Nursing Skills and The Delivery Of Care

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The range of skills used in the problem based learning sessions was substantial and diverse. The ability to work together as a team was crucial to the project, it was also necessary to communicate effectively, to research the topic using appropriate methods of enquiry, and to aptly employ obligatory skills such as diplomacy and compromise in order to gain the maximum benefit in learning outcomes. For the purpose of this assignment the author will focus on one particular skill that was utilised, an aspect of effective communication; the powerful skill of listening expertly.

Good listening is described as the basis of learning, (Mackay, 1995) as a skill it enables a deeper understanding of people and achieves an appreciation from the person talking that what they say is both valued and respected. During the problem based learning sessions listening skills were utilised and were effective. This was evident because there were certain aspects to the sessions that demonstrated good listening; for example each participant displayed undivided attention to the person speaking.

Each member of the group refrained from interrupting the person who was speaking and tended to utilise non-verbal responses such as nodding or direct eye contact to indicate their level of attention. During the discussion element of the session some of the group members paraphrased a statement that they had listened to in order to clarify its meaning and thus display an understanding of what was said. This is a key skill sometimes referred to as ‘reflective listening’, and confirms to the speaker that they are the focus of the listeners attention.

The skill of listening is often undervalued, (HILP, 1999) and yet listening carefully and skilfully can lead to better comprehension and a deeper awareness of what the talker is actually saying. (Burley-Allen, 1995) In the practice setting, better understanding and an appreciation of what patients and work colleagues are saying would, without doubt, influence the organisation and delivery of patient care.

There are numerous ways that listening skills can be utilised in the practice setting, and these skills can be draw upon when dealing with patients, or other members of the multidisciplinary team during the organisation and the delivery of care. A team of nurses may have great difficulty implementing the planned care if the person who delegates their duties did not listen and respond effectively to spoken or non verbal concerns regarding actual, potential or perceived problems in the organising of staff duties, roles or tasks.

To organise the delivery of care successfully a manager, team leader and the staff they are leading all benefit from good listening skills. A vast proportion of time spent during organisation of care requires listening skills. It is often a mistake to assume that good communication involves only the distribution and imparting of knowledge and information to other parties. Good and effective communication should also engage with the receiving of information and knowledge that is gained from good listening skills. Rees, 1991) An example of how organising care can be enhanced in the practice setting is for the person delegating duties to listen carefully to how the nursing staff and other multi-disciplinary team members feel and say about the established routines. Based upon the information gathered the organisation of care could then be modified to take into account the learned information.

Such issues as staffing levels and competencies are fundamental to the organising of care, and listening skills are imperative to ensure that the organisation of care takes into account a nurse’s own acknowledgement of their limitations, as required by the code of professional conduct. (UKCC, 2002) Delivery of patient care is influenced by how good or poor the communication between nurses and patients is, and communication between other members of the multi-disciplinary team also influences the care that is given. Effective communication requires good listening skills as stated previously.

Listening to and respecting what patients are saying empowers them with the autonomy to actively participate in the care they receive. (Cribb, 1993) Listening to the concerns and opinions of other members of the multi-disciplinary team can also affect how care is delivered. Mistakes and confusion may occur if team members do not listen to each other, a lack of acknowledgement and respect for each person’s input can lead to adversely influenced care. In order to benefit the patient with good care the nurse can use listening skills to enhance the relationship with the patient.

To listen effectively the careful choice of environment is valuable, privacy may be required, and eye contact shows the other person that you are focused on listening to them. (CancerBACUP, 2002) Delivery of patient care with a holistic approach requires careful consideration to every aspect of their care including the psychological needs of both patient and relatives. (Cribb, 1993) The use of listening skills as part of the nursing role can enhance the delivery of care holistically because a greater awareness, insight and knowledge into the patient’s feelings, thoughts, and psychological needs is usually achieved through careful listening.

A fine example of how listening skills influence the delivery of care in a beneficial way is Harteveldt’s (2002) description of his personal experience when his wife was dying of cancer. He describes how the nurses’ listening skills and the use of silence were so important during his wife’s palliative care and also after her death. To conclude, the use of good listening skills as a method of communication could influence the organisation and the delivery of care in a positive and effective manner.

The lack of this skill can cause confusion and other problems in the organisation of patient care and it can also be detrimental to the delivery of good care. Listening skills encompass many factors; environment and other issues like eye contact are all important, however, listening as a communication skill is often overlooked and undervalued. The way forward is for nurses and other members of the multi-disciplinary team to develop their ability to listen effectively and to utilise this valuable skill to enhance the organisation and the delivery of care to patients in their practice setting.

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