Week Two Flashcards
What is active listening?
A communication technique requiring the nurse to be present physically and emotionally by listening attentively to the client
What is authenticity?
The ability to be genuine and true to yourself in word, deed, and action
What is a close ended question?
Constrained question requiring a limited response
What is Confidentiality?
The assurance given to an individual that his or her personal and private information will not be shared indiscriminately and without consent
What is Interpersonal Communication?
The simultaneous exchange of information between two individuals, whereby they mutually influence one another with the goal of creating shared meaning and understanding
What is Intrapersonal Communication?
Occurs within each individual and comprises our thought and internal voice
What is Therapeutic Communication?
Intentional and purposeful interpersonal techniques used by healthcare workers, with the goal of enhancing the physical, emotional, and spiritual needs of a client
What are the 5 levels of communication?
1) Intrapersonal Communication (otherwise referred to as self talk)
2) Transpersonal Communication (Discussions about spirituality means to the client. How his/her spirituality helps them in difficult circumstances)
3) Interpersonal Communication
4) Small Group
Communication (occurring among 2-15 individuals)
5) Public Communication
What is a therapeutic relationship?
Constructive relationship between a nurse and a client, consisting of four progressive phases
What are the 4 phases of therapeutic communication?
1) Pre-Orientation Phase
2) Orientation Phase
3) Working Phase
4) Termination Phase
What is the Pre-Orientation Phase in therapeutic relationships?
- Before meeting a client, nurses attend a shift report and review the Kardex and client chart
- The data needs to be completely objective
- Examine your thoughts and feelings about working with the patient
What is the Orientation Phase in therapeutic relationships?
Self-knowledge on the part of the nurse is one of the greatest influences when communicating within the orientation phase
During this brief phase, trust is established, and rapport begins to develop between the client and the nurse.
Keeping this in mind, the nurse employs specific communication skills to initiate a relationship with the client
nurses introduce themselves and begin to obtain essential information about clients as individuals with unique needs, values, beliefs, and priorities
What is the working phase of a therapeutic relationship?
- The nurse acknowledges that collaboration is the key to client success
- When engaged in the third phase of the therapeutic relationship, the nurse uses effective communication strategies such as silence, touch, open-ended questions, paraphrasing, shared observation, self-disclosure, and listening
- During the working phase, clients begin to accept nurses as health educators, counselors, and care providers.
- Nurses use therapeutic communication techniques to facilitate clients’ awareness of their thoughts and feelings and mutually develop goals and an individualized plan of care.
What is the termination phase of a therapeutic relationship?
Terminating the nurse-client relationship may occur at the end of each shift, upon client transfer to another unit ot facility, upon discharge, or end of shift, nurses summarize for the client the client’s care requirements, care plan, and goals met or unmet
Effective communication and active involvement of the client during the termination phase enhances patient knowledge and health outcomes, whereas nurses feel empowered and experience an increase in job satisfaction
What are the 3 models of Patient Centred Communication?
1) Linear
2) Transactional
3) Therapeutic
What is the linear model in Patient Centred communication?
Traditional form of communication only focuses on sending and receiving information
When is the best situation to use the linear model? (Patient Centred Communication)
Emergency Situations
What are the 5 components of the linear model?
1) Sender
2) Message
3) Receiver
4) Channel of Communication
5) Context
What is the transactional model in patient centred communication?
Requires more time, it is complex, it is reciprocal (I get something out of the interaction and so does my client)
We can influence each other simultaneously
I can look for perceptions and reactions
The transactional model of communication is based on the belief that communication is a two-way process in which both sender and receiver simultaneously send and receive messages.
Receive the information, Interpret the information
Which model of patient centred communication has feedback loops and output?
TRANSACTIONAL
Feedback loops built back into it so we can validate, reflect and correct
The client has a role with this type of communication
What is the therapeutic model in patient centred communication?
Dynamic
Interactive
Requires active engagement from all parties
What are the 3 main components of patient centred communication?
1) Active Listening
2) Shared Partnership
3) Self Awareness
What is the functions of patient centred communication?
It has goals and its health centered we use it to inform, we use this type of communication to support, educate, inform, and to empower
Combination of relationship building, information sharing and decision making
What are some characteristics to patient centred communication?
Honesty
Clarity
Empathy
Boundaries (professional boundaries)
Looking at the verbal and non-verbal responses
What are some components of active listening?
Ask questions to seek clarification
Requires your full attention
Using open ended type questions
Looking at the persons body language
Observing the room (silence and watching)
What is the goal of active listening in patient centred communication?
to understand (Not to be heard but to understand)
What are the components of a shared partnership in patient centred communications?
Broad range of collaborative communication skills
Fosters healing relationships
Gives us an opportunity to share information and respond to emotions
Manage uncertainty
Allows the opportunity to make decisions
Enables our patient to self manage
What are the components of self-awareness in patient centred communication?
Reflets to you as the nurse
Your have an ethical and professional responsibility
Be aware of your own vulnerabilities
Be aware of prejudices or biases
We have to be aware of our own non-verbal body language
What is countertransference?
Countertransference is the unconscious redirection of a clinician’s feelings, attitudes, and desires about a close, personal relationship onto the patient. This is a direct response to the transference exhibited by a patient.
What are verbal styles that influence communication? (6)
1) Moderate pitch and tone
2) Vary your vocalizations (louder, shorter, crisper)
3) Encourage involvement (when you are having these conversations you are having them with the patients and their supports)
4) Validate Worth
5) Advocate with/for that patient
6) Appropriately provide information (maybe even repeat it if necessary)
What are non-verbal styles that influence communication? (6)
1) Allow Silences
2) Use congruent non-verbal behaviours
3) Use facilitative body language
4) Touch (use touch appropriately)
5) Proxemics (personal space)
6) Seek clarification in regard to non-verbals
What is accommodation theory? (variations in communication styles)
This tells us that when we are communicating with other people we will adjust or adapt our speech (ex. HOH patient and adjusting speech for what my patient needs)
What is competence in variations in communication styles? (3)
1) Interpersonal: your competence level and will develop as you understand the communication process, meaning the complex cognitive, behavior and cultural factors that you need to be aware of
2) Social: Interpret communication from the other persons point of view
3) Message: know your audience, do you use medical terminology or not?
What are the 2 different types of meaning? (variations in communication styles)
1) Denotation: A word has a generalized meaning
2) Connotation: A personal meaning for that individual
What is metacommunication? (variations in communication styles)
Looking at the verbal and the non-verbal
What are the factors that can influence how that message is being received? → what is the pitch, tone or frequency of my voice
Seek for clarification in your conversations
Meta-communication is a secondary communication about how a piece of information is meant to be interpreted. It is based on the idea that the same message accompanied by different meta-communication can mean something entirely different
What are some style factors in communication that affect it?
slang, Jargon, where did we grow up, where did we live, LOC of patient, is the patient participatory, what is their role?
How to apply patient centred communication? (9)
- Find a common ground
- Develop a shared partnership
- Build rapport
- Engage the Patient
- Observe non-verbal cues
- Use respectful tone
- Maintain appropriate eye contact
- Face the patient
- Center on the patient
How do you build rapport when applying patient centred communication?
- Start off with routine questions first not the heavy questions (we want our patient to feel, safe, accepted, and validated)
- We need to be sincere and genuine
What non-verbal cues should we be aware of in patient centred communication?
- Movement
- Physical Space
- Tones
What are some organizational system barriers in therapeutic communication?
- Heavy workloads
- Production expectations
- Inconsistent caregivers
What are some bridges & barriers in therapeutic relationships?
Cultural barriers
Proxemics
Confidence Anxiety
Acceptance
Veracity (truthfulness)
Mutuality
Empathy
Empowerment
Caring
Respect
What are some components of “Active Listening”?
(ON EXAM: given examples and have to know what they are categorized under)
- Minimal Cues & Leads
- Silence
- Summarizing
- Reflection
- Paraphrasing
- Restatement
- Clarification
What are the different types of questions you can ask in therapeutic communication?
Listen for themes
Closed Ended
Open Ended
Focused
What are some other forms of communication in therapeutic communication?
Touch
Metaphors
Humour
What are some verbal communication and responses?
- Matching
- Use plain language
- Focusing
- Give feedback
- Validation
What are some components when giving feedback?
Focus on the content
Focus on relationship
Focus on feelings
Be specific
Be clear, honest and reflective
Ask before you provide feedback… is this going to advance the situation?
What are 7 therapeutic communication techniques?
1) Open Ended Questions
2) Clarification
3) Probing
4) Paraphrasing
5) Sharing Observations
6) Silence
7) Summarizing
