Soft_Skill_in_Nursing

Contemporary Issues in Professional Practice Nursing is a practice discipline which is dependency upon a high level of professionalism, ethics and human values that demand for intellect, skill and a high sense of social responsibility. It is refers to all nurses's professional activities, included nursing education, administration, research, and clinical or public health practice. Today nurses are facing the growing complexity and dynamically changing health care environment. Therefore innovation in skill is an important part of the development of the nurses needs opportunities to master their skills. Shamsuddin (2006), agreed in view of James P. Smith, in his 1978 Editorial that higher education would enhance the quality of nursing care and the standing of nursing profession. Contemporary issue can be defined as the problem, questions and concerns that are current for the present time which is happening or existing at the same time. Professional practice means, all registered nurses should have aspire to achieve excellence in patient centered care, to practice with awareness, compassion and competence to high ethical and clinical standards from an up to date knowledge base and to be responsive to policy, research and knowledge generations to meet confidence of patients. (Brown and Gobbi 2007). In this dissertation I will critically analyze what is the contemporary issue in professional practice at my workplace' The issue that i'm going to analyze is soft skill towards our client and how important it is to understand the situation in ordered to overcome it. The aim of this paper is toreflect critically appraise the practice in the light of the issue. According to Ministry of Health Malaysia report, number of complaints about health care provider especially nurses are increasing day by day. Related to the matter, I have decided to choose soft skills among nurses as a contemporary issue. I also have critically analyzed the issues of the soft skills and its impact on nursing profession, clients, organizations, practice arenas and our country Malaysia. Now nursing care had gone beyond where there are a lot of complaints, appeared in news, papers and email directed to editor of nursing saying that nurses are lacking in caring attitude and soft skill. A few of examples that I noticed appeared in electronic media and local dailies are nurse's attitude was shocking, nurses are rude, nurses have no respect, hospitals need to be more nurse friendly and so on. With increasing complaints on nurses's attitude, soft skill and nursing care had caused great impact on nursing profession. Soft skill definition are interpersonal skills such as the ability to communication well with other people and to work in a team. Nursing board had come up with a slogan in Bahasa Malaysia called “Ten S” (10S), which when translated means “Smile, Wish, Sensitive, Polite, Touch, Smart, Fast, Investigate, Supervise and Spirit. The smile is a noble act or image of an attending nurse. Wishing a client entails a relationship with client. All nurses must be sensitive to client's condition, feeling and ought to be caring attitude. They must also not be judgemental but speak with caring tone because the physical contact with patient plays a thousand words. Nurses should also portray skillfulness; be knowledge and efficient in providing services to patients. Health minister Datuk Seri Liow Tiong Lai already issued a directive to display the meaning of “10S” in all government hospitals and clinics. Via assessment and examing on the impact of soft skill with patients, nursing profession and the the organization it is necessary to identify contributing factors which also depends on placement area. My first priority is to discuss on the soft skill among health care provider. According to (Huge, 2007), as a registered nurse and health care provider, we should be aware, recognize the seriousness of unmitigated adverse event and place a specific ethical obligation upon ourselves to track down the error. Malaysian Nursing Board (2005), 'Code of professional conduct' state that nurses must provide safe and competent nursing care. They should intervene appropriately and promptly to prevent complication. With analysis, it is apparent to acknowledge why nurses are lacking with soft skill. As they are in the primary health care where they should be more nurses friendly. According to Watson, (1995) mentioned that health care restoration from the focus of health care delivery from a model based on the treatment of illness to a model expected on the concepts of health and community based on care that the future of medicine and nursing more to caring then to cure. According to Duffin C, (2000) also stated that recent evidence has indicated that ineffective communication remains a strong barrier in health care and that wide variation are evident in terms of the quality and quantity of nurse-patient communication. From that statements it was really clear that ineffectiveness of communication between nurses and health care can affect patient's care. Communication can be defined as the exchange of information, (I. A. Richards 1928). For me, i'm critically analyze that the factors leading to poor communication happened at my placement area. Barraclough, J. (2000) stated that poor communication and unhelpful attitudes from health professional, particularly at the time of diagnosis, can have lasting and destroy effect on patients. Malaysia also has a critical shortage of nurses and specialty nurses. It's estimated that 100,000 nurses of all categories are needed in the next 13 years. (Source from Nursing Board of Malaysia). So as a result, burden of workload may exists. These made the nurses getting busier with their works rather than to communicate and entertain their clients. Public or clients did not understand these situation and always put stigma on nurses are unfriendly, bold, unprofessional and fierce. Fifth- Cozens (2001) concludes that there is evidence that stressed the staff to produced inferior care and that the psychological well being of staff intimately affects the quality of patient care in a variety of ways. Sometimes the nurses also need to facing problems of patients and family members with difficult communication regarding patient's treatment and nursing care, but these particular patients purposely did not want to understand and follow nurse's instruction but makes things worse. Working patients like this made more the stress to nurses. According to Maguire (1985) stated that several factors including lack of training and fear of imposing further distress upon patients are implicated in ineffective communication. Also agreed by Heaven & Maguire (1996) noted that patient assessment underpins every aspects of nursing care. But there is a much evidence to suggest that many nurses lack of skills for communicate effectively with their patients and so assess their individual problem and concerns. (Appendix 1) Focusing on caring attributes, (Roach 1987) proposed that caring behavior in nursing are manifested via the '5C' that is competence, confidence, compassion, conscience and commitment. The nature and in the process of the caring provider client relationship nurses must have perception such as respectful deference to others, assurance of human presence, professional knowledge and skills. Nurses should develop into critical thinkers which needs to improvement at all levels. Soft skill and moral subject should be added in nursing curriculum for undergraduate program. According to Maslin-Prothero (1992) recommends that, developing life long learner will benefit from information seeking skills and the ability to process and critically analyze that information. Caring for someone is not easy, whereby nurses must communicate this care by showing concern, attention, respect and empathy as used in Lasswell's model of communication. According to Nestel D.et al. (2002) stated that much of nurses time will be spent communication with our patients so as a nurse we must have excellent listening skills. Throughout in nursing career, patients will turn to a nurse to express their fears, opinions, hopes and personal concerns. So we will know what tey really need or want to say. Kurzen CR, (2005) stated that effective communication skills to improve the quality of care to avoid many errors in patients care. Judging from complaints raised soft skills values are lacking from nurses. The uncaring attitude of nurses also led to wrong treatment on wrong patient and in wrong manner and wrong time as the examples. Nurses should evaluate themselves when they are facing with complaints in nursing arena. How was my body language' How was my attitude when communicate with patient' These question would give an insight, reflect, beliefs, values and nursing actions. Actually The Ministry of Health needs to look into staffing, staffs welfare, working environment and need to analyze the increasing in public complaints against health division. People are not longer prepared to work in a mechanistis organization where they are given orders, work only for money and remain in the same job. It has a negative effect to their ability to provide good care via poor morale and creating low motivation. According to Atwater & Base, (1994) if staff feels that they are not cared for so they find it difficult to care for clients. So the management should to show an important role whereby looking towards client and staff can work as a team work in making the environment a better place to work. According to Wills, (1999), change is difficult and challenging when working with unmotivated staff. So it is the challenge to be good leadership which is will encourage their subcoordinate to obtain for higher goals, will provide better care and will facilitate them in their own professional development. Denise Deppoliti (2008) stated that nurses experienced professional development via continuing education, learning to use technical equipment and become specialization. In a speech, (Abdullah, 2002) stated that government has initiated efforts to promote and implement programmes for long life learning. Knowledgeable nurse will be a confident nurse and able to educate others. Many nurses commented on the need to formally or informally learn new things daily. Several nurses returned to school to enhance their care for clients which is their responsibility to leran was seen as relating to quality care for clients and family members. In the Ninth Malaysia Plan, under human resource development there are few resources to look into nursing profession that is continues professional development (CPD) program will be further strengthened to develop skills of nursing personnel. CPD activities will be monitored to ensure consolidated quality and professionalism, effort will be undertaken to enhance competences of medical personnel in new area, post basic training in new and priority disciplines will be conducted and finally development of soft skills, including good ethics, values as well as caring attitude will be given emphasis. The Ministry of Health should have to closely support and overcome with nurses stress at work place to have a happy environment for clients so that unnecessary complaints published in papers and to improve quality of nursing care to all. Development of policies and guidelines, commitments from management, development of human resource through education with responsibility is the overall mission in reducing and preventing complaints. Actually the foundation of caring is the relationship between nurse and patient. To build this relationship the nurses must to have active listening skills and good communication skills. This is a trusting relationship where values are respected as the nurse listens to the patient's concern's, provides information and advice, relieves distress by encouraging the expression of emotion, improves morale through review of established outcomes and encourages the patient to practice self help. (Moyle 2003). According to Kurzen, (2005) stated that effective communication skills improve the quality of care; ineffective communication skills are the source of many errors in patient care. To communicate effectively with your patients requires paying close attention not only to what they say it. You may need to ask carefully worded questions to determine exactly what the patient is trying to say. Faulkner, (1998) agreed that to be able to communicate effectively with others is at the heart of all patient care. Nurses enter into the profession to do a good job and provide high quality services. When it become to pressures, burn out and conflicts it often demotivates them. When patient not to cooperate with health professional whether nurses are able to influence them and to control their negative emotions will make a difference.