Enhancing Nursing Practice Through Effective Communication and Social Identity Theory

Importance of effective communication:

In nursing, one of the most important skills you must have is communications skills. Effective communication helps the patient feel more comfortable and at ease, they feel valued and they know that they are not just another patient to you and you genuinely care about their well-being and recovery. Body language is really important when communicating, if you act tense they will feel that there is something wrong, you should also be at eye level with the patients, this makes them feel at ease and more like you are interested in what’s really going on (Klein 2005), this is non-verbal communication. The patient must be shown proper respect at all times and the healthcare provider must have patience with the patient as clearly they are ill and sometimes can be difficult to communicate with as they are in pain. Effective communication in healthcare allows for the development of trust, understanding and support. It is each health care providers job to make the patient feel safe at all times and there is many ways to do this. The health care worker must use verbal communication to put the patient at ease, speak in a clear manner and avoid using medical jargon. Questioning is a core verbal communication skill that every nurse must use to meet many communication goals. The use of open questions is very important. Open questions are those that give the patient the opportunity to give as much information as possible. Asking open questions in an atmosphere that is relaxed and comfortable for patients, encourages them to talk freely and express any concerns or confusion (McCabe et al 2013).

The Social Identity Approach:

“Social identity is that part of an individual’s self concept that derives from his knowledge of his membership of a social group together with the value and emotional significance attached to that membership” (Tajfel, 1978). Self-categorisation theory (SCT) outlines how we categorise as group members and how identities become salient. Social Identity Theory (SIT)  suggests that an organization can change individual behaviours if it can modify their self-identity or part of their self-concept that derives from the knowledge of, and emotional attachment to the group. Realistic Conflict Theory (RCT) argues that the nature of the goals in each group determine the likelihood of intergroup conflict - mutually exclusive goals are likely to result in conflict. These psychological theories combine to give The Social Identity Approach. The social identity theory was created by Henri Tajfel in 1979, social identity is a person’s sense of who they are based on their group membership. Tajfel (1979) proposed that the groups like family or football team which people belonged to were an important source of pride and self-esteem. Groups give us a sense of social identity: a sense of belonging to the social world. Social identity theory addresses the ways that social identities affect people's attitudes and behaviours’ regarding their ingroup and the outgroup. Social identities are most influential when individuals consider membership in a particular group to be central to their self-concept and they feel strong emotional ties to the group (Campbell, 2011)

How is the approach connected to communication:

The social identity approach looks at both the group and the individual in order to psychologically analyse human behaviour. The core belief of this research is that social identity can impact leadership, group performance, and organizational behaviour because collective behaviour is driven by individual psychological processes and intergroup relationships. The research concerning both parts of the social identity approach, including the self-categorization theory and the social identity theory, is valuable to communication skills and public sector collaboration. (Sedam 2015)

Example of the approach:

The Thompson 2015 study, which was published in the journal of interprofessional care involving nursing, medical and pharmacy graduates which examined interprofessional experiences using a social psychology perspective on the barriers to effective communication, teamwork and patient centred care. The main findings of this study were that the majority of interprofessional communications were noted to be hierarchically dependant, in a ‘top down’ direction, from doctors to pharmacists, to nurses. Some medical graduates said that nursing staffs participation was missing in collaborative communications, where they simply follow doctors instructions without utilising their specialised knowledge. Nursing graduates reported doctors being too busy and not interested in their input. Empathetic and sensitive nursing practice relies on equal relationships within the multidisciplinary team. Ineffective communication may be viewed as a multifaceted issue, with a lack of direct communication lying at the heart, driven by preconceptions and stereotypes, as well as a lack of knowledge, all of which influence behaviour and have a profoundly negative impact on patient outcome. A lack of interprofessional communication and team focus was noted by nurses to often result in conflict and competition for time with the patient. Stereotypes and profession-specific goals were elements associated with conflicts which threaten effective communication and patient-centred care.

Benefits:

The benefits of the social identity approach are clear. Social identity theory provides a framework for understanding intra group/inter category processes and intergroup/inter category relations by addressing the nature and consequences of the internalization of group and category memberships. (Whitham, 2017). Social identity has been found to promote prosocial behaviours, such as donating money to charity or volunteering etc. If you categorize yourself as something, you will act in the way you believe that this group behave, there will then be an emotional significance to you identification with a group, and your self-esteem will be boosted. Once we have categorized ourselves as part of a group and have identified with that group we then tend to compare that group with other groups. If our self-esteem is to be maintained our group needs to compare favourably with other groups. Once two groups identify themselves as rivals, they are forced to compete in order for the members to maintain their self-esteem. Healthy competition is good because it puts focus on the bigger picture. When a groups status is enhanced this identity becomes a beneficial psychological resource, there is positive consequences for our well being.

Arguments:

There are 5 main problem with the social identity theory the relationship between group identification and ingroup bias, the self-esteem hypothesis, the phenomenon of positive negative asymmetry in intergroup discrimination, the effects of intergroup similarity, and the choice of identity maintenance strategies by low status groups. The self- categorisation theory makes the members of a groups identities become salient. Organisation can change behaviours, modify the members self-concept and emotional attachment to the group.

This may result in negativity on the wards as a stereotype exists between the importance and hierarchy of doctors and nurses. As seen in the 2015 study which was already mentioned in the ‘example of the approach’, the strong group identification of doctors leads to a tendency to protect the status in the group by making comparisons to people outside the group (Thomson 2015). This may cause tension within the multidisciplinary team in a working environment. This may prevent effective communication in regards to planning the care and treatment of a patient. This has resulted in nurses thinking that doctors do not want to hear their input in regards to planning the patients treatment. Therefore, they  did not involve themselves in the decision making process of the patient’s treatment.

Conclusion:

This assignment was about how effective communication skills are an essential element of empathetic and sensitive nursing practise and about the social identity theory. These topics were discussed under the following headings; importance of effective communication, the social identity theory, how the approach is connected to communication, example of the approach benefits of the approach and arguments against the approach. The main points from this assignment were that effective communication can really influence a patients hospital experience and put them at ease which in turn aids recovery, it’s important to communicate well so they know what’s being done and why. Another important point is that the social identity theory is a person’s sense of who they are based on their group membership and when someone identifies with a group it boosts their self esteem and enhancing self image. The social identity theory is known for promoting pro social behaviours which is a big positive, but it was also known to cause conflict on the ward with regard to stereotyping. Just to reiterate, in social identity theory the group membership is not something foreign or artificial which is attached onto the person, it is a real, true and vital part of the person.  Again, it is crucial to remember in-groups are groups you identify with, and out-groups are ones that we don't identify with, and may discriminate against (Mcleod, 2019)

Reflection:

Personally, I think that my group worked very well in this group project. Given the circumstances, we communicated well via WhatsApp and other platforms. This group project thought me a lot considering how little I knew about psychology before I started this psychology module and then this project was like revision and it made everything a lot clearer. We allocated the sections to each group member in the group project and then in the alternative assessment where we worked alone we had to do all the sections for ourselves to make sure we understood each bit individually. I never knew how to voice over a Power Point either until I completed this project, I really enjoyed it and learned a lot, I never thought psychology would be an area I would be interested in but it was actually very interesting and I took a keen interest in it.

References:

1. Brown R (2000) Social Identity Theory: past achievements, current problems and future challenges; European journal of social psychology.
2. Klein ER (2005) Effective communication with patients; NCBI.
3. Leaper C (2011) Social Identity Theory; Science direct.
4. McCabe, C., Timmins, F. (2013) Communication skills for nursing practice, 2nd ed. Hampshire: Palgrave Macmillan.
5. Mcleod, S. (2019) Social Identity Theory; Simply Psychology.
6. Sedam M (2015) Team communication: The social identity approach to collaboration.
7. Whitham, M. (2017) Paying It Forward and Getting It Back: The Benefits of Shared Social Identity in Generalized Exchange.