Unit of competency details

Descriptor 

This competency unit describes the knowledge and skills required to use effective communication skills in the delivery or receipt of information in the health environment context. It includes communication with clients, family, carers, colleagues or members of the public

Application 

The knowledge and skills described in this competency unit are to be applied within jurisdictional nursing and midwifery regulatory authority legislative requirements

Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurses and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element.

ELEMENT 

PERFORMANCE CRITERIA 

1. Use effective communication  skills

1.1 Apply principles of effective communication, with an understanding of communication processes and factors that facilitate and inhibit communication

1.2 Use communication skills to enhance or promote effective interactions

1.3 Use effective communication as a basis for developing skills in therapeutic communication

1.4 Deliver information clearly, clarified, timely and in accordance with the situation

1.5 Apply a respectful and confidential communication manner at all times

1.6 Use health terminology correctly in written and verbal communication with clients, family, carers and colleagues, using accurate spelling and pronunciation

1.7 Comply with legal requirements for client documentation and use Australian/UK/English medical terminology

2. Communicate with client, carer and health care personnel

2.1 Maximise opportunities for staff to involve clients, family and carers in their care and treatment

2.2 Actively encourage clients, family and carers to share their information

2.3 Demonstrate politeness, respect and empathy to clients, family and carers

2.4 Provide a caring, sensitive, confident and reassuring manner in all interactions with clients

2.5 Refer to appropriate personnel when complicated situations are outside the role of the Enrolled/Division 2 nurse

2.6 Take into account the roles and responsibilities of various health care personnel involved in communicating in complicated situations

2.7 Complete all documentation detailing complicated and difficult situations complying with legal requirements

2.8 Identify and apply appropriate communication strategies and techniques in a number of varying complicated situations 

3. Effectively address constraints to communication

3.1 Identify actual and potential constraints to effective communication

3.2 Recognise difficulties in communication, possible causes and resolve using appropriate communication skills and techniques

3.3 Identify early signs of potential complicated or difficult situations and report or implement strategies as directed by the registered nurse

3.4 Clarify and address the issues and needs of people taking into account differing cultures, religious practices, language, physical disability and emotional state

4. Evaluate effectiveness of communication

4.1 Document and report outcomes of communication strategies

4.2 Refer to appropriate health personnel when situation is outside own role and responsibility

4.3 Assist in assessing the effectiveness of communication strategies

5. Effectively use the principles and processes of open disclosure 

5.1 Be aware of the principles and process of open disclosure in a health care environment

5.2 Communicate effectively with clients after an adverse event

5.3 Address own role and responsibilities in relation to open disclosure in line with organisation policies and procedures

6. Use information technology

6.1 Use computers and related information technology to support nursing practice

6.2 Comply with organisation protocols for electronic communication with clients, family and carers

6.3 Use information technology to access data appropriate to own role and organisation requirements

7. Give and receive feedback for performance improvement

7.1 Use feedback as a tool to achieve performance improvement

7.2 Use appropriate language and a respectful manner to accept and act upon feedback in relation to performance improvement

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge :

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• Confidentiality principles
• Issues and needs of clients taking into account differing cultures, religious practices, languages, physical disabilities and emotional disorders
• Legal implications of documentation/duty of care
• Potential constraints to effective communication
• Principles and processes of open disclosure
• Principles of informed consent
• Risk assessment in critical and non-critical clinical situations
• Statutory framework within which nursing takes place

Essential skills :

It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Apply Professional Standards of Practice:

• ANMC code of conduct
• ANMC code of ethics
• ANMC national Enrolled/Division 2 nurse competency standards
• state/territory Nurse Regulatory Nurses Act
• state/territory Nursing and Midwifery Regulatory Authority standards of practice
• scope of nursing practice decision making framework

• Communicate effectively with clients and other staff, both orally and in writing
• Recognise and address the special needs of clients
• Record assessment outcomes according to organisation policy and procedures which may include electronic data systems
• Report and record clinical information using appropriate medical terminology
• Use appropriate nursing and medico-legal terminology and language
• Use information technology to support nursing practice
• Use interpersonal skills, including working with others, empathy with clients, family and colleagues, using sensitivity when dealing with people and relating to persons from differing cultural, spiritual, social and religious backgrounds
• Use oral communication skills (language competence) required to fulfil job roles as specified by the health environment. Advanced oral communication skills include interviewing techniques, asking questions, active listening, asking for clarification from client or other persons, negotiating solutions, acknowledging and responding to a range of views.
• Use policies and procedures of health environment regarding effective communication
• Use written communication skills (literacy competence) required to fulfil job roles as specified by health environment. The level of skill may range from reading and understanding client reports and documentation to completion of written reports
• Utilise special communication skills of personnel such as interpreters appropriately as part of nursing practice

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit :

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of performance in a work context is essential for assessment of this unit
• Consistency of performance should be demonstrated over the required range of workplace situations and should occur on more than one occasion and be assessed by a registered nurse

Context of and specific resources for assessment :

• Where, for reasons of safety, access to equipment and resources and space, assessment takes place away from the workplace, simulations should be used to represent workplace conditions as closely as possible, prior to assessment in the workplace

Method of assessment 

• Observation in workplace or simulated situations
• Written assignments/projects
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
• Questioning verbal and written
• Role play/simulation

Access and equity considerations :

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance

Common terms associated with communication may include 

• Active listening
• Argument
• Body language
• Brainstorming
• Counselling
• Debate
• Discussion
• Electronic aids
• Empathy
• Facial expression
• Interview
• Intimate space
• Non-verbal communication - space, gesture, expression, posture, dress, voice tone, gaze
• Public space
• Reflective listening
• Self disclosure
• Social space
• Symbols and pictures
• Sympathy
• Touch
• Trust
• Verbal communication
• Written communication

Scope of practice includes :

• Statutory framework within which work takes place
• Scope of practice of Enrolled/Division 2 nurse (registered nurse division 2), under current legislation

Oral communication may include :

• Responding to questions and delivering health care environment information
• Interpretation of complicated situations
• Questioning, clarifying and confirming information
• Explaining information , procedures and descriptions

Constraints to effective communication may include :

• Environment difficulties
• Family and/or friends involvement
• Language difficulties
• Hearing and/or speech impairments
• Religious, social, spiritual or cultural factors
• Emotional state

Open disclosure includes :

• The provision of an open, consistent approach to communicating with clients following an adverse event
• Expressing regret for what has happened, keeping the client informed and providing feedback on investigations
• Includes steps taken to prevent an event from happening
• Provides information that enables systems of care to be changed or to improve client safety

(Open Disclosure  - a handbook for health care professionals to assist with the implementation of the open disclosure standard , Safety and Quality Council. 2005)

An adverse event means :

• An incident in which unintended harm resulted to a person receiving care

(Open Disclosure  - a handbook for health care professionals to assist with the implementation of the open disclosure standard . Safety and Quality Council. 2005)

Effective communication may include the use of :

• Non-verbal communication
• Establishing rapport
• Empathy and sympathy
• Honesty and openness
• Active and reflective listening
• Conflict resolution
• Therapeutic touch
• Use of personnel with special communication skills e.g. use of interpreters

Communication process includes :

• Information
• Encoder/sender
• Decoder/receiver
• Channel
• Message
• Feedback

Factors affecting communication may include :

• Age and gender
• Culture
• Language
• Physical/emotional/cognitive disorder/disability
• Values and beliefs
• Educational background
• Illness - pain and discomfort
• Grief and bereavement
• Stress
• Discrimination and stereotyping
• Environment (eg noise)
• Urgency of situation
• Personal bias

Complicated or difficult situations may include :

• Post suicide attempts
• Drug and alcohol affected people
• Disabilities
• Hearing impaired
• Personal threat
• Aggression
• Anger
• Emergency and crisis situations
• Trauma
• Death
• Grief and loss

Characteristics of effective partnerships include :

• Confidentiality
• Trust
• Self reflection
• Social conversation
• Creating a therapeutic environment
• Encouraging autonomy and independence

Performance improvement may include :

• Use of health care environment and professional standards
• Effective and constructive feedback
• Evaluation of all performances
• Use of constructive comments
• Accountability for own actions and evaluation
• Performance appraisal against role statement and/or environment contract
• Professional development based on personal and professional identified needs
• Remediation as identified by self and/or others

Self assessment strategies may include :

• Setting goals
• Journal writing
• Reflective learning principles
• Professional development activities
• Performance appraisal
• Evaluating own performance

Health terminology may include  (but should not be limited to ):

• Anatomy and physiology terms
• Medical conditions
• Medical investigations and procedures
• Abbreviations for medical and pharmacological terms
• Names of equipment and instruments
• Medico-legal terminology

Written and oral instructions may include :

• Memos and notices
• Drug orders
• Instructions for pre and postoperative care
• Client notes
• Routine reports
• OHS signs and instructions
• Telephone calls
• Communicating with clients and their families
• Communicating with health professionals
• Handover
• Email

Routine activities may include :

• Entering client details into a computer system/files
• Providing information to clients and their families
• Ordering stock
• Contributing to meetings and taking minutes
• Answering client and family enquires
• Scheduling
• Producing a range of complex nursing documents (e.g. client history, case report)

Documents may include :

• Client records
• Client health histories
• Case reports
• Nursing notes
• Electronic Health Records (EHR)
• Clinical pathways and nursing care plans