Communication strategies I: understanding Flashcards
What is understanding?
viewing someone’s world from their perspective
What is internal and external understanding?
internal understanding: subjective (what the person tells you)
External understanding: objective (you taking into account every piece of data)
What are the 5 ways of responding to express understanding?
ADVISING AND EVALUATING
ANALYZING AND INTERPRETING
REASSURING AND SUPPORTING
QUESTIONING AND PROBING
PARAPHRASING AND UNDERSTANDING
what is advising and evaluating?
offering a solution, opinion or advice
What are the potential problems with advising and evaluation.
- conveys superiority or “nurse knows best”
- advice may not be accurate for the patient
- potential for blaming if advice doesn’t work
What should you ask yourself before you give advice and evaluation?
are you CONFIDENT the advice is ACCURATE?
is this person WILLING to accept the advice
what WILL HAPPEN if the advice does not work
What is analyzing and interpreting?
it is reading into a patient’s message to convey that the nurse knows what the patient feels or thinks
What are the potential problems with analyzing and interpreting?
interpretation may not be correct
may limit further exploration of issues
conveys superiority or “nurse knows best”
What should you ask yourself before doing analyzing and interpreting?
What has the patient directly expressed?
even if you are correct, how will sharing this help?
What is reassuring and supporting?
statements that attempt to remove a patient’s doubt or fears.
What are the potential problems of reassuring and supporting?
May offer false reassurance
May deny people the right to their feeling or minimize the significance of the situation
What should you ask yourself before doing reassuring and supporting?
Is the reassurance realistic?
How will this help? Who will this help (can’t be to reassure you, needs to be for the patient)
What is questioning and probing?
it is gathering more information and exploring a situation
What are the potential problems of questioning and probing?
Can be distracting
Can turn a conversation into an interrogation
What should you ask yourself before doing questioning and probing?
Do you need more information to understand?
Why am I asking this question (can not be out of curiosity)
Will it help the patient be more precise?
What is paraphrasing and understanding?
rephrasing a patient’s expressions into the nurse’s own words to convey understanding and seek clarification
What are the potential problems of paraphrasing and understanding?
can shift focus of the conversation to the nurse?
What should you ask yourself before you do paraphrasing and understanding?
Do I want to demonstrate that I have been listening?
Do I need to check for accuracy in order to understand?
Is this the right time to demonstrate I have been listening in this manner or would something like a head nod be more appropriate?
What are the 4 therapeutic responses?
PARAPHRASING
SEEKING CLARIFICATION
REFLECTING FEELINGS
THERAPEUTIC TOUCH
Explain the therapeutic response of paraphrasing.
it is restating a patients primary words/thoughts
- allows nurse to communicate understanding
- acknowledges what has been said
- demonstrates listening
- very effective early in relationship because it builds trust
- allows ACCURACY, patient can correct
Why is the therapeutic response of paraphrasing more effective early in the relationship than later?
because early it helps to demonstrate respect and build trust/rapport
later on, trust and rapport have been established and paraphrasing becomes less important
Explain the therapeutic response of seeking clarification.
It is expressed as a question to the patient to allow a better understanding and accuracy:
- do you mean that?
- are you saying that….?
- could you try to describe that?
- I am not sure I understand…
Useful if message is unclear or not understood
Nurse takes responsibility for understanding
Explain the therapeutic response of reflecting feelings.
It is mirroring the feelings expressed by the patient.
- conveys recognition of the feelings
- confirms the existence of emotions
- identifies destructive/constructive emotions
What are the 4 steps to reflecting feelings?
- listen to the patient and identify the feeling
- read the patient’s non-verbal behavior
- rephrase this feeling using different words
- use personal pronouns
Explain the therapeutic response of therapeutic touch.
It is a powerful listening response that allows for human connection in communication. (often first experience of communication; handshake)
used when words may fail to convey depth.
What are the cautions of using therapeutic touch?
- be culturally sensitive
- consider duration/intensity/body part touched
- assess patient’s receptiveness
- contraindicated in certain situations
What are some tips to communicating with older adults that are hearing impaired?
- determine better ear, speak to that side
- adjust hearing aids
- speak in a normal voice
- address by name
- lower pitch if voice is high
- face person so facial expression is visible
- keep background noise to a minimum
- obtain feedback to monitor understanding
What are some tips to communicating with older adults that are vision impaired?
- ensure eyeglasses are clean and in place
- identify self by name when entering room
- stand in front and use hand movements
- verbally express information
- use appropriate lighting
- remove any hazards and lighting glares
- use words to describe landmarks
