204 Midterm #1 Flashcards
Communication Broad Definition
Process of acting on information
Intentions of Communication
To get a response
To share information, thoughts or feelings
3 Essential Elements of Interpersonal Communication
- A distinctive form of communication
- Transaction involving mutual influence b/w individuals
- Helps us manage our relationships
Models of Communication Process
Communication as Action
Communication as Interaction
Communication as Transaction
2 Goals of a helping relationship
a) helping clients manage health and live effectively
b) promote optimal independence in their daily lives
Peplau’s Theory
Nurse is the participant and observer
1. Orientation
2. Working
3. Termination
Intrapersonal Communication
Communication with oneself
Therapeutic Communication
Professional relationship strategy to support the well being of the client
CRNS (SRNA) Practice Standards #27
Identifying the effect of own values, beliefs and experiences in relationships with clients, recognizing and addressing potential conflicts.
Self Definition
The sum total of who a person is; a person’s central inner force
Self-Concept
A person’s subjective description of who the person thinks they are –> labels we use to describe ourselves to others
Personality
Enduring internal predispositions and behaviours –> characteristics that describe how people react/respond to their environments
Attitude
Learned predispositions (likes and dislikes)
Beliefs
Ways in which you structure your understanding of reality (true or not true)
Value
An enduring concept of good and bad (right and wrong)
Parts of Ourselves
Material self, Social self, Spiritual self
Material Self
Possessions, body, physical
Social Self
Different depending on context of interactions
Spiritual Self
Feelings about yourself, your thoughts, values, standards, your place in the universe
Self-Fulfilling Prophecy
When people believe about themselves often comes true because they expect it to
Self-Awareness
Having a clear perception of your personality, including strengths, weaknesses, thoughts, beliefs, motivation, and emotions, interests, likes, dislikes - allows you to understand other people
Self-Absorbed
Only concerned with own self
Self-Concept vs Self-Esteem
Self-Concept: subjective description of who you think you are
Self-Esteem: what you think you are worth; self worth
Social Decentring
Cognitive process in which you take into account another person’s thoughts, feelings, values, background, perspective
Other-Oriented
Begins with social decentring
Unbiased
Disclosure limitations in Therapeutic Relationships
What is the purpose of the self disclosure?
Who does the self disclosure serve?
How will the information affect the other person?
Johari Model of Self Disclosure
Open Area = known to self and others
Hidden area = known to self and not to others
Blind Spot = not known to self but known to others
Unknown = not known to self or others
Medicine Wheel
Circle represents wholeness
Spiritual, Physical, Intellectual, Emotional
Mandala Model of Self
Mandala means circle, circle represents wholeness, arrows represent relationships among all parts
Person, Action/Praxis, Individual, Wisdom/Knowledge
Stages of Perception
- Selecting
- Organizing
- Interpreting
Selecting Perception Stage
Perception - ignore other noise
Attention - based on wants/needs
Exposure - select things that reinforce comfort
Recall - remember things that we want to
Organizing Perception Stage
We create categories
We link categories
We seek closure (fill gaps)
Interpreting Perception Stage
Assign meaning/try to make sense
Impression
Collection of interpretations
Implicit Personality
Pattern of assumptions in order to understand
- based on our own biases
- can be right or wrong
Uncertainty Reduction
Use perceptions to get more info to reduce uncertainty
Types of Effects
Primacy, Recency, Halo, Horn
Primacy
Emphasizes what comes first (1st impression)
Recency
Emphasize what comes last
Halo
Attribute positive qualities because we like them
Horn
Attribute negative qualities because we dislike them
Attribution Theory
First impression, generally NOT holistic - NOT good for nurses
Causal Attribution Theory
Try to find a cause (kind of like finding an excuse/reason)
Circumstance
Stimulus
Person
Standpoint Theory
Interpersonal based on our reference point
Intercultural Communication Theory
Interpret behaviour based on cultural lens
Barriers to Accurate Perceptions
Stereotypes, ignoring info, overgeneralizing/oversimplifying, imposing consistency, focusing on the negative, blaming, avoiding responsibility
How to improve Perceptual Skills
Self-Reflecting, testing perceptions, and consider how others perceive you - become “other” oriented
Qualities of Skilled Communicators
Active listener, provide verbal and non-verbal feedback, good listening = good leadership, 55% of our communication is listening
Listening Process
- Selecting
- Attending
- Understanding
- Remembering
- Responding
Listening Styles
a) Relational - express emotions
b) Analytic - well-organized and brief
c) Critical - sceptical, finds underlying messages
d) Task-oriented - looking for an outcome
How to fix listening barriers
Self-Absorbed - be aware of self-focus
Unchecked Emotions - use self-talk
Criticizing - focus on the message
Speech rate vs thought rate - mentally summarize
Shifting attention - most important message
Info overload - don’t be tired or distracted
External Noise - eliminate distraction
Apprehension - concentrate on the message
Listening Effectively
STOP - LOOK - LISTEN
Symbolic Interaction Theory
Society is bound together through use of common symbols (understandings between people) Symbol (black cat) Referent (image of black cat) Thought (provide meaning, comes later)
Denotative
Literal/objective meaning
Connotative
Personal/subjective meaning
Power of words
Create our perceptions (good or bad)
Influence our thoughts (can distort) and actions
Affect and reflect culture
Affect quality of interpersonal relationships
Language shape culture and vice versa
Language impacts quality of relationships
Examples of Miscommunication
- Missed meaning of same word
- Confusion of meaning/context
- Level of specificity
- Overgeneralization
- Oversimplification
- Polarizing statements
- Biased statements
- Apologize
- Changed meaning/context
Assertive
Pursuing your best interest without denying communication with your partner
Aggressive
Pursuing your best interest by denying communication with partner
Behaving Assertively
- Describe - how you view the situation
- Disclose your feelings
- Identify Effects - of other person’s behaviour on you or others
- Be Silent - wait for a response
- Paraphrase - content and feelings
Good Communication Qualities
Moderate voice
Encourage client involvement
Advocates for client
Provides info clearly in a professional manner
Non-verbal messages
Provide more meaning than verbal (more believable) 55% of emotional meaning is communicated by the face and 38% vocal cues
Interaction Adaptation Theory
Interpreting others non-verbal messages help us adapt our communication
Interactional Synchrony
Mirroring of behaviour (useful in adapting to client)
Understanding non-verbal communication
Movement, posture, gestures
Eye contact
Facial Expressions
Vocal cues
Touch
Appearance
Movement and Gestures
Helps bridge cultural or language differences
1. Emblems
2. Illustrators
3. Affect Displays
4. Regulators
5. Adaptors
Eye Contact
- Cognitive - gives info
- Monitor - behaviour of others
- Regulatory cues - signal when we want to talk
- Express function - “mirror of the soul” - reveal emotions
Facial Expressions
- Emotional Displays
- Can betray our true emotions (makes it harder to lie)
- Universal emotional categories: Surprise, Fear, Disgust, Anger, Happiness, Sadness
Vocal Cues
- Communicate emotions
a) Infant; adult
b) Nature of Relationships
c) Relational cues - liking and trust
d) Self-Confience - Manage converstation
Spatial Zones
Public Space - 3.5m
Social Space - 1.5m-3.5m
Personal Space - 0.5m-1.5m
Intimate Space - 0-0.5m
Touch
Shows intimacy
Appearance
Alters perceptions of credibility and attractions
Interpreting Non-Verbal
- Immediacy
- Arousal
- Dominance
Immediacy
Move towards/away
Cues
Arousal
Responsiveness/passive/dull or excited
Dominance
Communicating power
How to check your perceptions
Observe non-verbal behaviour (frowning, eye contact)
Form a mental impression of what you think they mean (happy, sad, angry?)
Ask whether your perception is accurate (are you upset/angry?)
Improving non-verbal skills
- Be mindful
- Observe other peoples reactions
- Ask others
- Practise
Influence of non-verbals in Therapeutic communication
Listen and understand the value of silence
Body language (use facilitative)
Appropriate touch
Respects client’s space (proxemics)
Is attentive to client’s nonverbal cues
Influence of non-verbals in Therapeutic communication
Listen and understand the value of silence
Body language (use facilitative)
Appropriate touch
Respects client’s space (proxemics)
Is attentive to client’s nonverbal cues
Stages of Perception
Selecting, Organizing and Interpreting
Selecting
“tune in”
- Selective perception
- Selective attention
- Selective exposure
- Selective Recall
Organizing
Categorize perceptions
1. We create categories and patterns
2. Link categories
3. We seek closure
Interpreting
Assign meaning - try to make sense out of information you see or hear
Forming Impressions
Collection of Interpretations
Impression Formation Theory
Impressions are made based on physical qualities, behaviour, what is told to us by others, and what is told by the individual
Standpoint Theory
Interpretation based on or own reference point - power and privlege
Wheel of Power and Privlege
Everyone has different perceptions based on position (ex. CEO vs employee)
Intercultural Communication Theory
Interpret behaviour based on your own cultural lens
How much time in a day is spent listening
80%
Interpersonal Relationship Continuum
Shared Perception
Ongoing Connection
Relational Expectations
Interpersonal Intimacy
Increase intimacy = Increase in disclosure
Theories of Interpersonal Relationship Development
Social Exchange Theory
Relational Dialectics Theory
Social Penetration Theory
Social Exchange Theory
People make decisions on the basis of assessing and comparing the costs and rewards
- Immediate
- Forecasted
- Cumulative
- Expected
Relational Dialectics Theory
Management of tensions that pull us in two directions
- Connectedness vs autonomy
- Predictability vs Novelty
- Openness vs Closedness
Social Penetration theory
Interpersonal intimacy increases with increased self-disclosure (breadth and depth pies)
Upward Communication
Flows from subordinates to superiors
- helps managers to deal quickly with problems
- helps managers hear suggestions for improving
Downward Communication
Flows from superior to subordinates - ex. manager posting instructions
Safe work environment/Safe Communication
Supervisors have responsibility to eliminate the harassment in a hostile environment where employees feel their rights being violated
Horizontal Communication
Among colleagues or co-workers at the same level within an organization
Outward Communication
Flows to those outside an organization (such as clients/patients)
- focus on the needs of those they serve through outward communication
What is the core of the nursing practice?
Therapeutic Nurse-Client Relationship
Components of the nurse-client relationship
Trust
Respect
Professional Intimacy
Empathy
Power
Trust
Client is in a vulnerable position - be authentic and transparent
Respect
Recognition of dignity, worth and uniqueness of every individual without bias
Professional Intimacy
Type of care nurses provide - physical activities (bathing) as well as psychological, spiritual and social elements
Empathy
Expression of understanding, validating and resonating with the meaning of the experience for the client/family
INCLUDES APPROPRIATE EMOTIONAL DISTANCING
Power
Interpersonal Power: ability to influence another person in the direction one desires
Dependent: 1 person has power
Interdependent: sharing power
Principles of Interpersonal Power
It exists in all interactions/relationships
Primarily derives from someones ability to meet another person’s needs
Both partners in a relationship have some power
Power is circumstantial
Development involves a negotiation of each partner’s power
Types of Power Relationships
Complementary
Symmetric
Competitive Symmetric
Submissive Symmetric
Parallel
Types of Power
Legitimate
Referent
Expert
Reward
Coercive
Legitimate Power
Comes from a respect for a position another holds
Referent Power
Comes from our attraction to another person or the charisma they hold
Expert Power
Derives from a person’s ability to satisfy our needs
Coercive Power
Use of sanctions of punishment to influence others
Complementary Relationship
Power is divided unevenly where one is dominating and the other is submitting
Symmetric Relationship
Both partners attempt to have the same level of power
Competitive Symmetric Relationship
Both partners vie for control or dominance of the other
Submissive Symmetric Relationship
Neither partner wants to take control or make decisions
Parallel Relationships
Power shifts back and forth between the partners depending on the situation
What power do nurses hold in a therapeutic relationship?
Complementary and Symmetrical
How should nurses maintain boundaries?
Self-reflection
Following the care plan
Meeting one’s own personal needs outside of the relationship
Being sensitive to context
Initiating, maintaining and terminating the nurse-client relationship appropriately
CRNS RN entry level of competencies, 2019
Communicator and Collaborator
- Communicating respectfully and effectively in collaboration with client, family, colleagues and others and resolving conflict when it occurs
Therapeutic Relationships and Colonization
We each have an individual and collective responsibility to address the effects of present and past harms to Indigenous people
