventive health applications and can follow patients through the life cycle to include end-of-life communication and nursing interventions. The communication content supports health care applications across a broad service continuum of care that includes hospitals, long-term care, ambulatory and public health, rehabilitation, palliative and home care, and, more recently, preventive primary care health “homes.”
Chapter topics in the eighth edition mirror the nation’s shift from a health care system structured around medical disease to one based on an integrated holistic health approach to health care that begins with the patient’s perception, values, concerns, and preferences. Contemporary health care relationships consider every health experience as a holistic human experience, which requires a fresh, new perspective and level of patient and family involvement. This belief is reflected throughout the text and explicitly in several appropriate chapters.
Although the text continues to draw evidence-based principles from nursing, medical science, technology, psychology, public health, and systems-based communication, the new contemporary health care landscape emphasizes a more personalized level of care, which honors the personal dignity, values, and preferences of patients in making significant health decisions and in implementing meaningful care choices in care. Patients are expected to actively engage in their own care and, in partnership with their care providers, to make meaningful care decisions related to achievement of mutually determined health goals. Updated communication skills, combined with patient-centered applications, create the therapeutic partnership that patients nowadays need to have to successfully self-manage long-term chronic disorders.
In 2010 an Institute of Medicine report on the Future of Nursing states: “nurses have a key role to play as collaborative team members, and leaders leading to a reformed, and better integrated patientcentered health care system.” The eighth edition of Interpersonal Relationships: Professional Communication Skills for Nurses has been updated and revised to reflect the realities of this new and rapidly expanding health care landscape with an activated engagement of the patient and family participation in collaborative team-based health care relationships. Emphasis on safety in health care is stressed with a full chapter devoted to the importance of communication in making health care a quality, safe environment, immediately following the opening chapter on conceptual foundations of nursing practice.
The chapters on patient-centered relationship and communication have been updated to reflect the patient/family-centered focus incorporating patient preferences and values as the driver of care. The chapters on interprofessional collaboration and teamwork have been significantly reworked in line with the emerging team-based theme of different health care professional disciplines, working as a team as a preferred care model.
As the world has become better connected through technology, much more gets shared across clinical settings in real time. Nurses
have a pivotal role in making use of e-health technologies at point of care and electronic documentation. Direct relationship centered communication between patients and a provider is further enhanced through secure patient portals.
The central phenomena of professional nursing practice take place within a collaborative interprofessional team of health care professionals with patients, providers, and families working together. This major paradigm shift in health care delivery from a diseaseoriented to a person/family-centered model, which considers the patient as a person, is consistent with Institute of Medicine and other national reports.
The changes we have made in the 8th edition mirror a major paradigm shift in health care delivery from a “disease-focused” narrative to a more contemporary inclusive “patient-centered” preventive and health promotion emphasis in health care applications. The positioning of primary care as an essential component of health wellness is indicated in several chapters.
Greater attention in the text is directed to helping patients and families develop the healthy lifestyle and coping strategies needed to prevent or offset the impact of a marked increase in the incidence of chronic diseases. Such interventions are informed and proactive, as advocated by the Institute of Medicine, the World Health Framework for Action, and the Picker Institute.
The locus of health care delivery has shifted from the hospital to include community-based primary care delivery. Communication for continuity of care, across clinical settings, starting with health promotion and disease prevention, has become an essential component of care delivery. Shared decision making and therapeutic partnerships with patients require that nurses integrate patient preferences, values, motivations, and hopes with evidenced-based biomedical realities as the basis for shared decision making. A collaborative practice-ready workforce offering quality, safe health services strengthens the health care system and leads to improved health outcomes.
Computer technology has introduced a new dimension to health communication, allowing patients and clinical providers an immediate, transparent access to personal clinical records and offers secure portals for immediate discussion with providers. In this 8th edition, Chapter 25 has been retitled as Electronic Documentation, with relevant expanded content related to biomedical technologies documenting improved assessment, medication adherence, patient satisfaction, and sound decision making. New applications of use of technology at point of care are also discussed.
This edition has been revised and updated to meet the challenge of continuing to serve as a major communication resource for professional nurses in a time of significant changes in the national and global health care system. Some chapters have been retitled to better reflect the significance of these changes in the health care delivery system and to provide more up-to-date terminology. The simulation exercises in each chapter offer an additional opportunity for experiential understanding of concepts with appropriate reflective analysis related to each chapter. Although the text’s content, exercises, and case examples continue to be written in terms of nurse-patient relationships, the interactional data are also applicable to clinical practice student relationships entered into by other health care disciplines.
Role clarity and the importance of well-defined, clear communication are crucial to ensuring the safety and quality of care delivery in interprofessional health care environments in which multiple inputs must be coordinated. To emphasize its importance, we have reordered this topic’s chapter position to the beginning of the text so that it may serve as a foundational component of patientcentered communication. The chapter on patient relationships has been thoroughly revised and retitled to reflect the dimensions of patient-centered relationships in contemporary health care.
About the Chapter Organization
Each chapter incorporates a similar format to previous editions, consisting of chapter objectives, concepts, and an application section,
connected by a relevant research study or meta-analysis of several studies relevant to the chapter topic. Suggested simulation exercises with critical analysis questions offer an interactive component to the student’s study of text materials.
The chapters in the eighth edition (as previous editions) can be used as individual teaching modules. The text also can be used as a primary text or as a communication resource, integrated across the curriculum. Chapter text boxes and tables highlight important ideas in each chapter.
The eighth edition presents an updated synthesis of relationships in nursing and team-based health communication, with an emphasis on an integrated collaborative approach to patient- and family-centered professional relationships. Discussion questions for student reflective analysis are placed at the end of each chapter exercise.
The eighth edition is divided into six sections. As in previous editions, Part I: Theoretical Foundations and Contemporary Dynamics in Patient-Centered Relationships and Communication, introduces students to basic conceptual information needed for contemporary professional nursing practice. Chapter 1 traces the development of professional nursing, identifies its fundamental characteristics, and distinguishes between the science and art of nursing. The chapter introduces a theory-based systems approach to communication in contemporary nursing practice. Chapter 2 emphasizes communication concepts and strategies that nurses need to maintain a safe, quality health care environment. In Chapter 3, QSEN communication competencies, the nursing process, BSN essentials, and legal and ethical standards provide structural professional guides to action in health care communication. The process role of critical thinking and clinical judgment in providing safe, quality care is the focus of Chapter 4. Part II: Essential Communication Competencies, identifies the fundamental structure and characteristics of effective patient-centered communication skills and strategies. This section discusses selected professional approaches and communication strategies required for individual, intercultural,
and group communication skill development.
The chapters in Part III: Relationship Skills in Health Communication, explore the nature of patient- and family-centered relationships in health care settings. The chapters discuss communication strategies nurses can use with individuals, groups, and families in health care settings. Applying therapeutic communication strategies in conflict situations and special attention to health promotion community strategies and health teaching complete the section.
The three chapters in Part IV: Communication for Health Promotion and Disease Prevention, emphasize the use of specialized health teaching and coaching strategies as communication tools to support patient understanding and self-management coping. Part V, Responding to Special Needs, focuses on the communication needs of special populations: children, older adults, patients with communication deficits, patients in palliative/end-of-life care, and with those experiencing a crisis.
Part V: Accommodating Patients with Special Communication Needs, professionals from different disciplines working together from different care perspectives as a health care team is recognized as a preferred model of contemporary care delivery. Chapters related to the concept of continuity of care across clinical settings and nursing applications in the use of electronic health records with accompanying taxonomies are discussed. This section also identifies major changes in managing health care data and digital transmission of vital health information. The role of data transfer as an increasingly important form of communication at point of care is highlighted in Chapter 26.
Chapter Features
Each chapter begins with chapter objectives, followed by basic concepts, relevant clinical applications with updated references, and instructive case examples. The Evidence-Based Practice box offers a summary of research findings related to the chapter subject. This feature is intended to strengthen awareness of the link between
research and practice. An exemplar related to Ethical Dilemmas is presented at the end of each chapter.
Simulation exercises, with opportunities for reflective analysis offer students an opportunity to practice, observe, and critically evaluate professional communication skills from a practice perspective in a safe learning environment.
Through active experiential involvement with relationship-based communication principles, students can develop confidence and skill in their capacity to engage in patient-centered communication across clinical settings. The comments and reflections of other students provide a wider, enriching perspective about the person-centered implications of communication in clinical practice.
This eighth edition continues to give voice to the centrality of patient-centered relational communication strategies as the basis for ensuring quality and safety in professional health care delivery. Health care has changed dramatically, with the expectation that patients will be actively involved in their care. Our hope is that the eighth edition will continue to serve as a primary reference resource for nurses seeking to hone their communication and relationship skills in both traditional clinical and nontraditional community-based health care settings.
As the single most consistent health care provider in many patients’ lives, nurses have an awesome responsibility to provide communication that is professional, honest, empathetic, and knowledgeable in individual and group relationships. As nurses, we are answerable to our patients, our profession, and ourselves to communicate with all those involved with a patient’s care in an authentic therapeutic manner and to advocate for the patient’s health, care, and well-being within the larger sociopolitical community.
The opportunity to contribute to the evolving development of communication as a central tenet of professional nursing practice has been a privilege as well as a responsibility to our profession. We invite you as students, practicing nurses, and faculty to interact with the
material in this text, learning from the content and experiential exercises but also seeking your own truth and understanding as interprofessional health care providers in furthering a positive influence on the health care crisis in the United States.
Elizabeth C. Arnold
Kathleen Underman Boggs
PART I
Theoretical Foundations and Contemporary Dynamics in Patient-Centered Relationships and Communication
OUTLINE
1. Historical Perspectives and Contemporary Dynamics
2. Clarity and Safety in Communication
3. Professional Guides for Nursing Communication
4. Clinical Judgment: Critical Thinking and Ethical Decision Making
1 Historical Perspectives and Contemporary Dynamics
Elizabeth C. Arnold
OBJECTIVES
At the end of the chapter, the reader will be able to:
1. Discuss the historical evolution of professional nursing.
2. Describe the core components of nursing’s metaparadigm.
3 Discuss the role of “ways of knowing,” in patient-centered nursing care.
4. Compare and contrast linear and transactional models of communication.
5. Explain the use of systems thinking as a foundational construct in professional health care.
6. Discuss the role of health communication in interprofessional communication.
Introduction
This introductory chapter, provides the groundwork for understanding communication and relationship concepts presented in later chapters. The historical development of professional nursing, communication concepts, and systems thinking offer an evidence-
