321 exam 1 Flashcards
communication and nursing practice
lifelong learning process in which nurses develop meaningful relationships. Nurses use critical thinking to collect data, analyze health problems, provide counseling, and interact with purpose
verbal communication components
denotation
pace
intonation
clarity
timing
nonverbal communication componenets
appearance, facial expression, posture, eye contact, gestures, sounds, personal space
therapeutic communication
nurse is a professional that promotes an environment for change and growth within an explicit timeframe
motivational interviewing definition
encourages pt to share thoughts, goals, beliefs, fears, with the aim of changing behavior. the nurse understands their motives and values
lateral violence
workplace bullying
witholding info, hypercritical, or put downs
professional communication
appearance, demeanor, behavior
AIDET
acknowledge
introduce
duration
explaination
thank you
therapeutic communication techniques
active listening
sharing observations
empathy
share hope
share humor
share feelings
touch
silence
providing info
clarifying
summarizing
validation
asking questions
self disclosure
confrontation
active listening
facing pt, uncrossed legs and arms, relaxed, make eye contact
non-therapeutic techniques
asking personal questions
giving opinions
change subject
automatic responses
false reassurance
sympathy
asking for explanations
approval/being defensive
aggressive response
arguing
adaptive techniques for language barrier
interpreter, pictures, dictionary
adaptive techniques for hearing loss
reduce environmental noise
face patient with mouth visible
rephrase not repeat
ask simple questions
don’t interrupt
communication board/pics
adaptive techniques for cognitive impairment
simple sentences, be a good listener, include friends and family
adaptive techniques for unresponsive pt
call by name, explain, speak clearly as if they can hear
- attend mindfully
- behave calmly
- communicate clearly
social communication
informal with friends
confidentiality in nursing
ethical and legal responsibility
HIPAA
no sharing info without permission
no sharing pt conversations, no social media
HIPAA
health insurance portability accountability act
key concepts of professional communication
respect, assertive, advocacy, professional boundaries
respect
ask name preference, appropriate expressions and body language, please and thank you
assertive
nurse has confidence and commands respect
advocacy
nurse defends rights of patients, clear and effective communication
professional boundaries
limits and responsibilities, not social
phases of a helping relationship
pre orientation
orientation
working
termination
pre orientation relationship phase
before, reading chart, thinking and planning
orientation phase
introduction, observe, assess, identify needs, establish trust
working phase
solving problems, meeting needs, explaining things to patients
termination phase
goodbye
factors affecting nurse/pt relationship
developmental phase, proxemics, culture, distractions
developmental stage barrier
young prefer short sentences and concrete meeting
old prefer more time to answer, speak in low tone and facing patient
proxemics barrier
intimate, personal, social, public
intimate proxemics
0-1.5 feet
personal space proxemics
1.5-4 ft
social space proxemics
4-12 ft
public space proxemic
more than 12 feet
culture barrier to nurse relationship
genered caregiver, close or far, touching head, eye contact
distraction barrier
too many visitors, turn off devices, pt can request to keep family
compensation
individual strengths to overcome inadequacy
denial
refusing to admit reality
displacement
transfer of emotional energy away from source
introjection
taking on certain characteristics of another personality/person
projection
attributing undesirable feelings to another person
rationalization
denying true motives and choosing one that is more socially accceptable
regression
reverting to earlier stage of development
repression
painful or hostile feelings stored away and forgotten
sublimation
switching unacceptable impulses to socially accepted activites
supression
choosing not to think about unpleasant feelings
LGBTQ care barrier
use correct pronouns, be nonjudgemental
someone in pain/ w anxiety care
short and direct sentences, avoid teaching, keep company
motivational interviewing
asking patient about learning and to identify their motivation. Can reveal learning style preference
psychosocial adaptations to illness, grief, and learning
denial
anger
bargaining
resolution
acceptance
denial
avoids discussion of illness and withdrawals from others and disregards physical limitations
anger
patient blames and directs anger at nurse or others
baragining
offers to live a better life in exchange for health
resolution
pt expresses emotions and realizes illness has created changes
acceptance
recognizes reality of condition and pursues information to gain independence
READINESS to learn
based on patients willingness to engage in learning activities. Grief illness and loss can impact readiness to learn
attentional set
mental state that allows learner to focus and comprehend learning
ABILITY to learn
developmental capability, cognitive and physical abilities.
learning environment can impact this
teaching an adolescent information
help them understand feelings and self express, assist in problem solving and allow them to make health decisions
teaching a young/middle adult info
set mutual goals, encourage independent learning and offer learning so they can understand the effects of a health issue
teaching older adults
when alert and rested, involve them in discussion and teaching . keep it short
health literacy
cognitive and social skills that determine the ability of a person to find info and use it to become healthier
verbal 1:1 instruction
enhances comprehension
delivers pt centered edu
understand learner
communicate clearly
address health literacy
teaching
education
group instruction
economical and groups are able to learn from each other
preparatory instruction
provides info on a procedure, explain only important and normal feelings.
demonstration teaching
teaching psychomotor skills
teachback method
outcomes tied to low health literacy
increased hospitalization
poor plan adherence
med errors
high health literacy outcomes
greater understanding of conditions and treatments. better health management
people at high risk for low health literacy
older, ESL, immigrants, homeless, prison
components of health literacy
oral communication
reading comprehension
numeracy
technology
healthy people 2020 objectives
- increased pt reporting of hcp providing easy to understand guidance for their concerns
- increase number of patients reporting their hcp confirmed their understanding of info
- increase in pt reporting of office helping them fill out info on forms
challenges for nurses in patient education
short stays, limited time during outpatient visits, lack of supplies, pt gets conflicting info from other patients, low literacy, lack of learning readiness
Barriers to education
nurse lacks awareness of pt health literacy, inaccurate simplification, concerns of offending learner, staff turnover, nurse has wrong opinion of important info
Things that hinder the learning process
motivation
cognition
culture
emotion
ineffective communication
Teaching styles
question, lecture, demonstration, discussion, roleplay
questioning teaching style
help them make connections
lecture teaching style
printed and spoken material, helps if pt already has background
demonstration teaching style
does task and explains
domains of learning
cognitive
psychomotor
affective
cognitive domain
memorize and understand
psychomotor domain
DOING
affective
discuss feelings on new things
VARK
visual
auditory
reading
tactile
teaching a patient with low health literacy
plain language, only relevant info. begin with most important, use multiple formats
things to assess before teaching
knowledge level
age
language
readiness to learn
anxiety and stress
current health, wellness beliefs
cues to low literacy
excuses, points or mouths as they read, shows pills, won’t sign consent without family/seems non-compliant
teaching approaches
telling
participating
entrusting
reinforcing
telling patient approach
direct and to the point
participating with pt approach
teach them information and meaning
entrusting approach
pt manges their care and behavior
reinforcing approach
nurse notifies pt is something is off
patient education goals
specific
measurable
individualized
pt centered
optimal learning environment
quiet, private, comfy, good lighting. Not too hot or cold
