Communication remains a significant aspect in patient care. This is because patients need to be aware or have information about their conditions and how they are being managed. The same also applies to their families and friends. This information has to be relayed to them in whatever circumstance while giving them hope and avoiding deep medical information that they may not entirely understand. This discussion delves into the scenario in the second case. A nurse has just reported for their evening duty and there is no adequate information regarding a patient who has not yet been care for. The patient had a fall near a supermarket and sustained serious head injuries. She was supposed to be transferred to the intensive care unit for management but this has not been done. She is accompanied by her family members who are agitated that their insufficient attention has been given to their patient who is now unconscious. Clearly, there is a communication gap between the day and evening shift and between clinical staff and patient’s family members. This discussion delves into the applicability of the VERA framework and its suitability in this scenario. Other important tools necessary for proper communication between nurses are also discussed.
The VERA framework is most commonly utilized in patients who are in a confused state. In this case, this framework effectively addresses the needs of the patient’s family members. On the same note, there should be some improvements in nursing tools to enhance communication between nurses. These include handover notebooks, patient care files and nurse notebooks (Black, 2016). All these are aimed at addressing the communication gap. The evening shift nurse is not aware that the patient has not been taken to intensive care nor that she is accompanied by her family members. All these components should be contained in these tools. Furthermore, there are established nursing communication tools that ensure proper communication between shifts. The essence of this is to ensure a sense of continuity of care. Patients have to be accorded the same care that a nurse in the previous shift would have offered them. These tools enable the incoming nurse to take over from the point attained during the previous shift. The SOAP tool for instance, has four items in its constitution (Anderson, Malone, Shanahan, & Manning, 2015). All these four items are represented in the acronym. The first item is subjective data that contains the patient’s chief complaint, history of presenting illness and other information that directs to a certain possible diagnosis (Anderson, Malone, Shanahan, & Manning, 2015). The second component is the objective data which outlines the tests and investigations that have been ordered and conducted. This should also outline results obtained from these investigations (Anderson, Malone, Shanahan, & Manning, 2015). The assessment portion describes the possible diagnosis as attributed to the results of the investigations conducted. This is then followed by the plan of management that outlines where the patient will be admitted, medications prescribed and other possible therapeutic interventions (Anderson, Malone, Shanahan, & Manning, 2015). Likewise, the ISOBAR communication tool is important in handover. This is also an acronym that represents identity-situation-observations-background-agreed plan-read back (Anderson, Malone, Shanahan, & Manning, 2015). This tool ensures effective passing of crucial patient information from one nurse to the next in the incoming shift.
As earlier described, this scenario describes a poor communication between nurses and between caregivers and their patients. The patient’s family members are stranded and agitated within the hospital premises because their patient has not been accorded the care that she was supposed to receive. She was received in the morning shift and was scheduled for admission into the intensive care unit for management. This has not yet been done and she has deteriorated to an unconscious state. Patients have a right to information (Riley, 2015). The morning shift nurses did not relay adequate information to the family members neither did they fully brief the incoming nurse on the management plan for the patient or the fact that she was accompanied by her family.
The major nursing concepts that need to be addressed in this case scenario are stress and health. The hospital environment may a stressful environment for both medical and non-medical staff. The medical staff may be stressed due to overworking conditions and work-related issues. On the other hand, non-medical staff are new to this environment and may be subject to stress as a result of the long queues, medical procedures taking place in the doctor’s offices and the deteriorating conditions of their patients. Nurses have a central role in dealing with these issues (Black, 2016; Hojat, 2016). This lies in simply communicating with patients and their relatives. They have a role of assuring them that they have handled patients with these conditions before and they have been discharged in a good state of health (Black, 2016). This will be accompanied by relaying information on the therapeutic management strategies that are being employed on their patients. Poor relaying of information to patient’s relatives may be the probable reason for the hash reception accorded to the nurse. Communication should be done hand in hand with carrying out a specific activity that addresses the patient’s needs (Black, 2016). For instance, in this scenario, the nurse can dress the patient’s wounds and hasten their transfer to the intensive care unit.
The VERA framework is a suitable framework in this scenario. This framework is an acronym for the steps involved in this framework. These steps include validation, emotion, reassurance and activity (Beard, 2015). The validation step is the most important step in this framework. In this, the nurse addresses the patient’s family on what has been done so far to manage or care for their patient (Beard, 2015). This is done in concert with an explanation of the issues surrounding patient care. This will involve detailing to them why the patient has not yet been transferred to intensive care. An important component of this step is offering an apology (Beard, 2015; Hojat, 2016). This is appealing to their emotional aspect. Appealing to their emotional issues is crucial in calming their temperaments and building their patience and confidence with the healthcare providers and the system in general (Beard, 2015). The healthcare system is similar to a business organization where patients are the customers (Riley, 2015). Their satisfaction is crucial in ensuring the continued presence and relevance of the health institution in the society.
The next step in this framework is reassurance. This is coupled to the first two steps. While in the process of explaining to the family members what has been done so far and appealing to their emotional component, the nurse should reassure the family members and the patient that they are incompetent enough to handle this condition (Beard, 2015; Riley, 2015). They should state that they have tackled these cases before and that patients have recovered form similar states. This is important because it reduces the likelihood of the patient developing negative attitudes, assumptions or doubting that the caregivers can actually handle their patients. The final step in this framework is activity. In this step, the nurse actually does something that directly benefits the patient (Beard, 2015). For instance, they can dress the patient’s wounds and contact the intensive care assistants to take the patient to their unit. Alternatively, they can individually wheel them to this unit for admission. The significance of this is to make the family feel that the caregiver is actually concerned about their patient and doing something about it (Riley, 2015). For these aspects to be properly elaborated, necessary input is required from nurses in the previous shift. This is effective with properly kept and maintained SOAP and ISOBAR records. These records outline patient information and management plans that have been proposed to care for the patient (Anderson, Malone, Shanahan, & Manning, 2015). This ensures smooth transition to the nurses in the incoming shift.
In conclusion, proper communication is an important tool in patient care. This is because it contributes to patient satisfaction and reducing unease in the patient’s family members. The VERA framework is one of the most applicable frameworks in ensuring better communication in this scenario whereby the family members are distraught over the poor level of care that has been accorded to their patient. For there to be proper communication between caregivers and their patients, the healthcare professional themselves must embrace and utilize the available communication tools. Verbal communication may not be sufficient or applicable during shift changes. The SOAP and ISOBAR nursing tools provide an appropriate mechanism through which nurses can communicate with one another as they change shifts. These tools contain brief information regarding the patient and are important in ensuring better continuity of provision of care by incoming nurses.
Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover-an integrated review of issues and tools. Journal of clinical nursing, 24(5-6), 662-671.
Beard, C. (2015). The Development and Piloting of an Education Intervention Based on the VERA Framework to Support Student Nurses’ Person Centered Communication for People Living with Dementia: A Research Proposal (Doctoral dissertation, King’s College London).
Black, B. (2016). Professional Nursing-E-Book: Concepts & Challenges. Elsevier Health Sciences.
Hojat, M. (2016). Empathy in health professions education and patient care. New York, NY: Springer.
Riley, J.B. (2015). Communication in nursing. Elsevier Health Sciences.