Activity 2.4: Leadership and team-working

Read Molly’s story from the beginning of the chapter. What does this tell us about the role of communication in providing person-centred care? Additionally, what do we learn about the nurse’s role within the broader care team?

It would have been easy for the nurse Molly was working with to fall into the trap of speaking solely, or predominantly, with the patient’s carers. When there are time pressures on staff to gather information and make decisions quickly, then it’s natural to want to take the quickest route. However, such an approach undermines person-centred principles. The patient can easily be side-lined, and feel cut out of decisions about their care, and unimportant to the healthcare workers looking after them. It was worth the time and effort to try to establish a direct method of communication between the nurse and her patient, providing face-to-face communication, however limited in scope that might be on a practical level.

Just the use of good eye-contact, and a warm, friendly approach can help to establish a good therapeutic relationship. This can be enhanced by an effort to build channels of communication to gain clearer understanding. You should be wary of pushing this too far, however. It may become clear quite quickly that such an approach is not practical, and it would be prudent to shelve the idea under these circumstances, to prevent unnecessary frustration and the danger of miscommunication. (It can always be tried again another time if the situation improves for the patient.)

As far as your role as a nursing practitioner goes, you are often the central interface between the care environment and your patient. Gaining a good line of communication is key to your success, and sometimes it is necessary to spend some time and effort to find the best approach, even when other care staff might not. Communicating with relatives and carers about how best to establish useful contact with your patient may help – they may be able to inform you what to look out for, and what meaning a particular behaviourism might be expressing. Taking the lead on such matters is a natural, and important role for the nurse.