Comprehensive Flashcards
1
Q
The simplest model of communication reflects the work of?
A
Shannon and Weaver
2
Q
What does the shannon and Weaver model of communication consist of? 5 thing SMCNR
A
-Sender -Message -Channel -Noise -Receiver
3
Q
What is missing from the shannon weaver model of communication?
A
Context
4
Q
What is missing from the david berlo model o communication
A
Feedback
5
Q
What is the hawthorne effect?
A
States that words are not always needed to communicate. -we can communicate through actions and body language
6
Q
What is verbal communication
A
An exchange of information using words -Written or spoken
7
Q
What is a response
A
Feedback to the sender on how well the message was understood
8
Q
What is evaluation?
A
Reciever sorts facts from opinion, including logical and emotions components
9
Q
What is interpreting
A
to place a message in meaningful context
10
Q
What is sensing?
A
Hearing, seeing, and receiving verbal and non-verbal aspects of the message
11
Q
Who is credited with the origional model of communication
A
David Berlow
12
Q
What are the 5 major effects of effective communication with the patient?
A
- Builds trust 2. Increases compliance 3. Relieves Stress 4. Reduces recovery time 5. Improves patient satisfaction
13
Q
__% for Med error and __% of hospital deaths are from poor communication
A
55 65
14
Q
What goals need to be met to develop self-awareness?
A
-Distinguish own emotional needs vs patient needs -Meet the needs of personal emotions outside of the nurse-patient relationship
15
Q
Why is being self aware of nonverbal communication important.
A
Because patients WILL notice your nonverbal communications
16
Q
How can self reflection help you build self awareness?
A
It allows you to identify your behaviors and attitude and gives you the chance to adjust these attitudes
17
Q
How can deliberate thought help develop self awareness?
A
It allows you to make peace with your mistakes
18
Q
What are the four main factors in Self-awareness?
A
-Professional boundaries -Reflective practice -Avoiding stereotypes -Becoming nonjudgmental
19
Q
When do most boundary violations occur?
A
When there is confusing between the needs of the nurse and the needs of the patient
20
Q
Explain the Continuum of professional Behavior
A
It is a continuum that shows that therapeutic relationships are not set and defined. They occur over a range that depend on the stiuation
21
Q
What is the left side of the Continuum of professional Behavior?
A
Under involvement
22
Q
What are some things included under under involvement?
A
-Patient abandonment -Disinterest -Neglect
23
Q
What is on the right side of the Continuum of professional Behavior
A
Over involvment
24
Q
What are some things considered over involvement?
A
-Boundary crossing -Boundary violation -Professional sexual misconduct
25
Are boundary crossings a sudden thing?
Most of the time no. Crossing a boundary is something that is built up to.
26
How do you document a boundary crossing incident?
-Keep comments restrictive and specific -Document what lead to conclusions not the conclusions themselves -Be discriptive in notes
27
What are some questions you need to ask during self reflections of a boundary crossing event?
-What was the intent -Was it for therapeutic purpose -Patients best interest -Did it optimize or detract from care -Was it appropriately documented
28
What is reflective practice?
When you take time to focus on own thought and feelings and understand how these can affect behaviors toward patients
29
What are some steps to take to become less judgmental?
-Avoid stereotypes, prejudices, and bias -Acknowledge all patients rights to be who they want to be -Convey acceptance to patients
30
What is communication?
The exchange of thoughts, ideas, or information.
31
What are the two types of communication?
Verbal and non-verbal
32
What does verbal communication consist of?
All speech oral and written
33
What does non-verbal communication consist of?
All non-speech -Grooming -Clothing -Gestures -Posture -Facial expressions -Eye contact
34
What are some non-verbal communications to avoid during therapeutic communication
-Excessive or insufficient eye contact -Distraction and distance -Standing when the patient is sitting/laying down
35
What is congruent communication?
Verbal and nonverbal communication that are consistent and reinforce each other
36
What is incongruent communication?
speech and nonspeech that do not match
37
What are four ways to become a better communicator?
-Listen -Be empathetic -Ask open-ended questions -Give information
38
What are the two main factors that promote effective communication?
-Rapport builders -Dispositional Traits
39
What are Dispositional Traits?
Traits that make you who you are
40
Give examples of desirable dispositional traits
-Being warm and friendly -Being open and respectful -Being honest -Being empathetic -Be caring -Be competent -Be genuine
41
What is a rapport builders?
Things that build rapport with the client
42
What are some examples of Rapport builders?
-Ensuring the patient feels cared for -Maintaining open communication -Providing privacy -Ensuring confidentiality -Give personal space -Ensuring the patient is aware of the next steps
43
What are the three role types that a group member can take on?
-Task oriented -Group building or maintenance -Self-serving
44
What occurs during the forming phase of group development
The group comes together for the first time
45
What occurs during the Storming phase of group development
Roles are established
46
What occurs during the Norming phase of group development
A plan is made and agreed upon
47
What occurs during the Performing phase of group development
The work is done and completed
48
What occurs during the Adjourning phase of group development
The group disbands and debrief's
49
What are the three phases of therapeutic conversation
-Orientation -Working -Termination
50
What is the main focus of the orientation phase?
Relationship/trust building
51
What are the two best ways to build trust with a patient?
-Answer questions fully -Listen to client
52
Why is patient trust important?
If the patient trusts you they will continue to answer your questions
53
What are some aspects of the orientation phase?
-Trust and relationship are built -Agreement to work together is made -Concerns are identified -Establish Goals
54
What is the working phase?
-the phase when you are working towards the goals established in orientation phase. -Be self-aware -continue to build trust
55
When does the termination phase begin?
In the orientation phase
56
What is done during the termination phase
-Evaluate goals -Share feelings about relationship -discuss followup plans
57
What is the Attending skill in the orientation phase
Conveying to the client by giving them your total physical and mental attention that you are a person who cares about what concerns him or her
58
What is the empathy(primary) skill in the orientation phase
Responding to the client in a way which demonstrates that you understand the world from his or her perspective
59
What is the respect skill in the orientation phase
Communicating the valuing of the clients unique feelings and experiences
60
What is the genuineness skill in the orientation phase
Your caring and helping must come from your honest, open humanity
61
What is the concreteness skill in the orientation phase
Helping the client to identify feelings and behaviors very specifically
62
What is the Empathy (advanced) skill in the working phase
The nurse adds perspective to what the client says by including what may be implied or said non-verbally
63
What is the Self-disclosure skill in the working phase
The nurse share own experience IF and ONLY IF it will help the client to understand their experience
64
What is the Immediacy skill in the working phase
The urse shares own reaction to the nurse-client relationship
65
What is the Confrontation skill in the working phase
The nurse points out discrepancies, distortions, and misinformation in the clients life With the goal of promoting understanding
66
What is the "offer alternative frames of reference" skill in the working phase
Give new perspectives and opinions \* DONT FIVE ADVICE\*
67
Before the nurse used self-disclosure, _____ must be established
Trust
68
What is an open ended question?
A question that allows for the patient to explain or give information freely.
69
What is the most controversial term for open ended questions \*Explain\*
"WHY" It will sound like an accusation and will put the client on the defensive
70
What is a closed ended question.
A yes or no type question
71
What is an important consideration in regard to asking alot of closed ended questions?
To 'Break up the laundry list" meaning find ways to space the questions out so you do not sound like an impersonal robot
72
What is rephrasing?
Changing the way you communicate a question or statement to allow for better understanding
73
What are three types of verbal communication to avoid?
-Biases or leading questions -Rushing through the interview -Reading the questions
74
What are some considerations to take when using therapeutic communication on a geri
speak slower and louder
75
A helping relationship is characterized by \_\_\_\_\_
an unequal sharing of information
76
Helping relationships are built on \_\_\_\_\_
the patients needs
77
Who is accountable for the outcomes of a helping relationship?
the person providing assistance
78
What two adaptation forms maintain physiologic homeostasis?
-Local Adaptation system -General Adaptation syndrome
79
What is the Local Adaptation System (LAS) What are its two main parts?
-Localized adaptations in response to physical stressors. --Reflex pain response --Inflammatory response
80
What is the General Adaptation Syndrome? (GAS) Who is attributed with it?
The biochemical model of stress. How the mody adapts to stress that cant be controlled locally Hans Selye
81
What are the three stages of General Adaptation Syndrome
-Alarm reaction -Stage of resistance -Stage of exhaustion
82
What occurs during the Alarm reaction stage of GAS
-Stressor is perceived and defense mechanisms are activated -Fight or flight -Hormone levels rise -Shock and counter shock
83
What occurs during the Stage of resistance?
-Body attempts to adapt -Systems and vitals return to normal -Balance is achieved or Adaptation fails
84
What occurs if Adaptation fails during the stage of resistance?
Then the stage of Exhaustion occurs
85
What occurs during the stage of exhaustion?
The body enters rest and mobilizes defenses or it dies
86
What are the three major needs of psychological homeostasis?
-Love and belonging -Safety and Security -Self-esteem
87
What are the three main emotion responses to stress?
- Mind-Body interaction - Coping/defense mechanisms -Anxiety
88
What is the most common emotional reaction to stress?
Anxiety
89
What are the 4 levels of anxiety?
-Mild -Moderate -Severe -Panic
90
What happens to vitals during mild anxiety?
nothing
91
What happens to vitals during moderate anxiety?
They begin to slightly increase
92
What happens to vitals during severe anxiety?
-Tachycardia -Hyperventilation
93
What happens to vitals during panic anxiety?
-Palpitations -Choking -Chest pain -Tachycardia -Hyperventilation
94
What happens to Perception and Attention during mild anxiety?
-Increased arousal and focus
95
What happens to Perception and Attention during moderate anxiety?
Narrowed focus
96
What happens to Perception and Attention during severe anxiety?
Inability to focus
97
What happens to Perception and Attention during panic anxiety?
Distorted perception
98
What happens to communication during mild anxiety?
Increased questioning
99
What happens to communication during moderate anxiety?
-Voice tremors -Focuses on particular objects
100
What happens to communication during severe anxiety?
-Difficulty understanding -easily distracted
101
What happens to communication during panic anxiety?
-Trembling -Unpredictable responses
102
What are some examples of behaviors associated with coping mechanisms?
-Crying -Laughing -Sleeping -Cursing -Smoking/drinking -exercise -Lack of eye contact -limiting relationships
103
What are the three Task-oriented reactions to stress?
-Attack Behavior -Withdraw Behavior -Compromise Behavior
104
What are some Defense Mechanisms?
-Denial -Displacement -Introjection -Projection -Rationalization -Reaction formation -Regression -Repression -Sublimation -Undoing
105
What adapting to an illness, What are some general tasks?
-Maintaining self-esteem -Maintaining personal relationships
106
What adapting to an illness, What are some illness related tasks?
-Handling pain -Handling Disability
107
What are some family stressors?
-Change in roles and structure -Loss of control over normal routine -Financial Stability
108
What are the three main factors that affect stress and adaptation
-The source of the stress -The type of stressors -Personal Factors
109
What are the two main categories of stress?
-Developmental -Situational
110
What is developmental stress?
-Predictable stressors that come with normal tasks of development -example: Learning to trust as an infant and learning to control body eliminations as a toddler
111
What is situational stress?
Stress that does not occur in predictable patterns and comes from a multitude of stressor types
112
What are some ADL's that help relieve stress?
-Exercise -Rest/sleep -Nutrition -Support systems -Stress management techniques
113
What are some common Stress management techniques?
-Relaxation -Meditation -Anticipatory Guidance -Guided imagery -Biofeedback -Crisis intervention
114
What is Crisis intervention?
A plan that allows you to: -Identify the problem -List alternatives -Choose from the alternatives -Implement plan -Evaluate the outcome
115
Why is it important for nurses to remain civil?
-Because nurses don't always help each other in the way that they help patients -Incivility is extremely volatile -incivility increased the chance of bullying
116
what is lateral violence?
-Nurse to nurse aggression -When a nurse overtly or covertly directs satisfactions towards another nurse
117
What is incivility?
When rude behaviors are allowed to occur
118
What type of behaviors does incivility perpetuate?
discourteous
119
What type of environment does incivility create?
one that does not promote the individuals potential
120
Incivility arises from......
The social interactions allowed by leadership
121
What does lateral violence/incivility look like
-Gossiping -Lack of openness -Face-making
122
What are the three A's of civility?
-Acknowledgment -Authentic Conversations -Action
123
How does incivility make someone feel?
-Lone -Sad -Scared
124
What are the three main variables that can lead to incivility?
-Leadership -Culture -Inexperience
125
How does leadership effect bullying?
Extreme and weak styles of leadership promote higher rates of bullying
126
What is the outcome of incivility that is allowed to continue?
Bullying
127
What happens to the nursing profession if bullying is allowed to continue?
-Decreased job satisfaction -Decreased quality of patient care -Decreased physical and mental health of the RN -Increased turnover rates -Harm to the reputation of the profession
128
Group ____ is a strong predictor of nurse retention and work satisfaction
Cohesion
129
Nurses who experience occupational burnout are more likely to \_\_\_\_\_
Abuse other nurses
130
What are the four categories of incivility intervention? WCEE
-Workplace relationships -Communication -Empowerment -Environment
131
What accronym is used for negative workplace relationship intervention? What does it stand for?
CREW Civility Respect & Engagement in the Workplace
132
What are some aspects of CREW intervention?
-Use direct conversations -New ways of interacting -Move away from established patterns -focus on employee ownership -Be active not Passive
133
What intervention should be used for negative workplace communication?
-Use cognitive skills vs. reactive approach -Interrupt negative communication before more negativity is created
134
What is the cognitive rehearsal technique (CRT)
-Create a "mental plan" in response to an uncivil situation so you can react in a positive way instead of reacting blindly and possibly
135
What percentage of new grad nurses experience burnout due to a dis-empowering work environment?
66%
136
What intervention should be used for disempowerment?
Use the Structural empowerment model
137
What are some aspects of the structural empowerment model?
-Accomplish your work in meaningful ways -Communicate and share your goals -Support and recognize autonomy -identify your opportunities and ways to advance
138
What intervention should be used for a negative work environment?
Positive Behavior Support (PBS)
139
What are some aspects of positive behavior support?
-Create and preserve a safe environment -use different behaviors while communicating -interact in ways that are positive instead of negative
140
Who originated the term "therapeutic use of self"?
Hildegard Peplau
141
What is the grounding for therapeutic use of self?
The traditional nures-patient relationship
142
What are the three phases of the traditional nurse-patient relationship?
-orientation:introductory phase -Working:address tasks -Termination:Therapeutic end to relationship
143
Positive feelings during the termination phase are often about \_\_\_\_\_
the gains made
144
What does the older model of nurse-patient relationship assume?
that the relationship is linear, incremental, trusting, and cooperative
145
What is considered the more relevant model of the nurse patient relationship?
Patient-Centered Care (PCC)
146
What three things does PCC depend on? ACT
-Alleviating patient vulnerabilities -Therapeutic engagement -Communication as the primary instrument
147
What are the for main criteria for successful communication? AEFF
-Feedback -Appropriateness -Efficiency -Flexibility
148
What is feedback?
When a receiver relays to a sender the effect of the senders message
149
What is Appropriateness as a criteria for successful communication?
When a reply fits the circumstances and matches the message
150
What is efficiency as a criteria for successful communication?
When the speaker uses simple, clear words that are timed at a pace suitable to participants
151
What is flexibility as a criteria for successful communication
When the speaker bases messages on the immediate situation rather than preconceived expectations
152
What three things can be done to become a better communicator?
-Listen well -Convey Empathy -Ask open-ended questions
