6 ch3 communication PP Flashcards
role of therapeutic communication
*is ideal, exchange of information that forms a positive nurse-pt relationship and actively involves the pt in all areas of their care
active listening
*full attention to what pt is saying
i hear the message
interpret the meaning
give feedback indicating understanding
passive listening
*eye contact nodding uh huh
avoid this, misunderstandings can arise
assume the unresponsive patient CAN hear you
always explain to the pt any procedure or activity that involves the pt
1 way communication
*highly structured sender is in control, expects and gets very little response from the receiver
2 way communication
*meets the needs of both pt and nurseto establish a trusting relationship
seeking and accept the pts input and feedback
the “zones” intimate, etc
comfort zone
*intimate touching to 18 bathing
peersonal 18’ to 4ft sitting n talking
social zone 4ft to 12ft speaking w sm group
public zone 12ft+ public speaking
is jargon understood by everyone?
*common language unique to people in particular work setting, hospital talk
types of nonverbal communication
Nonverbal therapeutic communication
*moaning
voice tone volume rate
Listening, silence, touch, convey acceptance
Silence requires skill and timing
eye contact intention to interact, 2-6 sec involves the other person, significantly influenced by culture
physical appearance how you look and facial expression, professional=pride and competence
gestures emphasize idea
posture open/closed
at what level should you be with your pt
*same level as pt
sender
*person conveying the message
receiver
*to whom the message is conveyed
comfort measure for non English speaking pt during a painful procedure
* use a translator non verbal is important pantomime-simple words and actions pictures paper pencil
nonthreatening posture by the nurse
*most therapeutic posture and nonthreatening is the same position and level as pt or as close to it as possible
Erikson
Infancy birth-1 trust vs mistrust
Toddler 1-3 autonomy vs shame and doubt walking talking
Preschool 4-6 initiative vs guilt adult like activities
School age 7-11 industry vs inferiority do a task
Adolescence 12-19 identity vs confusion who am I
Young adult 20-44 intimacy vs isolation
Middle adult 44-65 generative vs stagnation productive or inactive
Late adult 65+ ego integrity vs despair reflect meaningful or despairing
Piaget
Sensorimotor birth -2
Preoperational thought 2-6
Concrete operational thought 7-11
Formal operational thought 12+
Stages of family development
1Engagement commitment 2 Establishment wedding 3 Expectant conception 4 Parenthood birth 5 Disengagement 6 Senescence
therapeutic nonverbal communication
Listening, one of the most effective and most difficult to master. conveys interest and caring.
active listening, full attention, hear interpret and give feedback indicating understanding
passive listening eye contact, nodding, uh huh,
Silence conveys respect understanding caring support often used in conjunction with touch.
Touch, safe place is elbow, use discretion, conveys warmth. be sincere and genuine
therapeutic communication
exchange of information forming a positive nurse pt relationship. it actively involves the pt in all areas of care
therapeutic verbal communication
*be accepting without passing judgement
closed and open questions
Restating
Paraphrasing
Clarifying
Focusing-when more specific info is needed to accurately understand pts meaning
Reflecting-is like restate but involves inner feelings and thoughts more than facts
Stating observation-validating accuracy
Offering information
Summarizing-review of the main points covered in an interaction
use of humor
provides psychological and physical release
enhances feelings of well being, reduce anxiety, and encourages sense of hope
factors that affect communication
Comfort zone
Environment-provide calm relaxed atmosphere
Level of trust-demonstrate confidence and competence
Language barriers-speak slowly not loud, use pictures, stress interferes w the ability to speak English
Culture
Age and gender
Physiological factors=pain, altered cognition, impaired hearing
Psychological factors=stress anger withdrawn, grieving
responses that block communication
false reassurance/you'll be fine advice or personal opinions/you should false assumptions/jumping to conclusions approval or disapproval automatic response/i don't make the rules, doctors know best defensiveness arguing asking for explanations changing the subject
ventilator dependent via endotracheal tube or tracheostomy
communication board
signal system/blinks
lip reading
sign language
aphasic patients
cant speak from ischemic(decreased blood supply to bodily organ/tissue) insult to the brain. stroke, brain trauma, anoxia(absence of oxygen)
expressive aphasia
unable to send verbal message
receptive aphasia
inability to recognize or interpret the verbal message being received
communication w pts w aphasia
listen be patient do not shout or speak loudly use simple short ?s speak of familiar things ask ?s that require yes/no answers communication board blinking pictures be calm and patient avoid childish patronizing phrases
