Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
76 Cards in this Set
- Front
- Back
|
3 levels of communication
|
- Intrapersonal
- Interpersonal - Transpersonal |
|
|
6 Processes of Communication
|
1. Refernt
2. Sender 3. Receiver 4. Message 5. Channel 6. Feedback |
|
|
5 Forms of communication
|
1. Verbal
2. Nonverbal 3. Symbolic 4. Metacommunication 5. Computer mediated |
|
|
6 Aspects of verbal communication:
|
1. Vocabulary
2. Denotative and Connotative meaning 3. Pacing 4. Intonation 5. Clarity & Brevity 6. Timing & Relevance |
|
|
8 Interpersonal variables which influence communication: (either sender or receiver)
|
1. Perception
2. Educational and developmental levels 3. Socio-cultural backgrounds 4. Values and beliefs 5. Emotions 6. Genders 7. Physical health status (pain, anxiety medication effects) 8. Roles and relationships |
|
|
7 Means of nonverbal communication:
|
1. Personal Appearance
2. Posture & gait 3. Facial expression 4. Eye contact 5. Gestures 6. SOunds 7. Territoriality & personal space |
|
|
4 Zones of personal space:
|
1. Intimate zone
2. Personal zone 3. Social zone 4. Public zone |
|
|
4 Zones of Touch:
|
1. Social zone
2. Consent zone 3. Vulnerable zone 4. Intimate zone |
|
|
6 Elemetns of professional communication:
|
1. Courtesy
2. Use of names 3. Privacy & COnfidentiality 4. Trustworthiness 5. Autonomy & Responsibility 6. Assertiveness |
|
|
8 Factors influencing a pateint's communication:
|
1. Psychophysiological factors
2. Relational factors 3. Situational factors 4. Environmental factors 5. Sociocultural factors 6. Gender factors 7. Physical & emotional factors 8. Developmental factors |
|
|
Therapeutic Communication
|
1. The nurse’s single most important tool
2. Client focused 3. Allows the client to express thoughts, feelings, behaviors, and life experiences in a meaningful way to promote change and optimal health |
|
|
Therapeutic Communication
|
• Planned
• Goal directed • Patient centered • Purposeful and carefully guided • Used to explore problems, issues, needs |
|
|
Therapeutic Communication Techniques:
- Active Listening |
S- Sit Facing Client
O-Open posture L-lean toward client E-Establish and maintain intermittent eye contact R-relax |
|
|
Therapeutic Communication Techniques:
- Sharing Observation |
- how the person looks, sounds & acts
“ You look tired…” “You appear to be happy with the news…” “I see that you didn’t eat your breakfast… |
|
|
Therapeutic Communication Techniques: DONT'S!!!!
|
• Do not state observations that might embarrass or anger the patient.
“ You look a mess!” |
|
|
Therapeutic Communication Techniques:
- Sharing Empathy |
- neutral and nonjudgmental statements that tell the patient you understood the feeling content in their message
“It seems like things are difficult for you right now” |
|
|
Therapeutic Communication Techniques:
- Sharing Hope |
- communicating a sense of possibility to others
“ I believe you will find a way to face your situation, because I have seen your courage and creativity in the past.” |
|
|
Therapeutic Communication Techniques:
- Sharing Humor |
– Laughter, sharing humorous incident, telling jokes
|
|
|
Therapeutic Communication Techniques:
- Sharing Feelings |
– The professional nurse models healthy expression of feelings and open communication
|
|
|
Therapeutic Communication Techniques:
- Using Touch |
– Holding patient’s hand
– Placing hand on shoulder |
|
|
Therapeutic Communication Techniques:
- Using Silence |
– provides time for nurse and patient to gather thoughts and reflect.
|
|
|
Therapeutic Communication Techniques:
- Asking Relevant Questions |
Patient:“My back hurts”
Nurse: “Which part of your back hurts?” Patient:“My lower back.” Nurse: “How would you describe the pain?” |
|
|
Therapeutic Communication Techniques:
- Open-Ended Question |
“What activities cause you to have chest pain?”
|
|
|
Therapeutic Communication Techniques:
- Closed-Ended Question |
“How may Nitroglycerine did you use?”
|
|
|
Therapeutic Communication Techniques:
- Providing Information |
“This medication is for…”
“I am a nursing student from CCM” “Mr. Smith, you have a fever and your doctor has ordered an antibiotic.” |
|
|
Therapeutic Communication Techniques:
- Paraphrasing |
Patient: “I can’t sleep, I stay awake all night.”
Nurse: “You have difficulty sleeping?” |
|
|
Therapeutic Communication Techniques:
- Clarifying |
“I’m not sure I follow you.”
“I don’t understand what you mean by ‘I didn’t feel good,’ can you describe it to me” |
|
|
Therapeutic Communication Techniques:
- Focusing |
“Let’s go back to that incident when you passed out.”
“ This point seems worth looking at more closely.” |
|
|
Therapeutic Communication Techniques:
- Summarizing |
“During the past hour we’ve discussed different ways to….”
“Have I got this straight…, you said that….” |
|
|
Therapeutic Communication Techniques:
- Self-Disclosing |
“I had to put my mother in a nursing home. It was a painful process for me.”
|
|
|
Therapeutic Communication Techniques:
- Confronting |
“You say you are upset, but you are laughing.”
|
|
|
Therapeutic Communication Techniques:
- Broad Openings |
“What’s going on.”
“Tell me what you think about it.” |
|
|
Therapeutic Communication Techniques:
- Reflection |
“So you start feeling depressed when no one calls you over the weekend.”
|
|
|
Therapeutic Communication Techniques:
- Suggesting |
“Have you considered the alternative of a self help group for weekly support?”
|
|
|
Non- Therapeutic techniques that inhibit communication.
|
• Ineffective techniques
• Hinder professional relationships • Discourage further expression of feelings or ideas • Trigger patient’s use of defense mechanisms |
|
|
Non- Therapeutic techniques
- Asking Personal Questions |
“How can you stay married to him?”
|
|
|
Non- Therapeutic techniques
- Changing the subject |
Patient: “I want to die.”
Nurse: “Did you have any visitors this weekend?” |
|
|
Non- Therapeutic techniques
- Automatic Responses - Stereotyped Comments |
- Clichés
“……, they don’t know what they don’t have a clue what they are doing.” “It’s for your own good.” “Keep your chin up.” |
|
|
Non- Therapeutic techniques
- Automatic Responses - False Reassurance |
“I wouldn’t worry about…”
“Everything will be alright.” “You are doing just fine.” |
|
|
Non- Therapeutic techniques
- Automatic Responses - Sympathy |
“I’m so sorry about your amputation, it must be terrible to lose a leg.”
Instead… “Losing your leg has been a major change. How has it affected your life?” |
|
|
Non- Therapeutic techniques
- Asking for Explanations |
Nurse:
“Why do you feel this way?” “Why did you do that?” Patient: “Who knows.” “I don’t know.” ~ Avoid why ~ |
|
|
Non- Therapeutic techniques
- Approval |
" That’s good.”
“I’m glad you…” |
|
|
Non- Therapeutic techniques
- Disapproval |
“That’s bad…”
“I’d rather you wouldn’t…” “You are upset now. We can’t allow you to do this.” |
|
|
Non- Therapeutic techniques
- Defensive Responses |
“I’m sure he/she only meant to help you.”
“No one around here would lie to you.” |
|
|
Non- Therapeutic techniques
- Passive Responses |
“There’s nothing I can do about it.”
|
|
|
Non- Therapeutic techniques
- Aggressive Responses |
“It’s your fault.”
|
|
|
Non- Therapeutic techniques
- Arguing |
“Don’t tell me that you didn’t sleep a wink. I heard you snoring all night long.”
|
|
|
Characteristics of a helping relationship:
|
• Professional relationship
• Therapeutic • Planned • Goal-directed • Patient-centered • Confidential • Nonjudgmental |
|
|
In a helping relationship, the nurse assumes the role of professional helper and comes to know the client as an individual who has unique health needs, human responses, and patterns of living. The relationship is characterized by the nurse’s nonjudgmental acceptance of the client.
|
The acceptance conveys the willingness to hear a message or to acknowledge feelings. The helping relationship is built on the client’s trust in the nurse. Show empathy (feel with them, understand their experience) don’t show sympathy (pity).
|
|
|
4 Phases of a helping relationship:
|
1. Preinteraction phase
2. Orientation phase 3. Working phase 4. Termination phase |
|
|
Methods of environmental control to facilitate interpersonal communication:
|
1) A private location
2) No unnecessary noises or distractions 3) A location where the client feels safe and comfortable |
|
|
Communication techniques for patients that have conditions that impair their communication:
- Speech impaired: |
listen intently and don’t interrupt, ask simple questions requiring yes or no answers, allow time to respond, use visual cues or communication aids
|
|
|
Communication techniques for patients that have conditions that impair their communication:
- Cognitively Impaired |
reduce environmental distractions, get client’s attention prior to speaking, use simple sentences and explanations, ask one question at a time, allow for response
|
|
|
Communication techniques for patients that have conditions that impair their communication:
- Unresponsive |
call client by name during interactions, communicate verbally and by touch, speak to client as if the hear, explain procedures, orient to time and place, don’t talk about client by them.
|
|
|
Communication techniques for patients that have conditions that impair their communication:
- ESL |
speak in normal tone of voice, establish method for client to signal if the want to communicate, get an interpreter, use communication aids, get a dictionary
|
|
|
Examples of Miscommunication in Documentation
|
• Patient’s mother died at age 7
• The pelvic exam will be done on the floor • Skin moist and dry • The patient is under our car for physical therapy |
|
|
Communication in the Nursing Process
- Assessment: |
- Verbal interviewing & history taking
- Visual and intuitive observation of nonverbal behavior - Visual, tactile, & auditory data gathering during physical examination - Written medical records, diagnostic tests and literature review |
|
|
Communication in the Nursing Process
- Nursing Diagnosis |
- Intrapersonal analysis of assessment findings
- Validation of health care needs & priorities via verbal discussion with client - Handwritten or computer- mediated documentation of nursing diagnosis |
|
|
Communication in the Nursing Process
- Planning |
- Interpersonal or small group health team planning sessions
- Interpersonal collaboration with client and family to determine implementation methods - Written documentation of expected outcomes - Written or verbal referral to health team members |
|
|
Communication in the Nursing Process
- Implementation |
- Delegation and verbal discussion with health care team
- Verbal, visual, auditory, and tactile health teaching activities - Provision of support via therapeutic communication techniques - Contact with other health care resources - Written documentation of client’s progress in medical record |
|
|
Communication in the Nursing Process
- Evaluation |
- Acquisition of verbal and nonverbal feedback
- Comparison of actual and expected outcomes - Identification of factors affecting outcomes - Modification and update of acre plan - Verbal and/or written explanation of revisions of care plan to client |
|
|
Q: A young patient with terminal illness says, “I just don’t think I’ll ever get any better. I really think I’m going to die.”
|
1. “Don’t talk like that. Where’s your fighting spirit?”
2. “You are still young and your chances of fighting your cancer are good.” 3. You sound very concerned about your health. I’ll sit and talk with you for a while.” 4. “I’ve discussed your emotional state with your doctor, and we are going to get the |
|
|
Q: Your patient is fighting back tears and looks very sad. Your best response would be…
|
1. “You look as though you are ready to cry.”
2. “Why don’t you cry? It will be good for you.” 3. “I know how you feel, but look on the bright side.” 4. “Let’s talk about the happy parts of your life.” |
|
|
A pregnant client mentally rehearses giving birth in her mind. This is an example of:
|
A. Intrapersonal communication
B. Interpersonal communication C. Transpersonal communication D. Metacommunication Intrapersonal communication is also called self-talk, self-instruction, and inner thought. Self-instruction can provide a mental rehearsal for difficult tasks, such as labor and delivery, so individuals can deal with them more effectively. |
|
|
The nurse may facilitate verbal communication with his or her clients by:
|
A. Using medical terminology to ensure accuracy
B. Using words that can have several meanings C. Speaking slowly and deliberately and allowing long pauses in the conversation D. Using short sentences that express an idea simply and directly. Verbal communication should have clarity and brevity. Fewer words result in less confusion. Communication that is simple, brief, and direct is more effective. |
|
|
A client’s family member wipes her eyes from crying at the loss of a loved one and says, “It’s no big deal; I mean, we all have to die sometime, right?” An example of metacommunication is when the nurse responds:
|
A. “You are taking this really well.”
B. “You are exactly right. Dying is inevitable.” C. “Let’s not talk about it. That will help you feel better. After all, God won’t give you more than you can handle.” D. “Losing a loved one can be really difficult. It looks like you’re pretty upset. I’d like to help.” Metacommunication uncovers the deeper message than is being said. This would be the most therapeutic response by the nurse |
|
|
In a nurse-client helping relationship, the nurse should:
|
A. Convey nonjudgmental acceptance with a willingness to hear a message or to acknowledge feelings
B. Convey acceptance by always agreeing with the client or approving of the client’s decisions or actions C. Problem solve for the client D. Distort the truth when the client is to receive bad news in order to protect the client The nurse-client helping relationship is characterized by the nurse's nonjudgmental acceptance of the client. Acceptance conveys a willingness to hear a message or to acknowledge feelings even if the nurse does not agree with the client. |
|
|
A diabetic client is hospitalized with a sore on his foot that has failed to heal. The nurse is gathering a videotape and some printed material on diabetes to begin teaching the client when he calls the nurse wanting something for pain. When considering the elements of the communication process, the referent in this situation is:
|
A. The videotape and printed material on diabetes
B. The nurse C. The client’s pain D. The client and nurse’s sociocultural background A referent motivates one person to communicate with another. In this case, sensations and perceptions of pain initiated communication. |
|
|
An example of the nurse’s focus area within the working phase of the nurse-client helping relationship is when the nurse...
|
A. Tells the client, “My shift will be over in about 30 minutes, but I’ll see you again tomorrow. You did really well with physical therapy today.”
B. Asks another nurse while receiving report, “What did the laboratory report indicate for Mr. Owen?” C. Says to the client, “Hi, Mr. Owen. My name is Gwen, and I’ll be your nurse today.” D. Asks the client, “What do you think would help you recover more quickly from your surgery?” During the working phase, the nurse helps the client with self-exploration and goal setting. By using therapeutic communication, the nurse encourages the client to express feelings. |
|
|
A nursing instructor notices a student nurse is lacking professionalism when the student:
|
A. Knocks on the door before entering and says, “Hello, Mr. Smith. I am Bill Johnson, and I’ll be your student nurse today.”
B. Shares personal information about their assigned client with other students not involved in the client’s care C. Arrives on time and is clean and neat, wearing no perfume or cologne D. Accepts responsibility for an error he made in documentation Sharing personal information about others violates nursing ethical codes and practice standards. Team members directly involved in the client's care should be given only relevant information about the client's status. |
|
|
An example of a positive outcome of a nurse-health team relationship would be:
|
A. Receiving encouragement and support from co-workers to cope with the many stressors of the nursing role
B. Becoming an effective change agent in the community C. An increased understanding of the family dynamics that affect the client D. An increased understanding of what the client perceives as meaningful from his or her perspective Benefits of positive nurse-health team relationships include building morale and strengthening relationships to help one another cope with the stressors of working in the health care field. |
|
|
A nurse is meeting a 3-year-old for the first time. To facilitate communication with the child, the nurse should:
|
A. Distract the child by clapping the nurse’s hands
B. Lift the child onto the nurse’s lap C. Kneel down, while holding and talking to a teddy bear D. Ignore the child Kneeling down puts the nurse at the child's eye level. Holding and talking to a teddy bear is nonthreatening and allows the child to make the first move in interpersonal contacts. |
|
|
To facilitate communication with an older adult who is hard of hearing the nurse should:
|
A. Help the client by anticipating what he or she is going to say and finishing the client’s sentences for him or her
B. Use lengthy explanations to ensure the message is made clear C. Face the client and maintain eye contact D. Cover several topics at one time to be most efficient in communication The nurse should get the client's attention before speaking and face the client so he or she can see the nurse's mouth. The nurse should speak slowly and clearly while maintaining eye contact. Words should be supplemented with visual gestures. |
|
|
A client says to the nurse, “It was a stupid thing that I did. If I had just stayed home, this car accident wouldn’t have happened.” The nurse’s best response is:
|
A. “You feel responsible for the accident as though it could’ve been prevented.”
B. “Why would you say that?” C. “If I were you, I’d quit worrying about it. You can’t change the past.” D. “So, why did you go out?” This response uses the therapeutic communication technique of paraphrasing. Paraphrasing is restating another's message more briefly using one's own words. Through paraphrasing, the nurse sends feedback that lets the client know that the nurse is actively involved in the search for understanding. |
|
|
The nurse says to the client, “We’ve talked a lot about your surgery and the implications for when you go home. Let’s discuss some of the exercises you can do.” This is an example of:
|
A. Summarizing
B. Clarifying C. Providing information D. Focusing This response depicts the therapeutic communication technique of focusing. Focusing is used to center on key elements or concepts of a message. Focusing helps guide the direction of the conversation. |
|
|
Intrapersonal communication is also called self-talk, self-instruction, and inner thought.
|
Self-instruction can provide a mental rehearsal for difficult tasks, such as labor and delivery, so individuals can deal with them more effectively.
|
