Unit of competency details

Descriptor 

This competency unit describes the skills and knowledge required for effective communication in complex communication situations and its application to nursing practice; the function and purpose of small groups; meeting procedures; and the dynamics of group work and evaluation as a tool for continuous improvement

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 in complex situations

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

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

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

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

1.5 Apply a respectful and confidential manner throughout all communications

1.6 Provide a therapeutic environment in all interactions with clients through a caring, sensitive, confident and reassuring manner

1.7 Demonstrate politeness, respect and empathy in all interactions with clients, family and carers

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

2. Deliver complex information effectively

2.1 Deliver complex information in a manner that is clearly understood by clients, carers, colleagues and others

2.2 Allow time for complex information to be comprehended taking into account people's differing levels of understanding

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

2.4 Confirm the understanding of information by clients, carers, colleagues and others

2.5 Communicate effectively in an emergency situation in line with the health organisation policy and procedure and in consultation/collaboration with registered nurse

2.6 Address stressful situations  using effective communication skills or refer to the most appropriate health care team member for resolution

2.7 Deliver complex information to clients/carers in a manner that enhances understanding and prevents 'information overload'

3. Identify and address actual and potential constraints to communication

3.1 Identify actual and potential constraints to effective communication in the workplace

3.2 Identify and apply communication strategies and techniques appropriate to a range of varying complicated situations

3.3 Identify early signs of potential complicated or difficult situations

3.4 Implement strategies to address complicated or difficult communication situations in line with relevant policies and procedures and within scope of role

3.5 Clarify roles of other health professionals involved in complicated communication situations

3.6 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 in complicated situations

4.1 Document and report outcomes of communication strategies to address complicated situations

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 in complicated situations

4.4 Ensure debriefing sessions are available for self and staff following difficult situations

5. Use information technology

5.1 Use computers and related information technology to support nursing practice

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

5.3 Use information technology, including the internet to access data appropriate to own role and organisation requirements

5.4 Use basic computing and word processing skills to access, develop and manipulate information in line with own role and organisation requirements

6. Lead small group discussions

6.1 Monitor and respond appropriately to changing group dynamics 

6.2 Clarify the purpose of group meetings and manage discussion in line to achieve identified objectives

6.3 Implement appropriate meeting procedures  and roles of members to support effective contribution to discussion

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 achieve performance improvement through feedback

7.3 Apply strategies to deliver constructive outcomes from giving and receiving feedback

7.4 Assess own performance as a basis for assessing the performance of others and providing feedback

7.5 Undertake mentoring within scope of practice of Enrolled/Division 2 nurse

8. Use the principles and processes of open disclosure effectively

8.1 Apply organisation principles and processes of open disclosure in consultation/collaboration with registered nurse

8.2 Follow organisation processes for notifying adverse events to clients, family or carers

8.3 Outline potential impact of adverse events on clients, family and carers

8.4 Communicate effectively with clients after an adverse event in consultation/collaboration with registered nurse

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

8.6 Apply principles and practices of risk management and quality improvement in regard to open disclosure in consultation/collaboration with registered nurse

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
• Group dynamics
• 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
• Medical terminology
• Potential constraints to effective communication
• Principles of informed consent
• Principles, processes and practices of open disclosure
• 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

• Apply problem solving skills, including an ability to use tools and techniques to solve problems, analyse information and make decisions that require discretion and confidentiality
• Comply with:

• open disclosure processes
• principles of informed consent

• Communicate effectively with clients and other staff
• Provide mentoring in line with jurisdictional regulatory requirements
• 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 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. The work may involve using interpreters
• 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 organisation protocols for electronic communication

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 work place 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

Related unit :

This competency unit incorporates the content of:

• HLTEN402B Communicate effectively in a nursing role

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

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 eg. use of interpreters

Communication process must include :

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

Factors affecting communication may include :

• Age
• Bereavement and grief
• Cognitive impairment
• Culture
• Discrimination
• Educational background
• Emotional state
• Environment (e.g. noise)
• Gender
• Illness
• Language
• Non-verbal communication
• Pain and discomfort
• Perceptions
• Personal bias
• Physical constraints to hearing, sight and speech
• Socialisation
• Stereotyping
• Stress
• Urgency of situation
• Values and beliefs

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

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)

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

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)

Stressful situations may be :

• Staff centred
• Client centred

Terms associated with group dynamics may include :

• Leadership styles
• Teams
• Group behaviours
• Cooperation
• Diversity
• Conflict
• Consensus
• Internal conflict
• Interpersonal conflict
• Aggression
• Assertion
• Passivity
• Time management
• Trust
• Forming
• Brain storming
• Performing
• Mourning/reforming

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

Conflict resolution strategies may include :

• Win/win
• Win/lose
• Lose/lose
• Compromising
• Confronting
• Withdrawing
• Forcing
• Peace maker
• Three-part statement
• Broken record

Meeting procedures may include :

• Types of meetings (formal, semi-formal, informal)
• Handover
• Agenda formation
• Purpose of the meeting
• Attendees
• Duration of meeting
• Day, date, time and venue
• Key roles (chairperson, note-taker)
• Summarising and evaluating processes

Terms associated with meetings may include :

• Agenda
• Minutes
• Apologies
• Business arising
• General business
• Propose
• Second
• Motion
• Parliamentary procedure
• Consensus
• Compromise
• Concession
• Interview
• Performance improvement

Common terms associated with performance improvement may include :

• Standards
• Benchmark
• Feedback
• Evaluation
• Constructive criticism
• Accountability
• Performance appraisal
• Performance management
• Professional development
• Strategic plan
• Remediation
• Evaluation of own performance
• Self disclosure
• Reflective learning principles
• Professional development activities