- 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 Group Communication...
- 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.
- feeling sorry for someone
Therapeutic Communication Techniques...
is specific responses that encourage the expression of feelings and ideas and convey acceptance and respect
Describe the basic elements of the communication process.
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
Identify and discuss levels of communication.
- 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
Discuss the various aspects of verbal communication.
- 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
Identify and give examples of interpersonal variables which influence communication.
- 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
Discuss the various means of nonverbal communication.
- 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
Differentiate b/t territoriality and personal space.
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.
List nursing actions that take place in each zone of personal space and touch.
- 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
- 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
List and discuss the elements of professional communication.
- Use of names
- Privacy and confidentiality
- Autonomy and responsibility
- Assertiveness- standing up for your rights without violating others
Identify the factors the nurse assesses that influence the pt's communication.
- 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
Identify and give examples of techniques that promote therapeutic communication.
- 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:
- Asking relevant questions:
- Providing information:
Identify and give examples of techniques that inhibit communication (non-therapeutic).
- Asking personal questions:
- Giving personal opinions:
- Changing the subject:
- False reassurances:
- Why?: Don't ask for explanations
- Showing disappointment or disapproval: Don't impose your own values, attitudes or beliefs.
- Defensive responses:
List the characteristics of a helping relationship.
- 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)
Describe the phases of a helping relationship.
- 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
List 3 methods of environmental control to facilitate interpersonal communication.
- a private location
- no unnecessary noises or distractions
- a location where the pt feels safe and comfortable
Describe the influence of culture in communication.
Discuss adapting communication techniques for pt's that have conditions that impair their communication.
- 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
NURSING PROCESS AND COMMUNICATION
- 1. identify barriers to effective communication
- 2. special needs
- Nursing Dx-
- 1. impaired verbal communication r/t ...
- 1. expected outcomes
- 1. adapting communication techniques
- 2. therapeutic communication techniques
- 1. outcomes; met? or not?