Communication is an extremely important element of human life. In fact, it is due to communication people can achieve really great results in the interpersonal relationships. At the same time, communication is extremely important for the efficient work of different specialists, including mental health professionals. Unfortunately, good communication is not a characteristic of all people. In stark contrast, only few are really good communicators while the rest should develop their communicative skills by observing people who communicate well (Watts 1986). Obviously, communication is an integral part of my future work in the mental health nursing since it serves as a basic component of the therapeutic nurse-clients relationship and the nursing process occur through this medium.
In fact, it is hardly possible to imagine a normal relationship without communication. Practically, the lack of communicative skills may lead to negative results of a mental health nurse because patients are extremely sensitive to the communication, to a significant extent because of their mental health problems. It is not a secret that often they feel deprived of a possibility to freely communicate with other people. This problem is aggravated by often negative attitude of social environment to such people because of existing stereotypes and prejudice. As a result, people with mental health problems turn to be in a sort of exclusion from society and their self-esteem gets to be extremely low basically because of the lack of communication since they feel as if they are a kind of outcasts who other people do not want to communicate with or, what is probably even worse, whom the rest of society does not perceive as equal members of the community.
In this respect, it is worthy of mention that Vydelingum (2000) suggests that ineffective communication remain a potent barrier in healthcare and that wide variations are evident in terms of the quality and quantity of nurse-patient communication. At the same time, it is important to underline that the concept and essence of communication is not always clear and, in actuality, this process turns to be extremely complicated.
To put it more precisely, communication is not simply the direct verbal communication that involves only the process of speaking and listening. In fact, the process of actuality involves practically all human senses and this is why a good communicator has to possess great skills in both verbal and non-verbal communication. Moreover, it should be said that the latter is even more important than the former because about 90% of the information people have is based on the decision of non-verbal communication and people arrive at the conclusions on the basis of language and other non-verbal clues.
As Kacperek (1997) claims, nursing is dependent on effective communication basically because nurses spend the most time with patients and, in actuality, often they serve as a link between patients and the multidisciplinary team, including not only mental health professionals but social workers as well. Moreover, in certain cases, nurses turn to be practically the only link between a patient with mental health problems and the surrounding world. This is why their communication is of a paramount importance since it provides the possibility for the patient to get not only attention but also proper treatment from the part of a nurse. It means that patients need not only particular attention from the part of the nurse but they also should be treated as equal in the process of communication and they should have a possibility to be in possibly equal conditions with nurse-communicator.
This is why nurses need to develop and apply effective communication skills. At the same time, it is necessary to remember about the great significance of non-verbal communication, especially with people with mental health problems which have special needs, since often they are physically deprived of a possibility to normally perceive non-verbal message of the communicator. Consequently, the verbal message should be accompanied by the proper and respective gestures and posture.
In such a context, I could draw some examples from my recent clinical practice placement. For instance, I experienced the work with older people with dementia. One of the patients could not remember things and he kept asking me the same questions repeatedly, had some difficulties in expressing himself of some needs such as hunger and thirst. This is why I made literature search and find out that it is recommended in communication with people with dementia to eliminate distractions and take time with service users, be relaxed since they are highly sensitive to gestures and body language, use plain verbal language, make your sentence very brief, and give the person time to respond. These recommendations substantially helped me improve communication with this patient.
Furthermore, it should be pointed out that Young and Hayes (2002) underline that therapeutic relationship occurs when the nurse assists the service users to meet their goals. To put it more precisely, in the process of communication with patients nurses should take into consideration the needs and goals of the former. Practically, it means that if you communicate with a patient who is sitting it is better to be on the same level to avoid appearing intimidating. Or else, quite places are recommended if long communication is needed.
In this respect, it is worthy of note that Hines (2000) observed that a deficiency in effective communication with hearing-impairment patients is due to inadequate training of doctors and nurses. For instance, in order to increase the efficiency of communication with such patients it is recommended to cut down on background noise because this can make it difficult for the patient to pick out your words above the hum of other conversations. Also, there is no need to repeat one and the same phrase several times if the patient did not hear or understand you. Instead, it is better to say the same phrase but in different words and speak more slowly and distinguishably.
It should be said that in the communication with hearing-impairment patients, verbal language may be practically inefficient, for instance, in the case of the profoundly deaf. In such a situation, it is worthy of returning to non-verbal communication, such as sign language or develop communication through writing.
Another example of possible problems in the communication with people with mental health problems may drawn from the communication with patients who have visual-impairment such as cataracts or glaucoma. The non-verbal communication with such patients may be a bit problematic because of their inability to clearly see your facial expression, gestures, etc. In such a situation, it is basically recommended to ease the communication by ensuring that you sit reasonably close to the persons and within their range of vision, while the room should be bright as well to enhance better vision.
At the same time, in the modern world the development of traditional verbal and non-verbal skills is obviously insufficient for a professional mental health nurse. In fact, nowadays the development of new technologies provides new opportunities for communication and receiving information. This is why I am currently encouraged to improve my IT skills which I really need as I am using the technology to communicate and retrieve information about clients.
Also, it should be said that the communication of a mental health nurse is not limited by patients only. In stark contrast, nurses need to develop their communication skills to increase the efficiency of their communication with other members of the team for the benefit of patients by sharing essential information and experience. Moreover, it is equally important to communicate efficiently with social workers, members of patients’ families, etc.
As for the patients, it is necessary to remember that to support their self-esteem and improve their state it is necessary to treat them as equal in the communication, meet their goals and special needs. For instance, listening is a sign of respect that re-enforces verbalization by the individual in crisis. It is also important to respect patients’ confidentiality that means respecting their wishes (Scudding 1993). In this respect, it is worthy of mention that NMC (2002) states that nurses should ensure that patients understand that some information may be made available to other members of the MDT involved in the delivery of care as it is impossible to obtain consent every time information is needed to be shared with others.
Thus, taking into account all above mentioned, it is possible to conclude that mental health nurses should constantly improve their communication skills and remember that communication is very complicated processes and constitutes both verbal and non-verbal elements. At the same time, the modern technologies progress rapidly that imposes new demands on the communication such as the development of IT skills. Obviously, to acquire all essential information concerning communication it is necessary to constantly search literature dedicated to this problem and learn information about recent achievements in this field. In fact, good communication skills are essential for highly professional nurses because this is one of the basic conditions of the successful treatment of patients with mental health problems and often they have special needs.
1. Hines, J. (2000) Communication Problems of Hearing-Impaired Patients: Nursing Standard 14(19), 33-37.
2. Kacperek, L. (1997) Non- verbal Communication: The Importance of Listening. British Journal of nursing Vol.6, 275-9.
3. Nursing and Midwifery Council (2002) code of professional conduct. London: NMC.
4. Ropper, N. et al (1996) The Element of Nursing 4th Ed. New York: Churchill Livingstone.
5. Tschudin, V. (2003) Approaches to Ethics. London: Butter worth, Heinemann.
6. Vydelingum, V.(2000) South Asian Patients Livid Experience of Acute Care in an English Hospital: A phenomenological Study. Journal of advanced Nursing.32 (1)1000-107.
7. Young, L.E. and Hayes, V. (2002) Transforming Health Promotion Practice: Concept Issues and application. Philadelphia: Lipincott.
8. Watts, F (1986) Dynamic Patterns in Communication processes. London: Penguin Books.