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The presence of effective communication in nursing care is important because it helps to provide ability to the nurses and service users to consult care needs in framing individualised care. Moreover, effective communication between patients and nurses as well as others helps to create seamless care in controlling and monitoring vital signs of patients during care (Sibiya, 2018). The vital signs are required to be continuously monitored by nurses as they provide prior and effective indication of any clinical deterioration of the patient at the early stage (Prgomet et al., 2016). In this study, the way effective communication improves the quality of patient care in relation to the vital signs monitoring is to be discussed.
The NMC Code of Practise mentions that the nurses are to provide key attention to promote well-being and prevent ill-health of the patients by meeting the challenging healthcare needs of individuals (NMC, 2018). In this respect, the appropriate monitoring of vital signs by the nurse is to be performed. This effective monitoring of vital sign needs effective communication between patient and nurses because it resolves barriers and confusion raised which makes patients to non-comply with the nurses in allowing them for smooth monitoring of their health condition. One of the initial vital signs to be monitored in the patient is body temperature. This is because body temperature provides an indication of presence of fever in patients which usually occurs as a result of abnormalities within the body that disrupts the body's homeostasis resulting in raising the temperature (Shin et al., 2019). The effective communication with the patient by the nurse helps in enhancing the monitoring of body temperature as vital signs because the patients through presence of good interaction immediately report of feeling of fever or change in body temperature to the nurses. It leads the nurses to take early step in detecting any change in the vital sign and initiate the process of temperature monitoring effectively (Fu and Zhang, 2020).
Temperature can be measured in different ways, which include measuring the temperature of deep tissues in the body such as abdominal cavity and pelvic cavity Kozier et al, (2008). This is an effective way of measuring one of the vital signs carefully and effectively. There are two different types of body temperature and surface temperature (Kozier et al., 2008). In monitoring body temperature of the patient orally, the nurses initially ask the patient to open their mouth so that their body temperature can be assessed. The presence of effective communication between the nurses and patient in this situation to monitor their temperature would be helpful. This is because through effective interaction with the patients the nurses can thoroughly explain the reason behind the patient is asked to open their mouth. It results the patient avoid feeling vulnerable or confused of getting inserted any inappropriate object in the mouth in turn allowing a smooth process of vital sign monitoring (Vanhoof et al., 2018).
On the basis of the health condition age of the patient, the body temperature is measured and monitored from different parts of the body. In case of a child, often the rectal temperature is taken by a thermometer because the rectum is closet part of the body that provides more accurate body temperature assessment (McWilliams et al., 2020). The rectum is considered to be private and delicate part of the body in the child as well as adults, therefore insertion of any object in the area often creates objection from the patient’s family as well as patients out of fear of experiencing damage or inappropriate health condition (Berksoy et al., 2018). According to NMC, the nurses are to share information regarding care with the patient’s family or their carers to allow them understand the way care is being managed for the patients and access informed consent (NMC, 2018).
The presence of effective communication with the child’s parents as the child is incapable to make their own decision out of less cognitive thinking and analysis ability by the nurses helps them in the process (Berksoy et al., 2018). This is because it leads the nurses to access approved permission to measure rectal temperature without experiencing any non-compliance in the act and ensure following the NMC code as the interaction resolves queries and concerns with the act among the patients and their family members. As mentioned by Pejovic-Milovancevic et al. (2018), good interaction leads the child’s parents as well as the child to be convinced by the nurses and develop understanding about the way the mentioned process is to be performed safety as well as its need. This allows the child as well as the parents to provide approval in accepting the care and ensure smooth monitoring of body temperature by the nurses.
In measuring the surface temperature of the body, the axillary thermometer is mainly used. In this process, the respective hands are pressed against the body for reducing possibility of any ambient temperature (Vardasca et al., 2019). The lack of knowledge regarding the different process used in measuring inner body and surface body temperature may lead the patients to oppose in supporting axially temperature and prefer taking the temperature orally during monitoring of their vital sign. The effective communication between patients and nurses during vital sign monitoring leads the nurses to provide evidence-based information to the service users in resolving their raised confusion and queries while comparing between different methods or care techniques considered to be provided to them (Lubkowska et al., 2019). Thus, the presence of effective communication in this condition is important as it leads the nurses to explain the reason behind with evidence-based information about different techniques is used for monitoring the patient's body temperature. It leads to resolve confusion and contradiction within the patient's mind in choosing either way of supporting their body temperature monitoring, in turn, ensuring quality care monitoring to be established.
The pulse rate is another vital sign which is continuously monitored by the nurses among all patients. This is because it allows the nurses to understand if the heart of the patient is pumping enough blood in the body to allow healthy condition (Yasri and Wiwanitkit, 2018). The normal pulse rate in adult ranges from 60-100 beats each minutes (Yasri and Wiwanitkit, 2018). In order to measure the pulse rate in patients, the nurses require taking the hand and feeling the wrist of the patients. The touching of any part of the patient’s body by the nurses who is familiar to them may lead the patient feel uncomfortable and consider it to be indication of inappropriate touching (Cahan et al., 2020). The presence of effective communication between patients and nurses helps to build trust as well as promotes familiarity and understanding between them. This is because the nurses are able to assure the patients of their positive intention of care through compassion and empathetic interaction which makes the patients feel approved and lack of vulnerability in accepting any form of care through touching or others (Melville-Wiseman, 2016). Therefore, effective communication in monitoring of pulse rate helps the nurses to be familiar to the patients and develop trust towards them out of positive belief created through extended interaction. This allows the nurses to avoid facing non-compliance in touching the patient’s hand to monitor their pulse rate and perform effective monitoring.
The measurement of oxygen saturation in the blood is a vital sign detected for the patients. This is to ensure that there is presence of enough oxygen in the blood to support normal breathing body functioning of the patient (McLaughlin et al., 2018). The oxygen saturation in the blood is monitored mainly through the use of pulse oximeter which is non-invasive device attached on the finger of the patient (Stenson et al., 2019). The presence of effective communication between nurses and patients in relation to oxygen saturation measurement through pulse oximeter enhances vital sign monitoring for promoting their health. This is because effective interaction leads the nurses to inform the patient regarding the way they can personally detect if their pulse rate is lowered by watching the reading in the pulse oximeter. It leads the patient to alert the nurses in emergency situation for providing them care in turn avoiding deterioration of health condition out of delayed care (Albert et al., 2017). However, the lack of effective communication between the patient and nurses during the use of pulse oximeter to monitor oxygen saturation leads the nurses fail to be alerted by the patients in emergency situation at the right time in turn leading the nurses to perform hindered monitoring and deliver delayed care (Amalakanti and Pentakota, 2016).
The vital signs of the patient such as blood pressure may be influenced to become lower due to factors such as stress, smoking, exercise, cold temperature and others (Dias et al., 2018). The presence of effective communication between nurses and patients during vital sign monitoring would lead to identify the nature of surrounding factors that are affecting the patient's health and make them take effective actions in resolving the issues (Afriyie, 2020). However, the lack of effective communication between nurses and patients in vital sign monitoring leads the nurses to remain unaware of the surrounding factors that are influencing the hindered change in the signs. This in turn makes the nurses unable to deliver effective care in resolving the raised issue to promote well-being of the patient through steady health monitoring (Norouzinia et al., 2016). In monitoring of vital sign such as respiration rate of the patient, the presence of effective communication between nurses and patients is essential. This is because the interaction leads the patients to report nurses regarding the nature of surroundings is hindering their respiration rate which the nurses are to be alert during monitoring to ensure better quality care for the patients (Sun et al., 2017).
During monitoring of the vital signs of the patients, the nurses due to lack of competence or knowledge at times may face issue with performing the action properly. The presence of effective communication between inter-professionals that is nurses and physicians and others during vital signs monitoring of the patient is important. This is because it leads the nurses to gather experienced advice and resolve problem faced in monitoring the health of the patients through assistance from the inter-professionals (Ganasegeran et al., 2017). Thus, effective communication between inter-professionals helps to resolve error in vital sign monitoring as expert advice and skills are included in recording the signs by the nurses. However, the lack of effective communication between inter-professionals in vital sign monitoring leads the nurses unable to resolve any problems faced in the situation, in turn, making the nurses face hardship in managing a seamless health monitoring of the patients (Carney et al., 2019). The effective communication between inter-professionals during vital sign monitoring of the patient is important because it allows the nurses to avail expert advice in taking decision regarding the way care is to be provided on detecting inappropriate vital signs among the patients (Illingworth and Chelvanayagam, 2017).
Early warning scores. (EWS) When a patient’s health deteriorates they may display common symptoms and signs that show respiratory illness and conditions. Respiratory rate is important and should be documented by staff as soon as the patient is admitted into the ward, as this is baseline for the patient.
Blood pressure is therefore monitored closely, sometimes patients may be denied potentially life-saving treatment. Another way to get a reading for blood pressure is by continuous invasive monitoring. This technique has a direct method of measuring blood pressure which involves the insertion of a cannula into the artery of the patient and the use of a pressure transducing unit. This technique is the most accurate, but as vital signs monitoring it must be closely monitored. The nurse must be able to show clinical expertise in this area of monitoring the patient and being able to take close observations. These methods are reserved for use in specialist units (such as intensive care units, theatres.)
Communication is vital as it is important for patients to know what treatment they are having to go through, through communication we can plan this with them and family members, also other members of staff who are involved in the patients care. Among children with asthma, they require hospitalizations, we can educate parents into recognizing the early signs of asthma attack, and how to respond to it. There are also written action plans to help improve healthcare of asthmatic children. This can help improve asthma-related health outcomes and reduce unnecessary health care use. Vital signs are important if there is any risk to the patient, we can find out by taking blood pressure readings, temperature, other recordings which need to be used to find out if there is a respiratory infection in the patient, ongoing problem. We can communicate this to other members of staff or the patient’s family through verbal communication.
Nurses assess and take records for the patient’s vital signs every so often to monitor the patient and see if they are not deteoriating or they may be forming a new infection. This is important to communicate any change on the PEWS chart for children and NEWS chart for adults. (Royal College of Nursing, 2017.) Must take informed consent from the patient before carrying out any sort of assessment for the patient. (NMC,2018.) documentation should be kept confidential when recording patients’ vital signs and discussing with any other health professionals within their care. Confidentiality shouldn’t be breached, there should also be privacy for the patient so they can feel at ease and comfortable while being assessed. Curtains should be drawn while assessing patient, and also always asking for consent before starting any course of treatment. (NMC,2018.)
Vital signs communication is essential for when assessing children, it is vital to see whether they are deteriorating, or their condition is getting worst. The situation background assessment recommendation (SBRAR) is a communication tool which is useful to get the right accurate results to get information about a sick child, this is used by all health professionals within the medical team to ensure the appropriate treatment is going to be given.
(RCPCH,2016). Registered nurses, Midwives and health visitors must comply with the NMC standards for maintaining their knowledge and skills. (NMC,2018). Other legal issues relating to monitoring and assessing young children, infants should be practiced appropriately. Critical thinking is important for nurses when filling in the pew’s charts for children, as to when vital signs falls outside the accepted norm for the child. Nurse should always know how to spot the sick child, and if changes are happening all of a sudden to communicate this with a senior nurse or someone who is looking after the child, another health professional involved.
To always have access to notes and records of the patient, to know medical history and background when treating symptoms and also if any vital signs monitoring becomes abnormal, readings are not the same and patient is not responding to treatment, this must all be recorded and communicated within professionals and family. Verbal communication with patients is a good way of communicating, but if the patient is non-verbal then you can get another health professional involved who may be able to communicate with the patient using sign language. So, it is therefore vital to communicate within language barrier. If there is one, get a translator to attend appointment and make it easier for the patient to communicate without struggling.
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