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76 Cards in this Set

  • Front
  • Back

Define communication

a dynamic, two way process of sending and receiving messages, a way of transmitting thoughts and feelings, a way to meet physical, psychosocial, emotional, and spiritual needs

explain the purposes of communication

to share information and receive a reponse

what are the levels of communication

intrapersonal - self talk


interpersonal - communication between two people


group communication - communication between 3 or more people


public speaking - person delivers a speech or leads a discussion with a dozen or more people



What are the two components of communication?

content and process

what is content?

describes the actual matter of the message. We can control the content. includes words and gestures of the message.

What is process?

the act of sending, receiving, interpreting, and reacting to a message. We try to improve the process with tone.

what are the five elements of communication process?

sender - person delivering the message, the source, the encoder




message- the verbal and nonverbal intention, thought, feeling the sender wants to send




channel - the medium used to send the message




receiver- the observer, listener, interpreter of the message




feedback- the receiver sends back an interpretation of the message to see if that is what was intended.

in verbal communication, what is denotative meaning?

the literal translation of the word

what is connotative meanings

the implied or emotional meaning of a word

what are examples of nonverbal communication?

gestures- be aware of cultural differences


touch- can convey caring or invade space


facial expression - learn to control, helps recovery if we treat as matter-of-fact

What are some factors affecting communication?

Environment


Developmental level


Gender


Personal space

What are the 4 realms of personal space in American culture?

intimate distance - , within 18 inches


personal distance - 18 inches - 4 feet


social distance 4-12 feet


public distance - beyond 12 feet





What is territoriality

space and things that an individual perceives as belonging to them


What kind of communication describes report communication, is objective, brief, to the point, describes communication with professional colleagues; many safety techniques, standardized tools, to help that have been researched, and should be assertive with "I" statements?

collaborative communication

what kind of communication describes rapport communication, establishes relationship and should focus on the patient and patient's needs?

patient centered, therapeutic communication

What are 5 key characteristics of therapeutic communication?

empathy


respect


genuineness


concreteness


confrontation

What are some examples of over involvement and crossing of professional boundaries?

excessive disclosure from nurse, talking to much about self.


secrecy - "don't tell anyone I will do this for you,"


sexual misconduct - don't date patients, dont flirt



Identify the components of verbal and nonverbal communication.

Verbal communication. Vocabulary, denotative and connotative meaning, pacing, intonation, clarity and brevity, timing and relevance, credibility, and humor are the components of verbal communication. Nonverbal communication. Facial expression, posture and gait, personal appearance, distance, gestures, and touch are the components of nonverbal communication.

What action should you take when there is a discrepancy between the client's spoken word and nonverbal body language?

You must directly discuss the communication discrepancy with the patient; seek clarification in the client's intended message; and convey caring within the context of a therapeutic relationship.

What are the major factors that affect communication?

Communication is affected by the following major factors:


Environment


Life span variations


Gender


Personal space (intimate distance, personal distance, social distance)


Territoriality


Sociocultural factors


Roles and relationships


Attitudes

In what distance(s) do most nurse–client interactions occur?

Most nurse–client interactions occur in either the intimate or personal distances.

Identify and describe the phases of the therapeutic relationship.

The pre-interaction phase occurs before you meet the client. In this phase, you gather information about the client.




The orientation phase begins when you meet the client. The goal of this phase is to establish rapport, trust, and a timeline.




The working phase is the active part of the relationship. During this phase, caring is communicated, thoughts and feelings are expressed, mutual respect is maintained, and honest verbal and nonverbal expression occurs.




The termination phase is the conclusion of the relationship.

What are the five characteristics of therapeutic communication?

The five characteristics of therapeutic communication are empathy, respect, genuineness, concreteness, and confrontation.

Describe the difference between a task group and a self-help group.

A task group is developed to address a task or need. Members are chosen based on ability to complete the task. A self-help group is a voluntary organization composed of individuals with a common need. The organization revolves around a belief that the experience of others who have resolved the need assists others with the need.

Compare and contrast the role of a therapy group with a work-related support group.

A therapy group helps members cope with issues, improve relationships, or address stress. It is a formal, organized group with a facilitator. A work-related support group helps members of a profession cope with the stress associated with their work. It may be a formal or informal group.

Identify at least five barriers to communication.

Any five of the following common barriers to communication would be an appropriate answer:


Asking too many questions


Asking why


Fire-hosing information


Changing the subject inappropriately


Failing to listen


Failing to probe


Expressing approval or disapproval


Offering (unwanted) advice


Providing false reassurances


Stereotyping


Using patronizing language

What word describes " Elicits more than a "yes" or "no" response" ?

Open-ended questions

What describes Being helpful by facilitating interactions that focus on the client and his concerns?

Therapeutic communication

What describes Warm, caring interest and concern for the person?

empathy

What describes A pause in communication that allows the nurse and client to think about what has taken place?

Silence

What describes The ability to see into the experience of another and understand the other's perspective of a situation?

Empathy

Use of the phrases "Tell me more about . . . " or "I see" encourages clients to continue talking and expressing themselves. This is called:


A. summarizing


B. asking open-ended questions


C. focusing


D. encouraging elaboration

D. encouraging elaboration




Rationale: Such questions are designed to elicit more comprehensive information from the client. Response A, summarizing, is restating briefly the patient's responses. Response B, asking open-ended questions, are questions designed to allow the patient to freely give a detailed response to them. Response C, focusing, is asking specific questions designed to have the patient provide more detailed information about one aspect of the assessment.

In which phase of the therapeutic relationship does the patient learn to trust the nurse?


A. Orientation


B. Working


C. Termination


D. Beneficial

A. Orientation




Rationale: Trust is developed during the orientation phase of the nurse–patient relationship.

(True or false)Assertive communication includes expression of both positive and negative thoughts and feelings openly, honestly, and non-judgmentally.

True.




Rationale: Assertive communication is the expression of a wide range of positive and negative thoughts and feelings in a style that is direct, open, honest, spontaneous, responsible, and nonjudgmental. Assertiveness recognizes your rights while still respecting the rights of others.

In the context of assertive communication, describe what "fogging" is.

Answer: "Fogging" helps you accept criticism without becoming anxious or defensive. It acknowledges that there may be some truth to the criticism but allows the person to remain the judge of her own action (e.g., Suppose a physician says, "Are you playing pharmacist today?" You might respond, "I agree that I may not be a pharmacist and that I do not know everything there is to know about analgesics.")

Which of the following is the best method for nurses to encourage clients to reveal their worries and concerns?


A. Stand close to the patient and maintain eye contact.


B. Sit down next to the patient and provide her with privacy.


C. Look professional and confident.


D. Provide privacy and avoid eye contact with the patient.

B. Sit down next to the patient and provide her with privacy.




Rationale: Sitting close to the patient and providing privacy conveys respect and empathy for the patient and her concerns. Maintaining eye contact is a technique that demonstrates concern for the patient. However, standing next to the patient and appearing professional and confident can convey an attitude of authority but may be intimidating and may inhibit the patient from sharing her concerns. This position in the room also conveys the nurse is too rushed to come into a more personal space and communicate at a more deeper level.

Which situation requires intrapersonal communication?


1) Staff meetings


2) Positive self-talk


3) Shift report


4) Wound care committee meeting

2) Positive self-talk




Rationale: The nurse engaging in positive self-talk is using intrapersonal communication—conscious internal dialogue to analyze a situation or reflect upon an issue. Staff meetings, shift report, and a committee meeting are all examples of group or interpersonal communication.

The nurse suspects that a patient is being physically abused at home. What is the best environment in which to discuss the possibility of abusive events?


1) The patient's shared semiprivate room


2) The hallway outside the patient's room


3) An empty corner at the nurse's station


4) A conference room at the end of the hall

4) A conference room at the end of the hall




Rationale: The best environment in which to discuss sensitive matters is a quiet room where conversation can occur in private, particularly when the space is comfortable, quiet, and nonthreatening. The patient might be distracted if conversation takes place in a room where others (e.g., patients and visitors) are present. The hallway outside the patient's room and the nurses' station are public areas and should not be used for private conversation.

A patient is admitted to the medical-surgical floor with a kidney infection. The nurse introduces herself to the patient and begins her admission assessment. Which goal is most appropriate for this phase of the nurse–patient relationship? The patient will be able to:


1) Describe how to operate the bed and call for the nurse.


2) Discuss communication patterns and roles within the family.


3) Openly express his concerns about the hospitalization.


4) State expectations related to discharge.

1) Describe how to operate the bed and call for the nurse.




Rationale: This is the orientation phase of the relationship. The orientation phase begins when the nurse introduces herself to the patient and begins to gather data. In this phase, the nurse and patient are getting to know each other. As part of the orientation phase, the nurse will orient the patient to the hospital room and routines. In the preinteraction phase, the nurse gathers information about the patient before she meets him. Discussion of personal information, particularly if sensitive or complex, is suitable for the working phase of the nurse–patient interaction. The patient expressing feelings and concerns also occurs during the working phase. During the working phase, care is communicated, thoughts and feelings are expressed, and honest verbal and nonverbal communication occurs. Stating expectations related to discharge is most appropriate for the termination phase—the conclusion of the relationship.

A local church organizes a group for people who are having difficulty coping with the death of a loved one. Which type of group has been organized?


1) Work-related social support group


2) Therapy group


3) Task group


4) Community committee

2) Therapy group




Rationale: Therapy groups are designed to help individual members cope with issues, such as the death of a spouse, divorce, or motherhood. Work-related social support groups help members of a profession cope with work-associated stress. Task groups meet to accomplish a specified task. Community-based committees meet to discuss community issues.

A mother comes to the emergency department after receiving a phone call informing her that her son was involved in a motor vehicle accident. When she approaches the triage desk, she frantically asks, "How is my son?" Which response by the nurse is best?


1) "He's being examined now; he's awake and talking. We'll take you to see him soon."


2) "Don't worry, I'm sure he'll be fine; we have an excellent trauma team caring for him."


3) "Everything will be okay; please take a seat and I'll check on him for you."


4) "Your son is strong and has youth on his side; I'm sure he'll be fine."

1) "He's being examined now; he's awake and talking. We'll take you to see him soon."




Rationale: By telling the mother that her son is awake and talking and being examined by the doctor, the nurse provides accurate information and helps reduce the mother's anxiety. Responses such as "Don't worry, everything will be okay" and "I'm sure he'll be fine" offer false reassurance and fail to respect the mother's concern.

During a presentation at a nursing staff meeting, the unit manager speaks very slowly ina monotone voice. She uses medical and technical terminology to convey her message. Dressed in business attire, the manager stands erect and smiles occasionally while speaking. Which elements of her approach are likely to cause the staff to lose interest in what she has to say? Select all that apply.


1) Slow speech


2) Monotone


3) Occasional smile


4) Formal dress

1) Slow speech


2) Monotone




Rationale: Speaking slowly in a monotone can contribute to reduced attention as the listener can think faster than the speaker is speaking, and the monotone voice has an almost hypnotizing effect. Smiling improves personal interest and connection between the speaker and listener so should not cause a loss of interest. Wearing formal business attire would not directly detract from listeners' engagement in the speaker's message unless it was unusual enough to distract listeners; nothing in the situation above indicates that is so.

Which therapeutic communication technique gives the client the opportunity to collect and organize thoughts, to think through a point, or to consider introducing a topic of greater concern than the one being discussed?

using silence

Which therapeutic communication technique conveys an attitude of reception and regard? "yes I understand what you said," eye contact; nodding

accepting

Which therapeutic communication technique acknowledges and indicates awareness; better than complimenting which reflects the nurse's judgement? "I see that you made a ceramic ash tray in OT, I see you made your bed..."

giving recognition

Which therapeutic communication technique makes onself available on an unconditional basis, increasing client's feelings of self worth?


"ill stay with you a while, we can eat our lunch together"

offering self

Which therapeutic communication technique allows the client to take the initiative in introducing the topic; emphasizes the importance of the client's role in the interaction?


"what would you like to talk about today, tell me what you are thinking"

giving broad openings

Which therapeutic communication technique offers the client to continue?


"Yes, I see, go on,"

offering general leads

Which therapeutic communication technique clarifies the relationship of events in time so that the nurse and client can view them in perspective?


"what seemed to lead up to...?"

placing the event in time or sequence

Which therapeutic communication technique verbalizes what is observed or perceived and encourages the client to recognize specific behaviors and compare the perceptions with the nurse? " you seem tense, I notice you are pacing,"

making observations

Which therapeutic communication technique asks the client to verbalize what is being perceived; often used with clients experiencing hallucinations?


"are you hearing the voices again?"

encouraging description of perceptions

Which therapeutic communication technique asks the client to compare similarities and differences in ideas, etc. and helps the client recognize life experiences that tend to recur as well as those aspects of life that are changable?


"Whats this something like...how does this compare with the time when...?"

encouraging comparison

Which therapeutic communication technique repeats the main idea of what the client has said, and lets the client know whether or not an expressed statement has been understood and gives them the chance to continue, or clarify if necessary?


cl "I can't study, I'm distracted"


ns: "you have trouble concentrating"


cl: I can't take that new job what if i cant do it?"


ns: "you are afraid that you will fail at this new position"



restating

Which therapeutic communication technique questions and feelings refer back to the client to that they may be recognized and accepted, and so that that the client may recognize that his or her point of view has value-a good technique to use when the client asks the nurse for advice. "


cl: "what do you think I should do about my wifes drinking problem?"


ns:" What do you think you should do?"



reflecting

Which therapeutic communication techniquetakes notice of a single idea or word, and works especially well with a client who is moving rapidly from one thought to another. This technique is not therapeutic with a client who is very anxious, and hsould not be used until the anxiety level has subsided?


"this point seems worth looking at more closely, perhaps you and I can discuss it together"

focusing

Which therapeutic communication technique delves further into a subject, idea, experience, or relationship, especially helpful with cients who tend to remain on a superficial level of communication. However if the client chooses not to disclose further information, the nurse should refrain from pushing or probing in an area that obviously creates discomfort.


"tell me more about this particular situation"

exploring

Which therapeutic communication technique strives to explain that which is vague or incomprehensible and searches for mutual understanding. Clarifies the meaning of what has been said facilitates and increases understanding for both client and nurse?


"I'm not sure that I understand, would you please explain...do I understand correctly that you said..."

seeking clarification and validation

Which therapeutic communication technique is used when the client has a misperception of the environment, and the nurse defines reality or indicates their perception of the situation for their client?


"I understand that the voices seem real to you, but I don't hear any voices"

presenting reality

Which therapeutic communication technique expresses uncertainty as to the reality of the client's perceptions; often used with clients experiencing delusional thinking.


"I understand that you believe that to be true, but I see the situation differently"

voicing doubt

Which therapeutic communication technique puts into words what the client has only implied or said indirectly; can also be sued with the client who is mute or is otherwise experiencing impaired verbal communication. This clarifies that which is implicit rather than explicit.


cl "It's a waste of time to be here, I can't talk to you or anyone"


ns: "Are you feeling that no one understands"


cl: - mute-


ns: "It must have been very difficult for you when your husband died in the fire"

verbalizing the implied

Which therapeutic communication technique is used when feelings are expressed indirectly, the nurse tries to desymbolize what has been said and try to find clues to the underlying true feelings?


cl: "I'm way out in the ocean"


ns: "You must be feeling very lonely right now"



attempting to translate words into feelings

Which therapeutic communication techniqueis used when a client has a plan in mind for dealing with what is considered to be a stressful situation, it may serve to prevent anger or anxiety from escalating to an unmanagable level


"What could you do to let your anger out harmlessly?"

formulating a plan of action

Which non-therapeutic communication technique indicates to the client that there is no cause for anxiety, thereby devaluing the client's feelings; may discourage the client from further expression of feelings if he or she believes they will only be downplayed or ridiculed


"I wouldn't worry if I were you"

giving reassurance

Which non-therapeutic communication technique refuses to consider and shows contempt for the client's ideas or behavior. May cause the client to discontinue interaction with nurse for fear of further rejection


"Let's not discuss, I don't want to hear about..."

rejecting

Which non-therapeutic communication technique sanctions or denounces the client's ideas or behavior; implies that the nurse has the right to pass judgmenet on whether the client's ideas or behaviors are "good" or "Bad" and that the client is expected to please the nurse. The nurse's acceptance of the client is then seen as conditional depending on the client's behavior.


"That's good, I'm glad that you..."


"That's bad. I'd rather you wouldn't..."


Better to say: "Let's talk about how your behavior invoked anger in the other clients at dinner"

approving or disapproving

Which non-therapeutic communication technique is indicating accord with or opposition to the client's ideas or opinions; implies that the nurse has the right to pass judgement on whether the client's ideas or opinions are "right" or "wrong". Agreement prevent sthe client from later modifying his or her point of view without admitting error. Disagreement implies inaccuracy, provoking the need for defensiveness on the part of the client.


"That's right, I agree.


"That's wrong, I disagree."


better to say: "Let's discuss what you feel is unfair about the new community rules."



agreeing or disagreeing

Which non-therapeutic communication technique tells the client what to do or how to behave implying that the nurse knows what is best and that the client is incapable of any self-direction. It nurtues the client in the dependent role by discouraging independent thinking.


"I think you should..why don't you..."

giving advice

Which non-therapeutic communication technique is persistent questioning of the client; and pushes for answers to issues the client does not wish to discuss. This causes the client to feel used and valued only for what is shared with the nurse and places the client on the defensive.


"Tell me how your mother abused you when you were a child, tell me how you feel toward your mother now that she is dead..."


better technique: The nurse should be aware of the client's repsonse and discontinue the interaction at the first sign of discomfort.

probing

Which non-therapeutic communication technique attempts to protect someone or something from a verbal attack. To defend what the client has criticized is to imply that he or she has no right to express ideas, opinions, or feelings. Defending does not change the client's feelings and may cause the client to think the nurse is taking sides against the client.


"No one here would lie to you"


"You have a good doctor, I'm sure he only has your best interests in mind"


better to say: "I will try to answer your questions and clarify some issues regarding your treatment.

defending

Which non-therapeutic communication technique asks the client to provide the reasons for thoughts, feelings, behavior, and events. Asking "Why" a client did something or feels a certain way can be very intimidating, and implies that the client must defend his or her behavior or feelings.


"Why do you think that?""Why do you feel this way? Why did you do that"


Better to say: "Describe what you were feeling just before that happened"

requesting an explanation

Which non-therapeutic communication technique attributes the source of thoughts, feelings and behavior to others or to outside influences. This encourages the client to project blame for his or her thoughts or behaviors on others rather than accept the responsibility personally"


"What makes you say that? What made you do that?"


better to say: "You became angry when your brother insulted your wife"



indicating the existence of an external source of power

Which non-therapeutic communication technique is when the nurse misjudges the degree of the client's discomfort, a lack of empathy and udnerstanding may be conveyed. the nurse may tell the client to "perk up" or "snap out of it." this causes the client to feel insignificant or unimportant. When one is experiencing discomfort, it is no relief to hear that others are or have been in similar situations.


cl: "I have nothing to live for. I wish I were dead."


ns: "Everybody gets down in the dumps at times, I feel that way too sometimes."


better to say: "You must feel very upset, tell me what you are feeling right now."



belitting feelings expressed

Which non-therapeutic communication technique desdcribes cliches and trite expressions being meaningless in a nurse-client relationship. When the nurse makes empty conversation, it encourages a like response from the client.


"I'm fine, how are you?"


"Hang in there, it's for your own good


"Keep your chin up"


better to say: "The therapy must be difficult for you at times. How do you feel about your progress at this point?"

making stereotyped comments

Which non-therapeutic communication technique denies that a problem exists and blocks discussion with the client and avoids helping the client identify and explore areas of difficulty.


cl: "I'm nothing"


ns: "of course you're something, everybody is somebody."


Better to say: "You're feeling like no one cares about you right now."

using denial

Which non-therapeutic communication technique is used by the therapist to seek to make conscious that which is unconscious, to tell the client the meaning of their experience.


"what you really mean is..."


better technique: "The nurse must leave interpretation of the client's behavior to the psychiatrist. The nurse has not been prepared to perform this technique and in attempting to do so, may endanger other nursing roles with the client.

interpreting

Which non-therapeutic communication technique changes the subject causing the nurse to take over the direction of the discussion, and may occur in order to get something that the nurse wants to discuss with the client or get away from a topic that he or she would prefer not to discuss.


cl: "I don't have anything to live for"


ns: "did you have any visitors this weekend?"


better technique: the nurse must remain open and free to hear the client and to take in all that is being conveyed, both verbally and nonverbally.

introducing an unrelated topic.