Background Draft 1

This proposal is made in response to the National University of Singapore Excellence Unit (NUSEU)’s request for recommendations to improve the communication component in the existing curriculum. Through our proposed changes, we hope to enhance undergraduates’ professional communication skills and provide them the cutting edge to be successful in their workplace. 

Our team had identified the nursing profession in a hospital setting as our area of research. We are concerned that in the high complexity of the healthcare industry, communication failure could result in inadvertent patient harm. There are numerous articles documenting the communication breakdown…

Nurses in a hospital undertake a vast variety of roles, making it almost impossible to make an exhaustive list. However, there are some basic roles which are applicable across the board. One such role is taking care of patients and being advocates for them. In order to perform such a task, nurses need to convey messages accurately to doctors and fellow nurses, in the form of both verbal and written communication. Another role of a nurse is to serve as a bridge between the hospital and the patients' next-of-kin. Nurses' clinical role provides them frequent opportunities to have contact with the family members of the patients. Therefore, anxious relatives would approach a nurse when there are any queries. A nurse has to deal with them professionally by answering to their needs and soothing out their anxiety. Last of all a nurse would also be involved in paperwork which includes reporting of patients condition and transfer and movement of patients to various wards. This role should not be underestimated as these documents are to be presented as legal documents when conflicts arise. 

Verbal skills expected of a nurse include being able to be understood by the patient. This could mean avoiding the use of medical jargons, and he or she has to speak many different languages and dialects to serve Singapore's wide diversity of patients. 

• a nurse must also choose the right words and avoid using medical jargons
• a nurse must also understand the background of the patient to better communicate with the patient (non verbal?)

Standing in the front lines, good communication skills in nurses is more than just an ability to help execute his or her work, but also makes a presentable ambassador of our healthcare system. Singapore’s healthcare services are highly rated for its world-class quality, safety, and reliability. We have Asia's best healthcare system and is sixth in the world ranking (World Health Organization, 2000).The government’s motion to promote Singapore as Asia's medical hub has seen the country clinch “Best Medical/Wellness Tourism Destination” at the TravelWeekly (Asia) Industry Awards for 2007 and 2008. Effective communication among health caregivers is one factor behind this professionalism that 'satisfies' Singaporeans and attract medical tourists.

Current curriculum for nursing undergraduates includes one module dedicated for communications: NUR1110 Therapeutic Communication. This module emphasizes the importance of interpersonal relations in the nursing profession and application of communication theories through simulated practices. The placement of NUR1110 to be read in year one semester two signifies the value of professional communication in nursing; that such skills should be learnt right from the beginning.  

Our interview conducted with Mrs Lee, Director of the Nursing Department in National University Hospital (NUH), has enlightened us regarding the situation, background, assessment and recommendation (SBAR) technique currently employed in NUH. The SBAR technique framework allows for effective communication about a patient's condition within the healthcare team. This involves verbal and written exchanges and is especially useful in case escalation or handover. By providing details in each component of SBAR, inadequate communication could be reduced. We feel that one of the biggest advantages of SBAR is that it levels the hierarchy among all healthcare providers by providing a common platform that uses the same language to communicate critical events. We did not find evidence that the SBAR technique is preached to nursing undergraduates.  

Problem statement (part of the above)

 
To identify key communication problems that nurses face when interacting with different groups of people.

Nursing involve lots of interaction with patients and also other health care professions. Therefore it is vital for nurses to be able to communicate effectively. Miscommunication often arises in the hospital setting, thus reflecting a need to further look into the communication skills of nurses. Although miscommunication can never be totally avoided, improving the communication skills of nurses we hope to minimize such instances thus improving the overall standards of Singapore's health care industry.