Communication can open many close doors in a persons life, which can make it more fulfilling, tends the individual to make his needs, wants and ideas known.Inselroth1996. p. 86, has characterized communication as “the process by which we establish contact and exchange information with others”. The underlying feelings, aspirations, requests of an individual could not be understood until that expression is verbalized. Oxford English dictionary defines verbal communication as transmission or trade of ideas, knowledge and information that is applied in words or can be written.
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Effective verbal communication is an essential tool above all other interventions in mental health setting, for positive outcomes, development of nurse-client relationship, for expression of sentiments, exploring underlying approach of patients about themselves and their illnesses.(Morrissey,Callaghan, 2011). Stevenson highlights the matter of weight saying these skills are the building blocks a clinical health team should be fluent on to blow the light of expressing thoughts of patients.(Stevenson, 2008, p.109).
In addition, mentally unstable individual sustain an equivalent dignity and self-possession which is anticipated by appropriate aids of effective verbal communication. This gave expressionto my thoughts to choose this topic. Our socio-cultural context uncovers some hidden realities that mental health setting of Pakistani culture owns. Due to cultural differences huge rail of stigmatization against mentally unstable figure is underlined, which could be diminish by effective verbal practices across cultures from health care providers.(rethink,2007).
As we encounter number of people around our capacity of work, who tend to talk on important matters but they couldn’t accomplish their desire just because of certain verbal techniques that influence so drastically to abandon one’s emotions.
A similar example that fortune had brought to us in clinical setup, a 31 year old, male patient when was decided to study in clinical practice was not equipped to interact at the beginning of interface. After an hour patient showed his readiness to talk but was not answering in anapt manner like hiding certain aspects of his life events, was getting anxious, was not being able to express his emotions and feelings. Due to noisy environment he was not even being able to hear the questions to think on, to pomp the mind on. To qualitatively intervene, next day we started the conversation by putting a scenario saying about family relationships and he was asked to reflect in a quite space. In this contact, patient was given questions that were easy to understand according to his academic condition. Moreover, patient was explained via certain examples in print to enhance his understanding for better interaction. Astonishingly our rapport was advanced promptly beyond the expectation.
To reflect the entire outlook, there were two definite types of verbal communication been used, formerly was the oraland later the written.(Champoux, 2010). To infer the clinical case picture captured above, nurse was instructing the patient some particular information to ponder, was facilitating the patient by writing questionnaires on a portion of paper with suitable examples for better understanding of the client, showing oral and written aspects of verbal communication respectively.
Effective verbal communication is achieved when desired outcomes are accomplished and maintained all the way through the interaction. Contrary, there are few factors that hinder the ultimate desire to get, named as barriers which tend to flip the coin saying ineffectiveness in communication.(Robbins, S., Judge, T., Millett, B., & Boyle, M. (2011),(Hogan,Stubbs, 2003).
Clinical setting where usually wards are overloaded with patients, their attendants and staff members, it is complicated to tend the patient to muse on the current conversation due to noisy setup, poor lightening or an environment which is very hot or cold beyond patient’s comfort.(Fielding,2006). Reflecting the scenario due to noisy and boisterous surrounding, patient was unable to hear a single question been articulated by the nurse.
Besides this, Literature enunciates that diverse cultural and academic backgrounds put their dark shadows during an interaction.Author supports his claim by stating about prejudices or biases notably affects the desired outcomes to be accomplished after an interaction.(C R McConnel, 1993 ). It gives a sense of belief to our clients that health professionals possess certain core preconceived notions against patients due to their cultural and academic differences.(Fielding, 2006). Scenario highlights that due to patients’ lower academic grade, nurse choose unproblematic vocabulary to convey her message successfully rather showing biases and demoralizing her client.Moreover, According to(Samovar Porter,McDaniel, 2009), caregivers face failure in communication due to lack of knowledge about patients culture and beliefs.
An additional significant barrier is poor ability to listen the client’s speech.(Morrissey,Callaghan, 2011). Health care team shows this behavior during history taking from respective patients by not concerning to listen to patient’s needs and emotions which are to be kept at priority.
Beside number of hindrances in a verbal communication, one can defeat by contemplating the tactics for effectiveness. Model of effective verbal communication speaks that sender should listen the receiver’s view point and ask questions to evaluate understanding of client about their illnesses and their self-concept. Professional’s thoughts are encoded in message, which is decoded to the recipient. Formerly sender should overcome internal and external disturbances in setup that embraces internal thoughts and feelings that deter comprehending actual message. However external noises are environmental obstacles. Semantic noises are concrete meaning of certain jargons used by staff which alters the real meaning on decoding. Whereas, later a thoughtful consideration is kept on patient understands on the prescribed advices.(AlanS.L.Wong, 2003)
Literature hold that listening builds the sense of respect, dignity of being a human like other ordinary creatures, feeling of being cared and not being ignored.(Morrissey,Callaghan, 2011).
The notion is appropriately interpreted by means of paraphrasing. At this juncture, patient’s messages are verbalized in nurse’s own words ensuring that she is listening to her patient as being a respectful entity.
Also the sender should build a trusting relationship with the receiver. In the light of clinical practice nurse should maintain a professional attitude from the beginning with sincerity. That will encourage patient to eloquent his thoughts in aninclusive form. Moreover, silence as another key to put an eye on.( Samovar Porter,McDaniel, 2009)
Literature asserts reflecting skills a basic tool to maintain patient-centered communication by presenting imperative messages to be reflected which are valuable to patient rather than nurse-centered communication.
Likewise, Summarizing skills are also significant aspect to be noted. Nurse should begin by using words like to ‘sum up’ to underline the methodology being used. It enables patient to hear vital points of his interaction and deliver details if needed.( Samovar Porter,McDaniel, 2009).(JTS,DST de,TF da et al., 2012)
While other techniques, probing skill is highly esteemed. Which entail exercising open ended questions by using when, what, how, who and where to get a complete picture of events arise with the patient. Literature elucidate that asking questions without using word ‘why’ may require patience and plenty of practice. For instance, in clinical setup nurse asks ‘why didn’t you take your medication’ is not counted to be satisfactory than stating ‘what stopped you from taking your medication’.
A study talked about how depressive person can be dealt by influencing him for positive thoughts by effective verbal communication.(Petrella, 2012).Study revealed that when people with depression where given an alternative word for their feelings like happy, excited, alert, hope, active, these people were observed to be integrating positive attributes in them.
Cognitive behavioral therapy is strongly associated while dealing with depressive individuals with finest possible communication skills.Firstly this therapy is based on cognitively conceptualization of client’s complains. Therapeutic alliance is another cognitive key, where therapist deals patient by counseling them, showing concern and empathy. This also improves judgment ability as therapist works collaboratively with the client in making decisions. The sessions are constructed in a flow of mood checking, setting agendas collaboratively as a team and establishing a two way communication.(Beck, Tompkins, 2007). Patients emotions are necessary to handle before they outburst.
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Life makes us face the rottenness some way or the other. But being a health care practitioner this rottenness could be reduced. Maintaining healthy life of our patients is our duty to be fulfilled.Verbal communication incorporates oral and written forms. Moreover, unkempt surrounds, poor listening, cultural differences and stigmatization are common obstacles. In contrary, listening, probing, paraphrasing, summarizing, prejudice-free care, sincere nurse-client relationship, and cognitive behavioral therapy are fundamental skills to be followed. Furthermore, for individuals suffering distress, brief phrases can turn their perception utterly. Life is a blessing than live it copiously.
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