Communication

• S- sit facing pt
• O- open posture
• L- lean toward client
• E- establish and maintain intermittent eye contact
• R- relax

conveys a sense af self assurance while also communicating respect for the other person

is the ability to be self-directed and independent in accomplishing goals and advocating for others

• the basic element of human interactions that allow people to establish, maintain and improve contact with others.
• a process that provides for the exchange of ideas, information and feelings b/t 2 or more people

feeling with the pt, understanding their experiences

setting in which communication occurs

• 1 on 1 communication
• used daily
• forum for an exchange of ideas

• talk within yourself
• should be positive and motivational

all other ways to communicate that are not verbal, nonverbal or symbolic

5 senses, facial expression

• are based on information received through the 5 senses
• also influenced by culture and education

are human tendencies that interfere with accurately perceiving and interpreting messages from others

.









.

Interactions with public audiences

• Small number of people
• goal directed
• all members must have an understanding of the topic

using gestured that are socially known, thumbs up, waving, etc.

• pity
• feeling sorry for someone

is specific responses that encourage the expression of feelings and ideas and convey acceptance and respect

• spiritual
• prayer
• meditation

spoken word

Referent; the stimulus to give a message, what motivates one person to communicate with another

Sender; the person who encodes and delivers the message

Message; the content of the communication

Receiver; the person who receives and decodes the message

Feedback; the message returned by the receiver

Channels; type, or means of conveying and receiving messages

• Intrapersonal communication: occurs within an individual
• Interpersonal communication: is one on one communication
• Transpersonal communication: occurs within a personal spiritual domain
• Small-group communication: occurs when a small # of people meet together
• Public communication: is an interaction with an audience

• Vocabulary; both parties must u/s
• Denotative Meaning; different culture has a different meaning
• Connotative Meaning; how you receive the message is based on the receivers experience
• Pacing; an appropriate speed or pace
• Intonation; your voice affects the meaning of the message
• Clarity & Brevity; simple, brief and direct
• Timing & Relevance; even if the message is clear, poor timing can keep it from being effective

• Interpersonal variables are factors within both the sender and the receiver that influence communication
• ex. perception, educational and developmental levels, sociocultural backgrounds, values and beliefs, emotions, gender, physical health status and roles and relationships

• Personal Appearance; physical characteristics, facial expressions, manner of dress and grooming
• Posture and Gait; a form of expression which reflects attitudes and emotions
• Facial Expressions; the most expressive part of the body, it conveys emotion
• Eye Contact; signals readiness to communicate
• Gestures; emphasize, punctuate and clarify the spoken word
• Sounds; communicate feelings or thoughts
• Territorality and Personal Space; provides a sense of identity, security and control

Territoriality is the need to gain, maintain and defend one's right to space. ex, fence around your yard, curtain around your hospital bed

Personal Space is similar to territoriality but it is invisible, individual and travels with the person.

Personal Space:

• Intimate Zone- (0"-18") holding a baby, bathing a person, conducting a physical assessment
• Personal Zone- (18"-4') sitting at a bedside, taking a pt's hx, teaching care
• Social Zone- (4'-12') teaching a class, conducting a support group
• Public Zone- ( >12') lecturing to a class, public speaking

• Touch:
• Social Zone- Permission is not needed; hands, arms, shoulders or back
• Consent Zone- Permission needed; mouth, wrists, feet
• Vulnerable Zone- Special care needed; face, neck or the front of the body
• Intimate Zone- Great sensitivity needed; genetalia

• Courtesy
• Use of names
• Privacy and confidentiality
• Trustworthiness
• Autonomy and responsibility
• Assertiveness- standing up for your rights without violating others

• Physical and emotional factors: pts with hearing or vision impairments have fewer channels to receive messages with; anxiety and anger can interfere with the communication process
• Development factors: the level of growth and development, such as in small children
• Sociocultural factors: culture is the blueprint for thinking, behaving, feeling and communicating. depends on a pt's education levels, language and customs
• Genger: male and female communication patters are different

• Active listening:
• Stating observations: how the pt looks, acts and sounds
• Sharing empathy: neutral and nonjudgemental statements that tell the pt you understood the feeling content in their message
• Sharing hope: communicating a sense of possibility to others
• Sharing humor:
• Sharing feeling:
• Touch:
• Silence:
• Asking relevant questions:
• Providing information:
• Paraphrasing:
• Clarifying:
• Focusing:
• Summarizing:

• Asking personal questions:
• Giving personal opinions:
• Changing the subject:
• False reassurances:
• Sympathy:
• Why?: Don't ask for explanations
• Showing disappointment or disapproval: Don't impose your own values, attitudes or beliefs.
• Defensive responses:
• Stereotyping:
• Interrupting:

• the RN assumes the role of professional helper and comes to know the pt as an individual who has unique health needs, human responses and patterns of living.
• the relationship os characterized by the RN's nonjudgemental acceptance of the pt. the acceptance conveys the willingness to hear a message or to acknowledge feelings.
• it is built off the pt's trust in the nurse.
• show EMPATHY(feel with them, u/s their experience) don't show SYMPATHY (pity)

• Preinteraction Phase- before meeting the pt, the RN reviews all os the available data and hx, talks to other caregivers abt the pt, anticipates concerns or issues and plans for the initial interaction.
• Orientation Phase- when the RN and the pt meet and get to know each other. It sets the tone for the relationship, assesses the status, begins to make observations, prioritizes problems and begins to set goals.
• Working Phase- when the RN and the pt work together to solve the problems and accomplish goals. Provides information needed, helps the client set goals, facilitates successful interaction with therapeutic communication.
• Termination Phase- the ending of the relationship. Remind the pt that termination is near, evaluates goal achievement, reminisces abt relationships with pt, relinquishes responsibility of care to the client or for the transition to another facility

• a private location
• no unnecessary noises or distractions
• a location where the pt feels safe and comfortable

.









.

• Clients who cannot speak clearly- listen intently; don't interrupt; ask simple questions requiring yes or no answers; allow time to respond; use visual cues or communication aids
• Clients who are cognitively impaired- reduce environmental distractions; get the pt's attn prior to speaking; use simple sentences and explanations; ask one question at a time; allow time for a response
• Clients who are unresponsive- call client by name during interactions; communicate verbally and by touch; speak to client as if they can hear; explain procedures; orient to time and place; dont talk abt client like they are not there
• Clients who do not speak english- speak in a normal tone of voice; establish a method for the pt to signal if they want to communicate; get an interpreter; use communication aids; get a dictionary

• Assessment-
• 1. identify barriers to effective communication
• 2. special needs

• Nursing Dx-
• 1. impaired verbal communication r/t ...

• Planning-
• 1. expected outcomes

• Implementation-
• 1. adapting communication techniques
• 2. therapeutic communication techniques

• Evaluation-
• 1. outcomes; met? or not?