This paper offers a personal reflection on communication skills and challenges encountered in nursing home environments. The author examines the necessity of adapting communication styles to meet the varied needs of elderly residents, including speaking more slowly or repeating information for those with health conditions. The paper discusses how to identify and reduce communication barriers — both obvious ones such as language differences and more subtle structural failures — and emphasizes the role of regular staff meetings and daily interaction in maintaining clear communication. Confidentiality and the responsible handling of sensitive resident information are also addressed.
Communication is an everyday necessity that is also a challenging endeavor. Though nearly everyone engages in communication, very few people are truly effective communicators. In reflecting on my own communication skills, I recognize the importance of adapting my communication methods to meet another individual's needs, wishes, and preferences. In a nursing home setting, I have had to speak louder or more slowly than I normally would. I have also had to explain something repeatedly or in several different ways because of the health conditions of the residents in the facility.
When it becomes evident that I am having problems communicating, I seek advice. I also seek advice when I am about to enter a new situation — such as beginning college, graduate school, a new job, or an unfamiliar work environment like the corporate world or the non-profit sector. In a nursing home context, I have sought guidance when dealing with particularly difficult or challenging residents. My experience in nursing homes comes from visiting relatives and, out of professional curiosity, asking staff about communication practices — especially among the nursing staff. I spoke with health care professionals, and even with some residents and family members who had spent considerable time in these facilities.
There are a number of steps one can take to identify and reduce barriers to communication. Language is an obvious barrier and a frequent source of confusion. Nursing homes often employ staff who speak languages other than the primary language of the country in which the facility operates. Literary resources are available, and instructors can be brought into nursing homes to provide linguistic assistance to seniors who need it.
Identifying more subtle or complex barriers to communication may require specialized training. Nursing home staff should remain open to the possibility that the root of a problem may not be a particular person or department, but rather a failure in communication itself. Regular staff meetings and consistent daily communication among staff are effective ways to locate and address barriers. It is equally important to monitor for communication barriers between nursing home staff and residents. Productivity is a reliable indicator that communication is functioning well and that few barriers exist. A pleasant work atmosphere further signals effective communication. This does not mean problems will never arise or that work will be perfect, but it will be better than average and there will be clear structures in place to support strong, clear communication.
Confidentiality essentially means not revealing personal information to parties who have no legitimate need for it. Nursing staff routinely encounter sensitive information that they must know in order to perform their jobs effectively. This is the kind of information that could put residents at risk for credit fraud and other harms. Confidentiality in healthcare encompasses understanding what information is sensitive and private, as well as having the respect and self-discipline not to disclose it unnecessarily. Examples include the medications nursing residents take and the procedures to follow if they fall ill — such as who holds power of attorney or whether a do-not-resuscitate order is in place.
Colon-Emeric, C. S., Ammarell, N., Bailey, D., Corazzini, K., Lekan-Rutledge, D., Piven, M. L., Utley-Smith, Q., & Anderson, R. A. (2006). Patterns of medical and nursing staff communication in nursing homes: Implications and insights from complexity science. Qualitative Health Research, 16(2), 173–188.
"Protecting sensitive resident information from disclosure"
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