Essay On Holistic Approach In Nursing

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Hi guys! This is my first essay i ever done in my life and i am bit worried about it. I am using harvard referencing and bit confused. Can anyone give me a feedback to my holistic communication in nursing care essay??? Any help you can extend will be appreciated. Thanks, Kim


This assignment discusses an approach for an effective nursing care delivery system which relates to my chosen branch of nursing. In this essay I will discuss the importance of holistic communication in nursing care and its implementation to show that it is necessary when treating the patient. Doctors, nurses and other health professionals cannot treat the patient with out using this method. I also discuss 2 barriers in communication and 2 types of communication which are verbal and none verbal and identify examples which clearly define the meaning of communication and its importance to our day by day living.

Communication is defined as a process of transferring information from one entity to another. Communication processes are sign-mediated interactions between at least two agents which share a collection of signs, rules and symbols. Communication is commonly defined as "the imparting or interchange of thoughts, opinions, or information by speech, writing, or signs".

Holism is the idea that all the properties of a given system cannot be determined or explained by its component parts alone. Instead, the system as a whole determines in an important way how the parts behave. It varies from physical, biological, chemical, social, economic, mental & linguistic.

Combining these two words, holistic communication is now formed. Quality interactions in communication depend a lot on how well one person understands the others needs. This element will ensure communication to be effective because the need can be met through the interaction or relationship. In the same way, the key to good relationships and effective communication between two parties is acquired through understanding, experience, empathy and humor. Furthermore, when used together these elements all have a positive effect on a quality interaction during the process of communication.

R. Ellis, (2003) Explained that communication process breaks down effective communication into the following steps: sender, message, receiver & feedback. As defined, sender is the communicator or is the person who is sending the message. There are two factors that will determine how effective the communicator will be. The first factor is the communicator's attitude. It must be positive. The second factor is the communicator's selection of meaningful symbols, or selecting the right symbols depending on your audience and the right environment.

The next step can either be in writing, speech or signals, which is known to us as the message.

Communication done through speech must involve spoken words. The speaker must be able to speak slowly, enunciating the words clearly. Choose words that can be clearly understood instead of using technical ones. Only relevant information should be conveyed to prevent confusion. It ascertains immediate response when time is short.

Written message must be clear, correct, complete and concise. This should be written in words that are clearly understood by the reader. Written communication comes in the form of memoranda, documentation, records, reports, policies & procedures. Ambiguous terms should be avoided to prevent misunderstanding.

Verbal communication is one way for people to communicate. Some of the key components of verbal communication are sounds, words, speaking, and language.

Non-verbal message or signals is the transmission of message without the use of words. People oftentimes unconsciously use facial expressions, gestures, touch, body language or vocal tones. This type of message sent can have several factors affecting the effectiveness of the message sent. For example, personal appearance gives the impression of his personality and self concept. Intonation of the voice must be soft & gentle so it would appear pleasant to the ears. Facial expression like a simple smile establishes immediate rapport and invites trust & confidence. Posture and gait indicate his physical wellness, emotions and attitude.

Effective communication takes place with shared meaning and understanding. Thus, the role of the receiver is important. Receiver is simply the person receiving the message, making sense of it, or understanding and translating it into meaning. Now think about this for a moment: the receiver is also a communicator. How can that be? When receiver responds, he is then the communicator. Communication is only successful when the reaction of the receiver is that which the communicator intended. And to complete the communication process, feedback can be a verbal or nonverbal reaction or response. It can be external feedback (something we see) or internal feedback (something we can't see), like self-examination. It's the feedback that allows the communicator to adjust his message and be more effective. Without feedback, there would be no way of knowing if meaning had been shared or if understanding had taken place.

Communicating is not an isolated series of one skill, it involves several skills. For example, speaking involves not only getting your message across but also being able to listen and understand what others are saying(active listening) and observing the verbal and nonverbal clues in order to monitor the effectiveness of your message. Quality interactions in communication depend a lot on how well one person understands the others needs. This element will ensure communication to be effective because the need can be met through the interaction or relationship.

Different types of communication can either be interpersonal communication, or the other end, intra-personal communication. Clearly, both of these types are present in a quality interaction. Intrapersonal addresses the understanding and empathetic part that furthers the communication process while interpersonal is the actual interaction. Therefore, understanding your own actions and goals will ultimately lead to a greater perspective of the specific communicative interaction. However, not all communication interactions involve the exchange of words.

Lines of communication also play an important role for holistic communication and it is in three forms. Downward communication is a traditional line of communication which is from superior to subordinate which may pass through various levels.

Upward communication emanates from subordinates and goes upward. This is usually in the form of feedback to show the extent to which downward communication has been received, accepted & implemented. This line of communication does not flow as easily as downward communication. Subordinates may not have the ability to express their thoughts or may be too shy to express them. Examples of which are discussions between subordinates and superiors, grievance procedures, written reports and statistical reports.

Horizontal communication or lateral communication flows between peers, personnel or departments on the same level. It is used most frequently in the form of endorsements, journal meetings, or referrals.

There are significant barriers to communication that can sour the elements of quality interactions such as understanding and empathy. In today's world, relationships and communication are often cheapened by technology. People have private conversations in the middle of the grocery store on the cell phones or even meet a new friend through instant messaging on the internet. Here is the dilemma of the 'global village.' Although it is a type of communication, according to J. Mcquillen while the world is becoming "smaller" the true distances between people are becoming larger. It is difficult to obtain a true representation of a person through an instant message or an electronic greeting. An article titled "The Influence of Technology on the Initiation of Interpersonal Relationships by (J. Mcquillen; Vol. 123, 2003) admits that studies show that many relationships that are initiated online develop similarly to those that are face to face they still develop slower. However, while staring into a computer screen it is easy to just perceive what you want to see in somebody rather than understand their true character. This is attained by an aspect of editing and planning that does not occur in real life interactions. Thus, this type of impersonal communication represents a barrier to a quality interaction.

There are two types of barriers-internal and external. Examples of internal barriers are fatigue, poor listening skills, attitude towards the sender or the information, lack of interest in the message, fear, mistrust, past experiences, negative attitude, problems at home, lack of common experiences, and emotions. Examples of external barriers include noise, distractions, e-mail not working, bad phone connections, time of day; sender used too many technical words for the audience, and the environment. Barriers keep the message from getting through.

Here are the some of the additional barriers that can possibly affect holistic communication. Physical barriers are environmental factors that prevent or reduce opportunities for communication process. Examples are physical space or distance, temperature and ventilation, structural or equipment problems & distracting noise. Socio-psychological barrier are inhibitors in communication that arise from the judgments, emotions and social values of people. Examples are stress & lack of trust. Semantics is the interpretation of messages through signs and symbols. In such circumstances, the holistic approach to healthcare is being used because it involves looking at the whole of the person along with their needs.

During a previous placement, I regularly encountered patients with difficulties such as walking as a result of their illness. Many would even have great difficulty in shaking hands. Such conditions left the patients feeling helpless. The majority would have led active lives in the past and as such, these difficulties left them with a feeling of frustrations and anxiety. Part of their wholeness was missing. The physical conditions were often helped with physiotherapy. However, the extent of the physical disabilities did not end there. The frustration and anxiety in most cases gave them a lack of confidence and self esteem and other such psychosocial problems.

A quality relationship also includes at least one of the people showing empathy for the other person. It was seen that strokes did not just inflict physical difficulties and the associated psychosocial problems. Many experienced severe confusion. The confusion took many angles. Some were confused that they could not even sit up to kiss their spouse goodbye after their visit. Some were confused because their son or daughter did not understand them telling them how much they love them. Some were confused but did not know why they were confused. The everyday social interaction was now missing. "Psychosocial stage theory is the development of ego identity. Ego identity is the conscious sense of self that we develop through social interaction"

Erikson's Theory of Psychological Development. Such problems can only truly be addressed by seeking to understand the feelings of the patient.

Circumstances in which these factors are essential are in the situation between the helper and the needy; or in a healthcare setting, the physician or nurse and the patient. Forming relationships through communication serves the purpose of the betterment of the patient as well as the health worker. In healthcare, communication is essential because without it the nurse or physician would feel detached from the patient's illness and problems. Our health is one of the most important things to us; so many factors come into play when a problem occurs in our health such as family, money and self-esteem. If a healthcare professional cannot understand these factors, then the health problem is not really being acknowledged. To avoid this barrier, the holistic approach is involved. A. Crouch and C. Meueier (2005) States when using a holistic approach the health professionals should considers all dimensions, with particular reference to the physical, psychosocial, cultural and spiritual aspects of a person. M. Dossey (2005) States that while caring is the context for holistic nursing and healing is the goal. In effect, medicine is not confined to an array of pills and injections. Instead, it is reaching out to the person's core needs.

A strong parallel to holism is what Dr. Dale Matthews, Professor of Medicine

Georgetown University School of Medicine, describe as 'connexional' relationships or experiences. These are categorised by having an experience inside the patient's world as if it were your own with the core element of such experiences being empathy. The word 'connexional' comes from the roots "co" which means 'together' and "nexus" which means 'a drawing together.' Obviously this idea parallels holism because you are taking into account the whole of the person in order to understand their problems from their perspective.

"Therapeutic contact takes place within a connexional, or transpersonal, dimension of human experience, within which basic human needs for connection and meaning are met."

In conclusion, I have discussed the means of communication needed for holistic nursing care and two types of barriers involved that is internal and external. I conclude that communication is hindered by the above barriers for they result in ineffective communication.

In essence however, effective communication is derived from the quality of interaction brought forth in a nursing care environment. Understanding, experience, empathy, and humor are presumably the elements involved in ordinary communication. However in the case of in nursing care, the most important aspect of quality interaction or communication can be found in holism.

The ability to effectively communicate is a critical skill. The more you become an effective communicator the more likely you are to achieve what you want. Remember, you can improve your communication skills by observing people who communicate effectively, learning new skills and practicing those skills. Acquiring effective communication skills in turn will help you become a better person.

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