N210 Week 5 Lecture Communication & Collaboration

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  1. 1. Describe various modes of communication and justify when a specific mode of communication may be most useful (453)
    • 1. Intrapersonal Communication
    • I. Self talk, or communication within a person
    • II. Affects nurse’s behavior and can enhance or detract from positive interactions with the patient and family
    • 2. Interpersonal Communication
    • I. Occurs between two or more people with a goal to exchange messages
    • A. Communicate with patients, family members, and members of health care team
    • II. Influences your sharing, problem solving, goal attainment, team build, and effectiveness in roles
    • 3. Group Communication
    • I. Small-Group Communication
    • A. Interacting with two or more people
    • a. Staff meetings, conferences, teaching sessions, and support groups
    • B. Members of small group must communicate to achieve their goal
    • II. Organizational Communication
    • A. Within an organization communicate to achieve established goals
    • III. Group Dynamics
    • A. How individual group members r/t one another during the process of working toward goals
  2. 2. Describe and give examples of barriers to successful communication and suggest strategies to reduce the risk of each barrier (470-471)
    • 1. Failure to Perceive the Patient as a Human Being
    • I. Nurses must focus on the patient as a whole and not just on the patient’s diagnosis
    • 2. Failure to Listen
    • I. Don’t miss valuable opportunities for important communication by approaching them with a closed mind or focusing on your own needs rather than on the patient’s needs
    • 3. Nontherapeutic Comments and Questions
    • I. Using Clichés
    • A. They offer false reassurance
    • “Everything will be alright.”
    • “Don’t worry. You will be just fine in another day or two.”
    • “Your doctor knows best.”
    • “Cheer up. Tomorrow is another day.”
    • 2. Tends to cut off communications and make people feels as thought they are insignificant
    • “Men tolerate pain poorly. That must be why you’re complaining of severe pain.”
    • “Everybody is afraid of surgery. Why should you be any different?”
    • “You teenagers are all alike. You aren’t cooperative because you deny authority.”
    • II. Using Questions Requiring a “Yes” or “No” Answer
    • A. Questions that can be answered yes or no tend to cut off discussion
    • “Did you have a good day?”
    • II. It’s bad to ask a question to which a patient can say no when that can present a problem
    • “Are you ready to get out of bed?”
    • C. Problem arises when seeking more detailed information or when question might be difficult
    • III. Using Questions Containing the Words Why and How
    • A. Questions using the words why and how are intimidating to patients
    • IV. Using Questions That Probe for Information
    • V. Using Leading Questions
    • A. Produces answers that might please the nurse
    • B. Unlikely to encourage patient to respond honestly without feeling intimidated
    • VI. Using Comments That Give Advice
    • A. Often implies that the nurse knows what’s best for patients and denies them the right to make decisions and have feelings
    • a. Tends to increase patient’s dependence on caregivers
    • VII. Using Judgmental Comments
    • A. Tend to impose the nurse’s standards on the patient
    • VIII. Changing the Subject
    • IX. Giving False Assurance
    • A. Gives patients the impression that the nurse is not interested in their problems
    • B. Use of clichés gives a patient false assurance
    • C. Communication might be impeded when providing the patient and family false assurance
    • X. Gossip and Rumor
    • A. Can produce detrimental effects on relationships and group building
    • B. Used to inform, influence others, entertain, or ventilate
    • XI. Disruptive Interpersonal Behavior
  3. 3. Compare and contrast different communication techniques aimed at preventing communication barriers (464-467)
    • I. Conversation Skills
    • A. Your tone should indicate interest rather than boredom
    • B. Be knowledgeable about the topic of conversation and have accurate information
    • C. Be flexible
    • D. Be clear and concise
    • E. Avoid words that might have different interpretations
    • F. Be truthful
    • G. Keep an open mind
    • H. Take advantage of available opportunities
    • II. Listening Skills
    • A. Sit when communicating with a patient
    • B. Don’t cross your arms and legs because that body language conveys a message of being closed
    • C. Be alert and relaxed and take sufficient time so that the patient feels at ease
    • D. Keep conversation as natural as possible
    • E. Maintain eye contact with patient, without staring
    • F. Be attentive to both your own and the patient’s verbal and nonverbal communication
    • G. Think before responding to the patient
    • H. Don’t pretend to listen
    • I. Listen for themes in patient’s comments
    • III. Silence
    • A. Patient may be comfortable
    • B. Patient may be trying to demonstrate stoicism and ability to cope without help
    • C. May be exploring inner thoughts or feelings, and conversation would disrupt this
    • D. Might be fearful and use silence as an escape from a threat
    • E. Might be angry and use silence to display emotion
    • IV. Touch
    • A. It can connect people; provide affirmation, reassurance, and stimulation
    • B. Decrease loneliness; increase self-esteem; and share warmth, intimacy, approval, and emo support
    • C. Therapeutic touch involves clearing, congested areas of energy in the body and redirecting energy
    • V. Humor
    • A. Maintain a balanced perspective in their work and encourage patients to do the same
    • B. Releases excess physical and psychological energy and reduces stress, anxiety, worry, frustration
    • VI. Interviewing Techniques
    • A. Open-Ended Question or Comment
    • a. Allows patient a wide range of possible responses
    • b. Encourages free verbalization
    • c. It prevents patient from giving a simple yes or no answer
    • B. Closed Question or Comment
    • a. Used to gather specific information from a patient and to allow the nurse and patient to focus on a particular area
    • C. Validating Question or Comment
    • a. Validate what the nurse believes he or she has heard or observed
    • b. Overusing may think nurse is not listening
    • D. Clarifying Question or Comment
    • a. Allows nurse to gain understanding of a patient’s comment
    • E. Reflective Question or Comment
    • a. Repeat what person has said or describe the person’s feelings
    • b. Encourages patients to elaborate on their thoughts and feelings
    • F. Sequencing Question or Comment
    • a. Place events in a chronological order or to investigate a cause-and-effect relationship
    • G. Directing Question or Comment
    • a. Nurse can gain additional valuable information to consider in assessing patient’s health status and educational or counseling needs
  4. 4. Diagram need for strong communication skills in each phase of nursing process
  5. 5. Strategies nurse may implement to improve communication with a client who has communication deficits (474)
  6. 6. Strategies nurse may implement to improve communication w/ limited English proficiency (474)
    • 1. Use interpreter whenever possible
    • 2. Use dictionary that translates words from one language to another
    • 3. Speak in simple sentences and in normal tone of voice
    • 4. Demonstrate or pantomime ideas you wish to convey, as appropriate
    • 5. Be aware of nonverbal communication
    • I. Nonverbal communication cues are universal
  7. 7. Explore characteristics of an assertive communicator (468-469)
    • I. Assertive behavior
    • A. Ability to stand up for oneself and others using open, honest, and direct communication
    • B. Focus is on the issue and not the person
    • C. They express feelings and beliefs in a non-defensive manner
    • D. Characteristics
    • a. Confident, open body posture; eye contact; use of clear, concise “I” statements; ability to share effectively one’s thoughts, feelings, and emotions
  8. 8. Predict the impact on client care when the nurse communicates assertively
  9. 9. Identify types of difficult communications
    10. Learner will be able to describe manifestations and consequences of difficult communications
  10. 11. Learning will be able to describe strategies to use during difficult communications to improve patient safety
    • 12. Describe the ISBARR form of communication and hand-off reporting (458)
    • I. Involves process of accurate presentation and acceptance of patient-related info from one caregiver or team to another caregiver or team using effective communication
    • II. SBAR
    • A. Situation
    • B. Background
    • C. Assessment
    • D. Recommendation
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N210 Week 5 Lecture Communication & Collaboration
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