Promoting Health Maintenance In Seniors: Community Service/Resources, Elder Abuse, Therapy, Grieving, Communication Strategies, And More

Community Service/Resources to Promote Health Maintenance in Seniors

It is important to apply various communication strategies to facilitate communication with a person from a diverse cultural and linguistic (CALD) background. Briefly describe how you would apply the following 3 (three) principles when communicating with a person from the CALD background (in 30-50 words each).

Courtesy can be shown towards persons from culturally and Linguistically Different (CALD) Backgrounds through respect and openness to listen to them. Being polite and respectful towards the personal boundaries is also another important strategy. Such aspects should be exhibited in both verbal as well as the body language.

Consideration:

The differential cultural and psychological needs of people from CALD should be also considered, understanding that such is a part of the cultural diversity, and as a professional, one has the responsibility to respect that diversity and take that into consideration while providing services to people from CALD backgrounds.

Clarity is one of the most effective ways of conveying information, and thus a basic strategy in any communication. Clarity of message ensures that the information contained in it is understandable or decipherable by the recipient. While communicating clarity can be ensured in the context of communicating the goals and objectives, as well as outlining the expectations and considerations.

The following table identifies various characteristics of effective partnerships in nursing. Complete the table below by providing an example of how you could apply each of these characteristics in your nursing interactions.

Characteristics of effective partnerships provide an example of how you could apply each of these characteristics in your nursing interactions:

Confidentiality (of patient’s or clients personal information) can be ensured by preventing the misuse and unauthorised access to the information, and ensuring that it is accessed and shared only on a need to know basis with the relevant professionals. Moreover, any access to the personal information should be done only after a prior approval from the patient or client or service user.

Trust of the client or patient is an aspect that needs to be earned instead of just expecting it. To earn trust, a professional should show values such as respect, confidentiality, non malefiscience, justice, respect for autonomy and beneficence. Through such values, a nurse can earn the clients/patient’s trust.

Self reflection can be incorporated to professional nursing practice by keeping self reflective journals that details the daily experiences, and thoughts related to the day to day activities, what knowledge can be acquired from them, and the learning objectives or skills that are to be further acquired.

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Social conversation

Social conversations can include asking the patient or client about their lives, work, families or friends and about things they like or enjoy doing, trying to find out what types of social interactions they enjoy. This can also help to set up a therapeutic conversation.

A therapeutic environment can be ensured only when the environmental stressors are reduced or eliminated from a care environment, and also fosters positive distractions, social support and provides the patients or client a general sense of control. Also, specific aspects such as control of noise, considering the left or right handedness of patients, access to daylight, proper lighting, closeness to other staff and help and using appropriate technologies can also be suggested.

An effective communication process requires you to understand and apply various elements and related skills such as active learning, negotiation and interpersonal skills.

3.1 Identify and describe 2 (two) Interviewing techniques you could use when interacting with a patient.

Two communication techniques that can be used with a patient that would exhibit active learning, negotiation and interpersonal skills are:

1. a) Focussing on the improvement of the wellbeing of the patient
2. b) Ensuring the communication is respectful, appropriate and clear for the client or patient.

3.2Describe3 (three) Non-verbal and3 (three) Verbal signs of active listening (in 30-50 words each).

Non verbal signs of active listening includes: postures, eye contact and giving positive reinforcements. A proper posture can exhibit whether a persona is actively listening or not paying much attention. For example having a conversation while sitting straight, as opposed to slouching down. Also keeping an eye contact while communicating helps to ensure that the person is actively listening. Positive reinforcements in the form of non verbal nods and mirroring the emotions of the other person can also exhibit active listening.

Verbal Signs of active listening includes verbal nods, repeating the information and seeking clarifications. Verbal nods helps emphasises the person is actively listening to information, and ready for the next information. Repeating the information and seeking for clarifications also helps to exhibit that the information is being actively followed.

3.3 Identify and describe 3 (three) Strategies you could implement in resolving a conflict.

Three important strategies that can be used to resolve a conflict are:

1. a) Accommodating, b) collaborating and c) compromising

3.4 Provide 5 (five) Examples of interpersonal skills you should demonstrate when communicating in a nursing environment.

1. a) Patience
2. b) Empathy
3. c) Self reflectivity
4. d) Active listening
5. e) Emotional Intelligence

3.5 Describe the steps you should follow when negotiating solutions to ensure that the process runs as smoothly as possible (Hint: four central guidelines to the principled negotiation approach) (in 70-90 words).

While negotiating or resolving a conflict situation, a principled negotiation approach can b used, which can be done in 4 steps:

1. a) Separating the people from the problem
2. b) Identifying the interests and positions of the negotiating parties.
3. c) Understanding the differences in opinions to ensure mutual gain
4. d) Basing the outcome from principled negotiation on the objective criterion.

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3.6 Identify and describe 3 (three) Approaches you could implement to improve group dynamics in your work setting.

Group or team dynamics can be improved through the following strategies:

1. a) Understanding the group or team
2. b) Managing conflicts and challenges incorporating effective feedback
3. c) Focussing on effective communication

3.7 Briefly describe the most reliable and preferred interpreting method in a healthcare setting from face-to-face, video and telephone interpreting. Provide a rationale for your response (in 50-70 words).

Medical interpretation can be conducted in person, through video or telephonically. However, the in person or face to face medical interpretation can be the most reliable and effective, and thus is most preferred form of interpretation. This is especially so, because in person overcomes certain limitations of the video and telephonic interpretations such as the quality of the carrier media, the technology and equipments used and factors that can affect the audio and visual data.

1.  Identify and describe 4 (four) factors that may facilitate communication in a healthcare setting.

In healthcare setting, effective communication with the patient or client s can be ensured by the incorporation of the following factors:

1. a) Proper presentation of information
2. b) Using appropriate channel for communication
3. c) Ensuring completeness of the message
4. d) Using the correct medium for communication
5.  Identify and describe 4 (four) factors that may inhibit communication in a healthcare setting.
6. a) Use of jargons and terminologies
7. b) Distractions and lack of attention
8. c) Differences in viewpoints and perceptions
9. d) Disabilities

1.  Refer to the Communication and Behaviour Support for Nurses Practice Package and answer the following questions in your own words.

6.1 Briefly describe the difference between expressive communication and receptive communication (in 50-70 words).

Expressive communication involves using the thoughts into the formation of words and sentences, in a manner that makes sense and is accurate grammatically.  This can be done both verbally as well as none verbally, and using communication devices and involves the ability to recollect words to be used in the formation of sentences.

Receptive communication involves the ability to comprehend and understand information delivered in a communication. It is literally the ability to understand language and is comparatively easier to develop, compared to expressive language. This ability responds to the language used by others, and includes the ability to follows directions and identifies objects or pictures.  

6.2 Provide 3 (three) Examples of outward-directed challenging behaviours you might experience in a healthcare setting.

1. a)   Aggression and Violence    
2. b)  Bullying or harassment
3. c) Suicidal behaviour                                                                

6.3 Identify and describe 4 (four) Core components you could implement in relation to positive behaviour support to implement challenging behaviours.

1. a) Patience while dealing with patients showing challenging behaviour
2. b) Showing empathy and understanding towards the factors triggering such behaviour
3. c) Addressing such factors in order to minimise of eliminate such factors
4. d) Using effective communication strategies to negotiate and manage conflicting situations

6.4 What is the most effective communication strategy Nurses could use when communicating with people with severe disabilities and sensory impairments?

The most effective communication strategies include:

1. a) Allowing time for the patient and not rushing the conversation (allowing the patient to decide the pace of the conversation)
2. b) Being clear and confirming what the patient said, and also repeating important parts of the information
3. c) Being respectful towards the disability of the patient, and not being condescending or patronising, and instead showing empathy and understanding.
4. d) Showing cultural competencies in communication.
5.  Refer to the Communication and Behaviour Support for Nurses Appraisal and answer the following questions in your own words.

7.1 Outline 4 (four) Strategies you could implement to enhance expressive communication when communicating with people with a disability.

1. a) Giving enough time for the patients to construct their responses and questions
2. b) Exploring the questions and statements to ensure the understanding towards what the person means.
3. c) Enhancing the meaning of the messages using visual cues like diagrams, objects and pictures.
4. d) Interpreting body language or facial expressions of the patients to interpret non verbal communication and also explore them to understand their meanings.

7.2 Briefly outline2 (two) Roles of Nurses in a healthcare setting in relation to communicating with people with a disability and their families (in 30-50 words).

Within the context of communication, nurses can play a vital role, relaying information between the patients, their families and also healthcare providers. Through effective communication nurses can also act as advocates to support the health and wellbeing of the patients.

1.  Health service organisations are required to implement open disclosure as part of the National Safety and Quality Health Service Standards. Refer to Australian Open Disclosure Framework and answer the following questions.

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8.1 Discuss the 8 (eight) Guiding principles of open disclosure in your own words (in 120- 150 words).

The eight principles of open disclosure according to the National Safety and Quality Health Service Standards of the Australian Open Disclosure Framework include:

1. a) Open and timely communication: where information on what happened is provided to the patients, families or caregivers in the event that anything goes wrong in a timely, proactive, honest and open manner.
2. b) Acknowledgement of the possible adverse effects should be done to the patient, their family and caregivers, as soon as predictable, and also when such event has taken place, through an open disclosure.
3. c) Expression of regret or apology towards the patient, their families or caregivers, when such adverse event takes place, and admitting liability and responsibility towards them.
4. d) Supporting or meeting the patient’s needs and expectations as well as of those of their families and care givers and providing fully informed facts about the untoward event and its consequences and showing empathy and respect.
5. e) Supporting and meeting the healthcare provider’s needs and expectations by fostering proper and prompt reporting of untoward or adverse incidents, and ensure proper preparation through training and education and also incorporate open disclosure processes.
6. f) Implementing integrated clinical risk management and systems improvement strategies: to ensure management of clinical risks and improvement of the quality of care.
7. g) Ensuring effective governance ensuring the proper investigation of the adverse events and prevent their recurrence.
8. h) Ensuring confidentiality by seeking permission from the patient to use their information and considering the need for their privacy.

8.2 Describe the 7 (seven) Key considerations and practices of open disclosure process (in 120- 150 words).

The 7 considerations and practices of open disclosure process include:

1. a) Detection and assessment of the adverse or untoward incidents
2. b) Signalling for the requirement for a open disclosure
3. c) Ensuring preparation for an open disclosure
4. d) Engaging in the open disclosure
5. e) Ensuring the provision of follow-ups
6. f) Completing the process of open disclosure
7. g) Documenting and recording the process in the patient records and updating the patient’s records timely.
8.  The verbal handover can be complemented by documentation. Identify and describe the purpose of 2 (two) documents you should prepare or gather in relation to a bed-side handover for a patient or client at the end of your shift (in 50- 70 words).

Documents that are necessary during the process of nursing handovers include:

1) Electronic Medical Records documenting the patient information in the ISBAR (Identification – Situation – Background – Assessment – Recommendation) format.

2) Copies of any clinical or diagnostic tests done on the patient.

1.  Various handover tools or checklists are used in Australian clinical settings. Briefly describe the difference between isobars, ISBAR and SBAR tools (in 60 to 80 words).

Within the context of the Australian clinical setting guidelines, isobar is an acronym for identify-situation-observation-background-agreed plan-readback, ISBAR is an acronym for identification – situation – background – assessment – recommendation, and SBAR is an acronym for – situation – background – assessment – recommendation.

iSoBAR is useful during inter-hospital transfers, especially when the handover occurred over the phone. ISBAR is applicable for the inter hospital transfers in NSW. SBAR is a simple handover tool which can be used in different scenarios like executive briefings, incident reports and also for shift to shift handovers.

1.  What legal obligations does a Nurse have in relation to the confidentiality of nursing documentation?

The nurses are legally bound to maintain and safeguard the confidentiality of information shared by the patient, and ensure that the data is collected, used or disclosed with the explicit and informed consent of the patient, and also ensure its safe storage which prevents unauthorised access or theft. The nurses are required to respect patient’s need for confidentiality, except in special cases where the wellbeing of a large number of people is at risk by withholding such information.

1.  Briefly describe the following principles underpinning nursing documentation (in 30-50 words each).

12.1 Factual:

The documentation should identify and outline all factual information in a clear and precise manner. Factual information would help to develop a better comprehension of the facts that are affecting the wellbeing of the patients as well as the status quo.

12.2 Accurate and complete:

All the patient related data should also be complete and accurate, to prevent any misinformation. Ensuring accurate and complete data will also help is a better understanding of the patient’s condition, and the care plan that should be used.

12.3 Current (timely):

Documentation and recording patient information should also be done timely (such as during the nursing visits), which can help to raise concerns in case any adverse or untoward incident takes place.

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12.4 Organised:

The documentation also should be clearly organised (for example following the ISBAR, ISOBAR or SBAR format), thereby ensuring a standardisation of the information and ease its reading and understanding.

1.  Provide 2 (two) examples of situations where information technology is used in nursing communication.

Information technology can be widely helpful in the nursing profession, and two important avenues where they can be significantly beneficial include:

1) Through communication and information technologies, sharing of information between the patients, nurses and other healthcare professionals can be improved (such as through electronic medical records and apps for reporting or sharing clinical data)

2) Using information technologies, providing referrals can also be made easier, thereby ensuring continued care for the patient.

1.  Outline 4 (four) email etiquettes you must comply with when sending and receiving work emails.

While sending or receiving work emails, the email etiquettes that needs to be complied to includes:

1. a) Using polite and respectful words
2. b) Being clear and precise in the information to be conveyed
3. c) Not assuming that the reader knows what is being conveyed in the email and providing all the relevant information
4. d) Proofreading the email before its being sent.
5.  Outline 3 (three) simple strategies you could implement in a healthcare setting to facilitate the special needs of a person with low vision to interpret their environment.

Three strategies to facilitate the special needs of a visually challenged person in a healthcare setting include:

1) Ensuring adequate and proper lighting of the premises

2) Arranging the furniture to ensure minimal obstruction and ensure they are in properly lighted places and also ensure that they have texture, thus providing sensory stimuli and help its identification. Also, furniture can have contrasting colours helping their better identification.

3) Elimination hazards from the environment, such as tripping hazards, electrical hazards, fire hazards and falling hazards.

1.  The social media policy was developed jointly by the National Boards to help practitioners understand their obligations when using social media.

(Reference: Social Media Policy for Health Practitioners, AHPRA 2014)

16.1 Who needs to use this policy?

These policies are meant to be followed by healthcare providers and professionals (like doctors, nurses, pharmacists or psychiatrists) working across various healthcare settings.

16.2 Identify 2 (two) Obligations of Nurses in relation to the social media policy.

According to the Nursing and Midwifery Board of Australia, the two obligations of the nurses in the context of Social Media policies include:

1. a) Professional obligation not to share any confidential information, photographs or any other information that can breach the confidentiality of the patient on the social media.
2. b) In relation to advertising, the nurses are obliged not to use any testimonials or feedbacks of the patients or clients in the social media as a form or promoting the advertising of the professional.
3.  The Nurse must seek assistance from interpreters or other persons according to the communication needs of the client in the workplace. To ensure effective use of interpreter services Nurse must be trained in how to work with interpreters.

17.1 Which clients need an interpreter? Provide 4 (four) Examples.

Clients who might need interpreters include:

1. a) Clients from a foreign linguistic background and need
2. b) Clients with speaking difficulties
3. c) Clients with learning or cognitive disabilities
4. d) Clients with hearing difficulties

17.2What seating position is most appropriate for 3 (three) People (you, interpreter and your client) when you are engaging an interpreter to communicate to a client?

The best sitting position while interpreting a client should be an upright position, with the back straight, with all three back curves being present, distributing the body weight evenly on both hips and keeping the feet flat on the floor.

17.3 Outline 4 (four) Considerations you must be aware of when booking an interpreter.

While booking an interpreter it is vital that the needs of the client are considered:

1) The interpreter must be competent and confident

2) The interpreter should be impartial

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3) Dignity and privacy of the patient should be respected

4) The interpreter also should be a good communicator able to bridge the communication barrier between the patient and the service providers

17.4 Outline 4 (four) Considerations you must be aware of when conducting a session with an interpreter and your client.

1) Confidentiality of information shared during the session

2) Accuracy of interpretation

3) Impartial

4) Disclosing any conflict of interest beforehand

1.  People in a group may interact differently. It is important to gain knowledge and skills in leading small group discussions in the workplace.

18.1 How could you as the chair of the meeting respond when you observe a participant dominating the discussion?

As the chair of the meeting, it is important to show who is in control of the conversation, and anyone trying to dominate the discussion should be politely dealt, trying to pick up their point of views and opinions, and analysing them through discussions. It is important to acknowledge what prompted the person to dominate the conversation and then address such aspects. If the conversation goes out of the agenda, it is also vital to bring the focus back on the topic being addressed in the meeting.

18.2 When should you set the purpose or agenda of the meeting? How could the chair of the meeting clarify the purpose of a group meeting?

The purpose or agenda of the meeting should be clearly outlined at the starting of the meeting. This can be done by debriefing the outlines of the agenda by the chairperson, informing the purpose of the meeting.

18.3 Assume that you are asked to participate in a small discussion to discuss and reflect on how interdisciplinary healthcare team or health service organisation effectively addressed a recent complaint. Identify 3 (three) Meeting procedures you would expect to receive to ensure you understand the meeting purpose.

1) Calling for Quorum

2) Deciding the point of order

3) Dissent from a chairperson’s ruling

18.4 Explain the role of a meeting chair in a formal meeting.

The meeting chair is responsible in the maintenance of the focus of the meeting/discussion, fostering its full participation, providing leadership and direction, and to represent the needs of the clients.

18.5 Briefly describe the communication strategies a meeting chair could use in involving participants who are less assertive or shy in a team meeting.

To involve participants who are less assertive and shy in a team meeting can be facilitated by:

1) Ensuring clarity and openness in the information and preventing any ambiguity

2) Clearly outlining the benefits of participation

3) Ensuring that people don’t feel pressurised to participate

4) Encouraging participation and trying to understand and eliminate the challenges towards participation faced by people.

1.  Provide 2 (two) examples of effective communication strategies you could use for giving feedback on own work performance to a leader or manager to whom one reports.

While giving effective feedbacks, it is important that two important communication strategies be used:

1) Honesty

2) Clarity

1.  Provide 2 (two) examples of effective communication strategies in receiving feedback on work performance from a leader or manager to whom one reports.

While receiving feedbacks, two communication strategies that can be used are:

1) Correct tone of voice

2) Proper body gestures and non verbal languages.