ATI - Chapter 32 Flashcards
Communication is a complex process of sending, receiving, and _____ messages between two or more people. It is a dynamic and ongoing process that creates a unique experience between the participants.
comprehending
Communicating ______ is a skill that nurses must develop. Nurses use communication when providing care to demonstrate caring, establish _________, obtain and deliver information and assist with changing behavior.
effectively
therapeutic relationships
Therapeutic communication is foundational to the ______.
nurse client relationship
Effective communication is a key to ensuring client’s ____.
safety
Levels of Basic Communication
intrapersonal interpersonal public transpersonal small group communication
One level of basic communication is called _____ communication within a group of people, often working toward a mutual goal, such as in committees, research teams, and support groups.
small group
One level of basic communication is called ______ communication which is communication within an individual. It is each person’s “self-talk”, the internal discussion when thinking but not outwardly verbalizing thoughts. It helps nurses assess clients and situations and think _____ about them before communicating verbally.
intrapersonal
critically
One level of basic communication is called _____ which is communication between two people. This form of communication is the most common in nursing and requires an exchange of information with another individual. However, messages the receiver perceives can differ from what the sender intended.
interpersonal communication
One level of basic communication is called ________ which is communication within groups of people. Using this type of communication, may nurses teach, give community presentations, or write about nursing or health care topics and issues.
public communication
One level of basic communication is called ________ which is communication that addresses spiritual needs and provides interventions to meet these needs, such as prayer and meditation.
transpersonal communication
Functional Components
Referent Sender Receiver Message Channel Environment Feedback Interpersonal variables
The incentive or motivation for communication between two people.
referent
The person who initiates and transits the message.
sender
The person to whom the sender aims the message and who interprets the sender’s message
receiver
The verbal and nonverbal information the sender expresses and intends for the receiver.
message
The method of transmitting and receiving a message (sight, hearing, touch, facial expression, body language).
channel
The emotional and physical climate in which the communication takes place.
environment
Can be verbal, nonverbal, positive, negative. The message the receiver returns to the sender that indicates the receipt of the message. An essential component of ongoing communciation.
feedback
Factors that influence communication between the sender and the receiver, such as educational and developmental levels.
interpersonal variables
Methods of verbal communication
vocabulary credibility denotative and connotative meaning clarity and brevity timing and relevance pacing intonation
These are the words that communicate a message the sender writes or speaks.
Limited _____ or speaking another language can make it difficult for nurses to communicate with clients. Using medical or nursing jargon can decrease client’s understanding. Children and adolescents tend to use words differently than adults.
vocabulary
Trustworthiness and reliability of the individual. Nurses must be knowledgeable, consistent, honest, confident and dependable. Lack of ____ creates a sense of uncertainty for clients.
credibility
When communicating, participants must share meanings. Words that have multiple meanings can cause miscommunication if people interpret them differently.
denotative (exact definition) and connotative meaning (used in a different context)
The shortest, simplest communication is usually most effective. Long and complex communication can be difficult to understand.
clarity and brevity
Knowing when to communicate makes the receiver more attentive to the message. When clients are uncomfortable or distracted, it can be difficult to convey the message.
timing and relevance
The rate of speech can communicate a meaning the speaker did not intend. Speaking rapidly can suggest not having time for the clients.
pacing
The tone of voice can communicate a variety of feelings. Nurses communicate feelings such as acceptance, judgement, and dislike through their tone of voice.
intonation
Nurses should be aware of how they communicate ______ and should determine the meaning of clients’ _____ communication as well. Culture also affects interpretation. Attention to the following in both the communicator and receiver is necessary.
nonverbally
nonverbal
Nonverbal communication methods
appearance, posture, gait
facial expressions, eye contact, gestures
sounds
territoriality, personal space
Physical characteristics can convey professionalism. Body language and posture can demonstrate comfort and ease in the situation. The first impression is very important.
appearance, posture, gait
_______ can reveal feelings that clients can easily misinterpret. Eye contact typically conveys interest and respect but varies with culture and situation. _____ can enhance verbal communication or create their own messages.
Facial expressions
gestures
Crying or moaning can have multiple meanings, especially when other nonverbal communication accompanies it.
sounds
Lack of awareness of territoriality (right to space) and personal space (the area around an individual) can make clients perceive a threat and react defensively.
territoriality, personal space
Some facilities permit nurses to communicate with clients via ____. An email encryption system is essential for assuring confidentiality. These facilities must also have guidelines that address when and how to use email and what info nurses may convey.
emaile
Many clients welcome the use of technology in this way; for all clients, nurses must have their permission to communicate ______ and must respect their preferences. ______ communication becomes part of the clients’ medical record.
electronically
Therapeutic communication is the purposeful use of communication to build and maintain _____ with clients, families, and significant others.
helping relationships
Nurses use interactive, purposeful communication to elicit and attend to clients’ thoughts, feelings, concerns, and ____.
needs
Nurses use interactive, purposeful communication to express _____ and genuine concern for clients’ and families’ issues.
empathy
Nurses use interactive, purposeful communication to obtain information and give feedback about _____.
clients’ status
Nurses use interactive, purposeful communication to intervene to promote functional behavior and ______ interpersonal relationships.
interpersonal
Nurses use interactive, purposeful communication to evaluate clients’ ____ toward desired goals and outcomes.
progress
Children and older adults often require specific, __________ techniques to enchance communication.
age-appropriate
Use of the nursing process depends on ________ communication among the nurse, client, family significant other, and the interprofessional health care team.
therapeutic communication
Therapeutic communication is client centered, not social or _____.
reciprocal
Therapeutic communication is purposeful, planned, and ______.
goal directed
Essential Components of Therapeutic communication
time attentive behavior or active listening caring attitude honesty trust empathy nonjudgemental attitude
In therapeutic communication you need _____ to plan for and allow adequate time to communicate with others.
time
In therapeutic communication ______ or active listening is used as a means of conveying interest, trust, and acceptance.
attentive behavior
In therapeutic communication a ______ shows concern and facilitates an emotional connection and support among nurses and clients, families, and significant others.
caring attitude
In therapeutic communication _____ is being open, direct, truthful, and sincere.
honesty
In therapeutic communication _____ demonstrates to clients, families, and significant others, that they can rely on nurses without doubt, question, or judgment.
trust
In therapeutic communication _____ conveys an objective awareness and understanding of the feelings, emotions, and behavior of clients, families, and significant others, including trying to envision what it must be like to be in their position.
empathy
In therapeutic communication a _______ displays of acceptance of clients, families, and significant others encourages open, honest communication.
nonjudgemental attitude
In therapeutic communication during the assessment/data collection phase you need to determine both verbal and _____ communication needs for client-centered care. Clients who have hearing, vision, or cognitive losses, are unresponsive, are aphasic, or do not speak the same _____- as the staff.
nonverbal
language
In therapeutic communication during the assessment/data collection phase you need to consider _____ status.
physical
In therapeutic communication during the assessment/data collection phase you need to consider the ______ level, and alter communication accordingly.
developmental
In therapeutic communication during the assessment/data collection phase you need to consider the developmental phase. With children use simple, ______ language. Be aware of nonverbal messages because children are especially sensitive to _____. Enhance communication with children by being at the child’s eye level. Incorporating play in interactions helps too.
straightforward
nonverbal communication
In therapeutic communication during the assessment/data collection phase when speaking with older adults recognize that many older adults require _____ of sound. Make sure assistive devices such as glasses and hearing aids are available for clients who need them. Minimize _____, and face clients when speaking.
amplification
distractions
In therapeutic communication during the assessment/data collection phase when speaking with older adults speak in short and simple sentences. Allow plenty of time for clients to _______. Ask for input from caregivers or family to determine the extent of any communication _____ and how best to communicate.
respond
deficits
In therapeutic communication during the assessment/data collection phase identify any ______ considerations that affect communication. Provide an interpreter. Address the client directly when the interpreter is present. Provide education materials and instructions in the _____.
cultural
client’s language
In therapeutic communication during the planning phase minimize distractions and provide _____. Identify mutually agreed upon outcomes and set ____ according to the clients’ needs. Collaborate with other health care professionals when ____. Plan adequate time for interventions.
privacy
priorities
necessary
In therapeutic communication during the implementation phase establish a ______ nurse-client relationship. Clients feel more at ease during the implementation phase when nurses establish a helping relationship.
trusting
In therapeutic communication during the implementation phase provide _____ responses and explanations by using observations, giving info, conveying hope and using ____.
empathetic
humor
In therapeutic communication during the implementation phase manipulate the ____ to decrease distractions.
environment
Effective skills and techniques for therapeutic communications
silence presenting reality active listening asking questions open-ended questions clarifying techniques offering general leads, broad opening statements showing acceptance and recognition focusing giving information summarizing offering self touch
This allows time for meaningful reflection.
silence
This helps the client distinguish what is real from what is not and to dispel delusions, hallucinations, and faulty beliefs.
presenting reality
This helps the nurse hear, observe, and understand what the client communicates and provide feedback.
active listening
This is a way to seek additional information.
asking questions
This facilitates spontaneous responses and interactive discussion. It encourages the client to explore feelings and thoughts and avoids yes or no answers.
open-ended questions
This helps the nurse determine whether the message the client received was accurate.
clarifying techniques.
One clarifying technique is _____ in which you use the client’s exact words.
restating
One clarifying technique is ________ which directs the focus back to the client for him to examine his feelings.
reflecting
One clarifying technique is _____ which is restating the client’s feelings and thoughts for him to confirm what he has communicated.
paraphrasing
One clarifying technique is _____, which allows the nurse to gather more information about important topics the client mentioned.
exploring
This encourages the client to start and to continue talking.
offering general leads, broad opening statements.
This acknowledges the nurse’s interest and nonjudgemental attitude.
showing acceptance and recognition
This helps the client concentrate on what is important.
focusing
This provides factual details that the client might need for decision-making.
giving information
This emphasizes important points and review what the nurse and the client have discussed.
summarizing
This demonstrates a willingness to spend time with the client. The nurse may share limited personal information, but the focus should return to the client as soon as possible. Relevant self-disclosure by the nurse helps the client see that others share his experience and understand.
offering self.
IF appropriate, touch can communicate caring and provide comfort.
touch
Barriers to effective communication
asking irrelevant personal questions offering personal opinions stereotyping giving advice giving false reassurance minimizing feelings changing the topic asking "why" questions or asking for explanations challenging offering value judgements asking questions excessively (probing) responding approvingly or disapprovingly (refusing) being defensive testing judging offering sympathy arguing
Faulty communication among the members of the health care team can have a negative effect on the work environment and on client’s outcomes. Incivility, bullying, and _______ can have negative effects.
lateral violence
rude dialogue or actions
incivility
repeated words or acts of intimidation
bullying
abusive words or actions of peers
lateral violence
