Weeks 2-4 Midterm Study Flashcards
Communication models (2)
Linear
Transactional
communication model components (5)
Sender
Message
Channel
Receiver
Context
Transactional communication model is a
Feedback loop
It’s more complex
Additional factors that influence commiunication
(Personal, self awareness, environment)
Personal
- gender, age, education
Self awareness
- values, beliefs
Environment
- timing, privacy
Therapeutic communication definition
Dynamic interactive process by clinicians and patients for the purpose of achieved identified health related goals
therapeutic communication can occur through
Word, facial expressions, body language, email, writing
Building rapport serves as…
The basis for a therapeutic relationship
Congruence
Presenting your true thoughts and feelings verbally and nonverbally
Incongruence
Verbal messages don’t correspond with nonverbal messages
Conflicting messages are sent
Non verbal communication examples
Facial expression
Body language
Touch
Gestures
Voice tone
Eye contact
Time
Appearance
Active listening
Intentional form of listening
- note feelings
- encourage patients to explore concerns and expand on ideas
- use of open ended questions
- requires full attention without judgement
Constructive feedback is …
Objective
Descriptive
Honest
Clear
Relevant
Focused on behavior (not the person)
Provided quickly
Few examples points from BCCNM confidentiality doc (know for exam)
- respect client right to access own health records
- share relevant info with the healthcare team
- comply with legal obligation to disclose info under court order, warrant, etc
Patient centred care relationships are the..
Basis of professional therapeutic relationships
They begin with the expectation that clients will take an active role in managing their health
Phases of patient centred relationship (4)
Preinteraction
Orientation
Working
Termination
Patient centred relationship: pre interaction phase
Gather information from charting
Familiarize yourself with precautions
Patient centred relationship: orientation phase
Introductions
BUILDS TRUST - key point
Defined purpose of relationship
Patient centred relationship: working phase
Utilize nursing process
Problem solving period
Patient centred relationship: termination
This phase is defined early so patient can prepare
End of work
Discuss outcomes with client
Characteristics of a therapeutic relationship
Patient centred
Respectful
Therapeutic
Based on trust
Appropriate power use
Client dignity and privacy is respected
Holistic
Specific
Goal directed
Time limited
Individualized
Examples of bridges
Respect
Trust
Empathy
Ethical behaviour
Confidentiality
Examples of barriers
Anxiety
Stereotyping
Space violation
Confidentiality violation
Characteristics of the nurse in a therapeutic relationship
Care
Self awareness
Presence
Respect
Authentic
Protects privacy
Empathy is the ability to
Truly know another person within a trusting and mutually respectful relationship
Compassion
Seeking to address the suffering and needs of a person through relational understanding
Presencing
Being fully present (body, mind, emotions, and spirit) to another person
Active listening vs presencing
Active listening - more words/responding
Presencing - more action and non verbal communication
Nontherapeutic communication techniques
Asking personal questions
Giving personal opinions
Changing subjects
False reassurance
Sympathy
Arguing
Obstacles within the patient that effect communication
Pain
Inability to understand
Feeling defensive
Deprived of privacy
Obstacles within a nurse that effect communication
Preoccupation
Rushing
Making assumptions
Stereotypes
Defensiveness
Aphasia
Partial or total loss of the ability to communicate verbally or in writing
- person with aphasia may have difficulty speaking reading writing or understanding
Types of aphasia
Expressive
- cannot put thoughts into words
Receptive
- cannot understand what is being said
Global (both)
For an unresponsive client, you should…
Always assume the client can hear what you say
Self concept
Totality of each persons beliefs about themselves. Contains cultural concepts, gender, environments, beliefs, values, education, etc
Culture
Integration of historical, social, economic, physical contexts
Self esteem
A persons personal sense of worth and well being
- related to life experiences and childhood
Self clarity
Extent to which a person clearly and confidently knows who they are
Self efficacy
Persons beliefs about their ability to accomplish a task and deal with challenges
Person centred relationship (PCC)
Therapeutic relationship links to assisting people to achieve health goals
Person centredness
Recognizing a persons knowledge and expertise in managing their health
Person centred care is a set of…
A set of therapeutic relationships where healthcare providers engage with people
- understand persons experience with health
- Support effective self management
- promote healthy lifestyle behaviours
Person centred vs social relationships
Social
- no defined end
- no set out goals
- friendship purposes
Person centred (therapeutic)
- subject to ethical and legal standards
- defined beginning and end
- goals to be met
Boundaries
Invisible structure impaired by legal, ethical, and professional standards
Countertransferance
Occurs when something activates a nurses unconscious/unresolved feelings from a past relationship
Shared decision making (SDM) is …
Person specific
- reviewing care plans, asking about priorities,e tc
CARE acronym
Connect with the person
Appreciate the persons situation
Respond to persons needs
Empower the person to solve problems with you
Empowerment
Assisting people to assume responsibility for their own health
semantic noise
using medial terms, or when stereotypes/emotions influence Communication
categories of questions
open
Focuses
Closed
Open ended questions
Begins with what, how, or describing
Reflect on situation
focused questions
useful in emergencies
Need concise info
What was the signs and symptoms of…..
Meta communication
Combination of verbal and non-verbal behaviours integrated to share info
Used to describe all factors that influence how messages are received
Ex. Body language, tone, eye contact, etc
Relational practice
A way for the nurse to care for a person while encompassing their cultural contexts
Guided by conscious participation with clients using relational skills such as listening, questioning, and empathy
Caring is fundamental to…
An effective nurse client relationship
Themes from caring theories
Empowerment
Commitment of nurse
Relational practice
Understanding context
Getting to know client as a unique person
Caring from a critical social perspective…..
Directs nurses to critically examine the dominant social conditions that often constrain people and their health
Strategies for communicating with those with aphasia or other communication difficulties
Go slow
One thing at a time
Do not interupt
Treat as an adult
Don’t pretend to understand
Use gestures
Minimize distractions
