Chapter 24 Communication Flashcards
Communication
lifelong learning process
Builds relationships with patients, families, and multidisciplinary team members
Communication and Interpersonal Relationships: Nurses express caring by-
- becoming sensitive to-self and others
- promoting and accepting the expression of positive and negative
- developing helping-trust relationships
- instilling faith and hope
- promoting interpersonal teaching and learning
- providing a supportive environment
- assisting with gratification of human needs
- allowing for spiritual expression
Perceptual biases:
human tendencies that interfere with accurately perceiving and interpreting messages from others
Levels of Communication:
Intrapersonal, interpersonal, transpersonal, small-group, public
Intrapersonal communication:
powerful form of communication that occurs within an individual
-self-talk, self-verbalization, inner-thought
Interpersonal communication
one-on-one interaction between a nurse and another person that often occurs face to face
Transpersoanl communication
interaction that occurs within a person’s spiritual domain
small group communication
interaction that occurs when a small number of persons meet
public communication
interaction with an audience
referent
motivates one person to communicate with another
sender
the person who encodes and delivers the message
receiver
the person who receives and decode the message
message
the content of the communication
channels
means of conveying and receiving messages through visual, auditory, and tactile senses
Ex. facial expression=visual
Feedback
the message the receiver returns
ex. indicates the receiver understood meaning
Interpersonal variables
factors within both the sender and receiver that influence communication
-another word is perception
Environment
the setting for the sender-receiver interaction
Ex. provide privacy, and remove noise
Verbal communication
uses spoken or written words
Vocabulary in verbal communication
limit use of medical jargon to conversations with other health care team members improves communication
Denotative and Connotative Meaning
denotative: words with several meanings
connotative: the shade or interpretation of the meaning of a word influenced by thoughts, feelings, or ideas
Pacing in communication
speak slowly and clearly
Intonation in communication
tone of voice
Clarity and Brevity communication
simple, brief, and direct
timing and relevance
best when a patient expresses an interest in communication
nonverbal communication
includes the 5 senses and everything that does not involve the spoken or written word
personal appearance
physical characteristics, facial expression, and manner of dress/grooming
posture and gait
way of walking - forms of self expression
Reflects attitudes, emotions, self-concept, and health status
facial expression
most expressive
convey emotions
eye contact
maintaining eye contact shows respect and willingness to listen
gestures
emphasizes, punctuate, and clarify the spoken word
sounds
sighs, moans, groans, or sobs also communicate feelings/thoughts
territoriality and personal space
need to gain, maintain, and defend one’s right to space
-sense of identity
symbolic communication
the verbal and nonverbal symbolism used by others to convey meaning
meta-communication
broad term that refers to all factors that influence communication
Phases of the helping relationship
- Preinteraction phase: before meeting patient
- orientation: when nurse and patient meet and get to know one another (1st interaction)
- Working: work together to solve problems and meet goals
- Termination: during end of relationship
zones of personal space and touch
- Intimate zone: 0-18 inches
- Personal zone: 18inches-4feet
- Social Zone: 4-12ft
- Public Zone: 12 feet and greater
- Zones of touch Social Zone: hands, arms, shoulders, back
- Consent Zone of touch: Mouth, wrists, feet
- Vulnerable Zone of touch: face, neck, front of body
- Intimate Zone of touch: genitalia, rectum
Elements of professional communication
courtesy, use of names, trustworthiness, autonomy and responsibility, assertiveness
Autonomy
being self-directed and independent in accomplishing goals and advocating for others
Assertiveness
allows you to express feelings and ideas without judging or hurting others
Assessment
- through the patient’s eyes: values, preferences, backgrounds
- Physical and Emotional factors: psycho-physiological factors influence communication
- Developmental factors: patient’s growth
- Sociocultural factors: culture= thinking, feeling, behaving, communicating
- Gender: influence how we think, act, feel communicate (men= less verbal)
Nursing Diagnosis: causes of communication disorder
impaired verbal communication: anxiety social isolation ineffective coping compromised family coping powerlessness impaired social interaction
Planning Diagnosis of communication disorder
- Goals and Outcomes: patient initiates conversation about health care problem, able to attend appropriate stimuli, etc
- Setting Priorities: maintain open-line communication
- Teamwork: ensure effective plan, collaborate with other staff members
Therapeutic communication
techniques are specific responses that encourage the expression of feelings and ideas and convey acceptance and respect
active listening
being attentive to what a patient is saying both verbally and non-verbally
non verbal skills in attentive listening: SOLER
S= Sit facing the patient O= observe an open posture L= Lean toward the patient E= Establish eye contact R= Relax
Therapeutic communication techniques :
active listening, sharing observations, sharing empathy, hope, humor, feelings, using touch, using silence, providing info, clarifying, focusing, paraphrasing, asking relevant questions, summarizing, self-disclosure, confrontation
empathy
ability to understand and accept another person’s reality, accurately perceive feelings, and communicate this understanding to the other
non-therapeutic communication techniques:
asking personal questions, giving personal opinions, changing the subject, automatic responses, false reassurance, sympathy, asking for explanations, approval or disapproval, defensive responses, passive or aggressive responses, arguing
sympathy:
concern, sorrow, or pity felt for a patient (more emotional)
Communication techniques for the patient with special needs
environmental considerations, cultural understandings, picture boards
Evaluation:
effectiveness of own communication:
through patient’s eyes
patient outcomes
Communication and Interpersonal Relationships:
-Developing communication skills requires an understanding both of the communication process and of
one’s own communication experience.
-The ability to relate to others is important for interpersonal communication.
-Communication is the means to establish helping-trust relationships.
Developing Communication Skills: you need to have
- critical thinking (best)
- perseverance and creativity (identifying innovative solution)
- self-confidence
- fairness and integrity (listen to both sides)
- humility (you don’t have to know everything)
Thinking is influenced by
perception: five senses, culture, education
perceptual bias
You are invited to attend the weekly unit patient care conference. The staff discusses patient care issues. This type of communication is:
Small Group
Forms of communication- Verbal aspects
- Vocabulary: denotative, connotative
- Intonation: clarity and brevity
- Pacing: timing and relevance
Professional Nursing Relationships:
nurse-patient relationships
nurse-family
nurse-health team
nurse-community
Helping relationships serve as the foundation of clinical nursing practice. Contracts for a therapeutic helping relationship are formed during the
orientation phase
types of communication
therapeutic, non-therapeutic, and adapting communication
Adapting Communication Techniques go towards:
Patients who cannot speak clearly- marker board
Cognitive impairment
Hearing impairment- picture boards
Visual impairment-
Unresponsive- use touch
Patients who do not speak English (or your language) -body language
While admitting a patient, during the initial interview, a family member tells you, “My mom really means that she does not understand her medical diagnosis.” The communication form used by the family member is
Clarifying
