Module 4 Flashcards
5 Parts of the Communication Process
- Stimulus/Reference
2.Encoder (Sender/Source) - The Message Itself
- Medium/Channel of Communication
- Decoder (Receiver)
3 Channels of Communication
- Visual
- Auditory
- Kinesthetic
What can distort the message of the communication process?
The environment
Once the Decoder receives the message what do they do?
give feedback
Levels of Communication
- Intrapersonal
- Interpersonal
- Group
Intrapersonal Communication
self talking or communication within a person (talk in your head)
Interpersonal Communication
communication occurring between two or more people with the goal to exchange messages
Group Communication
group of multiple people that communicate to support, teach, solve various things
as the size of the group increases, they complexity of the communication increases since perceptions among people are different
comes in small group and organizational group communication
Organizational Group Communication
people in an organization coming together to meet a goal
employs interdisciplinary groups in effective circumstances to assure quality
What should you study to determine group communication effectiveness?
Bruce Tuckman’s Group Dynamics/Process Theory
5 Stages of Group Dynamics/Process
- Forming
- Storming
- Norming
- Performing
- Adjourning
Forming Stage
First stage of group dynamics where the group is immature/new and uncertain with one another, feeling each other out, testing rules out, and establishing rules and goals
Storming Stage
Second Stage of group dynamics where the group is fractional with some disengagement over priorities and whose leadership to follow, as well as potential hostility and cliche formation occurring
Norming Stage
3rd Stage of Group Dynamics where a consensus occurs where leadership, roles, rules, and co-operations occurs alongside stability
Performing Stage
4th Stage of Group Dynamics where the group is finally an EFFECTIVE GROUP - with successful performance and flexibility, open roles, open to ideas, with only some delusion but general acceptance present
Adjourning Stage
final stage of group dynamics where the group has finished what they came together to do so they disengage with positive feelings toward the leader or sadness toward leaving, and potential self evaluation entow
Characteristics of Effective/Ineffective Group Communication
Group Identity
Cohesiveness
Patterns of Interaction
Decision Making
Responsibility
Leadership
Power
Effective v Ineffective Group Identity
Effective - members clearly articulate and understand goals and rules
Ineffective - members do not care about the rules or goals
Effective v Ineffective Cohesiveness
Effective - trust and cooperation with one another is effective in the group
Ineffective - members feel alienated with low commitment and better off working alone
Effective v Ineffective Patterns of Interaction
Effective - effective communication and constructive criticism
Ineffective - selfish goals, aggressors/self serving roles among the group
Effective v Ineffective Decision Making
Effective - ID problems and have unanimous decisions among the group
Ineffective - ineffective problem solving and poor group communication
Effective v Ineffective Responsibility
effective - members feel responsible for group outcome
Ineffective - they do not feel pride/responsibility in the main goal
Effective v Ineffective Leadership
effective - leadership style meeting desired goals and considering the other members
ineffective - power hungry and not being effective at getting to the goal
Effective v Ineffective Power
Effective - sources of power are recognized in the group and used appropriately, and those with little power are still acknowledged
Ineffective - opposite of above
Factors that Influence Communication or Distort the message
- Developmental Level
- Gender
- Sociocultural differences
- Roles and responsibilities
- Space and territoriality
- Physical, mental, and emotional state
- Values
- Environment
Forms of Communication
- verbal
- nonverbal
*also electronic communication, but it also may fall within nonverbal
Verbal Communication
language communication / spoken
Nonverbal communication
Body language / non-spoken language
ex: facial expression, touch, eye contact, posture, gait, gestures, physical appearance, mode of dress and grooming, sounds, silence, electronic communication
You _____ communication is the truth of what you are trying to say
nonverbal
Electronic communication
social media (has guidelines by ANA and NCSBN on use for RNs), email, and text message
The risk of violating patient privacy and confidentiality is high when …
any message is sent electronically / electronic communication is used
often there are security measures to safeguard email and texts in health care agencies
The Helping Relationship
Intangible, non-spontaneous, active relationship that is purposeful, dynamic, and time limited
there is an unequal sharing of information, but both people have responsibilities in the relationship
It builds on the patients needs as the person being helped, by the nurse who is the helper
____ is the means used to establish rapport and helping-trust relationships
communication
Important characteristics of the Helping Relationship
- Dynamic
- Purposeful
-Time-limited
-Helper is professionally accountable for the outcomes and means used to attain them
-it is not spontaneous
Phases of the Helping Relationship
- orientation
- working
- termination
Orientation Phase
-First phase of the helping relationship
Characterized by:
- Calling the nurse by name
- Patient will accurately describe the roles of the nurse participants in the relationship
- Patient and nurse will establish and agreement on goals, location, frequency, length of contacts, and the duration of the relationship
Working Phase
- second phase of the helping relationship
Characterized by:
- patient actively participates
- patient cooperates in activities that work toward achieving mutually acceptable goals
- patient will express feelings and concerns to the nurse
Termination Phase
- final phase of the helping relationship
Characterized by:
- patient will participate in ID goals accomplished or the progress made toward those goals
- Patient will verbalize feelings about the termination of the relationship
What is done at the end of the helping relationship’s termination phase?
the phases can repeat for the nurse
Factors that Promote effective communication
- Dispositional Traits of the people
- Rapport building/builders
Ideal Dispositional Traits of the nurse that promotes effective communication?
- Warmth and Friendliness
- Openness and Respect
- Empathy
- Honesty, Authenticity, Trust
- Caring
- Competence
Why do nurses not give sympathy?
You cannot sympathize something you never went through, but you can give empathy when you want to understand
How to build rapport with a patient?
- Specific Objectives
- Comfortable Environment
- privacy
- Confidentiality
- Patient Focus > Task focus (show you care)
- Utilization of nursing observation (see a theme to get ideas of problems and ask questions to see if you can help)
- Optimal pacing
How do nurses communicate with other nurses using hand-off communication?
SBAR Technique
What does SBAR Technique stand for?
Situation
Background
Assessment
Recommendation
How to develop effective conversation skills?
Think before you speak
control tone of voice
be knowledgeable on the topic
be flexible
be clear and concise
avoid words with different interpretations
be truthful
keep an open mind
take advantage of available opportunities
develop good listening skills
How to develop effective listening skills?
sit when talking
be alert and relaxed and take your time
keep conversation natural and bring them back to the main topic
maintain appropriate eye contact
utilize non verbal communication well
think before responding
DO NOT PRETEND TO LISTEN
if they scream, do not respond with screaming - take it in
Listen for themes in the patients comments (Active listening)
use appropriate silence, therapeutic touch, and humor
______ _____ is the key to productive communication
listening attentively
What techniques convey to the patient that you are trustworthy, listening, and care?
eye contact, touching/therapeutic touch, and active listening/nonverbal communication
7 Important Interviewing Techniques
- Open ended Questions or comments
- Closed questions or comments
- Validating questions or comments
- Clarifying questions or comments
- Reflective questions or comments
6.Sequencing questions or comments - Directing questions or comments
Open Ended Questions
questions open to any answer and can explore/open up allowing the patients to talk more
Closed Ended Questions
Limited choices of responses (ex: y/n, what pill do you take?, are you in pain?)
Validating Questions
Confirm what the nurse has heard in the observation and interview of the patients in order to validate the information (ex: At home you take these pills, did you take them today?)
Clarifying Questions
Used for clarifying a comment and validate it (ex: Is this the first time? - clarify what they just said?)
Reflective Questions
Repeating what the patient said or describing what they described - allowing better understanding of the information and characteristics of the patient
Sequencing Questions
questions placing events in chronological order in order to get a possible cause-and-effect
ex: “No energy. Did it start AFTER beginning medicine?”
Directing Questions
Questions that direct at getting more information on the important topic at hand, or getting things back on topic
ex: Are you afraid that will happen to you like it did your dad?
Assertive
being able to show confidence and act forcefully in a positive and calm way (not aggressive)
good nurses are assertive, but approachable, so patients love them
Characteristics of an Assertive Nurse
- confident with open body posture
- uses clear and concise “I” statements
- Ability to share effectively their thoughts, feelings, and emotions
- Work to capacity/hard with OR without supervision
- Ask for help when needed
- give and accept compliments
- admits mistakes and takes responsibility
Characteristics of Aggressive Behavior
- Asserts oneself in a negative way that violates other’s rights
- can be verbal or physical
- communication has tension or anger, inhibiting the formation of good relationships or collaboration
- angry tone of voice, making accusations, and demonstrating belligerence and intolerance
- focus of “winning at all costs”
Blocks to Communication
- Leading Questions
- Advice giving comments
- Judgmental comments
- Changing the subject
- Giving false assurance
6.Using gossip and rumors - disruptive interpersonal behavior
- failure to see the patient as a human being
- failure to listen
- nontherapeutic comments and questions
- using cliches (“dont worry” “theyve done this before”)
- using closed questions
- using questions containing the words “Why” and “How”
- Using questions that probe for information
Avoid using questions containing what words?
- Why
- How
Examples of Disruptive Interpersonal Behavior
- Incivility
- Bullying
- Organizational Response to Disruptive Behavior being ineffective, thus allowing more (They NEED to respond to this)
Incivility
person being rude, disruptive, or intimidating
Bulling
Psychological, physical, or social harassment
can occur horizontally between two nurses, nursing bullying between person on floor and the nurse, and negative communication between nurse and physician
____ is the building block of nursing
Communication (who we interact with, how, and with what)
IOM
Institute of Medicine
IOM Recommendations in Regards to Communication
We as a health care community need to improve verbal and in-writing communication between professionals by being ACCURATE and as BRIEF as possible
What is conflict?
A problem/issue between two people, able to occur in anytime, occurring when there is a disagreement in vision or manner
Why is it important to understand conflict?
- It is human nature to encounter it
- It offers a good point of reflection
Bidirectional Conflict Possibilities in Healthcare?
Nurse Patient
Patient Other Health Care Workers
Nurse Other Health Care Workers
People you could experience conflict with in health care?
Practitioners
Nurses
Social Workers
Nursing Assistance
Patients
Families
Insurance companies
How do you resolve conflict?
1 recognize it
2 find the right time to discuss it
3 discuss BOTH sides
4 document the issue with the relevant topics
5 End with mediation, negotiation, or agreement to disagree
The key to communication is …
Teamwork
Teamwork in communication involves…
- communication
- coaching
- patient satisfaction
- servant leadership (listening, empathy, healing, awareness, conceptualization, foresight, commitment to the growth of people building the community)
Important Features for Effective Interprofessional Communication
- Respect
- Clarifying communication
- Responding professionally
- Taking and Giving Constructive Criticism
- Support Systems
- Proper Documentation
- Follow ups
Method of clinically communicating back and forth?
SBAR
