As a nurse and working together with your team, effective communication is key in patient-centered care and safety. Team-work, collaboration and competent nursing staff is critical. Lack thereof leads to medical errors/medication mistakes that can harm the patient or worse. Ineffective communication that leads to patient harm, leads to malpractice—not so good for the hospital or the nurse. The team must have respect and dedication for the patient and each other. It is not easy to effectively communicate within a team. There are various factors to consider: behavior, ethnicity, language barriers, educational differences, skill level, and even the way the person was raised (do they pout and throw a fit, how do they handle stress and anxiety, do they withhold information?). I worked at Ashland for 18 years, I know how hard it is to work with a group of people. We did team building days away from the office a few times a year. It was necessary for cohesiveness and communication. Hospital leaders must be committed to developing strategies and the willingness to continually train their staff, so they will perform at their highest level. Above all, it should be instilled in everyone that the patient’s safety and care is the priority. Murray, E., (2017), Nursing leadership and management, F.A. Davis Co.: Philadelphia, PA.2. Describe the communication process (in your own words). Create your own story to describe the steps to communication.When I think of the communication process. I think of how messed up it is today with all the technology we have. Nobody knows how to have a real conversation anymore because all we do is text. Let’s face it, conversations through texting get misconstrued all the time because there is no feeling involved, you cannot see the person to read facial expressions and you certainly cannot see gestures or body language. Even through email, conversation can be taken the wrong way, if not worded properly. Communication is a lost art!I will try to explain the communication process with a bit of a different twist on it. The teacher (Sender) stands at the front of the class and whispers a sentence in the ear (Encoding) of the first student. She now says, “You will tell that same sentence to the next student word for word (message). Then the following student will tell the next student and the following student will tell the student next to them, etc., (sensory channel) until everyone in the class has received the message (message). The final student (ultimate receiver) will then relay the sentence to me. This is an exercise in not only effective communication but effective listening!” Will the sentence be correct by the time it is told to each student and relayed back to the teacher?The entire class is decoding the sentence as each one is told the sentence by their peer. Are they effectively listening to that peer and then communicating the information correctly onto the next student? Probably not—we have all been challenged by this game at some point in our lives. It seems rather trivial at the time, but it really is a good test of communication. The feedback would come into play if you changed the game up a bit. For example, when you are receiving the statement from your peer, you write the sentence down, state it back to them to confirm it is correct before telling the student sitting behind you. Just as we are to do when we receive orders from physicians—writing down what was said and verbally stating it back is a double check—therefore, you have better communication, far less errors and patient safety!Murray, E., (2017), Nursing leadership and management, F.A. Davis Co.: Philadelphia, PA.3. Why does the book highlight nonverbal communication as being so important? Nonverbal communication puts an emphasis on the things that are being said. It reinforces your emotions and feelings that you are trying to convey (good and bad). Nonverbal communication is also done unconsciously most of the time. For example, if you asked your child not to throw a ball in the house; but he did anyway and broke a very expensive vase. You will be upset, hurt, angry and your nonverbal communication will show it as you scold your child and give him/her the punishment that is necessary. The child reads the body language along with punishment and knows that playing ball in the house was not a good idea (hopefully)!The person speaking, their body language must match the verbal message they are sending.Murray, E., (2017), Nursing leadership and management, F.A. Davis Co.: Philadelphia, PA.4. Reflect upon the Julian Treasure video you watched. What does HAIL stand for? Do you think that integrating HAIL into your communication would make you a better nurse and leader? How so? I like how he explained the seven deadly sins of speaking. Julian is a great speaker, as he didn’t use any “ums” or “ehs” like most people do during public speaking. Everything was just very smooth and fluent. The vocal warm-up exercises for the audience was quite funny.HAIL: Honesty, Authenticity, Integrity, Love.The HAIL method is used for persuasion in speaking. The more people can trust you, the more likely they are to listen to you and do what you want—so very true!! Just like integrating the ICARE values into our student world, during clinical and into our careers, HAIL can also be used to enhance our communication and enable us to become better nurses and leaders. Every nurse should be honest and show their authentic self. As a nurse, we should not be in this profession if we are not going to exemplifying integrity at all times. Love is expressed in many ways—one being human compassion or the simple touch to a shoulder or hand of a patient to ease their fears.https://www.youtube.com/watch?v=eIho2S0ZahIChapter 111. Review the characteristics of the flowing nursing care delivery models such as case method, functional nursing, team nursing, partnership nursing, and primary nursing. Describe each of them briefly. Case Management: Improve the quality of life for the patient, decrease costs while also optimizing resources to their fullest potential. The RN who functions as a case manager will follow the patient from admission through discharge. These are usually high-risk patients. The RN will act as the liaison between the patient and all other health care professionals.Functional Nursing: Originally set up to care for patients by ancillary staff (i.e., to perform skills, hygiene, pass medications) until nurses returned from the war. However, it became very popular because it increased time management and functionality, so it was permanently established. It is mostly used by RNs in nursing home facilities.Team Nursing: There is typically an RN who is a team leader with other licensed and unlicensed personnel working with him/her to deliver total patient care to several patients. The team leader will serve as the liaison to the physician’s and do shift reports to with the next team leader coming on to duty. The team leader will assign duties according to education, skill level, etc. The team leader will effectively communicate and follow-up with the team throughout the day.Primary Nursing: The primary nurse develops the plan of care for the patient. She will develop a relationship with the patient and family because her work is done at the bedside where she is responsible for direct care of the patient. The primary nurse will serve is the liaison to the physicians and other members of the healthcare team and will also provide shift reports.Partnership Nursing: This was adopted from Team Nursing and included UAPs to decrease the costs of nursing care and increase productivity. UAPs can be cross-trained (learn more skills) to provide more direct patient care, thus allowing them to work more closely with the RN (on their same schedule). The communication is lateral and provides constant direct care to the patient and is more cost effective than primary nursing. The RN continues to stay accountable for the patient.Murray, E., (2017), Nursing leadership and management, F.A. Davis Co.: Philadelphia, PA.2. What are the potential complications of an inadequately staffed unit and/or poor skill mix?It affects the nurse’s ability to deliver safe and effective quality care to all patients. According to “A 2017 study published in the Annals of Intensive Care found that higher nurse staffing ratios were tied to decreased survival likelihood. The analysis of 845 patients found that patients were 95 percent more likely to survive when nurses followed a hospital-mandated patient-nurse ratio” (Lee, et al., 2017).There are a multitude of complications that can arise due to inadequate staffing. The nurse becomes overwhelmed, physically tired and this increases the risk of mistakes which can lead to hospital-acquired infections, medication errors and increased lengths of stay for the patient. This will then lead to patient dissatisfaction. Nurses can also experience “burnout” more easily when they are pushed to their limit daily. Nurses who are overstressed all the time tend to leave the profession—one of the reasons there is now a nurse shortage.Murray, E., (2017), Nursing leadership and management, F.A. Davis Co.: Philadelphia, PA.3. Differentiate between centralized and decentralized staffing, explaining the advantages and disadvantages of each.A centralized staffing structure is hierarchical—authority for decision-making is held by just a few people in top level management (i.e., CEO and administrators). The people in these positions have the ability to hire and fire, make financial decisions and implement changes. Communication in this organization flows from top to bottom and is often tightly controlled. Disadvantages:*Nurses may or may not be a part of the decision-making process in the centralized staffing structure. *Nurse leaders and managers’ responsibilities will vary depending on their position/level in the organization. A decentralized staffing structure is flat—authority and power for decision-making are shared by many people across an organization. Problems are usually resolved right at this level, and the staff make decisions related to their areas of expertise. Communication will flow from the bottom upward and between units. Advantages: *Nurses will participate in decision-making that affects patient care and their nursing practice. *Nurse leaders and managers can promote shared governance, teamwork and collaboration.*A decentralized structure also promotes autonomy at all levels.