By sitting squarely the nurse or midwife is showing their patient that

By sitting squarely, the nurse or midwife is showing their patient that they are interested and involved in what is being said. If a nurse or midwife was to sit closed it gives off the impression that a feeling of judgement is being put across, resulting in the client keeping to themselves but on the other hand, if the nurse or midwife was to sit too closely to the patient they may begin to feel like their personal space and dignity is being invaded. Having open posture allows the health care professional to feel engaged and gives off a positive atmosphere therefore creating a calm and peaceful environment for both the client and nurse or midwife. Leaning shows that the service user is being listened to without the atmosphere being too intense causing the patient to feel at ease. The use of eye contact shows that the nurse or midwife is taking in what the service user is saying and is focused on what is taking place during that moment in time. It is important to stay relaxed during the appointment as this will show that both health care professional as well as the service user are not uptight and un edge. Dr Albert Mehrabian discovered that seven percent of communication was down to the use of words, thirty-eight percent was a result of the use of someone’s voice and the last fifty-five percent is expressed through the use of facial expressions (https://www.psychologytoday.com/gb/blog/beyond-words/201109/is-nonverbal-communication-numbers-game ). This proves that although a nurse or midwife may be saying the ‘right things’ their body language can give off the opposite impression and instead of a welcoming environment being created, a brusque environment is portrayed. First impressions are important as studies show that it only takes roughly seven minutes after meeting someone before a judgement is created. In terms of nursing, providing eye contact when in contact with patients and their family is vital as it is proven that patients feel more welcomed, secure and at ease during their stay. Through the use of eye contact, it enables the nurse or midwife to have the ability to sit back and listen to the clients concerns and needs which allows the health care professional to gain an understanding about their patient and proceed in the way that will best fit the service user. A non-judgemental and welcoming atmosphere is created when the use of eye contact is used in the appropriate manner, for instance intense eye contact may make the patient feel uneased as well as this the nurse and midwife may become distracted due to them focusing on keeping eye with their patient. The ‘best’ type of eye contact has breaks in between the gazing to ensure that no one is uncomfortable, therefore resulting in a higher quality of care being provided Just like every theory, Egan’s Soler Model has its pro’s and cons. The positive aspects of the Soler Model are that it is proven to work, puts the clients at ease and creates a good impression for the service user contrary to this some parts of this theory may be viewed as disrespectful due to the difference in cultures and what is classified as respect. The Soler Model will not work for everyone especially since every individual is unique. Although the theory was created as a non-verbal communication device that helps clients, it may have the complete opposite affect on patients who are diagnosed with autism. Clients who have low functioning autism will often use body language to express how they are feeling and a health care professional, must be able to adapt to different circumstances to support that client in the best way fit. If there is a patient who has autism and struggles with eye contact the nurse or midwife should ensure that the appropriate procedures are in place for the individual, this may include having to use a visual support for instance a ‘time tracker ‘ and a timetable with information for the client, this will help them to put their minds at rest. When it comes to individuals with autism, time management is often very important to them, so a nurse or midwife should always remember to allow extra time for a patient who has a learning disability and reassure them frequently. Eye contact is known to overstimulate the brain in individuals who are on the autism spectrum (ASHA Leader, 2017) leading them to feel pressured. Individuals who have been diagnosed with autism spectrum disorder (ASD) often find social interactions challenging due to their lack of social skills and social awareness (Reference). In this case it is best that the nurse or midwife allows the patient time to think of what they want to say, be patient and explain to the patient what the problem is or what is going to happen using clear and simple terms. In certain cultures, eye contact is viewed as being disrespectful and aggressive. Throughout the United Kingdom and North America, eye contact implies that the individual is interested and wants to be apart of the conversation. However, it is important that the visual contact is not being overdone resulting in the public feeling uncomfortable. In certain Asian countries, eye contact is seen as confronting someone’s authority or being flippant (https://www.brighthubeducation.com/social-studies-help/9626-learning-about-eye-contact-in-other-cultures/). Due to body language being displayed through our eyes at certain points, a patient can easily pick up on a nurse or midwife’s mood and interest in what they are saying. A consequence of a health care professional coming across as uninterested is that the service user may feel rushed and unimportant to the health care professional which may result in information being held back, which could turn out to be vital. Overall eye contact should be natural and relaxed avowing the service user to feel more confident. VALUE’S BASED APPROACHIn any health care professional job personal values will always be important. These could be as simple as family, respect, loyalty, compassion, equality or even commitment but these can vary from person to person. As a nurse or midwife having these qualities assures the service user that they are in a good place with someone who cares about them. Values are influenced by social, cultural, economic status and religious aspects of life. A person’s social environment can influence their values due to their social class. If they belong in a high social class which focuses on the material aspects of life, then family and equality may not be as important to them. Whereas, if an individual is from a low-income family, they may value their family and respect more. Being a nurse or midwife is having the ability to love a complete stranger at their weakest moments until they are strong enough to love and take care of themselves. According to the nursing and midwifery code, nursing values include the need to value people, value fairness and value transparency (NMC Code, 2015). A good nurse or midwife knows how to respect and recognised other client’s values without offending the patient or getting offended due to the difference of personal values. Throughout nursing, No one can teach a nurse or midwife how to sit and cry with a patient or their family during hard and lonely times, it is just a natural reaction. Compassionate care which is one of the six c’s (compassion, care, competitive, courage, communication and commitment) involves a person’s attitude, appearance and body language which is reflected through their personality. There are six key themes that all help to shape the definition of compassionate care. The themes are caring conversations, flexible person-centred risk taking, feedback, knowing you knowing me, involving valuing and transparency and the last key them is creating spaces that work (reference). In terms of ‘knowing you, knowing me’ as a nurse or midwife, it is important that service user and health care professional create a bond even if it is only a small one just to ensure that the element of trust is present. When it comes to caring conversations that take place between the client and health worker, the nurse or midwife must be able to empathise with the patient during difficult times and be supportive in the decisions that the patients chose to make. Feedback allows the nurse or midwife to improve their practice as no one is prefect but with the use of feedback it will allow the care to be given to be a higher standard for the public. Compassionate care is based on empathy, respect and dignity. This can be as simple as a smile, a choice of words or even listening (England NHS) which help the client to feel comfortable. In order to deliver a values-based approach, a nurse or midwife have to reflect on what they have previously done in the past and improve this allows compassionate care to be developed. Reflection plays a key factor when it comes to nursing. The reason that reflection is crucial is because it allows nursing practices to be updated regularly, it is involved in academic writing and is part of a revalidation process. The three most common reflection models that are used throughout nursing and midwifery practice are Borton’s, Gibb’s and Barksby’s. Borton’s model includes three basic steps which are what, so what and now what. This is one of the simplest templates of reflection that is used on a daily basis without the nurse or midwife realising. Gibb’s reflection model has double the number of steps compared to the Borton model. The first step is description, followed by feelings, evaluation, conclusion and action plan then the cycle is repeated to ensure that practice is up to a high standard. Barksby’s reflection model, stands for Recall, Examine, Feelings, Learn, Explore, Create, and Timescale. Gibb’s reflection model is effective as it allows to nurse or midwife to record the patient’s feelings at the time and evaluate how the practice could have been done better. When providing compassionate care to a service user who has been diagnosed with cerebral palsy which is an umbrella term for a disorder that affects an individual’s movement and posture a nurse or midwife should consider the fact that although the individual may not be able to communicate verbally, they should still be provided with a talking device so that the service user can openly express their feelings. The best way to proceed when a health care worker has a patient who has a learning disability is to ensure that the nurse or midwife introduces themselves and explains to the service user what is going to happen and asks if it is okay for them to proceed. As awareness increase for individuals who have a learning disability, a health care professional may find it useful to learn sign language as not every individual can communicate verbally. Individuals who have a learning difficulty may find it difficult to open up to a new nurse or midwife especially if their routine is changed. In this case, the health care worker may have to schedule several appointments beforehand to allow the service user to feel at ease with their new nurse or midwife. CONCLUSION In conclusion, nursing and midwifery practice is a very demanding and fulfilling job that requires regular reflection to ensure that the care being given is up to a high standard.

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