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INVESTIGATING COMMUNICATION BEHAVIOUR OF NURSES WHILE INTERACTING WITH PATIENTS © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

Introduction Across several professional domains, communication is of utmost importance. This is true particularly in the domain of nursing. Generally, establishing an effective communication pattern with patients is vital within the domain of nursing (Coats et al., 2018). Nursing staff with communication skills can identify patients’ healthcare needs. Highly meaningful communication with patients’ allows nursing staff to acquire detailed knowledge about each patient and their individual attributes (Sibiya, 2018). In fact, positive nurse-patient relations comprise of a variety of communication behaviours in nursing practice and are an integral aspect while delivering high quality nursing care (Hemberg & Vilander, 2017). In the healthcare sector, it is essential that nurse practitioners are sensitive to patient requirements, while non-verbally or verbally communicating with patients (Kwame & Petrucka, 2020). Nordby (2016) postulate that, in nurse-patient communication scenarios where there is an absence of a mutual verbal language, communication happens nonetheless either by body language or through eye contact. Regardless of their cultural fabric, people possess specific values, traditions and symbols. Given the situation, it is necessary that nurses perceive patients’ with due dignity while taking into account their individual requirements. Patients’ requirement usually originates from their individual cultures (Hölzel et al., 2016). Nonetheless, it is also necessary that nursing professionals possess particular knowledge and understand patients’ requirements and perspectives with regards to caring, as patients’ perceptions would significantly differ from that of a nursing professional. That the process of communication is reciprocal has been extensively acknowledged. This reciprocal nature would mean, sending and receiving messages facilitated through verbal and non-verbal signals. Arestedt et al. (2018) suggest that in a complex association like that of nurse-patient, communication is much more that information exchange. As a matter of fact, it would also include, an exchange of feelings, recognizing feelings and enabling patients’ to know that their feelings have been rightly interpreted. This paper has tried to capture communication behaviours of nurses during interactions with their patients. Communication behaviours here have been bifurcated into four distinct themes which comprise of; attending © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

behaviour, humour, communicative behaviour and empathetic communication behaviour. Attending Behaviour Attending behaviours can be explained as a physical representation of accessibility by nurses and their willingness to listen to patients using non-verbal communication (Wang et al., 2018). Attending behaviour is deemed as a procedure that revolves around the patient and the basic scenario required by a nursing practitioner to enable nursing would comprise of; genuineness, warmth and empathy (Kraft-Todd et al., 2017). Though patients would not directly refer to ‘attending’, it describes communicative behaviour, particularly those which are valued and specific to attending. Given the situation, it is the onus of a nurse to be aware about power imbalance, recognize scenarios that can be intimidating to patients while establishing therapeutic relations. This type of awareness enables nurses to setup and maintain proper boundaries. Sommers-Flanagan (2016) state that attending behaviours in a nurse-patient association makes up the base for interviewing. For ensuring success, it is necessary for nurses to accord due attention to their patients in ways that are culturally as well as individually apt. In case there is disruption in the thought process, behaving as well as feeling might emerge as ways that are projected by individuals on their own. Specific knowledge and skills with regards to listening (attending) is a vital component in identifying this kind of disruptions (Hardavella et al., 2017). Here, attending would refer to the intensity of presence on the whole, or expending time, or being physically present with a patient. In many situations, an act like being in the company of another person experiencing pain, or is passing through a painful period could make a vast difference. The level of attending could be indicated through some cues that are non-verbal and would comprise of; the posture of nurse (forward inclined position with arms at the sides), the level or degree of eye contact between nurse and patient, nurse’s body language (relaxed while interacting with patient and evaluation of patient’s response to nurse’s behaviour) (Sibiya, 2018). An aspect that needs to be noted is that body language, posture and eye contact of nurses are mostly influenced through culture and it needs to be assessed based on cultural norms of patients. © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

Humour The use of humour would be in contrast with nursing codes that exist in the nursing domain. However, utilizing humour could be beneficial to nurses while considering patients as individuals and setting up a therapeutic association between nurses and patients. There are many who perceive humour as a medium of communication, and it is also considered as a subjective emotional response (Sousa et al., 2019). It could also have a multidimensional value as far as provision of treatment to patients is concerned. It might be a result of the recognition and expression of incompatibilities during scenarios that are comic, impulsive or even absurd, remark, action or characteristics that conveys a feeling of closeness when distributed in a trust based environment between nurses and patients. In instances where humour is used by nurses as a communication medium, it could be highly advantageous to setup a natural relationship at the time of interaction with patients and result in major holistic benefits. When humour is used within a healthcare setting, it could be effective in facilitating nurses to create a bond with patients at a personal level. Almeida and Nunes (2020) opined that inclusive humour not just motivates interaction with patients but it also results in establishing peer support and bonding. This would be specifically advantageous for patients who are not very familiar or comfortable in a healthcare environment. Creating an environment for patients that is comfortable and secure would be helpful to nurses too especially considering that they work in stressful environments. Communicative Behaviour Nurse-patient interactions are usually complex and one of the possible drawback that can emerge is miscommunication. This holds true in case of patients’ understanding about their prognosis, care objectives, and treatment expectations (Moodbidri, 2017). These are major aspects that can influence choices that patients make regarding their end-of-life care and treatment too, which has implications on their condition too. In situations where communicative behaviour is practiced by nurses, it allows patients to perceive and deem themselves as being an active part of discussions pertaining to their health. At the same time, patients are also expected to use communicative behaviours wherein on their part they need to communicate all information regarding their ailments, experience or anything that concerns their health. © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

Empathetic Communication Behaviour Empathetic communication behaviour is a communication process where the focus is mainly on emotional engagement between nurse and patients (Babaii et al., 2021). As a concept, empathy is rather multidimensional in nature and includes behavioural, emotional, cognitive and moral components linked to it (Bettelli, 2017). It is implied that empathetic people (nurses, in this instance) understand the notions indicated, in tandem with feelings which exist in the other person (patients, in this instance). Empathy signifies a key focus along with feeling and in the patient’s world. It would be inclusive of; accurately identifying a patient’s condition, their perspectives and feelings, communicating their perceptions to patients and cross-checking with patients for accuracy, taking action on their understanding such that it is helpful and therapeutic to patients. There could be a biological angle to empathetic behaviour. This is characterized with the discovery of the mirror neuron where it has been suggested by Acharya and Shukla (2012), that actions noticed from others could be mapped by the nervous system onto the premotor cortex of the self. It has been suggested that there could be a right hemisphere mirroring system that could provide a neural substrate for empathy. As per nursing care constructs, an empathetic behaviour is the main component in a nurse-patient relationship. This can be applied for improved functioning patient and for patient who functions at a level which is comparatively primitive. It has been observed through a review of nursing literature that empathy has five conceptualizations; professional state, caring process, special association, human trait and communication process. Many nursing practitioners have considered empathy from diverse perspectives (Terezam et al., 2017). Certain nurses consider empathy from the perspective of time frames, while others perceive it at empathy measurements and then there are some who consider outcomes when empathy was evident. Empathy, as a notion can be deemed as collecting and maturing more in depth and breadth. Though every notion of empathy is considered as valuable particularly within nurse-patient communication behaviour, there is a possibility that a highly advanced and mature notion of empathetic behaviour would ultimately emerge. © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

Conclusion Communication is a vital facet in nursing and establishing a positive nurse-patient association is essential to deliver high quality nursing care. When there is clarity during communication between nurse-patients, it indicates that information is conveyed in an effective manner among individuals. With a view to be successful as a nursing practitioner, it is suggested to have effective communication skills. Nurses are known to communicate with several people with varied education levels and from different cultural and social backgrounds. In such a situation, they are expected to ensure that communication is effective, professional and caring. This is of specific significance at the time of communicating with patients and their families. However, communication is often challenging. But it has been evidenced through studies from the past that nurses are good at communicating with patients especially when a patient-centric approach is adopted. Adopting and practicing a patient-centric approach can only be possible when nursing practitioners comprehend and acquire knowledge about appropriate communicative behaviours that they can use with patients. Communicative behaviours like humour, attending, empathetic and others would motivate and nurture proper communication among patients and nurse and thereby ensure delivery of proper nursing care. © 2021-2022 All Rights Reserved, No part of this document should be modified / used without prior consent. Tutors India ™ - Your Trusted Mentor since 2001 No: 10, Kutty Street, Nungambakkam, Chennai – 600034 Contact Number: +91-4448137070 | Email: info@tutorsindia.com

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