Ethic

Disusun oleh :

Abdul Salam
Fauzi Alwi Yannoor

International Class of Nursing Diploma Program

Second Semester Academic Year 2011/2012
Relationship between Nurse with Nurse

We know that communication is the transfer of information between or among people.

The practice of nursing utilizes constant communication between the nurse and the patient, the
patients family, the nurses co-workers, supervisors, and many others. Communication in
nursing can be a complicated process, and the possibility of sending or receiving incorrect
messages frequently exists. It is essential that we know the key components of the
communication process, how to improve our skills, and the potential problems that exist with
errors in communication.

Successful communication has three major components: a sender, a receiver, and a

message. In nursing, we frequently have a great deal of information to send to others in a short
period of time. To do this effectively, we need to know that there are factors which could
influence how our message is interpreted. We must consider the setting in which the
communication occurs, the past experiences and personal perceptions of both the sender and
receiver, the timing of the message, etc.

Break down in communication can cause negative outcomes. We all know how
important it is to give a thorough patient report to the oncoming nurse at shift change. In
situations where this does not occur and important information is not conveyed, treatments,
medications, etc. may be missed. For example, in one situation an oncoming nurse was not
informed that a patient had fallen on the previous shift. The nurse therefore did not know to
assess the patient for injuries or other complications from the fall, or to initiate fall precautions.
The patient fell once again and was injured. This possibly could have been prevented had the
communication between the nurses been complete.
 We know that the trust of our patients and their families is an important part of providing
effective nursing care. If they dont trust us, any communication that we attempt to send to them
may be disregarded. We can take steps to ensure that we have their trust. They may seem simple
and self-evident; however, in our busy practice they are not always followed. The first step
towards effective communication is honesty. Dont tell a patient that you are going to do
something unless you mean it, and if you cant follow through, explain why. Promises, if made,
must be kept. Other important factors are availability and responsiveness. Patients and families
become impatient and sometimes angry when they feel that they are being ignored. Sometimes
these feelings are not reasonable, but sometimes they are justifiable. If we encounter this type of
complaint, we need to take a look at the communication process, timing, etc. between the nurse
and the patient. If it appears inadequate, take corrective action.

It has been said that as much as eighty percent of our communication is non-verbal. We
need to pay attention to our body language, eye contact, and tone of voice when addressing
patients and families. This also is true when addressing co-workers, nursing supervisors, and
virtually everyone else. Conflict among co-workers can impact patients, and sometimes can be
prevented or corrected if we are aware of how our attitude may be interpreted. Also, cultural
awareness can be an important part of the knowledge base that we need to have as nurses when
communicating. For example, we may want to pat the arm or hold the hand of a patient or
family member, but we need to make sure that this behavior is acceptable and not seen as
inappropriate.

Most importantly, we must appear to be empathetic with those in our care. We are the
face of nursing and the face of the facility to our patients and their visitors. We will encounter
many people in our professional lives. They may not remember our names, but they will
remember how we treated them during a difficult time in their lives.
Relationship between Nurse with Profesi

This study explored how nurses communicate professionalism in interactions with

members of their health care teams. Extant research show that effective team communication is a
vital aspect of a positive nursing practice environment, a setting that has been linked to enhanced
patient outcomes.

Although communication principles are emphasized in nursing education as an important

component of professional nursing practice, actual nurse interaction skills in team-based health
care delivery remain under studied.

Qualitative analysis of interview transcripts with 50 participants at a large tertiary

hospital revealed four communicative skill sets exemplified by nursing professionals:
collaboration, credibility, compassion, and coordination. Study findings highlight specific
communicative behaviors associated with each skill set that exemplify nurse professionalism to
members of health care teams. Theoretical and pragmatic conclusions are drawn regarding the
communicative responsibilities of professional nurses in health care teams.

Specific interaction techniques that nurses could use in nurse-team communication are
then offered for use in baccalaureate curriculum and organizational in service education.
Relationship between Nurse with client

Relationship nurse to client use the therapeutic communication begins with the nurse showing
respect for the patient and family members and recognizing that communication includes not
only verbal responses but also nonverbal expressions, such as tone of voice, body language and
facial expression. The nurse must listen and observe carefully and use communication techniques
that promote better communication in order to understand the needs and feelings of the patient.

Use names

"Mrs. Markson, I am John Stevens, your nurse." Using a person's name makes her feel more
valued, and introducing yourself is a basic step in establishing a therapeutic interaction.

Show empathy

You should be honest with the patient and acknowledge his concerns and feelings, answering
questions as completely as possible. Sometimes the patient's nonverbal behavior can
communicate more than words.

Provide encouragement

Patients often want to talk about their concerns but are reluctant to impose on your time or feel
intimidated. Open-ended questioning may facilitate communication: "Miss Jacobson, do you
have concerns you'd like to talk about?" Don't be afraid to allow periods of silence and
encourage the patient by brief acknowledgments, such as "Yes" or "I see." Use your own body
language, leaning forward and nodding your head, to promote communication. Listen for the
implied meanings and encourage people to express them: "When you say there's no point in
complaining, does that mean that your pain is not under control?
Include the patient

You must remember that patient care should be collaborative and include the patient in decision
making whenever possible. The patient often feels at the mercy of the system, but you can help
him find ways to feel in control: "How can we make these dressing changes more comfortable
for you?" Asking the patient is more effective than making assumptions: "Have the physical
therapy treatments helped you to walk better?"

Recognize limits

You should never try to force the patient to talk or express feelings until he is ready. If the patient
doesn't answer a question or chooses not to discuss feelings, back off. Respect the patient's right
to silence. You can indicate an openness to talk: "I'm happy to talk with you about your
treatments when you like."
Relationship between Nurse with Other Profesi

For future nurses still in nursing school: Take advantage of your clinicals times and ask your
preceptor or professor to let you make phone calls to doctors regarding your patient. For
example, let your professor or preceptor listen on one line while you make the phone call and
talk to the doctor on the other. This way if the doctor asks you something you dont know your
preceptor can help you out. Remember dont let the first time you talk to a doctor as a nurse be
when you graduate from nursing school.

Before you call a doctor have one of your colleagues or preceptor go over what you are going
to say. Sometimes this with help bring up questions the doctor might ask you .. this way you
can be prepared.

Always have the patients vital signs, recent lab work, and current medications on hand when
talking to the doctor. There is nothing more embarrassing when calling a doctor and they ask you
a question about one of these things and you say oh hold on let me go find it.

When begining the conversation, always state the name of the patient you are calling about,
room number, why the patient was admitted, and ask if they are familiar with the patient.
Sometimes other doctors cover for other doctors and they may not be familiar with that current
patient so be prepared to state why the patient was admitted. Here is an example of a
conversation:

Hello Dr. Smith. I am calling about John Doe in room 805. He came in with Congestive Heart
Failure exacerbation. Are you familiar with this patient?

No, Im not can you please tell me about them.

The patient came in yesterday with shortness of breath and weight gain of 6 lbs over his
baseline weight. Dr. Jones started him on IV Lasix 80mg BID and he has been responding fairly
well. However, within the past 10 minutes he has been having a new onset of crushing like
chest pain which is why I am calling.
 - Always be courtesy, even if the doctor is rude to you. Sometime during your time as a
new nurse you will encounter a rude physician but it is the best policy to not be rude
back but to be the bigger person.
- Try to have confidence in yourself because if you feel uncomfortable communicating
with doctors it will show while you are talking to them. You will start fumbling over your
words and this will convey to the doctor you are unsure of yourself. So be confident!
- If you have questions on whether to contact a doctor about your patients condition ask
the other nurses on your unit. Ask them what they would do! Remember you are not
alone on the floor and you have resources so use them.

Relationship between Nurse with community

The healthcare community has reached a tipping point, influenced by people exercising a
social gift. The social gift I am referring to is the gift of connectivity, enabled by social media.
When I entered the profession as a young student nurse, communication was, and continues to
be, the conduit enabling connection.

While much has changed, it seems logical to assume that the rules of engagement, as one
human being connects with another, are understood. However, as the wave of digital innovation
transforms our landscape there is concern that our digital voice, while technically silent, is
subjected to amplification and accelerated global transit. As is often the case, much is made of
the risk associated with the use of social media. For example, the threat associated with sharing
inaccurate health information and dissemination of content by healthcare professionals and
students. This may call into question their behaviour and, in some cases, fitness to practice.
This fear is also part of a wider discourse questioning the impact and implications of global
communication and the blurring of boundaries between the personal "I" and the professional
"I"". So why push open a door leading to a digital space? Well, I believe that door leads to
opportunity; a place where "I think" becomes "we think", a space where conversation,
participation and collaboration has the potential to positively influence healthcare.

Patient Opinion offers a digital platform enabling conversations between patients and health
services. It offers an opportunity for "we think", and the sharing of a public story. Another two
platforms are Healthtalkonline and Youthhealthtalk, where experiences and information are
shared about specific conditions, treatment choices and support.

People are becoming health experts, goggling, crowdsourcing and digitally triaging signs and
symptoms. They are listening to public stories and consuming qualitative content.

So how can healthcare professionals, nurses, midwives be part of this digital space, how can we
make a difference?

Ultimately, by upholding the standards of professional behaviour, exercising digital

professionalism. It's not rocket science but it is the code, and while the space may feel different
the rules of engagement focused on trust, treating people as individuals and respecting their
dignity are the same.

How reassuring it is to see the Nursing and Midwifery Council (NMC) leading the way, offering
guidance to support registrants (and students of nursing and midwifery) as they communicate
using social media.

This is not a race, nor is this a power struggle. As qualified nurses and midwives we can help our
patients and our healthcare communities, enabling them to navigate a digital space. We can
signpost to sources of information that have a recognised mark of quality and we can share the
skill of critical appraisal.

We can listen to the public stories and respond. We can be pro-active in support of activities that
promote equality of access and information literacy. We can share our skill and clinical wisdom
(for example, publishing content in open access journals), and connect communities to each
other.

Nurses and midwives can show leadership, encouraging creativity and supporting innovation that
enables people to access and control their healthcare information. We can help our colleagues in
the same way, so no one is left alone isolated in this information revolution.

Ultimately, I believe we can impact on culture such as "the way things are done around here"
role modelling and sharing, so we are all empowered to make every opportunity to communicate
count. So this is my vision of a social gift, the gift of social media.

Referens :

http://www.nursetogether.com/Career/Career-Article/itemid/906.aspx

http://www.guardian.co.uk/healthcare-network/2012/feb/16/social-media-nurses-communicate-
public