Nurse-Patient’s Familly Communition in ICU

Dahlia Budi Utami*, Nur Khasanah*, Retno Romauli RP*, Ulfah Habibah I*
*Faculty of Medicine, School of Nursing Diponegoro University

A. INTRODUCTION
The caring of nurse were truly present with clients. It was noticed
that they were thoughtful, considerate, empatic and decisive and practice
hostically. They did not view the clients as being in isolated from their
families and in turn, viewed the families as part of the community.
High quality communication is the backbone of the art and science of
nursing. It has a significant impact on patient well-being as well as the
quality and outcome of nursing care, and is related to patient overall
satisfaction with their care. The maintenance of high nurse patient
communication also depends on the nurse and patient. The quality of care
in an ICU (Intensif Care Unit) has been shown to be influenced by several
factors such as inadequate nursing staff, too much nursing documentation,
too long waiting time, and lack of specialized nurse. (Loghmani et all, 2014)
Communication is most used in nursing care in hospital. The purpose
of communication is to share information among nurses, patients and
families of patients. The communication between nurses and patient’s
families impacts patient well being as well as the quality and outcome of
nursing care. This study aimed to describe communication between nurse
and patient’s family in ICU.
B. BODY
1. Definition of Communication
Nursing as a health care, focus on serving the human needs as a bio-
psychosocial and spiritual being. Its practice requires not only scientific
knowledge, but also interpersonal, intellectual and technical abilities and skills.
This means a composition of knowledge, clinical work and interpersonal
communication (Raya, 2006). Communication is a vital element in Nursing in all
areas of activity and in all its interventions such as prevention, treatment, therapy,
rehabilitation, education and health promotion (Movahedi et all, 2011). The
nursing process moreover as a scientific method of assessment and
implementation of Nursing, is achieved through dialogue, through interpersonal
environment and with specific skills of verbal communication (Raya, 2005).
Communication skills can define the exchange of information, thoughts and
feelings among people using speech or other means. Communication skills can be
summarized as sensitivity to verbal and nonverbal messages, effective listening
and responding (Buckman, 2001). Despite the views which support that
communication skills are innate and intuitive, many studies have proven that
various components of communication techniques can be learned and teachable
(Levinson and Roter, 1993).
Communicating with patient is an essential part of nursing care. High
quality communicating with patient is the backbone of the art and science of
nursing (Lind et all, 2011). It has significant impact on patient well being as well as
the quality and outcome of nursing care (Ramsey, 2012).
High Quality communication is a key determinant and facilitator of patient
centered care. Nurses engage in most of the communication with patients in the
intensive care unit (Deane, 2015). Such information from patient in intensive care
unit leads into the increase of knowledge about communication, it helps the nurses
in order to change the communication skills focused on the individual.

2. Nurses Communication techniques

Nurses Communication Techniques (Stuart and Sundeen, 2009) :
1. Using Broad Opening Statements
The use of a broad opening statement allows the patient to set the direction of
the conversation. Such questions as “Is there something you’d like to talk
about?” Give the patient an opportunity to begin expressing himself. In using a
broad opening statement, the nurse focuses the conversation directly on the
patient and communicates to him that she is interested in him and his problems.
2. Using General Leads
During the conversation, general leads, such as “yes” or simply the “uh hum”
will usually encourage the patient to continue. General leads, like broad opening
statements, leave the direction of the conversation to the patient. They also
convey to him that the nurse is listening and that she is interested in what he will
say next. This can be accomplished verbally or non-verbally, but nodding or
through facial expressions, which demonstrate attentiveness and concern
3. Sharing Observations
Here, the nurse shares with the patient her observations regarding behavior. The
patient who has a need is often unaware of the source of this distress, or
reluctant to communicate it verbally. However, the tension or anxiety created by
his need creates energy which is transformed into some kind of behavior, nail
biting, scratching, hand clenching, or general restlessness. By sharing her
observations of this behavior with him, the nurse is inviting the patient to verify,
correct or elaborate on her observations
4. Giving Information
Studies have shown that a major cause of anxiety or discomfort in hospitalized
patients is lack of information or misconceptions about their condition,
treatment, or hospital routines. When the patient is in need of information to
relieve anxiety, form realistic conclusions, or make decisions, this need will
often be revealed during the interaction by statements he makes.

5. Clarifying
If the nurse has not understood the meaning of what the patient has said, she
clarifies immediately. She can use such phrases as “I’m not sure I follow…” or
“Are you using this word to mean…” to request that the patient make his
meaning clear to her. In seeking immediate clarification when she is in doubt as
to the patient’s meaning, the nurse can prevent misunderstanding from hindering
communication, also, because her efforts in clarifying will demonstrate her
continued interest in what the patient is saying, the use of this technique can help
motivate him to go on.
6. Exploring or delving further into a subject or idea.
“Tell me more about that”, “Would you describe it more fully?” and “What kind
of work?” are examples exploring topics which the patient has brought up for
discussion. The nurse should recognize when to delve further – she should
refrain from probing or prying. If the patient chooses not to elaborate, the nurse
should respect the patient’s wishes. Probing usually occurs when the nurse
introduces a topic because she is anxious.
7. Validating
When the nurse feels that the patient’s need has been met, she should validate
her impression with him. If his reply to such a question as “Do you feel
relaxed?” or “Are you feeling better now?” suggests his need has not been
completely met, the nurse should renew her efforts to assist him. The nurse
should not assume that she has been successful in meeting a patient’s need until
this has been validated with him. Also, since the patient may have needs in
addition to that which the nurse has attempted to meet, validating gives him an
opportunity to make any such needs known. Also, the nurse observes his
nonverbal behavior. A lessening of tension or a positive change in behavior
would support an affirmative verbal response; if tension or behavior is not
perceptibly altered, however, an affirmative reply would not be as meaningful.
3. How to make communication between nurse-patients in ICU

The patient as person domain encompasses attempts to understand a

patients unique personality outside the patients illness. Many communication
behaviors fit in this domain. The interaction often involved discussions about a
patients children , religion or spirituality, and career, as well as everyday topics
such as the weather, television, and books. In addition, nurses often shared similar
person details about themselves. The conversation style was often informal or
familiar for instance, nurses referred to a patients and the patients family members
with colloquialisms such as buddy, darling, honey, and sweetie. Patients, patients
families , and nurses often shared small jokes and good naturedly teased each
other. Non verbal communication behaviors were frequent nurses often used
touch and other personal interaction , including offering and receiving hugs,
holding hands, placing an arm around the person, and silently praying for the
patients.

4. The Function Communication Of Nurse-Patient’s Family In ICU

High quality family Communication is the backbone of the art and science of
nursing. 1 it has a significant impact on patient well-being as well as the quality
and outcome of nursing care, and is related to patients‟ family overall satisfaction
with their care. The maintenance of high nurse- patient‟s family communication
also depends on the nurse and patients‟ family. The quality of care in an ICU has
been shown to be influenced by several factors including: inadequate nursing staff,
too much nursing documentation, too long waiting time, and lack of specialized
nurses. There are challenges in nurse- patients‟ family communication evidence
from four sources. These are personal observation, narratives from client and their
families, media reports, and official health reports. There is public outcry about the
behavior of nurses during communication with their patients family in ICU.
(loghman, 2014)
Identifying factors believed to facilitate positive interactions between
nurses and their patients‟ family or patients‟ family as well as barriers to these
positive interactions will do much to promote the well-being of those seeking
health care. The increased insight about nurse- patients‟ family experiences in this
study should help nurses and other health care workers establish positive and
appropriate therapeutic relationships with patients‟ family.(Loghman, 2014)
C. CONCLUSIONS
Critical care including communication is a collaborative effort.
Understanding how nurses engage in patient centered communication in the
intensive care unit can guide future intervention to improve patient centered care.
Use Non verbal communication behaviors were frequent nurses often used touch
and other personal interaction , including offering and receiving hugs, holding
hands, placing an arm around the person, and silently praying for the patients.

D. RECOMMENDATION
Nurse can apply good communication techniques to patient and family, so
miscommunication will be prevented. Communication is very important in
Intensive Care Unit (ICU) because of nursing care in ICU must be clear and
minimalize error procedures. So all nursing care must in clear communication, to
patient and family, among nurse or between interdisipliners.
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 Nurse-Patient’s Communication in ICU
Submitted for the Fulfillment of English for Nursing I Assigment
Instructor: Ns.Fatikhu Yatuni Asmara,S.kp,MSc

By:

Dahlia Budi Utami 22020112120004

Nur Khasanah 22020112130112
Retno Romauli R P 22020112140068
Ulfah Habibah Irfani 22020112140033

SCHOOL OF NURSING
FACULTY OF MEDICINE DIPONEGORO UNIVERSITY
2016