HUMANISM, NURSING, COMMUNICATION, AND HOLISTIC …

1 Humanizing nursing communication Running Head: Humanizing nursing communication humanism , nursing , communication , AND HOLISTIC CARE: A Position Paper. By Bonnie W Duldt-Battey, , RN 2921 Bellflower Drive Antioch, California 94531 Adjunct Professor School of nursing Samuel Merritt College Oakland, California Copyright, May 7, 2004, Bonnie Weaver Duldt-Battey. All rights reserved. No part of this proposal may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval system, without permission in writing from the author. Humanizing nursing communication 2 humanism , nursing , communication , AND HOLISTIC CARE Abstract: A position paper by the author and theorist proposing that of Humanizing nursing communication Theory become the benchmark for effective nurse-patient communication in all areas of nursing practice.

2 Introduction: The Problem There is a great need in the health care professions to provide HOLISTIC care (body, mind and spirit) to all clients, regardless of religious, ethnic, or cultural characteristics in a humane (non-judgmental and compassionate) manner. Major trends in today s American health care systems emphasizes certain business and management concepts. Efficiency, accuracy, and economy have become core concepts of health-care delivery. Efficiency and accuracy are expected in use of sophisticated medical terminology and highly skilled specialists who operate modern equipment. The very language used is often ineffective in aiding patients to understand the issues presented. Economy is necessary because of the spiraling costs and the increased expectations of citizens regarding accessibility of health care.

3 In addition, major issues in our political, legal, and ethical systems focus on all phases of health care; who should receive it, who should decide what is received, who can provide the resources, who should have the right to start or stop treatments, and who should pay for it. Finally, according to the census bureau, (2004), the population of the United States is projected to increase by approximately 40% by 2050, and the world by about 45%. The pressures on the present health care system can be expected to increase exponentially in association with the population. With the impact of these trends, it becomes possible to overlook the purpose of the entire system:, , providing HOLISTIC and humane care to the client or consumer. Across the proverbial table from the consumer is the nurse who is also frequently overlooked.

4 This nurse represents the largest licensed professional health care provider group in America. In this health care area, the professional nurse traditionally has had the closest and longest interpersonal contact with patients, particularly when hospitalized, than any other health care provider. In this same health care system, it has been possible to overlook the fact that all the buildings, equipment and Humanizing nursing communication 3sophisticated monitoring machines need to be operated by a human professional nurse, practical nurse, or some type of nursing assistant within the organizational nursing system. Yet other health care professionals, as well as nursing colleagues, overlook the need to communicate with one another in a HOLISTIC and humanizing way.

5 For example, Ulrich (2004) speaks of the fear factor nurses experience when other professionals use verbal abuse, refusal to answer questions, condescending voice intonation, and threatening body language in communicating. The Institute for Safe Medication Practices ( ; and ) reports a survey indicating the role that intimidation plays in the safe administration of medications. Childers (2004) describes the hostile work environments in which professional colleagues behave as bullies Namie, a social psychologist and founder of the Workplace Bullying and Trauma Institute ( ), states that many nurses have just accepted working in a toxic environment with control-freak physicians and out-or-control have long ruined their quality of life and driven many good nurses out of the profession.

6 Namie s studies indicate 70% of the people targeted by a bully have to quit either because of health (33%) or as victims of manipulated negative performance reviews (37%). In a second report, plans are outlined for changing the culture are offered by the Institute for Safe Medication Practices. The plans involve long, expensive administrative processes to establish a zero tolerance policy, a reporting systems, conflict resolution and educational programs ( ). Toxic work places are expensive and need to be addressed for nurses and other health care providers. Health-care providers in general, and nursing as a discipline and practice profession in particular, are basically humanitarian that is, concerned with and focused on the well-being of people. Yet an unfortunate trend, reported by both health-care consumers and providers, appears to be a growing lack of concern for one another.

7 People frequently describe unpleasant encounters that leave them confused, insulted, irritated, and indignant when they seek care. Why this happens is not clear. It is noteworthy that an old and basic interpersonal communication model is operative: Speaker Message Receiver In this model, the person who initiates the communication is referred to as the sender and the person to whom the message is directed is the Humanizing nursing communication 4 receiver. Effective communication occurs when the receiver interprets the sender s message in the same way the sender intended it. (Patton and Giffin (1977). See Table 1 for the ten characteristics of interpersonal communication .)

8 In the nursing context, the model looks like this: Nurse & Other ) Health Care ) Message Patient/Client Providers ) (Bad News) By the very nature of being a nurse or other health care provider, many messages to patients or clients may be characterized as bad news. Messages delivered by nurses frequently are about delayed meals, unpleasant and even painful procedures, and distressing revelations about illness. The age old pattern of blaming the messenger may be in effect and disrupt relationships. Clients confronted with their own unhealthy life style and poor health practices may be unable to understand or just reject the messages they receive.

9 Yet, the more the health care costs, the greater the potential for consumer s dissatisfaction. Health-care providers, especially nurses, are experiencing reality shock, burnout, anger dismay, and job dissatisfaction. They frequently choose to resign, resulting in high annual turnover and high inactivity rates among practitioners. Regretfully, there appears to be a trend for people to interact in a dehumanizing manner in the health-care system, and this trend can be expected to continue. In the 21st century, our society is moving toward a nationwide shift in the financing and lack of availability of health care resources, the increased numbers of clients, the increasingly complexity of care, as well as the lack of personnel in nursing and other heath care professions.

10 (Johnson, 2000) The dehumanizing processes can be counteracted by effective interpersonal communication , the key to humanizing relationships between people. To humanize means to recognize the individual s human characteristics and to address the presented health care issues with dignity and respect. A concerted effort is needed by health-care educators, especially nurse educators, to guide students in a careful exploration of interpersonal communication processes that are known to promote humanizing relationships not only between the nurse and client but also between health care colleagues. The critical data about the patient or client lie within this person and his/her family and/or key relationships. According to Tanner, Benner, Chesla and Gordon (2003), in their research about critical thinking of expert nurses, the concept of knowing the patient is unique to nursing discourse.