For nurses who work in high-pressure teams in hospitals and psychiatry, assessing and managing patients suffering is one of the greatest challenges they are likely to face. The actions taken and decisions made in these situations significantly impact the future well-being of patients. Communication with these patients is also crucial. So, what kind of high-pressure situations are likely to occur in a medical setting, how will good team collaboration and communication help improve patient outcomes, and how can clinical placements help prospective nurses acquire these skills?
In this article, we will examine the key role communication plays in dealing with difficult situations in healthcare and the role clinical placements can play in learning to cope with them. In addition, we also explore the ways in which nurses can work to improve their knowledge and preparation in this area, with a particular focus on education, experience, and lifelong learning.
Communication while under pressure
A physical or mental health crisis occurs when an individual experiences a serious physical or psychiatric issue. Regarding physical health, this might be a serious injury or a sudden illness, such as a heart attack or stroke. Examples of crises in mental health can include severe depression and suicidal thoughts, psychosis, extreme anger or rage, and self-harm. Although medical staff who work in hospitals or other acute care units are most likely to face these kinds of situations daily, all health professionals in all settings will encounter them frequently throughout their careers.
Dealing with these episodes can be distressing and demanding for all teams involved. Medical professionals must be capable of reacting quickly and effectively to ensure patients receive the treatment they need. Though it is often up to the treating physician to make the final decision in terms of diagnosis and treatment procedures, registered nurses (RNs) are frequently responsible for providing crucial primary care and monitoring tasks. RNs must provide feedback with clear, concise notes to physicians and assistants so that they may know the root of the problem, and the next actions to take so patients receive appropriate aftercare treatment.
In many states, qualified nurse practitioners (NPs) are also responsible for providing primary care in terms of diagnosis and issuing prescriptions. For this reason, good communication is essential to being a good NP and delivering quality patient care.
Phase one: Rapid evaluation as a team
Whenever someone is experiencing a significant and acute health issue, the first and most important step for a team of nurses is to try to identify the issue at hand.
In some cases, particularly if someone has a pre-diagnosed condition and is displaying symptoms that are clearly consistent with their illness, the diagnosis may be relatively quick and easy to establish. To do so, nurses can find old medical assessments, marrying up the existing symptoms to quickly build a plan of how to alleviate a patient’s pain. In some cases, it is far more difficult if there is some ambiguity concerning the severity of the patient’s condition and the type of response it requires.
Of course, diagnosis is absolutely key to ensuring the right treatment, and here, communication and teamwork couldn’t be more important. Very often, nurses and physicians from different departments will converse and assess the situation to gain a more rounded picture – this is called inter-departmental communication and is particularly vital in clinical placements where nurses are less experienced and rely more on the opinions and advice of clinical educators.
At this stage, details are everything. It is essential to obtain as complete a medical history as possible, which is often the responsibility of the nurse. Deciphering whether the information provided is accurate or not can make the difference between a positive or negative outcome for the patient. It may be important to ascertain, for example, if the patient has any prescription medication, and whether they have been taking it on a regular basis.
Once the key basic information has been collected and a physical examination has been carried out, the main priority is to decide swiftly on the actions that need to be taken. Again, because nurses will learn to work closely with other medical staff on their medical placements, they will have the chance to see just how experienced professionals communicate in these kinds of situations.
Phase two: Communicating to establish a treatment plan
The medical staff – which might be nurses, paramedics, or physicians – must decide whether the patient is in need of urgent care. In many cases, the individual will be taken to an acute care facility, though it might also be appropriate to offer them home or on-the-spot care, too. Once this has been accomplished, the responder will usually consult with other professionals and observe the patient in order to establish a firm diagnosis, any potential causes of their condition, and a subsequent plan of treatment.
At this stage, close friends or family may also be involved in the process, as the medical team seeks to build a support structure that can help the patient through the period of crisis and beyond. Medical professionals may offer not only medical treatment but also explore options in terms of coping skills, potential carers, or any other people who can in some way offer support. Clinical placements enable students to listen to and participate in these kinds of situations on a regular basis – an important learning experience. Often, patients themselves will also be able to offer examples of positive or ineffective communication.
Phase three: Cooperating through referrals and follow-ups
Finally, the medical staff must decide if it is necessary to refer the patient to other specialists for further assessment and treatment. Follow-up sessions and opportunities for monitoring the patient’s health may also be scheduled. In many ways, this final phase could be the most important part of the process and is another area where good communication is paramount.
After all, many – if not most – people who experience acute physical or mental health issues will undergo more than one episode in their lifetime. Consistent and appropriate treatment and monitoring can help reduce the likelihood of this happening, while a clear action plan – often shared with family members as well as the person in question – can help limit the damage or impact of any future issues.
The right skills and knowledge
Naturally, in these situations, a calm head, resilience, and a firm hand are essential to ensure the right decisions are made and the individual does not cause any harm to themselves or others. At the same time, great care and empathy are also very crucial. Severe health episodes can be incredibly traumatic for the sufferer and the people around them, and the right kind of communication mixed with a sympathetic approach can do a lot to help ensure a positive outcome.
To make the right decision, however, it is also vital for nurses and other healthcare professionals to have enough experience and background theoretical knowledge to help them choose the best possible path for their patients. A failure to properly identify the cause of a serious patient crisis, for example, can be dangerous in both the short- and long-term.
Real-world experience
This is one of the key benefits of a clinical placement: it allows prospective nurses to gain real-world experience and deal with high-pressure situations with structured support at all times. Of course, education plays a key role in any medical professional’s preparation, and many nurses who are interested in taking on greater responsibility and learning more advanced strategies for dealing with difficult situations choose to study to become a nurse practitioner. This kind of position, which in many states enables nurses to perform a range of tasks, including making diagnoses, identifying treatment plans, prescribing medicine, and referring patients to other specialists, is particularly crucial in the US healthcare system, where there is a shortage of available qualified physicians, especially in rural and low-income areas.
Many educational institutions, such as Spring Arbor University, offer clinical placements for their students where they can receive hands-on experience in hospitals and community surgeries. While on their clinical placements, students will be mentored and encouraged to discuss their experiences with peers. On accredited online MSN programs, such as those provided at Spring Arbor University, students will learn that team building in nursing is one of the most important steps to excellent communication in a crisis. Discussion and peer reviews can also help nursing teams build up a high level of rapport with each other and ensure smooth cooperation, which is absolutely crucial in acute medicine where stress levels can often be through the roof.
Conclusion: Preparation is key
There is no question that whether we are concerned with physical or mental healthcare, preparation is everything when it comes to dealing with crisis situations. Nurses and other medical staff must have the right training, experience, and background knowledge to react swiftly and appropriately to a range of difficult situations. In addition, they also need to be able to remain calm under pressure, make good decisions, and also show empathy to their patients.
Experiencing acute situations in the context of a clinical placement can be a major learning opportunity for prospective nurses, while communication lies at the center of ensuring a swift and effective response. Fortunately, with an accredited nursing program, there is a clear path for nurses who would like to develop their abilities in this area, enabling them to not only increase their own level of knowledge but also the level of care offered to patients.
