National Institute for Health and Clinical Excellence

Question: Discuss about the National Institute for Health and Clinical Excellence. Answer: Introduction: At first, I have got Sophies attention by standing in front and facing her on the same level with good light shining in my face and not on Sophies eyes because face is an important tool for communication (Newton, 2013). I have tried to reduce external noises from television, radio, etc while talking to avoid distortion. I used visible hand, facial and eye expressions to ask as whether she has got the information. I have positioned on the side of the better ear. I have used written information such as instructions and dosages for her child to make her better understand. I have spoken normally, clearly, naturally and distinctly without shouting (UCSF, n. d.). I have asked Sophie to wear hearing aid, if she has it. I have gained focused attention and decreased the missing words by calling her name at the beginning of conversation. I have slowed down the words to some extent and paused in between phrases and sentences rather than speaking rapidly and used simple sentences. I have waited to make sure that Sophie has understood the conversation. I have avoided keeping hands, pen, chewing gum, candies, etc to reduce distraction and promote lip reading (Newton, 2013). Ultimately, I have checked understanding of Sophie by asking open-ended questions rather than using yes or no questions. I have asked to repeat the medication doses again to know her understanding. I have avoided changing the topic suddenly. Speaking normally, distinctly, slightly louder, clearly and naturally without shouting and exaggerating movements of mouth will help to communicate effectively with Sophie. Usually hearing impaired persons will be sensitive to loud sounds (UCSF, n. d.). Speaking loudly should be avoided as the higher sounds will impede the hearing of vowel sounds and consonants (Douglas, 2012). This will cause distortion of sounds leading to difficulty in understanding the words. Moreover it may cause severe pain for wearer of hearing aid. Speaking too slowly will distract Sophie from hearing and make her embarrassed. Sophie will feel respectful and listened. She will gain self confidence, motivation and self respect. She will understand the conversation better and contribute her ideas to others without distraction. I know that communication is a two way process and both the speaker and listener and the speaker has responsibility for appropriate communication (Australian hearing, 2013). I will learn the basic sign language and practice with my colleagues. I will prepare myself to write simple sentences or words and communicate with hearing impaired person and I will give opportunity to them to write down. I will write instructions to take medications, dosages of her child in large print (Newton, 2013). I will use diagrams and pictures to help them. I will use auslan which is a combination of facial expression, body language and sign and finger spelling is used for words without signs (e.g. name of person or place) (Queensland government, n. d.). If the impaired person has difficulty, I will use different method of saying the words rather than repeating the words. Reflective Questions - Hassan According to me, its not reasonable. He may not share his food with others while eating yet he can participate in preparing meals for the children to promote cooperation and equality in giving care. Hassans cultural belief has to be respected but he should be guided to develop emotional intelligence with trans- cultural care skills in his workplace. The emotion of Hassan will definitely cause changes in opinions, thoughts, ideas and values among his colleagues leading to conflict and discrimination between them. The conflict may lead to differences or divergence in opinions causing discord with complete lack of agreement between other staff members (American Sentinel- University, 2011). Because of that the people may divide into groups and will defense that only their personal ideas and culture is best. This will create dispute leading to arguments and hostile behaviors affecting the emotional levels and create tension in workplace affecting the workplace relationship. Hassans emotion may influence his work place environment affecting the patient and hospital. It will raise the personal emotions and may make the personal interests over ride the goals of workplace. These emotions may affect the productivity, workplace morale and patient care adversely (Ramsay, 2001). It will result in increased turnover of employees and reduces the contributions of staff and affects efficiency. The communication will become poor and colleagues may withhold the information by not letting out to Hassan (Ramsay, 2001). The withheld information may be important for the well being of the patient. Hassan may loss the support from other staffs and become isolated. If the problem persists, it may lead to retaliation causing failure to get assistance from other staff. Ultimately, it affects the morale and team spirit ending up with a dysfunctional team (Ramsay, 2001). If interventions are taken, staffs will regain their sense of team, if not may damage the workplace relation ship, client service, morale and productivity of an institution (American Sentinel- University, 2011). The emotions and values that are specific to his culture and his colleagues culture should be identified. Hassan should be helped to understand that ones intelligence is shaped by their culture and gives unique specifications and should be cautious while expressing his culture and value peoples culture (Douglas, 2012). Generally a child professional should be culturally determined. He should be made to learn the communication methods and space of other cultures while caring the child. He should be helped to become culturally competent professional and overcome discriminations of race, culture and religion in childs care. He should be guided to do self and social assessment to identify his effect of behavior on others (Faculty assistance programme, 2013). He can follow his religious beliefs and avoid non- Halal foods but he should be advised to take part in preparing food to maintain good relationship with child. Some flexibility in workplaces should be given to Hassan. He should be m otivated to develop emotional intelligence while taking care of a child and adapt to the hospital environment (Holland, 2012). Reflective Questions- Ling Ling is a 62 year old educator with out-dated beliefs. As the technology changes, the nursing education have also underwent a lot of changes. Her older beliefs and values have gone into a number of transitions and were revised. If Ling is not going to change to the current beliefs and values, her colleagues attitudes and their perception on her will change. They will be reluctant to follow her instructions which may lead to get disrespect from her colleagues. Ling is in unfreezing stage of change which means that she is cast with her own behavior which might be irrelevant, in-appropriate, and inadequate to the changing needs of the pediatric care (Gupta, 2006). Her colleagues may underestimate her potentials, values and her teaching. This may cause destruction of her support from other educators. Ling may experience lack of authority and disrespect (Tomey, 2004). It will reduce group contact, team interpersonal relationship, lack of growth in profession, stagnating behind in profession and reduced cooperation from children, parents and institutions. Sometimes the institute may take serious steps on her. This may lead to demotion, reduced incentives and reduced benefits (Prasad, 2009). The easiest step to overcome Lings resistance to change is by educating, training Ling to adapt to change, counseling and communicating about various aspects of change (NICE, 2007). This will change the values and attitudes of Ling towards present education. Ling must be taught about new educational skills and motivated to develop new education guidelines and attitudes. It may take a long process but continuous motivation will help to change (Gupta, 2006, Prasad, 2009). Ling can be helped to change her education style by making her to understand the need for change. The best method is to involve Ling in designing and implementing the new education technique to make her to adapt to change (Prasad, 2009). This involvement and participation in latest education techniques by Ling will push her to change. Ling should be made to commit to her changed responsibility in child education. I will maintain cultural competency by valuing the cultural diversity of the children. I will not see any discrimination in structure of body, color of skin and hair, race, childs place of birth, ethnicity, and values (Douglas, 2012). I will develop the capacity to perform self assessment of cross cultural care in child bearing. I will maintain needed communication skills and space while caring the child. I will be conscious about the dynamics that is inherent during the interaction of culture and will provide trans- cultural care irrespective of culture or religion. I will understand my culture and childrens culture and values. It is the culture that shapes a persons intelligence. Culture is a systematic patterned response that helps to develop social as well as religious customs (Douglas, 2012). I will develop my intelligence into socio cultural aspects to provide trans- cultural care to the children. I will obtain cultural knowledge of the institution (Coe, 2013). I will not see a ny discrimination in structure of body, color of skin and hair, race, childs place of birth, ethnicity, and values. References American Sentinel University. (2011). The Sources Costs of Conflict in Nursing. Retrieved from https://www.americansentinel.edu/blog/2011/07/20/nursing-strategies-understanding-the-sources-costs-of-conflict/ Australian hearing. (2013). Communicating with someone who has a hearing loss. Retrieved from https://www.hearing.com.au/communicating-hearing-loss/ Coe, S. (2013). Cultural Competency in the Nursing Profession. Retrieved from https://www.nursetogether.com/cultural-competency-nursing-profession Douglas, C. (2012). Potter and Perrys Fundamentals of Nursing- Australian version. (4th ed.). St. Louis, Missouri: Elsevier Faculty assistance programme. (2013). Emotional intelligence in workplace. Retrieved from www.woodassociates.net/FAP/Newsletters/Search/PDF/FAP% 20August%202013%207_23_13.pdf Gupta, C. B. (2006). Management theory and practice. Sultan Chand Sons: New Delhi Holland. (2012). Developing Emotional Intelligence for Good to Great Nurses. Retrieved from https://www.nursetogether.com/developing-emotional-intelligence-good-great-nurses Newton, V.E. Shah, S.R. (2013). Improving communication with patients with a hearing impairment: Community Eye Health Journal. 26(81): 67. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678307/ NICE- National Institute for Health and Clinical Excellence. (2007). How to change practice. Retrieved from https://www.nice.org.uk/media/default/about/what-we-do/into-practice/support-for-service-improvement-and-audit/how-to-change-practice-barriers-to-change.pdf Prasad, L.M. (2009). Principles and Practice of Management. Sultan Chand Sons: New Delhi Queensland Government. (n. d.). How to work with a person who is deaf or hearing impaired. Retrieved from https://www.health.qld.gov.au/multicultural/interpreters/ howtoworkwithdeaf.pdf Ramsay, M.A.E. (2001). Conflict in the health care workplace: Proc Bayl Univ Med Cent. 14(2): 138139. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291328/ Tomey, A. M. (2004). Guide to nursing management and leadership. Mosby: Elsevier. UCSF- University of California San Francisco. Communicating with People with Hearing Loss. Retrieved from https://www.ucsfhealth.org/education/communicating_with _people_with_hearing_loss/