Exam III (Communication)

one-to-one interaction between the nurse and another person.

occurs within an individual. Examples inclide positive self reassurance or rehearsing for a difficult task.

religious communication with a higher power such as in prayer.

interaction between a small number of people

interaction with an audience

• 1. stimulus: reason for communication
• 2. sender: person initiating the message
• 3. message: information sent
• 4. reciever: recipiant of message
• 5. feedback: response of reciever to message

what motivates one person to commuinicate with another

factors that influence communication

means of conveying and recieving a message

when a word can mean something in one context and has a completely different meaning in another. one nees to watch for this type fo communication when dealing with language barriers.

the tone of one's voice

being brief

non-verbal

the occupation and defense of a territory can give intimidating non-verbal signals

drawings, artwork, or dreams

messages that are incongruent with spoken words

when two messages are in agreement

when two verbal messages are not in agreement.

when verbal and non-verbal messages are not congruent. this is a no whin situation.

acknowledge the situation and explain the reason behind it to prevent any anxiety for the patient. for example, stress during shift changes should be explained if a psych patient picks up on it unstead of just saying that everything is fine.

they compund eachother and can cause patients conditions to worsen.

• 1. Psychophysiological: internal factors such as physiological and emotional status
• 2. Relational: the nature of the relationship between those communicating
• 3. Situational: the reason for the communication
• 4. Environmental: the physical surroundings in which the communication takes place
• 5. Cultural: sociocultural elements (such as education, language, or customes)

• goals: in a personal relationship goals are not usually present vs proffesional relationships which are goal oriented.
• focus on needs: in a personal relationship both parties needs are important vs in a proffesional relationship the needs of the patient are the focuse
• intimacy: in a personal relationship intimicy is accepted vs in a proffesional relationship intimicy is avoided
• acceptance: in a personal relationship there is no obligation to accept people vs in a professional relationship acceptance of the patient is unconditional
• trust: in a personal relationship trust is earned on both sides vs in a professional relationship trust is earned by the healthcare provider
• confidentiality: in a personal relationship confidentiality is up to one's discretion vs in a professional relationship confidentiality is strict
• boundaries: in a personal relationship bounradies are flexible vs in a professional relationship boundaries are well-defined

• Facilitating communication of distressing thoughts and feelings
• Assisting patients with problem solving to help with ADLs
• Helping patients examine self-defeating behaviors and test alternatives
• Promote self-care and independance

because patients are volnerable and may test a nurses boundaries.

• if a patient in attractive and the nurse tries to persue a relationship with them
• keeping secrets with patients
• having special clients that you spend extra time with

sometimes feedback from collegues can help a nurse avoid these type of issues. also, looking inside yourself and asking if what you are doing is for the patient's benefit or your own.

• Overhealping: doing things for patients that they are able to do themselves
• Controlling: asserting authority and assuming control for the "patient's own good"
• Narcissism: focusing on a patient's weakness instead of promoting their strengths

when a patient unconciously displaces emotions and judgments from their childhood onto the nurse

when the nurse unconciously displaces their emotions or accuired judgements onto a patient

• 1. Preinteraction: before the meeting (chart review etc)
• 2. Orientation: when the patient and nurse first meet and start to get to know eachother.
• 3. Working: when the nurse and the client work together to solve problems and accomplish goals
• 4. Terminate: the end of the relationship. use this time to evaluate goals and achievements.

when a patient is given dificult news they can sometimes "take it to the heard rather than the heart" whcih means that they deal with it in more of an intellectual way rather than dealing with the emotional acceptance of the situation.

when the patient needs to be "woken up" to their situation. just be sure that it is for the patient's benefit and not just to make you feel better.

During this time expect patient to try and test your competency. This is often due to their anxiety and is an unconcious reaction.

it can awaken unresolved feelings of loss or abandonment and can make them feel lonely. this may happen to the nurse as well. make sure that the patient knows when your shift is over so that they aren't taken by surprise. also discuss any feelings that the patient may be having.

duration

stages

scientific evidence that a policy or procedure is really the best way of doing things

• consistancy
• pacing
• listening
• positive initial impression
• promoting patient comfort
• promoting patient control

• inconsistancy
• unavailabilty
• failure to act on requests
• lack of knowledge

sympathy is actually feeling a patients feelings causing the nurse to lose all abilty to help and support the patient. Empathy however is when a nurse understamds a patient's feelings but retaines their abilty to be helpful and supportive thus this is the preffered nursing reaction.

• allow patient to set the pace
• use a setting that promoted a feeling of security
• use open ended questions for maximum information
• keep eye contact when appropriate
• have appropriate clinical supervision

Hispanic, french, and italian use much body language whereas asian, german, or british people are calm under deres. african americans often use guarded communication. a nurse needs to take into considderation a patient's cultural background so that they can be comfortable with a patient and understand what is normal or abnormal.

hispanics, asians, and native americans view eye contact as disrespectful, whearas germans, americans, french, and british consider it important

hispanic, mexican american, italian, and french view touch as comforting. however, german, british, sweedish, indian, japanese, and chinese view it as intrusive.

it is an acronym to aid in "non-verbal listening"

• S - Sit facing the client
• O - Open body posture (not having arms crossed etc). gives a non-defensive impression
• L - Lean in slightly to express interest
• E - Eye contact is important
• R - Relax

A

ask permission

they will often react with an attempt to intelctualize their response in order to justify. this in often unhelpful

loss of ability to express or comprehend language. this makes communication very difficult.

difficulty articulating speech due to disturbances in muscule control resulting from CNS or PNS damage.

difficulty or refusal to speak. most often due to deafness

it places the child in a position where they must understand and convey difficult messages. things that may be beyond their years.

speak to parents first in order to allow child time to get comfortable with their surroundings

eye level whenever possible

yes. this makes the child's surroundings feel less mysterious

direct speech. analogies can often confuse children

• broad smiles
• sudden advances
• staring

"cute" etc because is it makes them seem infantile

• superficially bright (happier than what would be normal for a situation)
• normal
• constricted (less expression than would be expected)
• blunted (much less expression than what would be expected)
• flat (no expression at all)

mood by definition is how someone feels so that is subjective data

halucinations

mental functioning

a Mental Status Evaluation evaluates a client's current psycological state. this involves mainly subjective data.

it provides additional information to develope a care plan beyond the initial MSE.

• -chief complaint
• -history of violent, or suicidal behavior
• -alcohol or substance abuse
• -family psyc history
• -any personal psychiatric treatment
• -stressors and coping mechanisms
• -quality of life
• -personal background
• -support system
• -patient's weaknesses, strengths, and goals
• -racial, ethnic, and cultural beliefs
• -spiritual and religious beliefs/practices.