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Communication
- Reciprocal process in which messages are sent and received between people
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Sender
- Person conveying the message
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Receiver
- The individual or individuals to whom the message is conveyed
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One way communication
- Very little place in the nurse-patient relationship
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Two way communication
- Requires that both the sender and the receiver participate in the interaction
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Purpose of two way communication
- Purpose is to meet the needs of both of you and to establish a trusting relationship.
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Verbal communication
- Involves the use of spoken or written words or symbols
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Connotative meaning
- Of a word is subjective and reflects the individuals perception or interpretation.
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Denotative meaning
- Refers to the commonly accepted definition of a particular word. No guarantee but most likely it is seen the same way all around
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Jargon
- Commonplace �language� or terminology unique to people in a particular work setting, such as a hospital, or to a specific type of work, such as nursing
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Nonverbal communication
- Messages transmitted without the use of words (either oral or written). Nonverbal cues include tone and rate of voice, volume of speech, eye contact, physical appearance, and use of touch
- What significantly affects how people interpret eye contact?
- Culture significantly affects how people interpret this
- Interpret what?
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What are the components of voice?
- Tone, volume, pitch, rate of speech
- Components of what?
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What are the components of eye contact?
- Extended (longer than 6 sec); brief but direct (2-6 sec) absent or fleeting
- Components of what?
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What are the components of physical appearance?
- Size, color of skin, dress, grooming, body carriage, age, sex
- Components of what?
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What are the components of gestures?
- Distinct movements of hands, head, body
- Components of what?
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What are the components of posture
- Open stance vs. closed stance
- Components of what?
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Gestures
- Movements people use to emphasize the idea they are attempting to communicated. Also play a useful role in clarifying
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Posture
- Potential to convey warmth and acceptance or distance and disinterest
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Open posture
- When you take a relaxed stance with uncrossed arms and legs while facing the other individual
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Closed posture
- A more formal, distant stance, generally with the arms, and possibly the legs, tightly crossed
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Assertiveness
- Ability to confidently and comfortably express thoughts and feelings while still respecting the legitimate rights of the patient
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Assertive communication
- Style is interaction that takes into account the feelings and needs of the patient, yet honors your rights as an individual
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Aggressive communication
- When you interact with another in an overpowering and forceful manner to meet your own personal needs at the expense of the other
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What type of communication is destructive?
Aggressive communication is that
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Unassertive communicated
- Nurse agrees to do what the patient requests even though doing so will create additional problems for the nurse
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What type of communication sacrifices your legitimate personal rights to the needs of the patient and there is a price to pay: resentment
Unassertive communication
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The focus of each interaction should be what and should not be?
- In interaction the patient should be and not be equipment or the task
- ?
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Communication in nursing has the potential to be?
- It has potential to be therapeutic or nontherapeutic
- What does?
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Therapeutic communication
- Ideal type of communication. Consists of an exchange of information that facilitates the formation of a positive nurse-patient relationship and actively involves the patient in all areas of her or his care
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Nontherapeutic communication
- Usually blocks the development of a trust relationship
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Listening is what kind of skill?
- It is an acquired skill
- What is?
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What is one of the most effective methods of therapeutic communication, it is also one of the most difficult to master
Listening
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What type of technique is a behavior that conveys interest and caring toward the patient?
- Nonverbal communication technique
- What type of technique is this?
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It is possible to _____ without ______. (regarding comm..)
Possible to hear without listening
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Active listening
- Requires full attention to what its meaning, and five the patient feedback indicating your understandning of the message. Patent has an opportunity to validate that you received or didn�t receive the message as intended.
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Passive listening
- Indicate that you are listening to what the patient is saying either nonverbally, through eye contact and nodding, or verbally through encouraging phrases
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Which technique is an extremely effective therapeutic communication technique, and yet it tends to be quite underused.
- Maintaining silence
- Is what type of communication technique?
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Maintaining silence allows you to?
- It allows you to observe the patient�s nonverbal messages, which often more accurately convey the patient�s thoughts and feelings than words
- What allows you to?
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What is the benefit of active listening?
- This type of nonverbal technique conveys interest and caring; gives patient full attention; allows feedback to verify understanding of the message
- Which technique is this?
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Interpretation of touch is depended on what factors?
- Depended on: duration and intensity of the contact; the body part touched; the culture, sex and age of both the patient and the nurse; the environment; and the stage of development of the relationship
- Factors of what?
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Your acceptance is?
- It is your willingness to listen and respond to what a patient is saying without passing judgment on the patient
- What is this?
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Minimal encouragement
- Subtle therapeutic technique that communicates to the patient that you are interested and want to hear more
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Closed question
- Focused and seeks a particular answer
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�what time do you usually take your insulin?� what type of question is this?
Closed question
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What type of question usually requires and elicits only a �yes� or �no� or one to two word answer?
Closed question
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Open ended question
- Does not require a specific answer and cannot be answered by �yes� �no� or one word response
- What type of question?
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This type of question usually begins words like �how,� �what,� �can you tell me about,: �in what way�
- Open ended question
- Usually begins with?
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Restating
- Repeating to the patient when the nurse believes to be the main point that the patient is trying to communicate;
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What type of verbal therapeutic communication has the tone of voice rises slightly at the end of the phrase as if asking a question?
- Restating
- What happens with the tone of ones voice?
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Paraphrasing
- Restatement of the patient�s message in the nurse�s own words
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Clarifying
- Seeks to understand the patient�s message by asking for more information or for elaboration on a point; expressed as a question or statement followed by a restatement or paraphrasing of part of the patient�s message
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Focusing
- Nurse encourages the patient to select one topic over another as the primary focus of discussion
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Reflecting
- Assists the patient to reflect on inner feelings and thoughts rather than seeking answers and advice from another
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Stating observations
- The nurse makes observations of the patient during an interaction and communicates these observations back to the patient
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Offering information
- Nurse provides the patient with relevant data and asks for feedback to determine the patient�s level of understanding
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Summarizing
- Concise review of main ideas from a discussion
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Stating observations
- Communicating your observations to the patient
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Offering information
- Much of the communicating that the nurse does takes the form of this. This happens when preparing a patient for what to expect before, during, and after an invasive diagnostic
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With this you have the ability to enhance feelings of well being, reduce anxiety, and encourage a sense of home
- With humor you have this
- Have what?
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It is never appropriate to laugh ____ - only ____ a person
At only with
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Comfort zone
- Intangible personal space
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Intimate zone
- Distance from touching us to 18 inches away
- Which zone?
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Personal zone
- Distance from 18 inches to 4 feet away
- Which zone?
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Social zone
- Distance from 4 feet to 12 feet away
- Which zone?
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Public zone
- Distance from 12 feet or more away
- Which zone?
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Make every attempt to make what kind of environment for interaction
a calm, relaxed environment
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what type of relationship is essential to effective nurse-patient interaction
- a trusting relationship is essential for this
- for what?
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What is one of the main ways of fostering trust?
- Foster it by demonstrating confidence and competence
- Foster what?
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What are largely influenced by cultural and social beliefs and attitudes on communication?
- Age and gender are largely influenced by this
- By what?
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What are the different types of physiological factors that may interfere with effective communication?
- Pain, altered cognition, impaired hearing
- What type of factors that effect communication?
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Altered cognition
- Another physiologic factor that frequently hinders effective communication. If the patient lacks this ability to receive, process, and send information, communication is derailed
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Impaired hearing
- Physiologic factor common in the older adult
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Ways to communicated with patients who have hearing impairment
- Check for hearing aids and glasses, reduce environmental noise, get pts attention before speaking, face pts with our mouth visible, do not chew gum, speak at normal volume, rephrase rather than repeat if misunderstood, and proved a sign language interpreter if indicated
- What does all this help with?
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What are a couple of psychological factors that may interfere with effective communication?
Stress and grieving
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Nursing diagnosis of impaired verbal communication is used to describe?
- �decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols�
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What types of responses are used to block communication?
- False reassurance, giving advice or personal opinions, false assumptions, approve or disapproval, automatic responses, defensiveness, arguing, asking for explanations, and changing the subject
- These are all what type of responses used for?
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Aphasia
- Deficient or absent language function resulting from ischemic insult to the brain, such as a stroke, brain trauma, or anoxia
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Expressive aphasia
- They are unable to send the desired verbal message
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Receptive aphasia
- Inability to recognize or interpret the verbal message being received
- Term?
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