Ch 24 Communication

Meta communication

Metacommunication is a broad term that refers to all factors that influence communication.

List elements of professional communication.

a. Courtesy: "Please, Thank you." b. Use of names: Addressing people by name conveys respect for human dignity and uniqueness. Hello, Mr. Callahan c. Trustworthiness d. Autonomy and responsibility

Identify four zone of personal space?

a. Intimate distance (0 to 18 inches) b. Personal distance (18 inches to 4 feet) c. Social distance (9 to 12 feet) d. Public distance(12 feet and greater)

Give some example of how to communicate with the older adults who have hearing loss.

a. Make sure the patient knows that you are talking b. Face the patient with your face/mouth visible and don't chew gum c. Speak clearly, do not shout d. Speak slowly e. Check for hearing aids, etc. f. Quiet, well-lit environment with minimal distraction g. Allow time for the patient to respond h. Give the patient a chance to ask questions i. Keep communication short and to the point

List the four goal-directed phases that characterize the nurse-patient relationship.

a. Preinteraction phase: Before meeting a patient. b. Orientation phase: when the nurse and the patient meet and get to know each other. c. Working phased: when the nurse and patient work together to solve the problems and accomplish goals. d.Termination phase: During the ending of the relationship.

A technique for encouraging patients to share their thoughts, beliefs, fears, and concerns with the aim of changing their behaviors is called ?

Motivational Interviewing (MI)

Why do nurse need Perseverance and creativity?

it helps nurses to motivates and identify innovative solutions.

Non verbal technique for facilitating communication.

Active listening Silence Therapeutic touch

Integrity

Allow nurse to recognize when their opinion conflict with others.

Arguing or challenging

Asking how someone can claim not to have slept when he or she was heard snoring indicates arguing or challenging, not a defensive response.

Assertiveness

Assertiveness is expressing feelings and ideas without judging or hurting others.

What is autonomy ?

Auto means Self, therefore autonomy means Self-directed and independent in accomplishing goals and advocating for others.

In the communication process, which person is the receiver of the message? A.The person who encodes the message B.The person who decodes the message C.The person who delivers D.The person who seeks the feedback

B Thew receiver is the one who receives and decodes the message. The sender is the person who delivers and encodes the message. The sender also seeks both verbal and nonverbal feedback while the receiver provides feedback to the sender.

Which technique would the nurse use to actively listen to a patient? SATA A.Stand away with hands folded. B.Lean forward toward the patient. C.Sit erect facing the patient with uncrossed arms. D.Make eye contact. E.Pace up and down the room. F.Close eyes and listen.

B,C,D. Several actions promote active listening, including leaning toward the patient, sitting facing the patient with an open posture, and making eye contact. This helps communicate to the patient that the nurse is involved and interested in the conversation and is there to listen to concerns. Standing away with hands folded suggests disinterest. Restlessness and closing the eyes while listening expresses a lack of interest and discomfort.

"I'm not sure I understand what you mean by 'sicker than usual.' What is different now?"

Clarifying

Explain the focus of the Nurse- health care team.

Communication with other members of the health care team affects patient safety and the work environment. The SBAR technique is a popular communication tool that standardizes communication.

"You say you've already decided what to do; yet you're still talking a lot about your options."

Confrontation

Which form of communication is appropriate to assess understanding and clarify misinterpretations when the nurse is teaching a patient about a health concern? A.Public B.Small-group C.Intrapersonal D.Interpersonal

D. Interpersonal communication is one-on-one interaction between a nurse and another person that often occurs face-to-face. This interaction is useful to assess understanding and clarify misinterpretations when teaching a patient about a health concern. Public communication is interaction with an audience. Nurses often speak with groups of consumers about health-related topics; however, this scenario dealt with just a nurse and a patient. Small-group communication occurs when a small number of people meet, not just a nurse and patient. This type of communication is usually goal-directed and requires an understanding of group dynamics. Intrapersonal communication is a powerful form of communication that one uses as a professional nurse. This level of communication is also called self-talk; it does not involve communication with another person.

"We've talked a lot about your medications; now let's look more closely at the trouble you're having in taking them on time."

Focusing

Explain the focus of the Nurse - family relationship.

Many nursing situations, especially those in community and home care settings, require the nurse to form helping relationships with entire families.

Trust and Trustworthiness

Trust is relying on someone without doubt or question. Being trustworthy means helping others without hesitation.

What are the different forms of communication?

Verbal communication Non- verbal communication Meta communication

What are the types of Non-therapeutic Communication

1.Asking personal questions 2.Giving personal opinion 3.Changing the subject 4.Automatic response 5.False assurance 6.Sympathy 7.Asking for explanation 8.Approval or disapproval 9.Defensive response 10.Passive or aggressive response 11.Arguing

What are the 4 ways of providing therapeutic touch?

1.Holding the hand of a patient 2.Providing a back rub 3.Touching a patient's arm lightly 4.Shaking hands with a patient in isolation.

What are the 5 level of communication?

1.Intrapersonal (intra means within/self-talk/ self verbalization) 2.Interpersonal (1:1) 3.Small group( inside the committee / Patient-centered conference. Organize, concise, complete) 4.Public( present scholarly work to a colleague at conference /classroom discussion with students/ peers) 5.Electronic (mnemonics Small piie)

Six Examples of Active listening

1.Maintaining intermittent eue contact 2.Matching eye levels 3.Attentive posturing 4.facing the patient 5.Leaning toward the person who is speaking 6.Avoiding distracting body movement.

6 Verbal communication

1.Vocabulary 2.Denotative and Connotative meaning 3.Pacing 4.Intonation 5.Clarity and Brevity 6.Timing and Relevance Washington DC TIP

What are the Therapeutic communication technique?

7S (2HOEFSS) 2(ACUP)V 1.Active listening 2.Sharing Observations 3.Sharing Empathy 4.Sharing Hope 5.Sharing Humor 6.Sharing Feelings 7.Using Touch 8.Using Silence 9.Providing information 10.Clarification 11.Focusing 12.Paraphrasing 13.validation 14.Asking a relevant question 15.Summarizing 16. Self-disclosure 17.confrontation

What is an advantage of summarizing? Select all that apply. SATA A.Promotes recall of previous discussions B.Participants focus on key issues C.Reveals true personal experiences D.Useful in the terminal phases of the patient relationship E.Brings a sense of caring and human connection

A,B,D A.Summarizing provides a short review of the key areas of interaction, which helps in recalling previous discussions and makes further discussions easier. B.Summarizing helps the participants focus on key issues, offers a chance for revision, and makes the interaction more productive. D.It is also useful in the terminal phases of the patient relationship, to sum up, the discussion. Using this technique, any points that are misunderstood can be clarified. Revealing true personal experiences is part of self-disclosure. Using touch, not summarizing, brings a sense of caring and human

A patient tells the nurse there is no meaning to life, and that he or she wants to see the end of it. The nurse asks the patient, "Are you talking about suicide?" Which term is this communication technique referred to as? A.Clarifying B.Focusing C.Paraphrasing D.Self-disclosure

A. Clarifying refers to seeking more information from the patient for better understanding. Focusing is used when a patient is rambling to help focus the conversation on a specific area. Paraphrasing is rephrasing a patient's sentence in one's own language without changing the meaning. Self-disclosure is the term used when a person intentionally reveals personal experiences to another person

Which level of communication is applicable when the registered nurse (RN) is teaching a group of nursing students about the care of patients? A. Public B.Electronic C. Small- group D.Interpersonal

A. Public communication is interaction with an audience. This level of communication may involve the registered nurse (RN) speaking to a group of nursing students about patient care. Small-group communication occurs when a small number of people meet in committees and patient care conferences, not when teaching nursing students

Which term describes the type of communication involved when the nurse teaches individuals about healthy meal planning? A.Small-group B.Transpersonal C.Intrapersonal D.Nonpersona

A. Small-group communication is a goal-directed type of communication that occurs when a small number of people meet. When a patient is communicating through prayer, meditation, or other means with a higher power or deceased loved one, transpersonal communication is taking place. Intrapersonal communication happens within the person. Nonpersonal is not a type of communication

Silence

Being present with a person without verbal communication.

Which communication technique is non therapeutic? A.Sympathizing B.Focusing C.Clarifying D.Summarizing

A. Sympathizing. Sharing feelings is therapeutic but not Sympathizing. Sympathizing is a nontherapeutic communication technique. The nurse may take patient's feelings on as his or her own, which may hinder the nurse's ability to be objective and help the patient process feelings

Effective communication

Establishing rapport with a patient ensures more effective communication. Effective messages are clear, direct, and in understandable language. Favourable environment and condition

Which special zone of touch requires the nurse to get permission to take a pulse at a patient`s wrist? A.Social B.Consent C.Intimate D.Vulnerable

B.Consent. The consent zone requires permission to touch a patient's wrist. In the consent zone, the nurse needs permission to touch a patient`s mouth, wrists, and feet. In the social zone, the nurse does not need permission to touch the patient's hands, arms, back, or shoulders. In the intimate zone, great sensitivity and permission are needed in the areas involving the genitalia and rectum. In the vulnerable zone, the nurse takes special care to handle the patient`s face, neck, and front of the body.

According to the circular transactional model, which element motivates a patient to communicate with the nurse? A.Channels B.Message C.Referent D.Environment

B.Referent. According to the circular transactional model, the referent motivates one person (a patient) to communicate with another (the nurse), initiating the communication process. Communication channels are means of sending and receiving messages through visual, auditory, and tactile senses; they do not motivate a person/patient to communicate. The message is the content of the communication. It contains verbal and nonverbal expressions of thoughts and feelings; it does not involve the motivation to communicate. The environment is the setting for sender-receiver interaction. Environmental distractions are common in health care settings and interfere with messages sent between people; they do not reflect the motivation to communicate.

Which nontherapeutic communication technique is the nurse using when saying, "Don't worry; you'll be fine " to a patient? A.Demonstrating sympathy B.Offering false reassurance C.Giving personal opinions D.Asking personal questions

B.The nurse is using false reassurance. When a patient is seriously ill or distressed, the nurse may be tempted to offer false hope statements such as, "Don't worry, you'll be fine." Sympathy is a concern, sorrow, or pity felt for another person. This is indicated by stating, "I'm so sorry about your condition," not, "Don't worry; you'll be fine." Giving personal opinions may be indicated by stating, "I think you should consider terminating treatment," not, "Don't worry; you'll be fine." "How would you describe your relationship with Sue?" is an example of asking a personal question, not "Don't worry; you'll be fine."

Give example of lateral violence or work place bullying.

Behaviors such as withholding information, backbiting, making snide remarks, nonverbal expressions of disapproval

Active listening

Being attentive to what patient is saying both verbally and non verbally.

Aggressive response

Blaming someone for incomplete work indicates an aggressive response

Which zone of personal space is involved when the nurse is instructing visitors in the hallway to avoid talking loudly? A.Public B.Intimate C.Personal D.Social

D.Social The social zone may involve giving directions to visitors in the hallway. The public zone may involve speaking at a community forum, not instructing visitors in the hallway. The intimate zone may involve changing a patient's surgical dressing, not instructing visitors in the hallway. Taking a patient's nursing history involves the use of the personal zone, not instructing visitors in the hallway.

is the ability to understand and accept another person's reality, accurately perceive feelings, and communicate this understanding to the other

Empathy Empathetic statements are neutral and nonjudgmental and help establish trust in difficult situations. For example, a nurse says to an angry patient who has low mobility after a stroke, "It must be very frustrating to not be able to do what you want."

Sharing Observation.

Nurses make observations by commenting on how the other person looks, sounds, or acts. Making observations is a gentler and safer technique: "You look tired ...," "You seem different today ...," or "I see you haven't eaten anything." Never use "You look a mess!"

"I've been overweight all my life and never had any problems. I can't understand why I need to be on a diet." Paraphrasing this statement by saying "You don't care if you're overweight" is incorrect. It is more accurate to say, "You're not convinced that you need to make different food choices because you've stayed healthy."

Paraphrasing

7 Non verbal communication

Personal appearance Posture and gait facial expression eye contact gestures sounds Territoriality and personal space PP GETS

"John, your heart sounds have changed from earlier today, and so has your blood pressure. I'll let your doctor know."

Providing information

For example, a nurse says to an angry patient who has low mobility after a stroke, "It must be very frustrating to not be able to do what you want."

Sharing Emapthy

For example, a nurse says to a patient discouraged about a poor prognosis, "I believe that you'll find a way to face your situation because I've seen your courage and creativity."

Sharing Hope

"sense of possibility"

Sharing Hope For example, a nurse says to a patient discouraged about a poor prognosis, "I believe that you'll find a way to face your situation because I've seen your courage and creativity."

"You look tired ...," "You seem different today ...," or "I see you haven't eaten anything." This an example of ?

Showing Observation

Full form of SBAR

Situation Background Assessment Recommendation

full form of SURETY

The SURETY Model is one model you can use to facilitate attentive listening and therapeutic communication with your patients. S— Sit at an angle facing the patient. U— Uncross legs and arms. This position suggests that you are "open" to what the patient says. A "closed" position such as crossing arms conveys a defensive attitude, possibly provoking a similar response in the patient. R— Relax. It is important to communicate a sense of being relaxed and comfortable with the patient. Restlessness communicates a lack of interest and a feeling of discomfort to the patient. E— Eye contact—Establish and maintain intermittent eye contact to convey your involvement in and willingness to listen to what the patient is saying The absence of eye contact or shifting the eyes gives the message that you are not interested in what the patient is saying. T— Touch. Use touch that is respectful to communicate empathy and understanding to the patient. Ensure that your use of touch is therapeutic and acceptable to the patient. Y— Your intuition. Trust your intuition as you grow in confidence to individualize, adapt, and apply communication techniques in your interpersonal encounters with your patients.