Lecture 3 Flashcards
Communication
exchange of thoughts, ideas, or information
dynamic process that is a primary instrument through which change occurs in nursing situations
can be good or bad
all communication influences behavior
Intrapersonal
occurs within a person
inner thoughts, feelings, self concept
interpersonal
one to one interaction
usually occurs face to face
transpersonal
occurs within a person spiritual domain
prayer, meditation
small group
interaction between two or more persons meeting together
public
interaction with an audience
Why do we need to communicate?
patient advocacy, patient safety, optimal patient care, meet clinical standards of care, build and maintain relationships
Number one reason for medical error is miscommunication
Verbal
form of communication
vocabulary, denotative and connotative meaning, pacing, intonation, clarity and brevity, timing and revelance
Nonverbal
form of communication
personal appearance, posture and gait, facial expression, eye contact, gestures, sounds, personal space
symbolic
form of communication
art and music childs play drawings dance verbal and nonverbal symbolism used by others to convey meaning
Metacommunication
form of communication
awareness about all the factors influencing communication
arms crossed
how you communicate
The Nurse asks the client where the pain is and the client responds by pointing to the pain. What kind of communication is this?
Nonverbal
specifically gestures
Intimate Zone (0-18 inches)
holding an infant
performing a physical assessment
bathing, grooming, dressing, feeding, and toileting a client
Personal Zone (18in-4 feet)
sitting at a client’s bedside
taking medical history
teaching an individual client
shift report
Social Zone (4-12 feet)
making rounds with health care provider
teaching a class for clients with diabetes
conducting a support group
Public Zone (12 feet or greater)
speaking at a community forum
testifying at a hearing
lecturing to a class of students
A nurse wants to present information about Flu immunizations to the older adults in the community. Which type of communication should the nurse use?
Public
Social Zone
zone of touch
permission is not needed
hands, arms, shoulders, back
Consent Zone
permission needed
mouth, wrists, feet
Vulnerable Zone
special care needed
face, neck, front of body
Intimate Zone
great sensitivity needed
genitalia. rectum
bathing patient
Therapeutic communication
Occurs within a healing relationship between a nurse and a patient
empowers others to know themselves and make their own choices
anything can have the potential to hurt or heal
initiated by nurse
Therapeutic Communication
use of silence, active listening, ask open questions, offering self, reflection
restatement, empathy, giving information, focusing/exploring, seeking clarification
Non Therapeutic Communication
Advising, devaluing, disapproval/judgment, focus on nurse instead of client, giving reassurance, probing
defending, accusatory, stereotype, interrupting, introducing another topic
Elements of professional communication
Courtesy, use of names, privacy and confidentiality, trustworthiness, autonomy and responsibility, assertiveness
A client just received a diagnosis of cancer. Which statement by the nurse demonstrates empathy?
This must be hard news to hear.
lateral violence
workplace bullying
What to do when lateral violence happens?
request a mentor address the behavior calmly describe how the behavior affects you ask for the abuse to stop notify manager make a plan for taking action in the future document incidences do not instigate or allow others to bully
Clients who cannot speak clearly
listen attentively, do not interrupt ask simple yes or no questions use visual cues let client know if you have not understood them collaborate with speech therapist
Clients who are cognitively impaired
use simple sentences and avoid long explanations
be attentive and allow time for client to respond
include family and friends in conversations
Clients who are hearing impaired
check for hearing aids reduce environmental noise get clients attention before speaking face client with mouth visible do not chew gum speak at a normal volume provide a sign language interpreter if indicated
Clients who are visually impaired
check for glasses
identify yourself when entering the room and notify when leaving
speak in a normal tone voice
do not rely on gestures or nonverbal communication
Clients who are unresponsive
call client by name during interaction
communicate both verbally and by touch
speak to client as though he or she can hear
explain all procedures and sensations
avoid talking about client to others in his or her presence
Clients who do not speak english
Speak to client in normal tone of voice
establish method of patient to ask for assistance
provide a professional interpreter
avoid using family members as interpreters
translate words from native language into english list for client to make basic request
The staff is having a hard time getting an older-adult client to communicate. Which technique should the nurse suggest the staff to use?
Allow time to respond
Self concept components
identity, body image, role performance
identity
involves the internal sense of individuality, wholeness, and consistency of self
Body image
involves the attitudes related to physical appearance, structure, or function
Role performance
how individuals carry out their significant roles
Self concept
perception you have of yourself
self esteem is closely related
A positive self concept gives a sense of meaning, wholeness, and consistency to a person.
Which individual is most likely to need the nurse’s assistance in coping with identity confusion?
A 35 year old recently divorced mother of twins
How can we affect clients self concept?
nurses need to remain aware of their own feelings, ideas, values, expectations, and judgments
use a positive and matter of fact approach
build a trusting relationship
be aware of facial and body expressions
Cultural considerations
develop open, nonjudgmental attitude
ask clients what they think is important
encourage cultural identity by individualizing self care practices
assessment of altered self concept
avoidance of eye contact self harm passive lack of interest slumped posture unkempt appearance
The nurse is caring for an older adult client. Which technique will the nurse use to enhance an older adult clients self concept?
Reviewing old photos with cleints
Sexual Health
state of physical, emotional, mental and social well being in relation to sexuality; it is not merely the absence of disease.
contributes to self worth and to positive interpersonal relationships
sexual development
changes with stages of development
Sexual Orientation
Describes the predominant pattern of a person’s sexual attraction over time
heterosexual, homosexual, lesbian, gay, bisexual, transgender
Stages of Sexual Development
infancy and early childhood
gender identity
school aged years
questions
puberty
emotional and physical changes
young adulthood
emotional maturation
middle adulthood
concerns reattractiveness
older adulthood
sexual response changes, but aging does not lead to diminished sexuality
Nonprescription Contraceptive Methods
abstinence, barrier methods, spermicide, rhythm
Healthcare provider methods
hormonal contraception, IUD, diaphragm, cervical cap, tubes tied/vasectomy
STI’s
Sexually transmitted disease
19 million diagnosed every year
half are 15-24 years old
transmitted from infected individuals to partners during intimate sexual contact
curable: syphilis, gonorrhea, chlamydia
Viral STI’s: HPV, HSV herpes, HIV
Sociocultural dimension of sexuality
impact of pregnancy and menstruation on sexuality
nurses who have trouble discussing sexual issues need to explore their discomfort and develop a plan to address it
Alteration in sexual health
infertility, sexual abuse(nurses must report suspected abuse to proper authorities), personal and emotional conflicts, sexual dysfunction
