chapter 26 communicating
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. What would you like to do?
any means of exchanging information or feelings between two or more people
What four elements does the communication process include?
1. sender 2. message 3. receiver 4. feedback
definition: the selection of specific signs or symbols (codes) to transmit a message
Examples: language and words to use, how to arrange the words, tone of voice, gestures
What does the receiver do?
- Listen, observe, and attend.
- Decode - interpret the perceived message
Define response also known as feedback
- The message that the receiver returns to the sender.
- can be verbal, nonverbal or both
When Verbally communicating nurses must consider the following:
pace and intonation, simplicity, clarity and brevity, timing and relevance, adaptability, credibility, and humor
What are examples of nonverbal communication?
Personal appearance, posture and gait, facial expression, gestures
What is the most common form of electronic communication?
List a few advantages and disadvantages
- Advantages: fast, efficient, legible, improving communication, and continuity of care
- Disadvantage: risk to client confidentiality, socioeconomics
What are some factors that influence the communication process?
Development, gender, values and perceptions, personal space, territoriality, roles and relationships, environment, congruence, interpersonal attitudes, and boundaries
What is the distance for: intimate, personal, social, and public space?
- Intimate: touching to 1 1/2 feet
- Personal: 1 1/2 to 4 feet
- Social: 4 to 12 feet
- Public: 12 to 15 feet
the study of distance between people in their interactions
Define congruent communication
the verbal and nonverbal aspects of the message match
List a few interpersonal attitudes that facilitate communication
caring, warmth, respect, acceptance
List a few interpersonal attitudes that inhibit communication
condescension, lack of interest, and coldness
- limits in which a person may act or refrain from acting within a designated time or place.
- focus should be on the patient
What is Therapeutic Communication?
- Promotes understanding and can help establish a constructive relationship between nurse and client.
- Example: Attentive Listening and Physical Attending
What is Attentive Listening?
- listening actively, using all senses.
- Pay attention to verbal and nonverbal messages, and whether these communications are congruent.
- Conveys an attitude of caring and interest, thereby encouraging the client to talk
What are the five actions of Physical Attending?
(Egan - "posture of involvement")
- 1. Face the other person squarely
- 2. Adopt and open posture
- 3. Lean toward the person
- 4. Maintain good eye contact
- 5. Try to be relatively relaxed
List a few therapeutic techniques
using silence, providing general leads, being specific and tentative, using open-ended questions, using touch, restating or paraphrasing, seeking clarification, perception checking or seeking consensual validation, offering self, acknowledging, clarifying time of sequence, presenting reality, focusing, reflecting, summarizing and planning
What are 3 major barriers to communication
failure to listen, improperly decoding the client's intended message, and placing the nurse's needs above the client's needs
Give examples of techniques that inhibit communication (barriers)
stereotyping, agreeing and disagreeing, being defensive, challenging, probing, testing, rejecting, changing topics and subjects, unwarranted reassurance, passing judgement, giving common advice
What is the effective nurse-client relationship
a helping relationship that facilitates growth of the patient
What are the two goals of a helping relationship?
- - Help clients manage problems in living more effectively
- - Become better at helping themselves in their everyday lives
What are some keys for developing a helping relationship ?
- - Development of trust and
- - Underlying belief that the
- nurse cares about and wants to help the client
List a few influences on the helping relationship
- Age, sex, appearance, diagnosis,
- education, values, ethnic
- and cultural background, personality, expectations, and setting
Name the 4 progress phases of the helping relationship
- 1. Preinteraction phase
- 2. Introductory phase
- 3. Working phase
- 4. Termination phase
What are the nurse's task during the preinteraction phase of the helping relationship?
review pertinent assessment data and knowledge, consider potential areas of concern, and develop plans of interaction
Why is the Introductory (orientation) phase of the helping relationship important and what are the goals?
- it sets the tone for the rest of the relationship
- Goals: develop trust and security.
How can the nurse overcome resistive behaviors displayed by the client during the introductory phase of the helping relationship?
by conveying a caring attitude, genuine interest in the client, and competence.
What are the 2 major stages in the working phase of the helping relationship
- 1. Exploring and understanding
- thoughts and feelings
- 2. facilitating and taking action
- (the nurse help client plan a program of action to meet preestablished goals
What skills must the nurse have to assist the patient in exploring and understanding thoughts and feeling during the working phase?
listening and attending skills, empathy, respect, genuineness, concreteness, self-disclosure, and confrontation.
What are other ways of helping clients that do not require special training?
listen actively, put yourself in the other person's shoes, be honest, be genuine and credible, use your ingenuity, be aware of cultural differences, maintain client confidentiality, know your role and limitations
What are the 3 main functions required for any group to be effective?
- 1. Unity or cohesion
- 2. Develop and modify its structure to improve its effectiveness
- 3. Accomplish its goals
List other characteristics of Groups
atmosphere, purpose, leadership and member participation, communication, decision making, conflict tolerance, power, problem solving, and crativiety.
What type of barriers must the nurse assess in order to determine communication impairment?
language deficits, sensory deficits, cognition impairments, structural deficits, paralysis
Define Process recording
- verbatim (word for word) account of a conversation
- made by nurses to evaluate the effectiveness of communication
Communication problems among health care personnel have been implicated as
The cause of most client errors
Define disruptive behaviors
behavior that interferes with effective communication among health care providers and negatively impacts performance and outcomes
list 3 common disruptive behaviors reported among nurses
- 1. Incivility
- 2. Lateral violence
- 3. Bullying
SBAR communication technique
- S= Situation. Your name, health agency, client name, and brief info about the problem
- B= Background. Admitting dx, date of admission, important clinical info r/t call
- A= Assessment. What nurse thinks is wrong or what body system and severity.
- R= Recommendation. Your recommendation or what you need
What would you like to do?
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