How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 55
This book is in B&W, not color - Print page in Grayscale for Correct view!
work of Hildegard Peplau (Peplau 1991). However there have also been several reports of low levels of actual
nurse-patient interaction, with 8% of nursing time spent in interaction with patients
(Altschul 1972), 15% (Sandford, Elzinga, & Iversen 1990), 19% (Tyson, Lambert, & Beattie 1995), 21%
(Sanson-Fisher, Poole, & Thompson 1979), 7% of nurses’ time in potentially therapeutic interaction
(Whittington & McLaughlin 2000), and patients spending only 4% (Hurst, Wistow, & Higgins 2004) or 6%
(Martin 1992) of their time in interaction with nurses. One of these studies showed that as staffing numbers
increased, staff-staff but not staff-patient interaction increased (Sandford, Elzinga, & Iversen 1990). These
figures are quite variable, indicating that some places at some times have up to three times as much nursepatient interaction as others, nevertheless nursing has generally been intensely criticised for low levels of
interaction. This has resulted in a low valuation of the time consuming and complicated case management work
also carried out by ward staff which does not involve direct nurse-patient interaction (Deacon 2003). Another
effect of this critique has been a concentration on interpersonal skills during nurse training, exercises to improve
communication (Star Wards 2009) and more lately, centralised audits and policies that require a documented
minimum of 15 minutes one to one nurse patient interaction for every patient during the course of a nursing shift
(Healthcare Commission 2008).
Interpersonal and communication skills
Curriculum changes in psychiatric nurse education in the 1980s gave much greater emphasis to training in
interpersonal skills. These advances were swiftly overtaken by further nursing education changes (Project 2000)
during which nurse education in the UK was brought into the University sector and the first half of training
became a common foundation programme (CFP) for all nursing specialities (i.e. psychiatric nursing combined
with general nursing, children’s nursing etc.). Whilst this new model brought greater academic breadth and rigor
to nurse training, it also adversely impacted on intense, small group interpersonal skill development in
psychiatric nurse training.
The interpersonal skills which are taught to nurses are based on social psychology research into communication
and social 6