This assignment is a UK based.INTRODUCTIONSWOT ANALYSISHOLLIESEA OF WORDSCONCLUSION
1 Reflect on the development of your communication and professionalism abilities across this module (2,200 words). Create an Action Plan to identify four action plan goals to continue to develop your communication and professionalism skills ready for your first clinical placement (300 words). Essay Word Count: *** Action Plan word count: *** Total: *** Student ID: ****** 2 Reflect on the development of your communication and professionalism abilities across this module (2,200 words). Create an Action Plan to identify four action plan goals to continue to develop your communication and professionalism skills ready for your first clinical placement (300 words). Communication plays an important and vital role in successful health care provision. Upheld as one of 6 Cs (Introducing the 6 Cs 2015) and a foundation of the NHS constitution, good communication enables health care staff and service users to form trusting relationships to enable the best possible health outcomes. The Nursing and Midwifery Council (NMC) pre-registration standards require all nurses and midwives to use effective and ethical communication in order to ‘ensure people receive all the information they need in a language and manner that allows them to make informed choices and share decision making (Nursing and Midwifery Council England 2010)’. Demonstrating an understanding of need for compassion, active listening, positive body language, team working, and courage to communicate effectively is fundamental to forming a culture of best working practice and people centred care. This reflective essay discusses the theory and significance behind paralanguage and teamwork in healthcare and the importance of reflective practice to improve the quality of care to service users. Reflective practice is a fundamental skill within midwifery. The primary themes of the NMC Code are to prioritise people, practice effectively, preserve safety and promote professionalism and trust in order to provide public protection (Read The Code Online 2015). In order to practice effectively within their level of competency, all midwives must revalidate every three years. One of the requirements to meet revalidation is providing a minimum of five reflective accounts within the three year period. A research project lead by Linda Sweet et al. studying the importance of reflection to enhance the learning for midwifery students found: 3 ‘Reflective practice is an essential component of one’s personal and professional development as a midwife and learning to undertake critical reflection on practice is considered the cornerstone of being an accountable and autonomous practitioner.’ (Sweet et al. 2019) Reflection allows individuals to examine the actions, feelings and reactions to experiences by themselves and others within a practice situation to identify opportunities to change their approach and respond more effectively in the future. Reflective models provide a starting point and framework for reflection; allowing the individual to focus on the process of self-awareness and learning. It can be argued that reflective models can be restrictive due to the continuous process of reflection and it may not always be possible to follow the structured steps, however, the study conducted by Sweet et al. (2019) concluded that using a structured model of reflection improved reflective writing components including self-awareness, critical reflection and evidence informed practice. I have undertaken a reflection of the development of my own communication skills using Driscoll’s model of reflection (2000) which begins by asking what?; identifying my communication strengths and weaknesses. So what?; what implications may these strengths and weaknesses have on my progression in placement and training, the importance of addressing these to become a competent healthcare practitioner and the implications of what may happen if I don’t develop these skills. Now what?; how can future outcomes be modified, identify opportunities in my action plan to develop these skills. At the beginning of the course I undertook a SWOT analysis in order to establish my strengths, weaknesses, opportunities and threats throughout training and placement. I have identified one of my strengths as excellent communication skills however I lack in confidence within a team. I also 4 undertook the Belbin questionnaire to learn more about my role within a team. As the ‘plant’ my skills help to embrace lateral thinking; forming new ideas and challenging the norm, however, plants may also struggle to evaluate their ideas (Belbin 2019). Driscoll challenges us to ask So What? What effect might my lack of confidence have on my communication skills with both service users and multidisciplinary teams. Confident communication is fundamental to providing excellent person-centred care, allowing service users to be involved within the care pathway and make informed decisions which will help to build a therapeutic relationship with healthcare professionals (Gault et al. 2017). Lacking in confidence may affect my non-verbal communication, particularly my use of paralanguage. A 2013 review into NHS hospitals complaints systems Putting Patients Back in the Picture found that a significant proportion of the complaints related to the lack of compassion and communication within the care they received. The verbatim comments regarding staff behaviour within the report included ‘offhand, rude, impatient, callous (Clwyd 2013: 15-19)’. Highlighting the significance of a compassionate discourse between staff and service user and the importance of this interaction in ensuring a positive experience. The use of paralanguage; making adaptations to tone, volume, pitch and rhythm of voice as well as using noises to indicate listening can dramatically improve compassionate interaction. Hargie (2017) says ‘how information is delivered paralinguistically has important consequences for how much of the message is understood, recalled and acted on’. Therefore, accurate information shared within the interaction is vital, but conveying the message successfully relies heavily on paralanguage; the words used in the interaction may be polite, informative and accurate, however, if paralanguage is used ineffectively responses may appear abrupt, curt or uninterested. This skill is significant due to the culture of language within midwifery. Clinical language has the potential to isolate service users, ensuring they have understood the information is vital to gain informed consent for them to make an informed decision on their care. 5 Good communication does not arise purely from the practitioner, but their ability to listen to and interpret the responses from service users. Understanding paralanguage allows the practitioner to ‘read between the lines’ and gather information on how the service user is feeling or thinking, for example the use of “I’m fine”. The interpretation of the words would suggest that the person is well, however, in the UK it is widely culturally understood that when the words “I‘m fine” are delivered in a monotone, curt or aggressive manner means that the individual is angry, upset or hurt. Culture can inform the use of paralanguage: ‘Speakers of British English use loudness only when they are angry, speakers of Indian English use it to get the floor. So when an Indian speaker is trying to get the floor, the British speaker thinks s/he is getting angry—and gets angry in response. The result, both agree, is a heated interchange, but each thinks the other introduced the emotional tone into the conversation.’ (Tannen 1984: 193) Understanding the presence cultural differences within linguistics allows healthcare professionals to avoid such situations in Tannen’s research. The norms of culturally informed communication are described as a pattern of internalised behaviours, hidden to the people that enact them (Roebuck, 2016). Acknowledging and reflecting on personal biases allows healthcare professionals to understand and appreciate the individual backgrounds, cultures and experiences of service users and use this to adapt their communication style effectively. In order to be an effective communicator with vulnerable service users, it is important to understand cultural difference as well as your own personal culture (Roebuck 2017). By understanding bias and the culture that has informed a communication style encourages an awareness of the potential impact individual cultural communication has on those who communicate differently. Through working on the concept of unconscious bias, I am aware that my own personal culture has the potential to influence my thoughts or opinions on others. Within healthcare settings, there are dominant (staff) and non- dominant (service users) cultural groups (Hall 1959). In order to avoid the non-dominant group 6 feeling negatively during and after an exchange, the healthcare professional must first acknowledge any ethnocentrism, anxieties and prejudice and enact cultural sensitivity. If unaddressed, my unconscious bias and lack of confidence has the potential to appear through paralanguage, which may negatively impact on my interactions with service users, especially with those who may be vulnerable due to a cultural difference or communication challenges and with other healthcare professionals. It is important to understand individual communication styles, cultures and skills in order to communicate effectively with vulnerable service and is necessary to engage proactively within mutli- professional teams. Using the Belbin questionnaire (1969), I found out more about my individual style of communication and the role I play in teamwork scenarios. Knowing my strengths and weaknesses within in a team has helped me to address my self-identified weakness of a loss of confidence within my abilities and knowledge when in a teamwork situation. Identifying what qualities I can offer a team will help to improve confidence in my role and empower me to seek support where needed. Within healthcare settings a successful ‘team’ incorporates healthcare professionals, the service user and their family to provide holistic care. Holistic care is the adaption and deviation of pathways by combining a range of healthcare professional’s knowledge and experience with the service user at the centre, playing an active role in their health (Dossey et al. 2005). The production of Grandma Remember Me (Howard 2019) focused on the effects Dementia has on families and individuals. Initially, I felt sceptical about the production as dementia has no direct resonance with maternity services. The average age of primigravida women is 28.6 years and multigravida 30.3 years (ons.gov.uk 2015). Young onset dementia affects individuals between 30 and 65 years old, and accounts for 5% of people living with dementia (Young Dementia UK 2019). Where it is possible for women accessing maternity services to experience young onset dementia it is a very rare occurrence. I decided to watch the performance from a holistic service point of view; how 7 would I look after the family holistically, using an integrated approach to identify the individual needs of the service user and their family and consider which other health and social care providers would I refer the family to in order to improve their experiences and outcomes. It became clear that the family