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communication is an
essential lifelong learning process for nurses to build relationships with pts ,families, and team members
know pt so the nurse can BUILD TRUST so they can provide information/instruction to the pt
communication skills requires
creativity, self confidence, fairness, integrity, humility
thinking is influenced by
five senses, culture, education, biases.
- occurs within an individual
- inner thoughts and self talk
one to one on interaction with two people
- interaction within a person's spiritual domain
- meditation, prayer
- interactions with a small number of people
- committees pt, support group
- interaction with an audience
- public speaking, classroom lecture.
communication process: Referent
motivates one to communicate with another
communication process: Sender and receiver
- one who encodes and one who decodes the message.
- can switch between the nurse and the pt
communication process: message
content of the message between the sender and the receiver
communication process: channels
- means of conveying and receiving messages.
- ex: verbal and non verbal
communication process: feedback
- message the receiver returns.
- making sure one understands what is being said
communication process: interpersonal variables
factors that influence communication
communication process: environment
- the setting for sender-receiver interactions
- make sure tv is turned down
forms of verbal communication
- denotative and connotative meaning
- clarity and brevity
- timing and relevance
forms of nonverbal communication
- personal appearance
- posture and gait
- facial expressions
- eye contact
- territoriality and personal space
- 0-18" like performing a bed bath, holding a crying baby, physical exam
- most of nurses work done in this zone
- 18"-4' pt teaching and taking a pt history
- a lot of nurse's work done in this zone
social zone and public zone
- 4'-12' making rounds with dr and sitting at the head of the conference table
- 12' plus - speaking and lecturing
- basic human need that transmits messages to the brain to calm the stress response to illness and trama. we have social permission to touch.
- warm hands, stethoscope, ask permission, inform pt of what you are doing
- non/verbal symbolism used by others to convey meaning
- ex: music and art
- broad term that refers to all factors that influence communication.
- ex:body language (and also symbolic communication)
occurs before meeting the pt
when the nurse and the pt meet and get to know each other
when the nurse and the pt work together to solve problems and accomplish goals.
- occurs at the end of the relationship
- "closure" with clear boundaries and expectations
factors resulting in difficultly with communication
- lacking skills in attending, listening, responding, or self expression
- inability to articulate, inappropriate verbalization
- difficulty forming words
- difficulty with comprehension
therapeutic communication techniques
are specific responses that encourage the expression of feeling and ideas and covey acceptance and respect
Active listening means
- being attentive to what a pt is saying both verbally and non verbally. SOLER
- S: sit facing the pt
- O: observe an open posture
- L: lean toward the pt
- E: establish and maintain intermittent eye contact
- R: relax
types of Therapeutic techniques
- sharing observations, empathy, hope, humor, and feelings
- using touch and silence
- provide info, clarify, focusing, paraphrasing, summarizing
- appropriate self disclosure
types of Nontherapeutic techniques
- arguing, confrontation, changing the subject
- asking personal questions, giving personal opinions
- automatic responses, false reassurance
- sympathy, asking for explanations
- approval or disapproval
types of Pt's who need adaptive communication techniques
- pts who cant speak clearly
- cognitive, hearing, visual impairment
- unresponsive and language barriers
Tips for talking to children
- eye level, calm voice, caregiver present, simple sentences and explanations
- allow children to handle equipment or supplies
tips for taking to elders
asses for hearing and visual deficits, give time for elders to respond, wait for an answer to one Q before asking another, clarify and get feeback
- language, customs, values, social structure, gender differences.
- a friendly gesture of one culture may be insulting to another. be sensitive to the body language of your pt
- avoid stereotyping
- needs to be through the pts eyes
- nurses and pt need to determin whether the care has been successful.
strategies for effective communication
- be respectful and professional, active listening, understand others viewpoint
- collaboration be cooperative and direct
state your feelings using
- I statements
- learn to say I was wrong and you could be right
- N: name the pt emotion
- U: understand " I can see why you feel that"
- R: respect "you've been through a lot, that takes courage
- S: support "I want to help you get better"
- E: empathy "that must be difficult"