204 FINAL PREP Flashcards
Communication
Process of acting on information
Human Communication
Process of making sense out of the world & sharing that sense with others by creating meaning through the use of verbal & non-verbal messages
Types of Communication
- Interpersonal
- Intrapersonal
- Impersonal
- Mass
- Public
- Hyperpersonal
- Small Group
Interpersonal communication
Distinctive, transactional, involving mutual influence, helps us to manage our relationships
Intrapersonal Communication
Communicate with oneself
Impersonal Communication
Treat people as objects or by their role rather than as unique individuals
Mass Communication
Same message communicated to many people at once (usually not in person)
Public Communication
In person, address large number of people
Hyperpersonal Communication
Using email/instant messaging to establish relationship
Small Group Communication
3-15 people interact with a common purpose, mutual influence
Action
Message Transfer
Source
Originator of thought/emotion
Encoding
Translate thoughts/ideas/feelings into an understandable code
Decoding
Receiver interprets the thoughts/ideas/feelings
Message
Written, spoken or unspoken, sent intentionally or unintentionally, verbally or non-verbally or written
Channel
Pathway on which message is communicated
Receiver
Person who decodes the message which is filtered through past experiences, attitudes, beliefs, values, prejudices and biases
Noise
Interferes with message, prevents it from being understood
Feedback
Response to message, necessary for message to be effective
Context
Physical & Psychological environment, people present, etc.
Transaction Model of Communication
Interaction is simultaneous (send & receives messages concurrently) with people reacting to each other
Systems Theory of Communication
System of interconnected elements - change in one element can affect the other elements
Episodes Model of Communication
Sequence of interactions whereby message of one person influences the message of another
Principles of Interpersonal Communication
- connects us to others
- irreversible
- complicated
- governed by rules
- content & relationship dimensions
Social Learning Theory
People can adapt behaviour toward others
Strategies of the Social Learning Theory
Become Knowledgeable
Become Skilled - practice & feedback
Become Motivated - improve
Become Adaptable - skills differ by situation
Become Ethical - sensitive
Become Other-Oriented - not egocentric
Active Listening
The interactive process of responding mentally, verbally and non-verbally to a speaker’s message
Uses SOLER
SOLER
- Squarely face the person
- Open your posture
- Lean towards the sender
- Eye contact maintained
- Relax while attending
Self-Concept
Your subjective description of who you think you are
Components to self
Material Self
Social Self
Spiritual Self
Material Self
Physical things (ex. body, possessions)
Social Self
Part of you that interacts with others (ex. friend, classmate, etc.)
Spiritual Self
Your thoughts & introspections about your values and morals (ex. who you think you are)
Attitudes
Learned predisposition, reflect on likes and dislikes
Beliefs
The way you structure your understanding of reality (True vs False)
Values
Enduring concepts, one’s judgement of what is important in life - more difficult to identify & more resistant to change than attitudes & beliefs
Reflected Appraisal/Looking Glass
Develop self-concept that often match ways in which we believe others see us
Self-Label
Process of Self-Reflectiveness - we interpret what we experience so our self-labels may change over time
Personality
Set of enduring internal predispositions and behavioural characteristics that describe how you react to your environment
Communibiological Approach
Genetics is major factor affecting how people communicate
Laframboise - Medicine Wheel Components
East: Mental/Intellectual - healthy minds
South: Spiritual - strong inner spirits
West: Emotional - inner peace
North: Physical - strong healthy bodies
Mussell - Medicine Wheel Components
Physical Development: health maturation requires oxygen, food, water, rest, exercise, sensory stimulation, safety & security
Emotional: love & belonging, recognition, acceptance, understanding, privacy, limits, boundaries, discipline
Intellectual: connect new info with life experience so it becomes personal knowledge
Spiritual: spiritual state reflects inner peace, personal harmony and balance
Myers Briggs Personality Test Components
Energy Source: (E)xtraversion or (I)ntraversion
Perceiving Mental Process: (S)ensing or i(N)tuition
Favoured Judging Mental Process: (T)hinking or (F)eeling
Outside World Orientation: (J)udgement or (P)erception
Self-Concept
You describe who you are
Self-Esteem
You evaluate who you are
Techniques to Improve your Self-Esteem
- Positive self-talk
- Visualize positive image of yourself
- Avoid comparisons with others
- Reframe appropriately
- Develop honest relationships
- Let go of the past
- Seek support
Symbolic Interaction Theory
Making sense of our world through our interaction with others
Other-Oriented
Must first be centred (know yourself & understand how others see you)
Self-Fulfilling Prophecy
What people believe about themselves often comes true
Schultz 3 Social Needs Affecting Degree of Communication
- Need for Inclusion
- Need for Control
- Need for Affection
Self Disclosure
Purposely provide info to others about yourself that they wouldn’t know otherwise
Social Penetration Model
Superficial
Intimate
Personal
Core
“I’ll share if you share”
Johari Window
OPEN - known to self & others
BLIND SPOT - known to others but not self
HIDDEN - known to self but not others
UNKNOWN - not known to self or others
Self-Disclosure Guidelines
- Be other-oriented when disclosing: how will it affect the other person? Will it make them uncomfortable? Are you disclosing only to meet own needs?
- Monitor non-verbal responses: to determine if giving too much info or could ask them if its too much
- Do not disclose too much too soon
- Decrease self-disclosure if not being reciprocated
Stages of Interpersonal Communication and Perception
- Selecting
- Organizing
- Interpreting
Perception
Process of understanding or making sense of sensory experiences
Selecting Stage
Perception
Attention
Exposure
Recall
Thin slicing
Selective Perception
See & don’t see things because we perceive selectively
Selective Attention
Focus on stimuli that meet our wants/needs (and ignore others)
Selective Exposure
To put ourselves in situations where we feel comfort & support the way we see the world - attitudes, beliefs, values and behaviours
Selective Recall
Remember what we want & repress or forget things unpleasant, uncomfortable, unimportant
Thin Slicing
Generalize based on small sample of someone’s behaviour
Organizing Stage
We create categories - superimpose/search for patterns
We link categories - punctuation/link categories
We seek closure - Fill information gaps
Interpreting Stage
After selecting & organizing stimuli, you try to interpret what it means
How do we form impressions
Primacy Effect - first impression
Recency Effect - last impression
Halo Effect - attribute good qualities
Horn Effect - attribute bad qualities
Stereotype
Oversimplified BELIEFS about a group of people
Prejudice
THOUGHTS OR FEELINGS based on beliefs or ideas
Discrimination
Actions taken toward a certain group
Barriers to Accurate Perceptions
Ignoring info
Overgeneralizing
Oversimplifying
Imposing Consistency
Focusing on the Negative
Blaming
Fundamental Attribution Error
Avoiding Responsibility
Ignoring Info
Tend to explain motives for a person’s actions on basis of most obvious & superficial info rather than in-depth info
Overgeneralizing
Assume small sampling of person’s behaviour represents who they are
Oversimplifying
We find simple explanations more believeable
Imposing Consistency
We overestimate the consistency of others’ behaviours - believe they always act that way, ignore normal fluctuations
Focus on the Negative
Give more weight to negative than positive behaviours
Blaming
Assume others have control - more likely to blame others than ourselves when they go wrong
Fundamental Attribution Error
Believe cause is something that others could control
Avoiding Responsibility
Self-serving bias (ex. we save face by believing other people, not ourselves, are the cause of the problem)
Indirect Perceptions
Seek additional info passively
Direct Perceptions
Ask if your interpretation is correct - shows that you are committed to understanding
Listening
Complex process of selecting, attending to, constructing meaning from, remembering, and responding to verbal and non-verbal messages
Listening Activities - Selecting
Sort through various sounds competing for your attention & select which receives your attention
Listening Activities - Attending
Focus on sound you have selected
Listening Activities - Understanding
Assign meaning
Listening Activities - Remembering
Recalling information
Listening Activities - Responding
Confirm your understanding of the message by responding verbally or non-verbally
Listening Styles
People-oriented
Action-oriented
Content-oriented
Time-oriented
People-oriented Listening
Comfortable with & skilled at listening to people’s feelings & emotions
Focus on feelings of person - empathize & search from commonalities
Action-oriented Listening
Prefers brief, well-organized, accurate info
Want to know the point of story, likely to be skeptical (second guess)
Content-oriented
Comfortable listening to complex, detailed info
Time-Oriented
Want succinct message as keenly aware of other things we need to do
Listening Barriers
DISTRACTIONS
- self-adsorbed
- unchecked emotions
- criticizing the speaker
- speech rate vs thought rate
- information overload
- external noise
- listener apprehension
Improving your Listening, Comprehension & Responding Skills
STOP - be present
OBSERVE - for non-verbal cues
LISTEN - actively
ASK - questions/clarify
REFLECT - by paraphrasing & summarizing
Empathy
Feeling what someone else is feeling rather than just acknowledging they are feeling a certain way - requires active listening
Social Decentring
Imagining what they are thinking… based on past experiences
Confirming Response and Types
Positive, helps validation
1. Direct acknowledgement
2. Agreement about judgements
3. Supportive response
4. Clarifying response
5. Expressions of positive feeling
6. Compliment
Disconfirming Response and Types
Negative, the “I’s”
1. Impervious (fail to acknowledge)
2. Interrupting (implies that what you have to say is more important)
3. Irrelevant (unrelated to what speaker was saying)
4. Impersonal (distances from other person, may use third person)
5. Incoherent (mumble, ramble, unintelligible)
6. Incongruous (verbal & non-verbal messages are inconsistent - confusing
Power of Words
Create Perceptions
Influence Thoughts
Shape & Reflect Culture:
- linguistic determinism
- linguistic relativity
- Sapi-Whorf hypothesis (language shapes culture)
Affect the quality of our interpersonal relationships
Word Barriers
Bypassing
Lack of Precision
- malapropism
- restricted code
Allness
Indexing
Static Evaluation
Polarization
Biased
- sexist
- racially biased
- demeaning language
Bypassing
Miscommunication because of different understandings of the same words
Malapropism
confusion of word/phrase for another that sound similar OR use words out of context or inappropriate grammar
Restricted Code
Words or jargon that only have meaning to a subgroup
Allness
Make unqualified, often untrue generalizations
Indexing
To avoid generalization, acknowledge that each individual is unique
Static Evaluation
Pronounce judgement without acknowledging things could change
Polarization
Language of extremes, leaves out middle ground
Biased
Insensitivity to people
Using words to establish supportive relationship
- debate vs dialogue
- own feelings instead of evaluating the behaviour of others
- solve problems > trying to control others
- Genuine > manipulative
- Empathize > remaining detached
- Equal > Superior
Words of Assertion - 5 Steps
1) Describe how you view situation
2) Disclose your feelings
3) Identify effects of other person’s behaviour
4) Be silent
5) Paraphrase content & feelings
Challenges of Interpreting Non-Verbals
- Often Ambiguous: may be known only to person displaying, may be unintended
- Continuous: may be no start/end
- Culturally Based: some non-verbal messages are universal but others are culturally unique
Non-Verbal Communication Codes
- Body Movement and Posture
- Eye Contact
- Facial Expression
- Vocal Cues
- Personal Space
- Territory
- Touch
- Appearance
Body Movements and Posture
Quasi-courtship behaviour - 4 stages
Warm vs cold non-verbal behaviours
5 Categories of movements/gestures
- Emblems: generally understood meaning
- Illustrators: accompanying message
- Affected Displays: communicate emotion
- Regulators: help control flow of communication
- Adaptors: adapt to situation, satisfy a need (ex. fix. hair)
Function that Eye Contact Serves
Cognitive: gives info about others thoughts
Monitor: behaviour of others
Regulatory Cue: Signal if we want to communicate
Expressive: eyes reveal our emotions
Facial Expression
6 Primary categories: surprise, fear, disgust, anger, happiness, sadness
Vocal Cues
Communicate emotion
Manage conversations
Silence
Personal Space - Hall 1996
- Intimate - very personal interactions (0-0.5m)
- Personal - typical for conversation (0.5-1.5m)
- Social - group interactions (1.5-3.5m)
- Public - speaking to many people (3.5 + m)
Territory
Announce ownership of space with territorial markers
Touch
To express intimacy; viral for personal development & well-being
Appearance
Canadian culture places high value on weight, style of hair, clothing
Dimensions for Interpreting Non-Verbal Communication
Immediacy: communicate liking & feelings of pleasure, contagious
Arousal: communicate responsiveness
Dominance: communicate power, status, control
Kinds of Englishes
British, American, Canadian
Native speaker of a language
Speaks language very well/first language
Linguistic Othering
When this person speaks, you recognize they are from another group/culture
Linguicism
Use accent to put bias there to affect the person
EAP
English for Academic Purposes
ESL
English as a Second Language
Linear Culture
English/German Culture - straight forward, point A,B,C
Zig-Zag Culture
Romantic - Russian, Arabs, Latin America - Feelings are important in description
Circular Culture
Asia, Japan, China, Korea - Understand wisdom and power in description
Things to Consider with Language (as a nurse)
Be diversified
Clarify Expectations
Don’t make assumptions and ask questions
Interpersonal Relationship General Stage
Stranger –> Acquaintance –> Casual Friend –> Friend –> Close Friend –> Best Friend
Relationships of Circumstance
Due to circumstance - where we were born, where we study, etc.
Relationships of Choice
Due to our choice to seek out and develop them
Relationships and Power
- Complementary
- Symmetric
- Competitive Symmetric
- Submissive Symmetric
- Parallel
Complementary Relationship
Where power is unevenly divided between partners where one dominates and one submits
Symmetric Relationships
Where power is evenly divided between partners - both behave towards it the same way (wanting or avoiding)
Competitive Symmetry Relationships
Where power and control is desired by both partners
Submissive Symmetric Relationships
Where power and control is not desired by either partner
Parallel Relationships
There is a shift back and forth shifting of the power between partners
How to Begin an Interpersonal Relationship
- Interpersonal Attraction: degree you are motivated to form/maintain relationship
- Short-term Initial Attraction: Degree you sense potential for an interpersonal relationship
- Long-term Maintenance Attraction: positive feelings that motivate you to sustain the relationship
- Predicted Outcome Value: Potential for relationship to confirm our self-image compared to its potential costs
Relational Development
Process of moving from one stage to another as a relationship moved toward or away from greater intimacy
Turning Points
Specific events or interactions associated with positive or negative changes in a relationship
Causal Turning Points
Events that directly affect or change the relationship
Reflective Turning Points
Event(s) that signals a change in the way the relationship is defined
Relational Escalation and Stages
The movement of a relationship toward intimacy through 5 stages
1. Pre-Interaction Awareness
2. Acquaintance (Introduction and Casual Banter)
3. Exploration
4. Intensification
5. Intimacy
Escalation Stage 1: Pre-Interaction Awareness
Where you gain information about others without directly interacting
Escalation Stage 2: Acquaintance
2 substages:
Introductions
Casual Banter
Escalation Stage 3: Exploration
Begin to share more in-depth information about each other, but you maintain social distance and limit time spent
Escalation Stage 4: Intensification
Spend more time together - depend on each other for self-confirmation and engage in more risky self-disclosure
Escalation Stage 5: Intimacy
Rely on each other for confirmation, highly personal conversation & self-disclosure, increased physical contact, commitment to maintaining the relationship
Relationship De-Escalation and Stages
Movement of a relationship away from intimacy through 5 stages
1. Turmoil or Stagnation
2. De-Intensification
3. Individualisation
4. Separation
5. Post-Separation Effects
De-Escalation Stage 1: Turmoil or Stagnation
an increase in conflict or the relationship loses vitality & partners complacent… increased conflict, decreased mutual acceptance
De-Escalation Stage 2: De-Intensification
Decreased interaction & dependance for self-confirmation, increased physical & emotional distance
De-Escalation Stage 3: Individualization
Defined less as a couple, turn to others for self-confirmation
De-Escalation Stage 4: Separation
Intentional decision to eliminate interpersonal interaction.. may still see each other but may be awkward due to extensive personal knowledge about one another
De-Escalation Stage 5: Post-Separation Effects
Lasting effects relationship has on your self & your other interactions & relationships
Social Exchange theory
People make decisions about their relationship by seeking the greatest amount of reward and least amount of cost
- immediate
- cumulative
- expected
- comparison to alternatives
Dialectical Theory and 3 tensions
Relationships are influenced by those forces pulling people towards intimacy or independence
3 tensions:
1. Connectedness vs Autonomy
2. Predictability vs Novelty
3. Openness vs closedness
Development of Therapeutic Relationships of Nurses are based on…
Trust
Respect
Professional Intimacy
Empathy
Power (balance)
Developing Therapeutic Relationship Stages
- Orientation
- Working phase
- Resolution phase
- Orientation (Goal Oriented)
- parameters are clear (time, length, place)
- trust, respect, honesty, effective communication
- expectations are discussed
- priorities addressed and understood
- consistency and listening
- nurse promotes comfort and reduces anxiety
- Working Phase
- INTERVENTIONS
- problems identified/addressed
- positive changes and setbacks
- exploration of thoughts/feelings/beliefs
- nurse advocates for client
- Resolution Phase
- mutual understanding and discussion of goals that have been met
- client and nurse share feelings about the end
- increased autonomy of client and nurse
Pelz Effect
People below have increased job satisfaction if they feel that supervisors have influence on decision at higher levels
If the supervisor is seen as supportive, it increases openness & satisfaction
Upward Communication
From team members up to superiors
Downward Communication
from superiors to team members felow
Horizontal Communication
Among co-workers at the same level
- usually work-related
- bullying
- workplace incivility
- ostracism
- horizontal/lateral violence
CIHC 6 Interprofessional Competency Framework Domains
- interprofessional communication
- Patient/client/family/community centred care
- Role clarification
- Team functioning
- Collaborative leadership
- Interprofessional conflict resolution
Interprofessional communication Qualities
Team-work
Active listening
Common understanding
Develop trusting relationships
Effectively use information & communication technology
Collective Competence - Dr. Lingard
Health care is full of highly competent individuals,, BUT, only sometimes do they come together to form a competent team
How do we adapt our thinking toward a collective competence to provide better patient care?
- More seamless transfer of accurate information
- Shift to primary health care team approach
- Address most impactful points of failure in collective competence first (targeted initiatives)
Safe Surgery Saves Lives (WHO)
Surgical Safety Checklist:
- before induction of anaesthesia
- before skin incision
- before patient leaves OR
Interpersonal Conflict Requirements
- An expressed struggle
- Between two interdependent people
- Perceived goal incompatibility, scarce resources, interference from others
- Who are attempting to achieve their specific goals
Spectrum of Interpersonal Conflict
Mild differences -> dispute -> campaign -> litigation -> fight
Common barriers to interprofessional communication & collaboration - O’Daniel & Rosenstein (2008)
Personal Values
Personality Differences
Hierarchy
Disruption
Culture & Ethnicity
Generational differences
Language/jargon differences
Types of Interpersonal Conflict - (RNAO, 2012)
- Relationship conflict: interpersonal incompatibilities involving irritation about personal taste, interpersonal style, different personal values, or other non work-related preferences
- Task Conflict: disagreements about the content or outcomes of tasks being performed, including differences in viewpoints, ideas and opinions
- Process Conflict: Focuses on disagreements about how to accomplish a task, who is responsible for a task, or the delegation of duties and resources
Myths about conflicts
- always a sign of a poor interpersonal relationship
- always to be avoided
- always because of misunderstandings
- always able to be resolved
Conflict Management Styles
- Avoidance (turtle)
- Accommodation (teddy bear)
- Competition (shark)
- Compromise (fox)
- Collaboration (owl)
Avoidance (turtle)
Lose-Lose
try to sidestep the issue (easier to withdraw) “demand-withdrawal” pattern
Advantages and Disadvantages of Avoidance (turtle)
Advantages:
- allow time to think, cool down, assess options, put things in perspective
Disadvantages:
- may appear to not care about the other person
- conflict remains unresolved
Accommodation (teddy bear)
I Lose-You Win
Give in to demands of others
Seek approval and want to be liked by others
Giving into the other (precent threats to self)
Accommodation (teddy bear) Advantages and Disadvantages
Advantages:
- show they are reasonable
- gain credibility if trivial issue
- appropriate if you are wrong/made a mistake
Disadvantages:
- produces a pseudo-solution because issue not resolved
- others may take advantage of you
- may prevent finding a real solution
Competition (shark)
I Win-You-Lose
Stresses winning
Blaming others
Resort to threats and warnings
Appropriate if you believe your position is correct & anything less harmful to you/others
Competition (shark) Advantages & Disadvantages
Advantages:
- Emotion is not the driver of conflict
Disadvantages:
- Ethical concern for others is not a priority
- damaged relationships
Compromise (Fox)
Lose/Win-Lose/Lose
Each person gives a bit
Finds a middle ground (somewhat meet the needs of all)
Compromise (Fox) Advantages & Disadvantages
Advantages:
- May find quick and/or temporary solution
- Reinforces perception of equal power
- save face
Disadvantages:
- may leave no one pleased
- may be avoiding underlying issues
Collaboration (Owl)
Win-Win
Use other-oriented strategies to achieve positive solution for everyone
uses Fisher and Ury’s Principals
Collaboration (Owl) Advantages & Disadvantages
Advantages:
- approach needed
- enhances commitment
- builds rapport
- considers other’s feelings
Disadvantages:
- skill
- patience & energy
Pines (2012) Stress resiliency, psychological empowerment and conflict management styles among baccalaureate nursing students
- student scored highest for avoiding and accommodating behaviours
- less likely to use competing or collaborating strategies
- age was a significant indicator - older student more likely to use collaborating style of conflict resolution
SBAR
Communicating critical information requiring urgent attention:
(S)ituation: what is happening with the patient?
(B)ackground: What is the clinical background?
(A)ssessment: What do you think the problem is?
(R)ecommendation: What needs to be done?
Skills to De-escalate (LOWLINE)
LISTEN: active listening and open-ended questions
OFFER: Offer reflective comments
WAIT: Don’t speak for the purpose of filling silence
LOOK: Use eye contact appropriately
INCLINE: Small incline of head allows relaxed posture
NOD: Nodding shows you’re listening
EXPRESS: Express empathy
Electronic Mediated Communication (EMC)
Use of an electronic medium to carry your message
Usually occurs between two or more electronic devices
Lack of Non-Verbal Cues in EMC
- words & graphics more important because they are the sole message
- may add symbols to indicate emotions
- may be more direct with questions & self-disclosure with new people in attempt to learn more about them in absence of visual cues
How does EMC differ from face-to-face
Time
Distance
Varying degrees of anonymity
Potential for deception
Non-verbal cues
Writing style
Permanence
5 Skills to guide professional communication via email
- Professional communication (spelling, grammar, flow, proofread)
- Introduce Self (name, title, use professional email address)
- Subject line reflecting actual subject
- Avoid informal communication & social familiarity
- Consider confidentiality
Using emails to contact physicians - 4 most desired activities
- ask questions when face-to-face visit is not fully necessary
- make appointments
- renew prescriptions
- receive results of medical tests
Saskatchewan eHealth
MySaskHealthRecord
eHealth Saskatchewan
Electronic Transfer of Images - x-rays, MRIs, mammograms
Southwest Ontario Digital Imaging Network
Telehealth/Telemedicine
Consultations via teleconference, webinars, etc.
Integrated Computer Systems
Share patient-specific data
ex. SIMS, PIP
Home Monitoring
of med use & physiological parameters (ex. B/P, blood glucose)
Are Robots the way of the future in healthcare? examples?
- triage (assign degrees of urgency to wounded/ill patients)
- draw blood samples
- scheduling
- assessments
- companions (reduce anxiety)
- caregiving (lifting, tasks)
Three main areas of Health Care Robotics
- IN the body (deliver medication, tissue samples, surgical robots)
- ON the body (wearable robotics, prosthetics, mobility exoskeletons)
- EXTERNAL to the body (carebots, companions, ADLs, simulators)
How do Infants Communicate?
Crying, coos, gurgles, grunts, facial expression, body/eye movements
How to respond to infant communication
- respond quickly
- use sing/song, high-pitched tone, exaggerated facial expression & wide open eyes to capture attention
- face infant - they like watching faces
- recognize infant preference for expressing emotion, level of activity & tendency to be social
How do toddlers communicate?
Grunts, gestures, 1-2+ word sentences, emotional expressions & body movements
How to respond to Toddler communication
- respond quickly & predictably to their communication
- build on their sentences
- give one direction at a time, provide warnings before transitions & give rationale for requests
- talk them through daily routines
- let them lead in play
How do preschoolers Communicate?
Talk in full, grammatically correct sentences, like to tell about past experiences & see links between spoken & written word, like sponges!
How to respond to preschooler communication
- ask questions about past events, probe for details & provide new words
- encourage them to talk about their feelings & causes
- create opportunities for fantasy/pretend play
- point out connections between spoken & written word
- allow self-talk as it helps them focus
How do school-aged kids communicate?
Lots of questions, seek justification for the way things are, understand perspective of others, spend more time with peers & friends
How to respond to school-aged kids communication
- keep up on dis/likes, activities & peer relationships through conversation
- help them set goals & problem solve
- give calm explanation when correcting
- encourage them to talk about emotions & causes
- use conversation to help child learn conflict management skills
How do adolescence communicate?
Like to talk about themselves & relationships, trying to understand who they are becoming, & what others think about them, see parents as imperfect, increase time alone or with friends, decreased time with family
How to respond to adolescent communication
- be sensitive & empathetic to their experience
- use conversations to keep up on activities & relationships
- GENTLY ask questions and seek explanations for behaviour (be flexible)
- Provide balance between expecting personal responsibility & offering support
- accept different ideas/beliefs if not harmful
Communicating with older adults
- avoid stereotyping or terms that reinforce incorrect perceptions about seniors
- avoid ageism & ageist language such as “the aged”, “the elderly”, “senile”, “feeble”, etc.
- Instead, use “older adults”, “older persons”, or ”senior”
- Avoid patronizing, condescending or childish expressions and tone
- communicate with respect
Effective Communication Ideas for Older Adults
- plain language
- large print
- fridge magnets with important numbers
- peel-off stickers to be placed on calendars for appointments
- Keep advice simple - not too much info
- Use short, familiar words & avoid jargon
- use pictures to illustrate when possible
- reinforce main points
Stress
Natural physiologic, psychological, and spiritual response to the presence of a stressor
Stressors
- a demand, situation, internal stimulus, or circumstance that threatens a person’s personal security or self-integrity
Anger & Hostility
most common stress emotions associated
Strategies with Difficult Situations
maintain reasonable, neutral & friendly tone
Deal with disruptive behaviours immediately
Set up consistent rules & expectations
Try to build trust, slow down
Anticipatory guidance
Acknowledge their feelings
Control your emotions
5 A’s for dealing with angry patients
- Acknowledge the problem
- Allow the patient to vent uninterrupted
- Agree on what the problem is
- Affirm what can be done
- Assure follow through
Transference
Projecting on you; previous bad experience
Countertransference
“We” (HCP) project our experiences of other patients to recent patients
Maslach Burnout Inventory (MBI)
psychological response to excessive and prolonged stress
multidimensional
valid and reliable tool
What is Compassion fatigue?
emotional and physical burden created by the impact of helping others in distress, which leads to a decreased capacity for empathy toward suffering in the future
Warning signs of compassion fatigue
- exhaustion/absenteeism
- reduced sense of empathy
- anger and irritability
- increased use of alcohol or other substances
- heightened anxiety/fears
- difficulty separating work and personal life
- dread working with certain clients
Keeping your emotional energy bank accounts filled
-improve self-care
- recognize warning signs
- embrace your personal resources
- rely on social supports
Organizational Strategies for creating supportive work environments
- Mental Health breaks
- Transparents dialogue
- Timely debriefing
- peer support
- assess/modify workloads
- relevant professional development
Code of Ethics part 1 - Nursing values & Ethical responsibilities
Describes core responsibilities central to ethical nursing practice - 7 primary values & accompanying responsibility statements
Code of Ethics part 2 - Ethical Endeavours related to broad societal issues
Describes activities nurses can undertake to address social inequalities. Ethical practice involves addressing the broad aspects of social justice associated with health and well-being
Code of Ethics components (A-G)
A. Providing safe, compassionate, competent & ethical care
B. Promoting health & well-being
C. Promoting & respecting informed decision-making
D. Honouring dignity
E. Maintaining privacy & confidentiality
F. Promoting justice
G. Being accountable
Types of Power
Legitimate (position)
Referent (attraction)
Expert (knowledge)
Reward (satisfy needs)
Coherent (punishment/force)
Masculine Cultures
Value achievement, assertiveness, heroism, and material wealth
Feminine Cultures
Values relationships, caring for the less fortunate, and overall quality of life
6 Cultural Values
Gender
Tolerance of uncertainty vs avoidance of uncertainty
High vs low context
Power (concentration vs decentralized)
Individual vs collectivism
Time (short-term vs long-term)
Improving intercultural competence
- developing bridging strategies
- developing motivation
- developing knowledge
- developing skills
Eustress
Short-term, mild level of stress, ability to cope
Listening Styles
Relational
Analytical
Critical
Task-Oriented
Metacognition Cycle
- Assess the task
- Evaluate Strengths
- Plan the approach
- Apply strategies
- Reflect
Randy Risto: Two world views
seeing things from our own perspective - tortoise and the hare
Becky and Liz key components
Inequity of drug users in health care
Need to treat them as values individuals and provide the same quality of care
These people would rather die on the street than seek unjust hospital care
Oberle and Raffin model (ARSER)
A: Asses the ethics
R: Reflect/Review actions
S: Select an ethical action
E: Engage in ethical action
R: Reflect/Review
Denotative vs Connotative
Denotative = objective/actual meaning of a word
Connotative = subjective meaning of a word
4 Emphasized Components of 2021 Code of Ethics for International Nurses
- Nurses and the Client
- Nurses and Practice
- Nurses and the Profession
- Nurses and Global Health
Cognitive Dissonance
Mental discomfort you feel when there’s a discrepancy between what you believe and new information
Pseudo-Conflict
Conflict triggered by a lack of understanding and miscommunication
Destructive Conflict
Each person has a win-lose attitude
Damages the relationship
Constructive Conflict
Builds new insight
Establishes a new power
Strengthens the relationship
4 Main Conflict Management Skills
- Manage your emotions
- Manage Information
- Manage goals
- Manage the problem
Co-Culture
A distinct culture within a larger culture
Leininger’s Theory of Transcultural Nursing
Culturally congruent care: congruent with patient values
Culturally competent care
Material Culture
Housing, Clothes, Cars
Social Institutions
Schools, government, religious organizations
Aesthetics
Music, theatre, art, dance
Language
Verbal and non-verbal communication system
Acculturation
We acquire other approaches, beliefs and values by coming into contact with other cultures
