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82 Cards in this Set
- Front
- Back
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Communication
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-The process of transmitting messages & interpreting meaning (Sender and Receiver)
-Basic to all human interaction -What is communication influenced by? |
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Communication is influenced by…
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-instillation of hope
-cultivating sensitivity to self and to others -establishing a trusting relationship -promoting the expression of feelings (+,-) -problem solving using the scientific method -assisting with meeting of needs -teaching/learning -providing a supportive environment |
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Communication is the central human activity
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-In some ways the ability to communicate is what allows us to separate ourselves from other species
- No communication is dehumanizing |
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Components of communication
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Referent – motivator
Sender – encodes & delivers the message Receiver – receives and decodes the message Message – content, verbal, nonverbal & symbolic Channels – sensory means of conveying message Feedback – returned message-indicating degree of understanding Interpersonal variable – filters and biases Environment – setting |
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Receiver
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For communication to occur, there must be at least two parties.
Even when you talk to yourself, you have conceived of yourself as “two parties” Receives and decodes message Translates and responds to message |
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Sender
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Delivers the message
Communication does not occur in isolation. It is based on a relationship between people. “Sending” can be intentional or unintentional “Sending” can be verbal, aural, visual, tactile Complex Multifaceted |
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Channels
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Not a linear process
Not solely a cognitive process Not an easy process (You just don’t understand.) More channels used, more easily understood = (more senses used more easily understood) refers to the medium used to convey information from a sender (or transmitter) to a receiver. |
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Feedback
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Message returned.
Reveals most about the person giving feedback Requires openness on both sender & receiver Spoken or written |
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Verbal communication
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Vocabulary-translate words and phrases related to Culture, Age, Education, Mental status
Denotative (=the obvious/ literal) meaning and connotative (=the hidden) meaning Pacing(tone,volume,matching to receiver) Intonation Clarity & brevity Timing & relevance |
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Nonverbal communication
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Powerful messages sent via body language
-facial expression, vocal cues, eye contact -gestures, posture, touch, odor -physical appearance, dress, silence, spatial boundaries Do verbal and nonverbal match? |
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Professional Nursing Relationships
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Courtesy
Use of names – introduce yourself (regardless of name tag) Always use last name. Privacy & confidentiality Trustworthiness Autonomy & responsibility Assertiveness (“I” statements) |
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Context of Interaction
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Experience, culture, values, beliefs
Purpose of interaction Physical & emotional context |
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Common Mistakes
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Finishing other’s sentences
Preparing to respond before someone is finished speaking Multitasking while “listening” Filtering content or meaning based on the speaker Speaking for others (we…) |
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Nontherapeutic techniques(Items that have asterisks are most common)
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Giving reassurance
Rejecting Giving approval or disapproval Agreeing/disagreeing *Giving advice Probing *Defending Requesting an explanation Indicating the existence of an external source of power *Social responding Belittling feelings expressed Making stereotyped comments, clichés, and trite expressions Using denial |
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Giving reassurance
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May discourage client from further expression of feelings if client believes the feelings will only be belittled
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Rejecting
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Refusing to consider client’s ideas or behavior
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Giving approval or disapproval
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Implies that the nurse has the right to pass judgment on the “goodness” or “badness” of client’s behavior
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Agreeing/disagreeing
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Implies that the nurse has the right to pass judgment on whether client’s ideas or opinions are “right” or “wrong”
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*Giving advice
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Implies that the nurse knows what is best for client and that client is incapable of any self-direction
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Probing
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Pushing for answers to issues the client does not wish to discuss causes client to feel used and valued only for what is shared with the nurse
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*Defending
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To defend what client has criticized implies that client has no right to express ideas, opinions, or feelings
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Requesting an explanation
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Asking “why” implies that client must defend his or her behavior or feelings
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Indicating the existence of an external source of power
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Encourages client to project blame for his or her thoughts or behaviors on others
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*Social responding
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Not client centered, superficial
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Belittling feelings that a client has expressed...
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Causes client to feel insignificant or unimportant
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Making stereotyped comments, clichés, and trite expressions
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These are meaningless in a nurse-client relationship
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Using denial
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Blocks discussion with client and avoids helping client identify and explore areas of difficulty
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SOLER (a Therapeutic Technique)
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Sit squarely facing the client
Observe an open posture Lean forward toward the client Establish eye contact Relax |
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Therapeutic – ask yourself:
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How do you know when someone is listening to you?
How does it feel when someone pretends to listen to you? |
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Active listening
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Is an acquired skill
-suppress biases -preoccupying person issues -internal/external distracters |
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Full and undivided attention
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-words
-voice -behavior |
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Therapeutic techniques (Items that have asterisks are most common)
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Using silence
Accepting Giving recognition Offering self *Giving broad openings *Offering general leads *Placing the event in time or sequence Making observations Encouraging description of perceptions Encouraging comparison *Restating *Reflecting *Focusing Exploring Seeking clarification and validation Presenting reality *Voicing doubt Verbalizing the implied Formulating a plan of action |
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Using silence
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Allows client to take control of the discussion, if he or she so desires
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Accepting
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Conveys positive regard (Can you accept all communication?)
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Giving recognition
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Acknowledging, indicating awareness
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Offering self
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Making oneself available
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*Giving broad openings
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Allows client to select the topic
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*Offering general leads
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Encourages client to continue
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*Placing the event in time or sequence
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Clarifies the relationship of events in time
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Making observations
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Verbalizing what is observed or perceived
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Encouraging description of perceptions
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Asking client to verbalize what is being perceived
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Encouraging comparison
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Asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships
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*Restating
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Lets client know whether an expressed statement has or has not been understood
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*Reflecting
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Directs questions or feelings back to client so that they may be recognized and accepted
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*Focusing
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Taking notice of a single idea or even a single word
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Exploring
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Delving further into a subject, idea, experience, or relationship
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Seeking clarification and validation
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Striving to explain what is vague and searching for mutual understanding
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Presenting reality
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Clarifying misconceptions that client may be expressing
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*Voicing doubt
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Expressing uncertainty as to the reality of client’s perception
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Verbalizing the implied
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Putting into words what client has only implied
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Formulating a plan of action
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Striving to prevent anger or anxiety from escalating to an unmanageable level the next time the stressor occurs
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Most people
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…Talk at a speed of 125 words/minute
…Think at a speed of 600 words/minute |
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Communication is not the message that was intended but rather the message that was received. The statement that best helps explain this is:
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Contextual factors, such as attitudes, values, beliefs, and self-concept, influence communication. Assessment of a client's ability to communicate includes gathering data about the many contextual factors that influence communication. These include the participants' internal factors and characteristics, the nature of their relationship, the situation prompting communication, the environment, and the sociocultural elements present. Assessing these contextual factors helps the nurse make sound decisions during the communication process.
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The nurse demonstrates active listening by:
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Assuming a relaxed posture and leaning toward the client. Active listening means to be attentive to what the client is saying both verbally and nonverbally. Several nonverbal skills have been identified as facilitative skills for attentive listening.S=Sit facing the client. O=Observe an open posture (i.e. arms/legs uncrossed). L=Lean toward the client. This posture conveys that you are involved and interested in the interaction. E=Establish and maintain intermittent eye contact. R=Relax.
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The nurse builds helping, caring relationships by:
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Establishing trust and demonstrating empathy. A helping relationship between nurse and client does not just happen -- it is created with care and skill and is built on the client's trust in the nurse. Statements reflecting empathy are highly effective because they tell the person that the nurse heard the feeling content, as well as factual content, of the communication. It is used to establish trust.
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Gender influences how a person thinks, acts, feels, and communicates. In Western culture it is important for the nurse to remember when he is trying to be sensitive to gender in communicating that:
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Males communicate to achieve goals, establish individual status and authority, and compete for attention and power. Gender is another factor that influences how we think, act, feel, and communicate. Male and female communication patterns tend to differ, which can sometimes create barriers to effective communication. Females communicate to build connections with others, include others, and cooperate with, respond to, show interest in, and support others.
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The statement that best explains the role of collaboration with others for the client's plan of care is the professional nurse:
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Collaborates with colleagues and the client's family to provide combined expertise in planning care. Nurses function in roles that require interaction with multiple health team members. Many elements of the nurse-client helping relationship are also applied in these collegial relationships, which are focused on accomplishing the work and goals of the clinical setting. It is especially important to involve the client and family in decisions about the plan of care to determine whether suggested methods are acceptable.
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"I'm not sure I understand what you mean by 'sicker than usual.' What is different now?" The nurse is using the therapeutic technique:
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Clarifying: to check whether understanding is accurate, the nurse can restate an unclear or ambiguous message to clarify the sender's meaning. Instead of restating the message, the nurse can also ask the other person to rephrase it, explain further, or give an example of what the person means.
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"We've talked alot about your medications, but let's look more closely at the trouble you're having in taking them on time." The nurse is using the therapeutic technique:
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Focusing on key elements or concepts of a message. If conversation is vague or rambling or clients begin to repeat themselves, focusing is a useful technique.
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"If I were you, I'd put your mother in a nursing home." The nurse is using the nontherapeutic technique:
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Giving personal opinions: when the nurse gives a personal opinion, it takes decision making away from the client. It inhibits spontaneity, stalls problem solving, and creates doubt.
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When working with an older adult, the nurse should remember to avoid:
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Shifting from subject to subject: A tip for improved communication with older adults is to stick to one topic at a time.
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A nurse should consider zones of personal space and touch when caring for clients. If the nurse is taking the client's nursing history, she should:
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Be 18 inches to 4 feet from the client. In the zones of personal space and touch, the personal zone (18 inches to 4 feet) includes nursing activities such as sitting at a client's bedside and taking the client's nursing history.
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What is the difference btw social and therapeutic relationships?
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Social: not client centered-superficial
Therapeutic -nurse/pt relationship |
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What are the key components of professional communication?
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1.Courtesy
2. Use of names 3.Privacy and confidentiality 4. trustworthiness 5. autonomy and responsibility 6. assertiveness explain each |
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Explain the elements of the communication process?
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1.Verbal communication
a.vocabulary b.denotative and connotative meaning c.pacing d.intonation e.clarity and brevity f.timing and relevance 2. non-verbal communication a. personal appearance b. posture and gait c. facial expression d.eye contact e. gestures f. sounds g.territoriality and personal space 3. Symbolic Communication 4. Metacommunication |
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Identify common impairments resulting in altered communication process?
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1. Aphasia, dysarthria, muteness- Cannot speak clearly
2. Clients who are cognitively impaired 3. clients who are unresponsive 4. clients who do not speak english |
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Describe methods of communication with persons with impaired communication.
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Clients who cannot speak clearly: listen attentively, be patient, do not interrupt
-ask simple questions w/yes and no answers -allow time for answers -use visual cues -allow only 1 person at a time to speak -do not shout or speak too loudly -encourage the client to converse -let client know if you have not understood -collaborate with speech therapist as needed -use communication aids |
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Describe methods of communication with persons with impaired communication.
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Clients who are cognitively impaired:
-reduce environmental distractions -get client's attention prior to speaking -use simple sentences and avoid long explanations -ask one question at a time -allow time -be an attentive listener -include family |
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Describe methods of communication with persons with impaired communication.
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Clients who are unresponsive
-call client by name during interactions -communicate both verbally and by touch -speak to client as though he/she could hear -explain all procedures and sensations -provide orientation to person, place and time -avoid talking about client to others in his or her presence -avoid saying things client should not hear |
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Describe methods of communication with persons with impaired communication.
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Clients who do not speak English:
-speak to client in normal tone -establish method for client to signal desire to communicate (call light or bell) -provide an interpreter as needed -avoid using family members, especially children as interpreters -develop communication board, pictures or cards -translate words from native language into english list for client to make basic requests -have language dictionary available |
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What is Metacommunication?
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Uncovers the deeper message than what is being said- this is a therapeutic communication technique
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What is Symbolic Communication?
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Language includes non-verbal as well as verbal symbolic communications. There is Sign language and Body Language. All communication with others is symbolic and involves the use of language, sound, bodily gesture and expression.
Symbolic communications are demonstrated by the cars we drive, the houses we live in, and the clothes we wear (e.g. uniforms – police, military). The most important aspects of symbolic communication are the words we use |
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The Referent is?
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anything that motivates one person to communicate with another. It can be sensations or perceptions of pain, a question on care, or simply "what time is lunch?"
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A nursing instructor notices a student nurse is lacking professionalism when the student?
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shares personal info about their assigned client with other students not involved with the client's care
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What is Intrapersonal communication?
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self-talk, self-instruction, and inner thought. can provide a mental rehearsal for difficult tasks, so they can be dealt with more effectively
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By using Therapeutic communication, the nurse encourages the client to?
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express feelings
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What would be an example of transpersonal communication?
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Prayer
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Positive self-talk is a form of __________communication that can be used to improve one's self-esteem
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intrapersonal
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What type of listening is an important principle for effective communication to take place in small groups?
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Active listening
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The nurse says to the client."We have talked a lot about your surgery and the implications for when you go home. Let's discuss some of the exercises that you can do." This is an example of
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Focusing-this is used to center on key elements or concepts of a message. helps guide the direction of the conversation
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What is clarifying?
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used to check whether understanding is accurate. Instead of restating the message as with paraphrasing, the nurse asks the other person to rephrase it, explain further, or give an example of what the person means
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Restating or Paraphrasing is?
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restating another's message more briefly using one's own words. the nurse sends feedback that lets the client know that the nurse is actively involved in the search for understanding
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