We need to communicate with patients, families, and other healthcare professionals to be successful at our jobs. When I was a case manager in a nursing home many years ago, there was a patient that was declining and almost at the end of life. After a discussion with her family, I had changed her care plan and “task list,” which was a list of how to care for each patient we kept in their closet, so staff knew how to care for each patient, to reflect comfort cares only. I had updated the LPN working that afternoon on the change, with the expectation the LPN would update the CNAs. That evening, the patient had a fall. Two of the staff had gotten the patient upon the commode, per the previous plan of care, after the patient reported having to go to the bathroom.
In this case, the transmission of the message was not relayed to the CNAs. I had assumed the LPN would relay the message to the CNAs but did not receive feedback from the LPN to ensure that would happen. According to Black (2017), effective nurses do not assume a message is understood without confirming with the receiver. It was the expectation that the staff followed the task list in the patient closet. The task list was a non-verbal form for transmission of the message or plan of care for each patient. Staff later told me, they did not always have time to check the task list. Siegel (2010) indicates that communication gaps between nurses and unlicensed assistive personnel are an obstacle to providing patient care.
After learning from staff they did not always have time to check the individual task list in the patient closet, a facility-wide change was made. In addition to the task list in the closet, we implemented resident data sheets, which listed all the patients on the unit and how to take care of them on 1 sheet. It was then the expectation that the staff carried the resident data sheets on their person. The other lesson learned was that feedback is essential for successful communication, Black (2017).
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