communication Flashcards
Preinteraction phase
Organize data
Identify areas of concern
Plan the orientation
Orientation phase
Acknowledge
Introduce
Duration
Explanation
Thank you
AIDET
Working phase
Develop and implement plan of care
Communicate and collaborate
Emotional-facilitate clients’ awareness of their thoughts and feelings
Mutually develope goals
Termination phase
Let them know the relationship is coming to an end evaluate
transition to another HCP.
Positive self-talk
Interpersonal
Motivation and encouragement for self-esteem and self-confidence.
Persevere
make tolerable
overcome anxiety and discomfort.
Negative self talk
Interpersonal
Harmful and destructive
Increases the perception of pain and anxiety
Meditation
Mindful reflection or contemplation.
Encourages reassurance and self-encouragement
Interpersonal communication
Two or more people
May be formal or informal.
Must be effective for PATIENT SAFETY
If ineffective leads to sentinel events or adverse events.
Small group communication
What makes small groups effective
Small number of people
* Goal oriented and must understand group dynamics.
* workable size and have an appropriate meeting
* place.
* suitable seating arrangements, and cohesiveness and commitment among group members.
* Group participants need to feel accepted, feel able to communicate openly and honestly
* and actively listen to others in the group.
Public communication
AUDIENCE
Patient and community education.
Education, preparation, openness to diverse opinions, and communication skills that encourage acceptance and dialogue.
Elements of verbal communication
Spoken
Electronic
Written
Intonation in verbal communication
Tone of voice affects meaning.
Timing
Pain
privacy
anxiety
Pacing
Speak slowly and enunciate properly
Clarity and brevity
Simple, brief, and direct
Disadvantages of written communication
lacks nuances of voice inflection and interaction
Importance aspect of electronic communication
Maintain confidentiality
Explain non-verbal communication
Wordless
Body language
Voice inflection
Body language
Relaxed
Crossed legs
Assistive devices
Slowly with bowed headEye contact
Posture, stance and gait
Relaxed- openness.
Crossed legs or arms: Lack of openness.
Assistive devices: Ambulation is temporally impaired.
Slowly with bowed head- Exhausted, hopeless
Eye contact- Interest
Facial expressions and eye movements
Inappropriate facial expressions are offensive.
Maintain a neutral facial expression.
Gently touching a blind patient’s arm before providing care
alert the patient to the nurse’s presence
Therapeutic touch
holding the patient’s hand or touching the patient’s shoulder, can provide comfort and may alleviate pain.
Proxemics
Intimate: 0-1-5
Personal: 1.5-4
Social: 4-12
Public: >12
Voice inflection
Emphasis placed by tone, rhythm, volume, and rate.
What is active listening
What is the patient saying verbally or non-verbally?
Aspects of active listening
- S- Sit at eye level with patient, if possible.
- O- Maintain an open stance.
- L- Lean toward the patient, keeping body in open stance
- E- Maintaining eye contact without staring.
- R- Relax
barriers for effective communication.
Timing
Educational levels
Mode of communication used
Physical and emotional factors
Medical jarhons may be foreign
Referent
Examples
Event or though initiating communication.
Sensation, thoughts, concern, pain
Sender
What is encoding
Person who initiates or encodes
(translate thoughts and feelings into communication)
Message
Content transmitted during communication.
Channel
Visual, auditory, kinesthetic
Receiver
Decode
Sending message to
Sort out meaning
Feedback
How do you ensure understanding
Has the message been understood?
Restate
Teach back
Rationale for offering self.
Example
T
Increases self worth, compassion and care
“I’ll stay with you until your family member arrives.”
Calling patient by name
T
Individual
Respect and care
Sharing observations
Example
Verbalize what is observed for client to recognize behavior and validate nurse perceptions
You look tense
Giving information
Facts about a specific situation
Open ended questions
Opportunity to share freely
Focused questions
Specific data
Area of concern
General leads
Encourage them to keep talking
show interest
Convey acceptance
Yes, nodding
Acknowledges the importance of the patient’s thoughts, feelings, and concerns
Use of humor
eg “You are really walking well this morning. I’m going to have to run to catch up!”
- Provides encouragement
- May lighten heavy moments
- Focus on positive progress
Verbalize the implied
Patient: “I can’t talk to anyone about this.”
Nurse: “Do you think others won’t understand?”
Elaborate
Paraphrasing
- Encourages patients to describe situations more fully
- Demonstrates that the nurse is listening
Seeking clarification
Best tool for clarification
Expand on a confusing topic.
Ask for an example
Summarize
- Reduces the interaction to three or four points identified by the nurse as being significant
- Allows the patient to agree or add additional concerns
Validating
“Did I understand you correctly that…?”
Allows clarification of ideas that the nurse may have interpreted differently than intended by the patient
How does acctive listening convey therapeutic communication
- Conveys interest in the patient’s needs, concerns, or problems
- Provides the patient with undivided attention
- Sends a clear message of concern and interest
How does silence convey therapeutic communication
- Provides the patient time to think or reflect
- Communicates concern when there is really nothing adequate to say in difficult or challenging situations
How does therapeutic touch help in communication
- Conveys empathy
- Provides emotional support, encouragement, and personal attention
- Relaxes the patient
Value judgements and opinion
giving one’s own opinion, evaluating, moralizing or implying one’s values by using words such as “nice”, “bad”, “right”, “wrong”, “should” and “ought”.
“You shouldn’t do that, its wrong”.
Incongruence
sending verbal and non-verbal messages that contradict one another.
The nurse tells the patient “I’d like to spend time with you” and then walks away.
False reassurance
Using cliché to reassure client.
“It’s going to be alright”.
Giving advice
telling the client what to do, giving opinions or making decisions for the client, implies client cannot handle his or her own life decisions and that the nurse is accepting responsibility.
“If I were you… Or it would be better if you do it this way…”
Approval /disapproval
You should not do those things.
Defending
Asking for explanations
Sypmathy
Automatic responses
Your doctor is very good
Why did you do that
I am so sorry about….
Stereotypes, cliches, parroting, repeating
Defense mechanisms
Compensation
Denial
Displacemet
Introjection
Projection
- Compensation- Using personal strengths or abilities to overcome feelings of inadequacy.
- Denial- Refusing to admit the reality of a situation or feeling.
- Displacement- Take out our feelings on another person or object.
- Introjection- Taking on certain characteristics of another individual’s personality.
- Projection- Assigning your own unacceptable feelings or qualities to others. You cheat and think they are cheating.
Defense mechanisms
Rationalization
Regression
Repression
Sublimation
Suppression
- Rationalization- Justifying an unacceptable feeling or behavior with logic.
- Regression- Reverting to behaviors consistent with earlier stages of development.
- Repression- Storing painful or hostile feelings in the unconscious, causing them to be temporarily forgotten.
- Sublimation- Rechanneling unacceptable impulses into socially acceptable activities.
- Suppression-Choosing not to think consciously about unpleasant feelings
To improve communication with a person with hearing loss, you can
attract their attention before starting a conversation
face them when you speak
reduce any background noise or try to find a quieter place to have a conversation
speak slowly and clearly
use visual cues and gestures
be patient
ask the person what helps them.
Visually impaired
- Visually impaired or blind patients is that they are rarely hearing impaired.
- Typically, blind patients have heightened auditory and olfactory senses.
- anticipatory, meaning that the nurse should alert visually impaired patients of potential hazards or object locations to provide necessary information and safe care.
- The position of numbers on an analog clock is often used as a reference when communicating the location of food on the plate of a blind patient.
For example, the nurse may inform the visually impaired patient that the meat entrée is in the 6 o’clock position and the coffee cup is at 2 o’clock on the tray. - Large-print, Braille, audio, or e-books may be helpful in communicating effectively with visually impaired or blind patients.
- Gentle physical contact, such as a light touch on the arm, alerts the blind patient that someone is present. This is especially important if the patient has been sleeping, is in a noisy environment, or is hearing impaired.
Respiratory difficulties
Nonverbal cues, such as head nodding or hand squeezing, to communicate their needs. A whiteboard with erasable markers or a computer tablet could be particularly helpful.
Dementia
Consulting with the family members of these patients often provides helpful hints and insights
AVOIDING CONFRONTATION IS IMPORTANT.
Empathy
understand and accept another persons reality, to accurately perceive feelings, and to
communicate this understanding to others.
Clients with aphasia
visual cues (e.g. words, pictures, and objects)
not shout or speak too loudly to
ask simple questions that require yes or no answers
_______________skills make the best communicators.
Critical thinking skills
How can a nurse a nurse to overcome personal biases?
Allow others to express their feelings and emotions
Explain assertiveness
Express ideas while respecting other people’s opinions.
contain I messages, such as I want, I need, I think, or I feel
How do these critical thinking attitudes contributes to an effective nurse-client relationship?
Fairness
Guarded
Curiosity
Creativity
Perseverance
Self-confidence
- Curiosity motivates the nurse to communicate and know more about a person.
- Perseverance and creativity are also attitudes conducive to communication because they motivate the nurse to communicate and identify innovative solutions.
- A self-confident attitude is important because the
- nurse who conveys confidence and comfort while communicating more readily establishes an
- interpersonal, helping-trust relationship.
- Risk-taking rather than a guarded attitude is important because colleagues sometimes question the suggested nursing interventions.
- At the same time, an attitude of fairness goes a long way in the ability to listen to both sides of any discussion.
