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Communications Within The Standards Of Nursing Practice Workbook (British Columbia College of Nurses & Midwives)

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Communication
BCCNM LEARNING MODULE — WORKBOOK
Within the Standards of Nursing Practice
Communication Processes
in Daily Nursing Practice
Identify 3-4 examples of
communication interactions that
you had during a recent workday.
For each of these examples, identify
who you communicated with, what
form of communication occurred
and the purpose or goal of the
communication interaction. Record
your conclusions in the table below.
An example has been provided to
help you begin.
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who did i
communicate
with?
brief description of
communication.
what form did the
communication take?
what was the goal or
purpose of communication?
Client Talked with client about how
client was feeling after surgery.
Discussed levels of pain, fatigue
& activity. Provided information
about reasonable expectations for
all of these factors.
Verbal.
Non verbal – smiled when greeting
client. Written (gave post-operative
information sheets)
Client assessment. Information
sharing. Supporting best
surgical recovery. Supporting
client in process.
Components in Communication Processes
To begin, select 2-3 communication
interactions from the analysis you
completed in Activity # 1. Using
these as a basis, and reflecting more
widely on your communication in
nursing practice if you wish, note
the common components that make
up each of your communication
interactions. For example, you may
notice that each communication
interaction includes a message
being ‘sent’ from you to the other
person.
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Now consider how these components relate to one another, for example, does one precede another?
Do they occur at the same time?
Your analysis does not need to
be complex or detailed and you
can record them in any manner
that makes sense to you. The
goal of the activity is to develop a
sense of the various components
within a ‘typical’ communication
interaction in your nursing practice
and the relationships between
these components. If you know
of nursing colleagues that are also
completing this module you may
find it helpful to compare your
conclusions with theirs.
The Nature of Communication
Return to the various
communication interactions that
you described in Activity # 1.
• How much of your
communication is linear,
asynchronous or synchronous?
• Which of these forms of
communication do you feel more
or less comfortable or competent
with? Use the information from
the module to help you identify
reasons for your conclusions.
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With the following principles of communication in mind, reflect on your examples (or your communication from
a broader perspective). What insights do these offer?
• intentional and nonintentional communication
• communication is always happening
• the meaning is not just in the words
• communication is not a solution to all problems
Now take a few moments to
reflect on this section of module.
What have you learned about
communication processes in your
nursing practice? Were there
aspects of your communication
that were affirmed by the discussion
and workbook activities? Perhaps
you experienced an‘ah-ha’ moment
regarding a challenge or insight in
your communication ?
Record your conclusions on the
“Affirmations and Insights” page
located towards the end of this
Workbook. At the completion
of the module, you will have an
opportunity to use the insights
and affirmations gained in various
learning activities, as part of your
planning for future professional
growth and development.
Communication Competence
Identify 2-3 different situations or
contexts in which you communicate.
Some examples might include
providing information to others
about a client’s condition,
expressing feelings, advocating for
client care with other members
of the health care team, giving
‘handover report’, communicating
with families, or handling conflict.
For each situation, consider your
communication competence
by reflecting on the following
questions:
• Do you have a wide range of
response styles or do you always
respond the same way regardless of
the situation?
• In the midst of a communication
interaction, are you able to choose
the most effective communication
actions? Or do you find yourself
wishing later you had spoken or
responded differently?
• Are you skillful in carrying out the
actions that you do choose?
• In what ways do you try to under-
stand the other person’s perspective?
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Now take a few moments to reflect
on this section of module and this
activity. What have you learned
about your communication
processes? Were aspects of your
communication affirmed by this
discussion and workbook activity?
Or perhaps you have experienced
some new insights regarding a
situation-based challenge you
experience in your communication
in your nursing practice?
Record your conclusions on the
“Affirmations and Insights” page
located towards the end of this
Workbook. At the completion
of the module, you will have an
opportunity to use the insights
and affirmations gained in various
learning activities, as part of your
planning for future professional
growth and development.
Effective Communication: Self
Please reflect on and respond
to the following questions.
With each question, consider
the influence of the self-related
quality on the effectiveness of your
communication.
Self-knowledge
• Is there a client group or an
individual with whom your
beliefs, values or life experience
challenge your capacity to
engage in conversation or to
listen attentively? How does this
influence the effectiveness of your
communication?
• Have you ever noticed a time
when the preconceptions or
assumptions that you brought
to an interaction impacted your
communication? What was
the influence of this on your
communication interaction?
Authentic presence
• What factors support or inhibit
you in being an authentic
presence in your communication
interactions with client, families
and colleauges?
Curiosity
• When you think about your
communication interactions
with family, clients or health care
professionals, would you describe
your ‘usual’ approach as one of
curiosity and discovery or one in
which you seek to confirm what
you think is true?
Flexibility and intentionality
• What is your usual response when
communication interactions take
unexpected twists and turns? Do
you push on with your original
‘agenda’ or are you able to adjust
to the new information that is
emerging?
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Key Elements of
Effective Communication
Describe a situation when you felt
you communicated effectively. This
can be done in point form if you
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Describe a situation where you felt communication ‘fell apart’ or ‘fell short’ of what you were intending or
wanting. Again, include details that provide a sense of the situation: what you said, what you did and so on.
Now, consider each of these situations in light of the key elements of communication that we have just
discussed. Using the various aspects of these elements that were addressed in the module, consider how
self, perceptions, language, nonverbal communication and listening influence the effectiveness of your
communication in each of the situations.
wish, but be sure to include details
– what you said, what you did and
so on.
Record your conclusions on the
“Affirmations and Insights” page
located towards the end of this
Workbook. At the completion
of the module, you will have an
opportunity to use the insights
and affirmations gained in various
learning activities, as part of your
planning for future professional
growth and development.
Contextual Influences in
Effective Communication
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Now take a few moments to reflect
on this section of module and this
Workbook Activity. What new
insights have you gained related to
the influence of context on your
communication processes? What
aspects of your communication
have been affirmed? Record your
conclusions on the “Affirmations
and Insights” page located towards
the end of this Workbook.
Return to the examples of effective
communication and ‘less than
effective’ communication that
you identified in Activity #6.
Using the information presented
in this section of the module,
consider the influence of
various levels of context on your
communication. In what ways
did your relationship with the
other individual, the nursing unit
(culture, lines of communication)
and the larger health care system
influence the effectiveness of your
communication in these situations?
Inter-professional Communication
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Now take a few moments to reflect
on the section of module addressing
Handover report and Inter-
professional communication. What
aspects of your inter-professional
communication have been affirmed
by this information? Have you
recognized any areas of your
communication that you would like
to develop further? Record your
conclusions on the “Affirmations
and Insights” page located towards
the end of this Workbook.
Choose a recent situation in your
nursing practice in which you were
required to communicate with a
member of the health care team
who was not a nurse. Now review
this interaction with the following
ideas in mind:
• How effectively do the
key elements of effective
communication (self, language,
perception, nonverbal
communication and listening)
support your communication
in this interaction?
• In what ways, if any, did the
culture of your health care team
influence this communication
interaction?
• Consider the exchange of
information in this interaction.
Was information relevant and
presented in an organized
manner? How did this influence
the effectiveness of the
communication?
Documentation
Recall a time in your practice when
documentation has been a barrier
for you in the process of providing
optimal nursing care. You may
find it helpful to note down details
of the documentation and the
surrounding situation.
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Now take a few moments to reflect
on this section of the module and
this Workbook Activity. What
aspects of your documentation
and communication practice have
been affirmed by this information?
Have you recognized any areas that
you would like to develop further?
Record your conclusions on the
“Affirmations and Insights” page
located towards the end of this
Workbook.
Locate the following BCCNM publications related to documentation:
• BCCNM Practice Standard for Documentation:
https://www.bccnm.ca/RN/PracticeStandards/Lists/GeneralResources/RN_PS_Documentation.pdf
• BCCNM Practice Support Guidelines for Nursing Documentation:
RN: https://www.bccnm.ca/RN/PracticeStandards/Pages/documentation.aspx
NP: https://www.bccnm.ca/NP/PracticeStandards/Pages/documentation.aspx
Using the information and direction presented in these publications, as well as the discussion presented in this
section, determine sources of concern in the documentation that contributed to your experience. For each
source of concern, identify changes in the documentation that would have supported you in providing effective
nursing care.
Giving and Receiving
Feedback
Return to the notes you made
during the previous Reflection
Point in which you considered a
positive experience of giving and
receiving feedback. Compare your
thoughts to the ideas presented in
this module and consider how your
understanding might guide your
future experiences of giving and
receiving feedback.
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Choose a situation from your nursing practice in which you had to provide feedback or will have to provide
feedback in the near future. Locate the resources regarding Peer Feedback.
Using this information, as well as the discussion presented in this section of the module, plan out the key steps
in providing feedback in your identified situation.
Communicating in
Challenging Situations
Choose a challenging situation in
which you had to communicate
with another health care
professional, client or family
member e.g. a conflict-based
situation. Note down the key points
of that communication interaction.
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Using the information presented in the module, review the situation and identify your areas of strength and
areas for development related to communicating in challenging situations.
Now take a few moments to reflect
on this section of the module. What
aspects of your communication
practice have been affirmed by this
information? Have you recognized
any areas of your communication
that you would like to develop
further? Record your conclusions
on the “Affirmations and Insights”
page located towards the end of this
Workbook.
Communicating
Difficult Messages
Choose a situation in your nursing
practice in which you have had
to share a difficult message with a
client or family member (or a health
care professional, if you wish). Take
some time to think about how this
situation unfolded: what you said
and did, how you felt, how effective
you felt your communication was.
Note down the key points.
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Using the information provided in the module, identify your areas of strength and areas for development with
respect to communicating difficult messages.
Record your conclusions on the “Affirmations and Insights” page located towards the end of this Workbook.
Communication in Nursing Practice:
Planning for Professional Growth
This final learning activity will
guide you in developing a plan
for future development of your
communication skills and processes.
Please refer to the last two pages in
the Workbook for a plan outline
and plan example.
Begin by reviewing “Notes from
Reflection Points” and “Affirmations
and Insights” pages in this
Workbook. These pages highlight
conclusions you have formed
about your communication as you
worked through this module. Now
its time to put those ideas to use!
Take some time to read through
these conclusions. First, notice
and acknowledge your strengths.
Then pay attention to the areas
that you have identified as areas for
development and growth. As you
read these, notice which ones seem
to resonate with you or feel most
important to you. Use these
conclusions to determine the goals
that will support ongoing growth
of your communication skills
and abilities.
Create three goals that reflect your
focus for development in your
communication. Write these in the
appropriate place in “My plan for
growth in communication”.
The next step is to develop an action
plan to help you meet those goals.
Begin by identifying resources
that you could use to assist you in
meeting your goals. If you are not
aware of specific resources, then
begin by listing the sources you will
explore in order to learn what
you can do to support your growth
toward your goals.
Once you are familiar with the
learning opportunities that are
available to you, create an action
plan that outlines specific strategies
you will use, what resources you
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need in order to implement these
strategies (e.g. who do you need
to talk to, learning materials
you want to acquire, learning
experiences you need to arrange
etc) and, importantly, a target
date for completion.
Not sure how to do identify goals
and create an action plan? The
planning for growth page has
provided a brief example of this
process (see last page of workbbok).
As well, it is recommended that you
use the BCCNM Quality Assurance
resources to assist you help in this
process.
Finally, add your plan to your
Quality Assurance file or portfolio.
And remember to update it once
you have completed the actions!
Notes from Reflection Points
page 14communications within the standards of nursing practice workbook
Affirmations and Insights
page 15communications within the standards of nursing practice workbook
My plan for growth in communications
Goals
1.
2.
3.
page 16communications within the standards of nursing practice workbook
Action plan
People or places that I can investigate for learning strategies to help me meet my goals for growth are:
1.
2.
3.
Specific strategies that will help me in meeting my goals are
strategy resources i need
to implement this
strategy
target
completion
date
other thoughts
Reminder: Add your completed action plan to your Quality Assurance Portfolio.
A P P E N D I X 1
My plan for growth in
communications: example
Goals
1.
2.
3.
page 17communications within the standards of nursing practice workbook
Action plan
People or places that I can investigate for learning strategies to help me meet my goals for growth are:
1.
2.
3.
Specific strategies that will help me in meeting my goals are
strategy resources i need
to implement this
strategy
target
completion
date
other thoughts
Reminder: Add your completed action plan to your Quality Assurance Portfolio.
To become familiar with best practices related to electronic documentation
Talk to Clinical Nurse Educator and/or Nurse Leader on Nursing Unit for suggestions about learning resources
Example: detailed plan
1. Review resources available in
my nursing unit
2. Review BCCNM resources
regarding electronic
documentation.
1. None – just look on
the shelves & on the
Intranet at work!
2. Use work or home
computer to do this.
Web site URLs in
Learning resource
section of module
1. During my next set
of scheduled shifts
2. By end of this
month
3. By end of next
month.
Could ask the nurse educator
at work – maybe she can help
me with this?
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