Interpersonal Relationships (Midterm 1-4) Flashcards
How are humans alike?
- similar biological characteristics (need oxygen)
- share universal experiences (birth and death)
Need
something that is desirable or necessary for life and well-being
True or false? Some needs are more vital and must be met first.
True
Describe Maslow’s Hierarchy of Basic Human Needs
basic human needs are arranged into five levels of priority, first level is the basic needs and highest level is most sophisticated needs
Name Maslow’s levels on the Hierarchy of Basic Human Needs
1) Physiological/physical needs
2) Safety
3) Love and belonging
4) Self-esteem
5) Self-actualisation
True or false? The order of Maslow’s levels on the Hierarchy of Basic Human needs is not important.
False they are important
True or false? We must satisfy the highest level of Maslow’s levels on the Hierarchy of Basic Human Needs and then move on to the lower ones.
False we must satisfy the lower ones before moving on to the higher ones
Why can some people not meet their own needs?
ill or injured
1) Physical needs
- most basic need
- highest priority
- must be met for life to continue
- death is under this level
Give two examples of needs for physical needs.
- oxygen
- food
- water
- elimination
- rest
- shelter
- temperature
- sex
Give two examples as to how a health care aide can help meet physical needs of clients
- maintaining oxygen mask
- using deodorizer to get rid of unpleasant smells in room during mealtime
2) Safety
- protection from harm, danger and fear
- physical safety involves reducing or removing threats to body or life
- psychological safety involves with knowing what to expect
Give two examples of needs for safety
Psychological safety: -order -familiarity -consistency -trustworthiness -reliability Physical safety: -safe environment -safe workplace -healthy
Give two examples as to how a health care aide can help meet safety needs.
- building trusting relationship
- ensuring environment is safe
- help explain procedures done on client
3) Love and belonging
- humans can’t live in isolation
- developed through interaction
Give two examples of needs for love and belonging
- love
- intimacy
- friendship
- family
Give two examples as to how a health care aide can help meet love and belonging
- warm
- friendly
- courteous
4) Self esteem
- worth, value or opinion a person has of themselves
- need to feel recognized, highly regarded and appreciated by others
- to feel confident and useful
Give two examples of needs for self esteem
- achievement
- confidence
- respect
- recognition
- status
Give two examples as to how a health care aide can help meet love and belonging
- praising
- encouraging
- respect
- approval
5) Self-actualisation
- can only be achieved when all other needs are met
- is rarely met
Give two examples for needs for self-actualisation
- self-fulfillment
- creativity
- originality
- independence
True or false? The ability to communicate effectively is not something everyone is born with, but developed with training and practice.
True
Communication
- a complex, continuous, simultaneous and active process between two or more individuals to send and receive information, thoughts or feelings
- uses five senses
Name three things that are needed for successful communication.
1) sender: the person who is giving the message thinks over the message
2) message: information being shared in a clear and organized manner for the receiver
3) receiver: person who is getting the message interprets the message
Encoding the message
the sender thinks over the message and chooses the correct way of sending it
Decoding the message
receiver interprets the message
True or false? Communication goes back and forth where the sender becomes the receiver and vice-versa.
True
Verbal communication vs non-verbal communication
verbal communication=use of words to communicate
non-verbal communication=body language
True or false? The majority of communication (85-90%) is verbal.
False, The majority of communication (85-90%) is non-verbal.
Give examples of non-verbal communication
1) personal appearance
2) tone of voice
3) facial expression
4) gestures
5) body posture
6) touch
How is personal appearance non-verbal communication?
- first thing noticed by others
- gives clues to our personality, social status, occupation, culture and self-concept
- we form an opinion of others within 20s to 4min
How is our tone of voice non-verbal communication?
- how a message is delivered
- enthusiasm, concern and anger
- affected by a person’s emotions
- change volume and intensity
How is facial expression non-verbal communication?
- sends information to help decode verbal messages
- support or contradict the message
- eye contact=willingness to communicate, honesty and interest
How are gestures non-verbal communication?
-emphasize and clarify a message
How is body posture non-verbal communication?
- reflects attitudes, emotions, self-concept and physical wellness
- leaning forward=shows interest
- leaning back=indifference
- walking straight=confidence
- slumped=depression
How is touch non-verbal communication?
- send messages of affection, support, encouragement and tenderness
- culture affects how much touch can be used, so must be used appropriately
- can easily be misinterpreted
True or false? Words and actions are interconnected in every way.
True
True or false? Non-verbal communication often tells less about what is felt than what is actually said.
False, Non-verbal communication often tells more about what is felt than what is actually said.
What usually happens if the non-verbal message conflicts with the verbal message?
tend to believe the non-verbal message
Do the words and the body language match? Amy rubs the side of her head with her hands and tells you she does not have a headache.
No
Do the words and the body language match? Bettina sits facing the window with her arms and legs crossed and tells you she is happy to see you.
No
Do the words and the body language match? Colleen makes a face when you feed her and says she hates broccoli.
Yes
Do the words and the body language match? Daniel comes to work with dirty shoes and a soiled uniform and says he is proud to be a health care aide/unit clerk.
No
Do the words and the body language match? Evan paces around the room, rubbing his hands together and says he feels OK about going to live in a nursing home.
No
Do the words and the body language match? Faith says she is sensitive to her patient’s feelings and stands near the door when talking with them when they are upset.
No
Do the words and the body language match? Glenda and Hilda say they act professionally at work and talk about their weekend activities and their friends as they work together bathing Mrs. Jalarbal.
No
Name the factors affecting communication.
1) age
2) values
3) perceptions
4) emotions
5) sociocultural background (language)
6) gender
7) knowledge
8) roles and relationships
9) environment
10) personal space
How can the health care aide increase the sense of privacy and personal space of the client?
- when performing personal care
- explaining procedures before
- announcing entry and waiting for permission
- designating space for personal items
- putting familiar items on night stand
- decreasing eye contact
Therapeutic communication
establishment of a helping relationship between a patient and a health care provider, not the same as social interaction
Name the two therapeutic communication techniques.
active listening and physical attending
Active listening
- being a good listener (receiving messages)
- not delivering routine comments
- requires to not just hear the words but the feelings and circumstances associated with it
How can you be a good listener?
- not interrupting the person speaking
- not planning what you will say next
- nodding and smiling
- not having a poker face
- no judging
- maintaining good eye contact
- giving your full attention
- not finishing the sentence of the person who is having trouble finding the right word
True or false. It is possible to stay attentive 100% of the time.
False.
Physical attending
-manner of being present or being with another person
How can you show physical attending?
- facing the other person squarely
- adopting an open posture
- leaning slightly toward the other person
- maintaining good eye contact
- trying to be relaxed
- nodding your head, raising eyebrows, smiling
Name important communication skills
- courteous
- patient and understanding
- tactful
- empathetic
- nonjudgemental
- respectful
How can you encourage a conversation?
- broad opening statements
- general leads
- reflexion
How can you help people to express their thoughts and feelings?
- share observations
- acknowledge feelings
- selective reflection
- silence
How can you help to ensure mutual understanding?
- clarify
- verbalizing implied thoughts and feelings
- validating
Give a therapeutic response. I hate feeling depressed like this.
Depressed? (reflexion)
Give a therapeutic response. Why do I have to walk all the way to the nurse’s station with you?”
Are you worrying you may not be able to walk that far? (clarifying)
Give a therapeutic response. Nobody pays any attention to me. I am always here alone.
You’re feeling alone. (selective reflexion)
Give a therapeutic response. I am so disappointed. I thought I would be going back to my own home.
Tell me more. (Broad statement)
Give a therapeutic response. I hate this place. I miss my family.
Go on… (general lead)
What are non-therapeutic responses?
- giving advice
- being judgmental
- using clichés
- questioning a decision or requesting an explanation
- disagreeing
- defending coworkers when patients make a complaint
- changing the subject
- interrupting
Therapeutic or non-therapeutic? Good morning! Isn’t it a lovely morning?
NT-cliché
Therapeutic or non-therapeutic? You did the right thing Mr Thoms.
NT-judgmental
Therapeutic or non-therapeutic? I’m not sure what you mean. Is it that…?
T-clarifying
Therapeutic or non-therapeutic? You are trembling.
T-shared observation
Therapeutic or non-therapeutic? But why did you do it?
NT-questioning a decision
Therapeutic or non-therapeutic? silence
T-maintaining silence
Therapeutic or non-therapeutic? You couldn’t have a better doctor.
NT-defending a coworker
Therapeutic or non-therapeutic? You must be right.
NT-judgmental
Therapeutic or non-therapeutic? Um hmmm yes.
T-general lead
Therapeutic or non-therapeutic? You say your husband ignores you.
T-reflexion
Name the guidelines and rules of etiquette while using the telephone.
- answer promptly within first 3 rings
- identify yourself stating your location, name, status using pleasant tone
- How may I help you?
- speak directly into phone
- do not carry out other tasks during call, put on hold
- be courteous
- locate someone who can answer question if you cannot, or take message
- do not use for personal calls
- can’t take doctors orders
What should be included when writing down a written message from someone else?
- who the message is for
- date and time of call
- name of caller
- telephone number where the caller can be reached
- purpose or message of call
- your name and status
How do people communicate in the hospital?
- telephone
- paging systems
- intercoms
- computers (emails)
- fax
- pneumatic tube systems (older)
Dementia
- condition where brain functions are gradually lost
- forgetful (first symptom)
- affect ability to use words, solve problems, make decisions, carry out activities, recognize things
- feel lost and confused
- cause=Alzheimer’s disease and stroke
- affects communication (worsens as dementia progresses)
Receptive Aphasia
Dementia affects both the individual’s to understand and interpret what others are saying
Expressive Aphasia
Dementia affects their ability to express themselves
Identify the communication guidelines when helping someone cognitively impaired.
- approach from side, gain attention
- address by name, use your name
- use soft voice, short and simple sentences, yes or no questions
- speak at normal rate
- don’t yell
- limit distractions and noise
- be sensitive
- do not overwhelm
- do not put on the spot
- be patient
- encourage skills
- try different communication techniques
- let it go and try again later
- treat them with affection, dignity and respect
How do some people with dementia express their needs?
with challenging behaviours
Identify methods to trying to understand the challenging behaviour of a client?
- look for clues
- do not startle
- establish eye contact
- be aware of own body language
- speak with positive terms
- do not rush the person
- be flexible
- do not persist
- reduce background noise
- do not overload with complex instructions
- keep voice calm and supportive
- avoid lengthy explanations or arguments
- respond to person’s feelings
Guiding principle
responsibility of health care system to:
- seek out and actively hear patient’s voice
- all are important
- not all have ability to self-advocate
- ensure all patient communication needs are met
- open communication
- every patient will have different communication needs
- approaches customized for each individual
Name the guidelines
- individualized
- consistent
- simple language
- quality information
- caring
- active, interactive and proactive
- ongoing
- appropriate setting and context
- inclusive of patients, families and clients
- culturally competent and responsive
When communicating with patients, health care aide workers should:
- listen and act on information provided
- understand and communicate big picture
- ensure they can ask questions
- make an effort
- patient not a conduit of information
- active communication cycle
- two-way conversation
Sensory impairments
-loss of hearing and vision
How can you communicate with a patient who is hearing impaired?
- face the person as you speak
- speak close to good side
- speak slowly in normal tone
- use short sentences
- use facial expressions and gestures
- use written messages
- ensure hearing devices are working, assist clients
- choose proper environment
- do not chew gum or eat while speaking
What should you consider when with a visually impaired patient?
- facial expression of sender
- body language of sender
- tone of voice of sender
- sense of touch
- sense of smell
How can you communicate with a patient who is visually impaired?
- let them know you’re approaching
- ensure glasses are cleaned
- allow patient to take your arm when walking
- explain placement of furniture and exits of room
- explain placement of food
True or false? Always assume that unconscious patients can hear, so explain step by step.
True
How can you communicate with an unconscious patient?
- always assume they can hear
- explain what you’re doing step by step
- tell the patient when you’re done and when you’re leaving the room
Observation
-the act of watching carefully and attentively, then recognizing what information is significant
-uses all five senses
-continuous process done throughout all of the patient’s care
“the active process of using the senses to obtain information about the client’s current condition”
How should you collect data on your patients?
- systematic
- starting at the head and working down to the toes
Name the two kinds of observations.
1) objective
2) subjective
Objective observations
- factual or measurable
- involve what you see, hear, touch or smell
- unbiased and free of judgment
Subjective observations
- what the patient tells you about how they are feeling
- cannot be seen, heard, smelled or touched other than the person experiencing it
- when reporting, use the same words as the patient described
Give examples of subjective observations
- headache
- nausea
- dizziness
- pain
- sadness
Objective or subjective? The resident’s housecoat is blue.
O
Objective or subjective? The resident’s housecoat is pretty.
S
Objective or subjective? The patient said the oxygen helped her feel better.
S
Objective or subjective? The patient weighs 40 pounds.
O
Objective or subjective? The patient is unable to recall what year it is.
S
Objective or subjective? The patient wanders down the hall and can’t find his way back to his room at least twice a day.
O
Objective or subjective? The patient stated that he did not want to take a bath.
O
Objective or subjective? The patient will not agree to having a bath.
S
Objective or subjective? The patient has an area on her heel that is hard, red and the size of a quarter.
O
Objective or subjective? The resident is clenching his teeth together and breathing very differently than he was at breakfast.
O
Normal vs to be reported observations: Level of consciousness
- alert and oriented
- confused, restlessness, drowsy, less response
Normal vs to be reported observations: breathing and chest
- regular rate (12 to 18 breaths per minute), effortless breathing, no cough, no pain
- irregular breathing, nasal flaring, rapid or slow breathing, gasping, cough, chest pain
Normal vs to be reported observations: mobility and activity
- good balance, symmetrical extremities
- limping, swelling, twitching, unsteady, redness, pain
Normal vs to be reported observations: skin
- color is good, clean, moist, intact
- pale, swelled, dryness, shivering
Normal vs to be reported observations: eyes
- clear, no itchiness, no discharge, vision clear
- itchiness, redness, discharge, difficulty with vision
Normal vs to be reported observations: mouth
- normal colour, moist, intact
- dry, irritated, redness, cracks, sores
Normal vs to be reported observations: urine elimination
- voiding 6-8 times per day, voiding 250-450mL per voiding, straw coloured, slightly aromatic colour
- incontinence, difficulty voiding, dark amber urine, pain, blood in urine
Normal vs to be reported observations: bowel elimination
- brown coloured, bowel mouvement (1-3 days), moderate amount
- clay coloured, black, bloody, liquid stool
Normal vs to be reported observations: nutrition and abdomen
- appropriate weight and height, energetic, alert, good apetite, no difficulty chewing or swallowing
- increase/decrease in weight, nausea, vomiting, difficulty chewing or swallowing
Normal vs to be reported observations: emotional state and mood
- calm, pleasant, happy, relaxed, interested in activities
- agitated, angry, aggressive, crying, sad, anxious
What is the quickest way to give a report on a patient?
oral report
When should you report to your nurse?
- at the beginning and end of shift
- before taking coffee and meal breaks
- when leaving and returning to the unit for other reasons
- when you note an unusual or emergent occurrence
What qualities should a report have?
- prompt
- thorough
- accurate
How can you better remember the observations you make to then put in your report?
take a notepad with you
What should be reported?
- changes in patient’s physical or mental condition
- anything out of the ordinary
- name, time and room number of patient
- only things you observe or did yourself
- observations reported by the patient’s family
- what you saw, felt, heard, smelled and what patient said subjective and objective observations
What should be reported immediately?
- severe pain
- twitching, shaking, seizures
- decreasing level/loss of consciousness
- weakness in extremities
- no movement
- signs of shock
- bleeding
- difficulty breathing and swallowing
- cyanosis of the skin
- chest pain
- fall or accident
- injuries
- sudden change in patient’s condition
Constant Care Guidelines
caring for individuals who exhibit behaviour that can potentially harm themselves or others:
- monitoring the patient on a constant one on one basis at all times
- reporting any changes in the patient’s condition at any time
- reporting off and reviewing care with the nurse at the completion of the shift
