Communication skills essential to advanced practice nursing

¶ … MS program's critical elements

Communication skills: Evolution

Verbal expression

Perhaps the most important thing I have learned from becoming an Advanced Practical Nurse (APN) is that communication is essential to the nursing profession. It is not enough to know what is right -- a nurse must effectively communicate with the patient, the patient's caregiver, and/or the other healthcare providers for that patient. The nurse must be technically fluent in the language of the medical profession, yet also be able to translate jargon into layperson's terms.

For example, a nurse might know that a patient who is pre-diabetic must lose weight and reform his or her diet. A nurse must communicate this fact in a way that is meaningful to the patient and help the patient understand the gravity of the risk of diabetes and of refusing to change his or her lifestyle and habits. The nurse must also leave the patient with a sense of positive empowerment and a belief in his or her ability to change. Good verbal communication, eye contact, firmness, gentle good listening and clearly and simply conveyed information are all vital components of effective nursing.

Written expression

Writing is the 'paper trail' that follows a patient. While it can be tempting to scrawl a few, brief notes comprehensible to other healthcare providers intimately acquainted with the patient, a nurse must be aware of the fact that a patient may be transferred, or that a healthcare provider in the future may read his or her notes for information. The nurse must always be accurate, and write with a larger audience in mind. The notes must also be detailed. If a nurse strives to be an acute observer of the patient's attitude, as well as his or her vital signs, this can also give a more comprehensive picture of the patient. Later on, additional problems may manifest themselves and benefit from more details that the nurse includes in the patient's file, even if these details may not immediately reference the patient's current complaint. The nurse must be fluid in his or her written expression as well as spoken expression and a good detector of potential future problems.

Ability to interact and document information via the computer

Sadly, technical fluency and knowledge is not widespread across the medical profession today. I have heard many sad stories of the prevalence of medical errors due to inaccurate computer reporting in the profession. This is why I am especially careful in my own use of technology and my documentation of critical patient data. Securing patient privacy and ensuring that data is accurate and secure are two critical concerns of using the computer in a healthcare setting. As more patient data is online and shared between organizations, nursing computer literacy will grow more important in the future, and APNs must lead the way in their examples.

Different roles for the Advanced Practical Nurse (APN)

This is one example of how the program has influenced my development as an Advanced Practical Nurse (APN). I had to act as an educator, as well as merely a caregiver and dispenser of medical knowledge. As well as a practitioner who identifies areas of patient need, such as future health problems in need of correction along the lines of high blood pressure, high blood sugar, and poor lifestyle choices that could lead to heart disease, a nurse must teach the patient about lifestyle changes that the patient can use before more aggressive medical intervention is warranted. Health-promotion and patient empowerment is always an important goal for a nurse.

The nurse must also act as a researcher into new forms of treatment for illnesses, and the least invasive forms of medical treatment possible that will enable the patient to live a high-quality life. These might include talking with a patient about how aggressive a treatment course he or she might want to pursue against cancer (radiation vs. chemotherapy, or a combination of both) or managing high cholesterol with dietary changes vs. statin drugs or using both treatments. A nurse can act as a community or family leader, advocating change, such as the need to provide an elderly individual with regular professional assistance once he or she leaves the hospital setting, as well as act as a consultant to the family about the best course of treatment.

In the future, giving the financial limitations on healthcare, APNs are likely to play an even more vital role in all of these critical areas within the healthcare setting. I have gained a greater appreciation for the necessity of APNs to act as teachers to patients and to act as a liaison between patient, family, and other healthcare providers. Nursing is a combination of health promotion and wellness of the body and treating the human being psychologically and socially. Nursing is truly a holistic discipline, and acknowledges that the optimization of health affects a variety of aspects of a patient's life, and everyone who knows the patient. When dealing with patients who cannot act as advocates for themselves or articulate their needs, like the incapacitated, or the very young, the very old, or patients with an imperfect command of English, the nurse must be especially mindful of the fact that a nurse must fulfill many roles simultaneously

In your role as an APN, how will you advocate for the client and nursing based on professional values?

The American Nurses Association (ANA) asserts a clear expectation that APNs have a professional responsibility to be politically informed and involved in shaping health care policy...the value of the nurse practitioner's role is that it provides cost-effective disease prevention, education, and holistic health care for patients...Studies confirm that NPs provide care with high levels of safety and competence, helping solve complex patient problems...Nurse practitioners work collaboratively with the physician, combining the medical and nursing models of care...This collaborative model encourages consumers to participate in the decision-making process which results in increased compliance with treatment, increased patient satisfaction, earlier discharges, and decreased unplanned readmissions" (Merrill 2001, p.1). As well as a collaborator, I see my role as an APN as giving a unique voice to the patient's different needs, who will understand the patient's physical, social, and psychological state of health in a holistic fashion and strive to promote health in a multifaceted manner.

Three professional goals: Within the next five years I will strive to Become more involved in professional organizations advocating for change within the nursing profession

Attend at least one professional conference about improving healthcare in America

Develop one area of expertise in the profession, either through experience, certification, or additional intensive study.