Week 2: Verbal and Non-verbal Communication and Attending Behaviours Flashcards
Communication: What is it?
Is an ongoing, dynamic and multidimensional process where messages are conveyed verbally, nonverbally, concretely an symbolically
Interpersonal Communication: What is it?
Is the one-to-one interaction between the nurse and patient that often occurs face-to-face. Most frequently used in nursing practice
Basic Elements of the Communication Process
what - message
who - sender/receiver
why - referent
Non-verbal Communication
55% - body movements, face, arms
38% - voice tone, modulation, pauses
7% - words
Functions of Nonverbal Communication
-Contradicting
-Emphasizing
-Regulating
-Complementing
-Substituting
Nonverbal Cues Include
shaking hands, posture, facial expressions, appearance, voice, tone, etc.
Voice
“Paralanguage” - It’s not only about what you say but how you say it
-The oral delivery of a verbal message, expressed through tone and voice, inflection, sighing, speed of delivery, pitch
How masks interfere with Communication
-Eliminate the roles of the middle and lower face
-Make it hard to hear due to a muffled voice
-More difficult to express yourself and difficult to read or interpret the meaning behind what is said
-Enhances difficulty for people with speech impediments or hearing disabilities
Enhancing Communication with a Mask
-Covid-19 Greeting Gestures
-Body Language
-Posture
-Appearance
-Touch (a vital form of communication)
Attending Behaviours
-Attending means paying close attention
-Consist of posture, eye contact and facial expression
-Effective attending skills communicates interest and a desire to understand
-Ineffective attending skills decrease likelihood of developing helping relationship
Listening vs Hearing
Listening
-Foundational skill for helping and most ancient of healthcare skills
-“Being with” another
-Ability to understand and correctly interpret message
Hearing
-One stage of listening
-“being there”
-Ears pick up sounds waves and transmits them to the brain
Active Listening
-“A dynamic, interactive process in which a nurse
-hears a client’s message
-decodes its meaning
-provides feedback to the client regarding the nurses understanding of the message”
-Listening is a deliberate act that requires a conscious commitment from the listener
Characteristics essential to listening
-Empathy
-Silence
-Attention to verbal and non-verbal
-Ability to be nonjudgmental and accepting
-Open body language
-Careful observation
Listening involves the ability to detect:
-Verbal and nonverbal cues
-Feelings/emotions in a client’s tone of voice and facial expression
-Incongruencies between what the client is stating and what you are seeing nonverbally
Silence
-Effective listening tool
-May be difficult to do as nurses often “action-oriented” and feel they must “do something”
Use of Silence
-Silence and not interrupting patients is a sign of respect and interest
-Allows both patient and nurse to reflect on what has been said particularly useful if the discussion is emotional
-May allow for a more appropriate response
-Long silence may be uncomfortable
-When teaching - used to draw attention to important points
-If client falls silent ~ consider the circumstances
-Shouldn’t last longer than 10-15 secs
Benefits of Listening
Patient:
-safe, comfortable
Nurse:
-the patient opens up, more info, better clinical judgement, patient will develop a trusting relationship
Ways nurses don’t listen
The patient…
-talking loudly
-becoming more animated
-talking faster
-moving closer or move into the nurse’s line of vision if they are looking around
-changing the subject
-giving up
Barriers to active listening
External interferences
-comes from outside the people in conversation, sus as a ringing phone
Internal interferences
-within the individual such as a lack of focus or feelings distracted
Non-verbal skill to facilitate listening (SURETY)
S - Sit at an angle to the patient
U - Uncross your arms and legs
R - Relax
E - Eye contact
T - Touch
Y - Your Intuition
Other considerations:
-unbroken eye contact can be uncomfortable
-cultural considerations related to eye contact and personal space
-physical environment - room, bed, other barriers, standing vs sitting
Negative Listening
-Is not hearing what is really being said
-Waiting for the other person to stop speaking so you can say what you wish
-Providing an answer without knowing the question
-Finishing the other person’s sentence for him/her
-Making more statements with “I” than asking questions with “you”
Negative Listening in Nursing
-False reassurances - “everything will be okay”
-Giving advice - “If I were you I would”
-Expression you own values about what is right and wrong
-Using value judgements - “I am glad you decided to choose surgery”
Listening Responses
Clarification
-seek to understand the message of the client by asking for more info or for elaboration on a point
Restatement
-restating a part of the message that you wish to further delve into or clarify
-used to focus on a specific part of what was said
Paraphrasing
-take the original message and transform it into your own words in order to clarify meaning
-used as an active listening response to find a common understanding of issues important to client
Reflection
-active listening response that focuses on emotional part of a message
-helps the client clarify emotions
-ways to reflect: reflect on your feelings with the content message, reflection on vocal tone, linking feelings with the content of the message
Summarization
-used to review content and process
-pulls together several ideas and feelings
Use of Medical Jargon
Unsafe - misinterpret prescription instructions
Frightening - “I have MRSA? What is that?”
Intimidating - “I am going to pretend I understand because I don’t want to seem unintelligent
Distancing - “This nurse is way above me”
Offensive - Where’s the Cow?
Condescending - makes patients feel lesser than, unintelligent
