NUR1020 Communicating & Therapeutic Relation

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NUR1020 Communicating & Therapeutic Relation
2014-02-17 23:08:32
NUR1020 Communicating Therapeutic Relation

NUR1020, Chapter Communicating & Therapeutic Relation
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  1. Qsen
    Quality and safety education for nurses

    effect. communcation about hazards, and errors to patient , family and healthcare team
  2. communication
    • sharing meaning and obtain response
    • building effective working realtionships
    • verbal and nonverbal
    • used to meet physical, psychosocial, emotional and spiritual needs
  3. 3 levels of communication
    • intrapersonal communication:
    • selftalk, can be positive or negative

    • interpersonal communication:
    • occurs between 2 or more people
    • mostly 2 face to face
    • to gather information during assessment
    • to teach about health issues
    • explain care, give comfort
    • also communicate effectively with personnel
  4. group communication
    • among several people
    • small group meeting, 2 or more e.g. staff meeting
    • needs effective working skills and understanding of group processes
  5. public speaking
    • speaker addresses a dozen t a hundred people with varying degrees of interaction
    • speech, talk directly, open discussion
    • public speeking often used to educate, to lobby, to address colleagues
  6. content of communication
    actually said words or gestures
  7. process of communication
    • act of sending, receiving , interpreting and reacting to a message
    • five elements:
    • sender/source/encoder

    • encoding-> selecting the words, gestures, tones
    • consciously or unconsciously
    • affected by situational stressors

    • message:
    • effective : complete, clear, organized, ...
    • apppropriate for situation and developmental level,
  8. channel
    • medium used to send message
    • face to face, touch
    • writing...
  9. receiver
    • observer, listener, interpreter of the message
    • interpretation is decoding
    • relating message to past experience
    • using the senses to receive
    • if decoding matches-> effective communication
    • sometimes not successful
  10. feedback
    • validates what was received and sending back
    • verifying message avoids confusion
  11. verbal communication
    • education
    • culture
    • language
    • age
    • experiences
    • -> goal: being understood
  12. vocabulary
    • technical terms and jargons-> not to lay persons
    • our responsibility to send a message the patient can understand
  13. denotative and connotative meaning of a word
    denotation = dictionary meaning of a word

    connotative= implied or emotional meaning of the word

    e.g. the word "baby"
  14. pacing
    • pace and rythm can alter meaning of the message
    • rapid-> hard to follow
    • better slow, so the receiver
    • can follow
    • can respond
    • fast enough to maintain interest
  15. Intonation
    • tone of voice
    • pitch (high and low)
    • cadence (rising and falling of the pitch)
    • volume (soft or loud)
    • here you can see emotions
    • too monotone- loosing interest
    • no intonations on electronic messaging
    • -> sometimes smiley faces used to give clues
  16. clarity and brevity
    • words should go conform with body language and intended meaning
    • use fewest words possible
    • if clear it holds interest and is effective
  17. timing an relevance
    • timing is crucial
    • assess before starting communication
    • distracted by pain, hunger, coping with stressors, presence of others,
    • effective when interesting and relevant for both
  18. credibility
    • depends on honest and timely response to patient concerns
    • congruence of verbal and nonverbal messages
    • I'll find out better than wrong answer
    • never lie
  19. humor
    • can have a positive influence on healing
    • use cautiously, highly subjective and personal
    • depends on cultural norms
    • misused can have effect on self esteem, confidence,...
  20. nonverbal communication
    often not consciously done
  21. facial expression
    • face and eyes are the most obvious forms of  nonverbarl message
    • everybody understands smiling
    • other facial expressions can differ  because of culture like eyecontact
    • micmatch-> doubt, mistrust,
  22. posture and gait
    offer clues regarding attitude, wmotion, well-being, self-concept
  23. personal appearance
    • provide clues regarding feelings, status , culture, religion, values,
    • think about own personal appearance
  24. gestures
    • should clarify spoke words
    • vary among individuals and cultures
    • use them with caution
  25. touch
    affection, caring, concern, encouragement

    avoid if someone is angry or mentally disturbed-> misinterpretation possible

    use with conscious and awareness of culture, situation,...
  26. environment
    • best if quiet, private, pleasant,
    • be sensitive how patient experiences environment
    • provide most comfortable environment possible
  27. developmental variations
    • physical and cognitive
    • language skills
    • education
    • alter communication to fit patient's level
    • with respect and effect with patients of all levels
    • children with chronic diseases often more knowledgeable
    • olders might be affectied by sensory alterations
  28. gender
    • women:
    • to form connections
    • establish relationships
    • be connected
    • consensus

    • men: maintaining independence
    • positions in hierarchy
    • be one
    • win or loss
  29. personal space
    • vary in amount of physical space needed
    • influenced by relationship
    • setting
    • cultural influences

    • intimate distance: immediatly surrounding people/ personal space
    • western around 18 inches
    • body contact can occur
    • performance of assessment
  30. personal distance
    • 18 inches to 4 feet
    • formal interaction
    • communication with group
    • no range of touch
    • answer might be more impersonal than when being closer
  31. public distance
    • beyond 12 feet
    • public speakers
    • lack of individuality and focus on group
  32. territoriality
    • space belonging to individual
    • visible or unvisible bounding
    • less at ease when away from territory
    • ask for permission when e.g. moving furniture
  33. sociocultural factors
    • culture and status strongly influence communication
    • male nurse might be no go for female patient
    • reaction with physician different than with nurse...
    • social distance-> evtl. no questions, concerns ...mentioned
  34. roles and relationships
    • affect communication
    • choice of words, tone, gestures,...
    • claify roles to patient
  35. communicating assertively
    • passive approach: avoids conflict and allows others to lead
    • helpless, indecisive, apologetic, whining

    • aggressive approach:
    • forces others to lose
    • goal is to win and be under control
    • bossy, arrogant, sarcastic, manipulative, intolerant

    • nonassertive style:
    • men-women
    • defferent status
    • unclear indirect communication leads to errors

    • assertive communication
    • expression of wide range of positive and negative thoughts
    • direct, open, spontaneous, responsible, non judgemental
    • responsible for own actions without blaming others
  36. therapeutic communication
    • improving health of client
    • to establish therapeutic relationship
    • provide/obtain healthcare information
    • express interest/concern
  37. pre-interaction phase
    orientation phase
    working phase
    termination phase
    • pre-interaction
    • gathering information about client
    • no diret communication yet
    • prepare for clinical days
    • can be anxious time for client

    • orientation phase
    • introduction
    • establish trust
    • exchange of initial information - reason for visit or concerns
    • in emergency very brief

    • working phase
    • active part of relationship
    • thought, feelings, respect exchange, honest
    • -> clarify feelings and concerns
    • confidental, active listening