Week 6 (Class 2) - Communication I. Flashcards
Therapeutic Relationships:
- In the beginning…
Need to establish a therapeutic nurse-client relationship FIRST in order to have a successful nurse-client encounter.
What is the framework for therapeutic relationships?
- RNAO
- Requisite knowledge
- Reflective practice/Self-awareness
- The process of developing a therapeutic relationship
What are the components of the therapeutic relationship?
- CNO
- Explain why
- Trust
- Trust is critical in the nurse-client relationship because the client is in a vulnerable position
- Expectation by client can be influenced by prior care
- May not know YOU but they trust the nurse
- Keeping promise, keeping them in the loop - Respect
- Respect is the recognition of the inherent dignity, worth, and uniqueness of each client regardless of the socio-economic status, personal attributes, or nature of the health problem
- Non-judgmental
- Meaning of behaviours
- Self-aware
- Advocate for what client wants - Professional intimacy
- This is inherent in the type of care and services that nurses provide
- Physical activities
- Personal info - Empathy
- The expression of validating, understanding and resonating with the meaning that the health care experience holds for the client
- Appropriate emotional distance to maintain objectivity
- Appropriate professional response
- Understanding on a deeper level; feeling their feelings - Power
- The nurse-client relationship is fundamentally unequal. The nurse has:- more authority and
influence in the health care
system - specialized knowledge
access to privileged
information - the ability to advocate for
the client
- Unequal power - must be appropriate use of power and work with client towards goal
- Misuse = abuse
- more authority and
What are the phases of therapeutic nurse-client relationship?
1) Pre-interaction
2) Orientation/Introduction
3) Working
4) Termination
What are boundaries?
Point at which the relationship changes from professional and therapeutic to unprofessional and personal.
- Does not have to be intentional
What is said about communication in therapeutic relationships?
“There is now considerable research evidence to demonstrate that good communication practices actually assist the rate of patient recovery and decrease reported pain, drug usage, postoperative complications, and length of stay. In short, they are cost effective” (Fielding, cited in Libster, 2001, p. 177).
Why is listening from the heart important?
- Three elements
Important part of “active” listening
Being completely focused on the 3 elements of the patient’s communication:
1) Words - what the patient actually says
2) Feelings - behind the words
3) Essence – what they “really” mean
The nurse puts their own thoughts and advice on hold until the patient finishes speaking and then identifies the essence of what has been said.
What is the communication process?
SENDER > TEXT > RECIEVER
- Sender: Encoder, writer, speaker
- Text: Written or verbal
- Receiver: Decoder, reader, listener
What factors influence the communication process?
1) Environmental factors
2) Personal Space
3) Physical appearance and dress
4) Non-verbal cues
5) Intrapersonal factors
6) The use of “I” messages
What are the elements of verbal communication?
1) Vocabulary
2) Denotative and Connotative meaning
3) Pacing
4) Intonation
5) Clarity and Brevity
6) Timing and Relevance
Elements of Communication:
Vocabulary
- What should one consider?
Communication is unsuccessful if sender and receiver cannot translate each other’s words and phrases.
Limiting of medical jargon in conversations with other health care team members will improve communication.
Children have limited vocabulary. Teenagers use unique words and slang.
Elements of Communication:
Denotative and connotative meaning
- Define
Denotative is the dictionary meaning of a word. i.e. baseball=baseball.
Connotative is the interpretation of the meaning of a word and is influenced by thoughts, feelings or the ideas people have about the words.
Elements of Communication:
Pacing
- Why?
Fast talker?
- May lose the listener
Good rate of speech = 140-160 words/minute
Too slow
- May make PT feel incompetent of uneducated
Elements of Communication:
Clarity and brevity
- How should one speak?
Effective communication is simple, brief and direct
Using fewer words equals less confusion.
Repeat important phrases and give examples.
Phrases such as “you know” or “ok” detract from clarity.
Elements of Communication:
Timing and relevance
- Why is it critical?
Timing is critical.
- You do not begin routine teaching when a client is in severe pain.
- When a patient is going into surgery you do not start describing a diet plan.
- Choose an appropriate time.
