However in nursing, patients value their personal space and feel discomfort, anger, or anxiety when their personal space is encroached so when entering their space it's imperative to knock before entering. When providing care, distance, body space, consent, touching, culture, posture, professional boundaries and proximity are seen as essential part of caring. The NMC (2008) maintains that a care provider must maintain clear professional boundaries, when providing care for a patient. Consequently personal space in care must be invaded to provide the appropriate care needed especially when feeding or changing patients. According to Encyclopaedia of Management (2009), "While this body language is generally well understood in each culture, there are major cultural differences in nonverbal communication." Thurman (2011) says in some Hindu communities, folding your arms is assign of humility whereas in Western cultures this could be a sign of stubbornness or aggression.
Signing.
Signing is a language which uses manual communication and body language to convey meaning, as opposed to acoustically conveyed sound patterns (Dictionary.com 2015). Thurman (2011) states that, "signs from British Sign Language (BSL) have been used in several vocabularies specifically for people with learning disabilities such as Makaton and Sign-along." However, this has helped communication in patients with learning disabilities. For example a patient is admitted with multiple impairments by using sign language the care giver can determine the patients' needs and emotions. It's important when caring for a patient to recognise their needs. As a result the NHS provides resources such as picture books, signers and the lite writer enabling communication to be effective."Signs are to eyes what words are to ears."- Ken Glickman (1999). When caring for patients with hearing impairment nurses should make sure that patients are wearing hearing aids as well as using other methods to communicate.
