Nurses must learn to communicate I
t would appear that a plethora of reports is suggesting that nurses are failing to communicate adequately with their patients; included is the latest offering from the Audit Commission. This is not a new problem, rather it is an old and depressing one, as a literature review of this topic carried out 20 years ago clearly shows (Ley, 1972). Each new generation of nurse educators claims that the problem has been solved. Current teachers assure us that communication is on the syllabus in both pre-and postregistration courses, and they point to Project 2000 (UK.CC, 1986) and PREPP (U KCC, 1990) as the latest aspirins offered up for consumption. Each week new texts appear on the subject, and exalted academic careers are built on the right way to teach nurses’ interpersonal skills. It would be easy to be lulled into a false sense of security; that is until yet another report comes along emphasizing once again the lack of communication be tween nurses and their patients. Where are we going wrong? Various authors have suggested that the problem lies within the profession (Faulkner, 1985), that nurses are not encouraged by their managers to talk to patients, that task is more important than talk. Others suggest that the problem is environ mental (Burton, 1985), that it is the setting that prevents nurses from communicating appropriately. Both arguments have some small merit. There are areas where completion of the task is more important than the opening of lines of communication, e.g. in lifethreatening emergencies, and there are also times when the physical environment docs prevent nurses from delv ing into the more private recesses of their patients’ prob lems. Yet it seems that the malaise is more deep-seated than this. The truth of the matter is that nurses do not value communication as a valid nursing skill; the reason for this is that it is not recognized as being a valuable skill either by the profession as a whole or by those who set the standards within it. The culture of nursing
places more value on such areas as physiology, pharma cology and physical procedures; such values are deeply embedded in every nurse and nurse teacher up and down the country. Communication may be on the syllabus, but it appears only in a secondary role, almost as a sup porting subject to the fundamental sciences. It is posited that this is as true in Project 2000 courses as it is in the traditional forms of training. It is not simply that communication should command more time on the syllabus; it is rather that a firmer emphasis should be placed on that time and the centrality given to the subject. It is not suggested that the fundamental sciences are not important; common sense alone dictates that they are. It is claimed, however, that in terms of every day nursing practice (working effectively as a member of a multidiciplinary team and ensuring the quality of patient care), communication is much more important than the fundamental sciences. If we are to get to grips with this alienation from our patients, the profession must realize that the one essential activity of nursing is communication; not bed baths, not catheterization, not drug rounds, not ECT, but communication. Let us make sure we get the mess age this time. Anni Telford Senior Lecturer in Psychiatry University of Central England in Birmingham Birmingham Burton M (19X5) Tjhe environment, good interactions and interperson al skills in nursing. In: Kagan CM, ed. Interpersonal Skills in Nurs ing; Research and Applications. Crooin Helm, London Faulkner A (1985) The organisational context of interpersonal skills in nursing. In: Kagan CM, ed. Interpersonal Skills in Nursing: Research and Applications. Croom Heim, London Ley I’ (1972) Complaints by hospital staff and patients: a review of the literature. Bull Br Psychol Soc 25: 115-20 U KCC (1986) Project 2000: A New Preparation for Practice. UKCC, London U KCC (1990) The Report o f the Post-registration Education and Prac tice Project, U KCC, London
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