Mental Health Exam 1 Communication Barriers and Communication Enhancers - 9.18.18

in regards to communication barriers that nurses use: 1. May make a person defensive. Defending one's ideas often tends to strengthen them. If a client has delusional thinking, defending such thinking prevents the exploration of feelings or refocusing energies into more productive activities or interactions? 2. Conveys that the nurse knows best and that clients cannot think for themselves. Fosters dependency and inhibits the problem-solving process? 3. May make clients feel used and valued only for the information they can give. Most people resent persistent personal questions, especially if they have not brought up the subject themselves? 4. Indicates that the nurse feels the client needs help; SHOULD: ask questions such as "Can you remember"? 5. Implies that the client has no right to express his or her impressions, opinions, or feelings. this could also imply to the client that the nurse is taking the others' side against the client; SHOULD: It is better to explore the other person's perspective.?

1. disagreeing 2. advising 3. probing 4. testing 5. defending

what communication barrier do these conservation pieces describe: 1. "I disagree with that." "The FBI is not out to torture you for your secrets." 2. "I think you should get out of this situation immediately." "Why don't you go back to school?" 3. "Tell me about your dislike for your wife." "Tell me why you run around with other men." 4. "What day is this?" "Do you know what kind of hospital this is?" "Do you remember...?" 5. "No one around here would lie to you." "I am only trying to help you straighten out."

1. disagreeing 2. advising 3. probing 4. testing 5. defending

in regards to communication enhancers that nurses use: 1. Aids the client in considering people and events within his or her own set of values? 2. Responds to the feelings expressed, not just the content. Often termed "decoding."? 3. Emphasizes working with the client, not doing things for the client. Encourages the view that change is possible through collaboration? 4. Brings together important points of discussion to enhance understanding. Also allows the opportunity to clarify communications so that both nurse and client leave the interview with the same ideas in mind? 5. Allows clients to identify alternative actions for interpersonal situations they find disturbing, e.g., when anger or anxiety are provoked?

1. encouraging evaluation 2. attempting to translate into feelings 3. suggesting collaboration 4. summarizing 5. encouraging formulation of plan of action

what communication enhancer do these conservation pieces describe: 1. "How do you feel about...?" "What did it mean to you when he said he couldn't stay?" 2. C: "I am dead inside." N: "Are you saying that you feel lifeless? Does life seem meaningless to you?" 3. "Perhaps you and I can discover what produces your anxiety." "Perhaps by working together we can come up with some ideas that might improve your communications with your spouse. 4. "Have I got this straight?" "You said that..." "During the past hour, you and I have discussed..." 5. "What could you do to let anger out harmlessly?" "Next time this comes up, what might you do to handle it?" "What are some of the other ways you can approach your boss?"

1. encouraging evaluation 2. attempting to translate into feelings 3. suggesting collaboration 4. summarizing 5. encouraging formulation of plan of action

in regards to communication enhancers that nurses use: 1. Clarifies that the lead is to be taken by the client. However, the nurse discourages pleasantries and small talk? 2. Puts events and actions in better perspective. Notes cause-and-effect relationships and identifies patterns of interpersonal difficulties? 3. The nurse calls attention to the person's behavior, e.g., trembling, biting nails, restless mannerisms. Encourages the person to notice the behavior in order to describe thoughts and feelings for mutual understanding. Helpful with mute and withdrawn persons? 4. Increases the nurse's understanding of the client's perceptions. Talking about feelings and difficulties can lessen the need to act them out inappropriately? 5. Brings out recurring themes in experiences or interpersonal relationships. Helps the person clarify similarities and differences?

1. giving broad openings 2. placing events in time/sequence 3. making observations 4. encouraging description of perception 5. encouraging comparison

what communication enhancer do these conservation pieces describe: 1. "Where would you like to begin?" "What are you thinking about?" "What would you like to discuss?" 2. "What happened before?" "When did this happen?" 3. "You appear tense." "I notice you're biting your lips." "You appear nervous whenever Mr. X enters the room." 4. "What do these voices seem to be saying?" "What is happening now?" "Tell me when you feel anxious." 5. "Has this ever happened before?" "Is this how you felt when...?" "Was it something like...?"

1. giving broad openings 2. placing events in time/sequence 3. making observations 4. encouraging description of perception 5. encouraging comparison

in regards to communication barriers that nurses use: 1. Underrates a person's feelings and belittles a person's concerns. May cause clients to stop sharing feelings if they think they will be ridiculed or not taken seriously? 2. Indicates that what the client is doing now is "good" and implies that not doing it is "bad." When praise is given, potential learning may be hindered because the client then seeks to gain the nurse's approval rather than to focus on the steps of learning? 3. May make the client feel rejected by the nurse because he or she is unable to express personal thoughts and feelings. Thus, the client avoids sharing thoughts or feelings to avoid further risk of this? 4. Is moralizing; implies the nurse has the right to judge the client's thoughts or actions. It further implies the client is expected to please the nurse. If the client's behavior is extreme or hurtful, the nurse should not label the behavior; SHOULD: Make an observation, e.g., "I notice that you are talking a lot even though you know it annoys others and pushes them away."? 5. Denies clients an opportunity to change their point of view?

1. reassuring 2. giving approval 3. rejecting 4. disapproving 5. agreeing

what communication barrier do these conservation pieces describe: 1. "I wouldn't worry about..." "Everything will be all right." "You're doing fine." 2. "I'm glad you made the right decision." "You wrote such a good poem this AM." 3. "Talk to your doctor about this." "This topic is too painful." 4. "I'd rather you wouldn't talk incessantly in group meeting." "You really shouldn't yell at your roommate." 5. "That's right." "I agree."

1. reassuring 2. giving approval 3. rejecting 4. disapproving 5. agreeing

in regards to communication barriers that nurses use: 1. Implies criticism; the client may respond defensively. It is better to ask people to describe what is occurring rather than why it is occurring; SHOULD: Ask questions that focus on who, what, where, and when? 2. Is evident when the nurse is unable to empathize or understand another point of view. When a nurse tells a client to "buck up" or "cheer up," the client's feelings or experiences are being belittled. This can cause a person to feel "small" or "insignificant."? 3. Lacks value in the nurse-client relationship. Encourages empty responses by the client and cuts off important areas of communication? 4. Blocks avenues of discussion. Clients are blocked from identifying and exploring their difficulties? 5. When the nurse does this, he or she is usually threatened by an anxiety-provoking topic. SHOULD: It is important for the nurse to become aware of what precipitates these occurrences and to discuss them in peer counseling or with a supervisor?

1. requesting an explanation 2. minimizing feelings 3. making stereotypical comments 4. using denial 5. changing the subject

what communication barrier do these conservation pieces describe: 1. "Why did you stop taking your medication?" "Why did you do that?" "Why do you always start an argument when we start to talk about change?" 2. C: "I wish I were dead." N: "Everyone gets down once in awhile." Or N: "I know what you mean." or N: "I get that way sometimes." 3. "Things get worse before they get better." "It's for your own good." "Keep your chin up." 4. C: "I am nothing." N: "Of course you're something. Everybody is something." C: "I'll never, never walk again." N: "Sure you will, a lot of people get better." 5. C: "I'd like to die." N: "Did you have any visitors this weekend?"

1. requesting an explanation 2. minimizing feelings 3. making stereotypical comments 4. using denial 5. changing the subject

in regards to communication enhancers that nurses use: 1. Repeats the main idea expressed. Gives the client an idea of what has been communicated. If the message has been misunderstood, the client can clarify it? 2. Directs questions, feelings, and ideas back to the client. Encourages clients to accept their own ideas and feelings. Acknowledges the right to have opinions and make decisions, and encourages clients to think of themselves as capable people? 3. Concentrates attention on a single point. It is especially useful when the client jumps from topic to topic. If a person is experiencing a severe or panic level of anxiety, the nurse should not persist until the anxiety lessens? 4. Examines certain ideas, experiences, or relationships more fully. If the client chooses not to elaborate, the nurse does not probe or pry. In such a case, the nurse respects the client's wishes? 5. Makes available facts the person needs. Supplies knowledge from which decisions can be made or conclusions drawn. For example, the client needs to know the role of the nurse; the purpose of the nurse-client relationship; and the time, place, and duration of the meetings?

1. restating 2. reflecting 3. focusing 4. exploring 5. giving information

what communication enhancer do these conservation pieces describe: 1. Client: "I can't sleep. I stay awake all night." Nurse: "You have difficulty sleeping?" C: "I don't know...he always has some excuse for not coming over or keeping our appointments." N: You think he no longer wants to see you?" 2. C: "What should I do about my husband's affair?" N: "What do you think you should do?" C: "My brother spends all of my money and then has the nerve to ask for more." N: "This causes you to feel angry?" 3. "This point you are making about leaving school seems worth looking at more closely." "You've mentioned many things. Let's go back to your thinking of 'ending it all'." 4. "Tell me more about that." "Would you describe it more fully?" 5. "My purpose for being here is..." "This medication is for..." "The test will determine..."

1. restating 2. reflecting 3. focusing 4. exploring 5. giving information

in regards to communication enhancers that nurses use: 1. Helps clients clarify their own thoughts and maximizes mutual understanding between nurse and client? 2. Indicates what is real. The nurse does not argue or try to convince the client, just describes personal perceptions or facts in the situation? 3. Undermines the client's beliefs by not reinforcing the exaggerated or false perceptions? 4. Clarifies that both the nurse and client share mutual understanding of communications. Helps clients become clearer about what they are thinking? 5. Puts into concrete terms what the client implies, making the client's communication more explicit?

1. seeking clarification 2. presenting reality 3. voicing doubt 4. seeking consensual validation 5. verbalizing the implied

what communication enhancer do these conservation pieces describe: 1. "I am not sure I follow you." "What would you say is the main point of what you just said?" "Give me an example of one time you thought everyone hated you." 2. "That was Dr. Todd, not a man from the Mafia." "That was the sound of a car backfiring." "Your mother is not here; I am a nurse." 3. "Isn't that unusual?" "Really?" "That's hard to believe." 4. "Tell me whether my understanding agrees with yours." "Are you using this word to convey...?" "When you say 'terrible' do you mean...?" 5. C: "I can't talk to you or anyone else. It's a waste of time." N: "Do you feel no one understands?"

1. seeking clarification 2. presenting reality 3. voicing doubt 4. seeking consensual validation 5. verbalizing the implied

in regards to communication enhancers that nurses use: 1. Gives the person time to collect thoughts or to think through a point? 2. Indicates that the person has been understood. The statement does not necessarily indicate agreement but is nonjudgmental. However, nurses do not imply they understand when they do not understand? 3. Indicates awareness of change and personal efforts. Does not imply good or bad, or right or wrong? 4. Offers presence, interest, and a desire to understand. Is not offered to get the person to talk or behave in a specific way? 5. Allows the other person to take direction in the discussion. Indicates that the nurse is interested in what comes next?

1. using silence 2. accepting 3. giving recognition 4. offering self 5. offering general leads

what communication enhancer do these conservation pieces describe: 1. Encouraging a person to talk by waiting for the answers. 2. "Yes." "Uh-huh." "I follow what you say." 3. "Good morning, Mr. James." "You've combed your hair today." "I notice that you shaved today." 4. "I would like to spend time with you." "I'll stay here and sit with you a while." 5. "Go on." "And then?" "Tell me about it."

1. using silence 2. accepting 3. giving recognition 4. offering self 5. offering general leads