N321 exam 1
Non-Verbal Communication:
*Eye Contact* *Facial Expressions* *Mannerisms/Gestures* *Posture*
Communication Tips
*To the point...* Be direct! *Clarity* Avoid confusing or ambiguous language *Manners count...* Be polite! *Don't interrupt* *Patience* Patience is a virtue, especially when it comes to effective communication
Top 10 "Soft" Skills
1. Strong work ethic 2. Positive Attitude 3. Good communication skills 4. Time-management abilities 5. Problem solving skills 6. Acting as a team player 7. Self Confidence 8. Ability to accept and learn from criticism 9. Flexibility/Adaptability 10. Working well under pressure
"Soft" Skills
A cluster of personal qualities, habits, attitudes and social graces that make someone a good employee and compatible to work with. Companies value soft skills because research suggests and experience shows that they can be just as important an indicator of job performance as hard skills.
Cultural Competence & Nursing
A culturally-fluent approach to good communication skills in nursing takes time, patience, good listening and awareness, and will go a long way to improve the communication across cultures and enhance personal and professional relationships. In the end, try not to assume someone is being rude or trying to offend you. Give them the benefit of the doubt.
Stereotype
A generalized assumption made about members of a particular group People are complex -If you try to hard to label a difference, you may make a generalization, or an overly simplified statement which can become a stereotype
Transcultural Nursing
A nursing specialization developed to understand and respect cultural differences when providing nursing care Differences in traditions, customs and beliefs can sometimes affect people's abilities, and sometimes rights to acquire the healthcare services they need
Principles of Verbal Communication: Language is rule guided
A set of unspoken, but widely understood rules exist in verbal communication Communication rules are a shared understanding of what and when communication is appropriate Regulative rules define proper etiquette of when, where, how & with whom to discuss certain topics Constructive rules define how to analyze various types of communication
Strength Diversity
A variety in the assets that different people have to offer
Constructive Criticism:
A well-meant evaluation Intended to help a person improve some aspect of their performance Should not include accusation or blame
The 7 "C's" of Communication
According to the 7 Cs, communication needs to be: 1) Clear. 2) Concise. 3) Concrete. 4) Correct. 5) Coherent. 6) Complete. 7) Courteous.
Generation Y
Also known as the Millennials Generation born from the late 1980s through the end of the 20th century Millennials grew up during enormous acceptance of and advances in digital technology
Generation X
Also knows as Gen X Generation born from the late 1960s to the early 1980s Gen X grew up in times that were more economically secure than the Silent Generation's, but less so than the Baby Boomers' Gen X grew up with technological advances like the home computer, cable television and the introduction to the internet
Questioning: *Open-ended Questions*
An open-ended question is not limited to a single answer, but invites a wide variety of responses
Flexibility/Adaptability
Are you able to adapt to new situations and challenges? Will you embrace change and be open to new ideas?
Good communication skills
Are you both verbally articulate and a good listener? Can you make your case and express your needs in a way that builds bridges with colleagues, customers and vendors?
Strong work ethic
Are you motivated and dedicated to getting the job done, no matter what? Will you be conscientious and do your best work?
Positive Attitude
Are you optimistic and upbeat? Will you generate good energy and good will?
Problem solving skills
Are you resourceful and able to creatively solve problems that will inevitably arise? Will you take ownership of problems or leave them for someone else?
Effective Communication at Work: Nonverbal Communication
Be aware of posture: professional vs. unprofessional Be aware of your face -What does your facial expression say? ---Try to match verbal expression to facial expression -Are you making eye-contact?
Generation Z
Born from the 1990s through 2010 Also called the Internet Generation, or "digital natives" They have always lived in a world connected by the Internet
Nonverbal Communication: Silence
Can be very powerful Can communicate a number of different meanings Can be interpreted a number of ways -Can indicate a level of comfort with an intimate, or awkwardness depending on the situation Silence can promote varying levels of comfort, and conversely, may be used to disconfirm
Working well under pressure
Can you handle the stress that accompanies deadlines and crises? Will you be able to do your best work and come through in a pinch?
Effective Communication at Work: Verbal Communication
Choose professional words -Yes vs. yeah Be aware of speed & volume Be aware of your tone & inflection -sarcasm
Nonverbal Communication: Paralanguage
Communication that is vocal but does not involve the use of words -Murmurs, gasps, vocal qualities such as pitch and inflection -Our voices can give others clues on how to interpret us -Whispering conveys secrecy while shouting conveys anger Our voices effect how others perceive us, so we are able to deliberately control our vocal cues which influence our image
Language and Culture Reflect One Another
Communication within a culture is a reflection on values Common expressions in one culture can have different meanings in other cultures Communication between cultures can be difficult when meaning gets lost in translation
Importance of "Soft" Skills
Companies seek candidates with both hard and "soft" skills when hiring for most positions. If you can't get along with others, don't have a positive attitude, can't work well as part of a team, and aren't able to think creatively and critically it may not matter how talented you are.
Pinpointing/Focusing
Concentrating on a single point
What if I've never worked?
Consider things you've learned in school: Ability to meet deadlines under pressure Ability to handle multiple tasks Ability to achieve goals Ability to adapt Writing skills Research skills
Behaviors that Block Communication
Conveying lack of interest Conveying sense of haste Closed posture Interrupting, finishing sentences Providing false reassurance Inappropriate self-disclosure Giving advice Failure to acknowledge comments or feelings
Cultural Diversity
Cultural diversity is the range of cultures represented Cultural diversity is increasing in the workplace
Culture
Culture is the particular customs, values & shared beliefs among a group Culture shapes the people of a group, and the people shape and pass on the culture The culture a person comes from affects his or her worldview
Exploring
Delving further into a subject -"Tell me more about that"
Cultural Competency
Demonstrating knowledge and understanding of the client's culture; accepting and respecting cultural differences; adapting care to be congruent with the client's culture Cultural differences can affect patient assessment, teaching and patient outcomes, as well as overall patient compliance How? An inclusive environment helps to assure that the standards of nursing care include cultural differences Using cultural competence helps minimize discrimination in healthcare
Reflecting
Directing the client's thoughts, feelings and actions back to the client -Pt: "Do you think I should tell the doctor?" -Nurse: "Do you think you should tell the doctor?" -Pt: "I'm worried." -Nurse: "Worried?"
Diversity
Diversity is variety, or a range of differences Every person brings their own unique background, beliefs, ideas and points of view to the world Understanding differences between people/cultures can be a way to understand them more & allows you to be respectful
Time-management abilities
Do you know how to prioritize tasks and work on a number of different projects at once? Will you use your time on the job wisely?
Self Confidence
Do you truly believe you can do the job? Will you project a sense of calm and inspire confidence in others? Will you have the courage to ask questions that need to be asked and to freely contribute your ideas?
Communication
Effective communication skills are constantly rated among the top five attributes that employers seek in today's workforce. According to the National Association of Colleges and Employers (2011), *verbal communication skills* topped the list of soft skills companies seek in college graduates.
Transferable Interpersonal Skills
Examples are: Developing a rapport Providing support Representing others' ideas Instructing others in any skill or process Demonstrating something you know well to others Working with a team Servicing customers effectively and pleasantly
Transferable Leadership Skills
Examples: Coordinating tasks and resources to meet deadlines Managing groups efficiently Delegating responsibility fairly Promoting change and a growth mindset Managing conflict on your team Scheduling others correctly Sharing credit where credit is due
Transferable Communication Skills
Examples: Speaking effectively one-on-one and in a group setting Writing concisely and correctly Listening attentively Expressing ideas clearly Providing appropriate feedback Reporting information effectively
Cultural Differences in Communication
Eye contact Use of touch Respect (use of titles, "auntie") Volume of voice Sense of personal space
Eye Contact
Eye contact is an important form of nonverbal communication. A personal connection is made - you are interested in what they are saying By not making eye contact, you may be implying more or even less than what you are actually saying. Culture - direct eye contact may be viewed as disrespectful Having trouble? Look at their nose or forehead
Formal vs. Informal Communication
Formal -Speech, conference, email blast, newsletter Informal -Conversation, personal note, overheard comment
PROFESSION
Higher level of education Requires more skills Requires more training Utilizes critical thinking skills The ability to master techniques Desire to expand knowledge Usually has a distinct body of knowledge specific to that field
Age Diversity
If people grew up during different times, they usually see the world very differently Age diversity = range of individuals of different generations
Patience
If you rush things and become easily frustrated, your communication abilities suffer. If you are always ready to slow the pace as needed or go back over certain points, you will communicate much more efficiently.
Check for Clarity
If you're not sure if your patient understood you, try checking for clarity: -"Is it okay with you if..." -"Are you comfortable when..." -"Can you explain to me how..." -"Was it clear when I said..."
New Healthy People 2020 goal:
Improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender (LGBT) individuals. LGBT individuals encompass all races and ethnicities, religions, and social classes. Research suggests that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights. Discrimination against LGBT persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide. Experiences of violence and victimization are frequent for LGBT individuals, and have long-lasting effects on the individual and the community. Personal, family, and social acceptance of sexual orientation and gender identity affects the mental health and personal safety of LGBT individuals.
Nonverbal Communication: Physical Appearance
In Western culture, an extremely high value is placed on physical appearance -Because of this, we often base our initial evaluations of people based on their appearance The high emphasis based on physical attractiveness and a youthful appearance contributes to eating disorders, use of steroids and other drugs, and the popularity of cosmetic surgery Often, culture is used to stipulate the ideal for physical form
Principles of Verbal Communication: Punctuation shapes meaning
In interpersonal communication, punctuation denotes the beginning and end of an interaction Commas, periods & semicolons are used to define where ideas begin end and pause in writing Objectively, punctuation cannot be correct; it can only be perceived subjectively
Healthy People 2020
In late 2010, the US Department of Health and Human Services launched a comprehensive, nationwide health promotion and disease prevention program. These include goals and objectives with 10 year targets designed to guide national health promotion and disease prevention efforts in order to improve the health of all Americans.
Personal Space
In the US, we typically interact with social acquaintances with a distance of 4 to 12 feet, but are comfortable with 18 inches or less with personal friends and romantic partners In Asian cultures, it is more customary for people to stand more closely together, almost touching
The Baby Boomers
In the prosperous period after World War II, the Silent Generation gave birth to the Baby boomers from the 1940s to the mid-1960s Baby Boomers grew up during the 1960s, a period perceived to represent significant social change and shifts in values Most baby boomers are moving toward retirement now, but there are still many in the workforce
Interpersonal Communication
Interpersonal communication is your personal interaction with others. Remember, communication is continuous and irreversible. You can't take back words or actions because they have already made an impact on the receiver.
JOB
JOB stands for "just over broke" Minimal education Little to no experience Person can be easily replaced
Language Diversity
Language differences can make communication challenging If you have difficulty understanding someone's accent, *consider a different form of communication (written)* Use a translator!!! Use active listening to pay attention when conversing with people with different language backgrounds to see if there is understanding Eye contact, facial expressions & body language can help you convey and assess understanding, or lack of it, across language barriers
Give Your Full Attention
Look at the speaker Face them if possible Put distractions away
Another Example
Marian: worked full time as a house keeper while going to school full-time NO: cleaned houses for multiple clients while going to school full-time YES: Maintained scheduling for multiple clients while maintaining 4.0 GPA as a full-time student NO: Kept and ordered supplies YES: Maintained inventory and created replenishment schedule for supplies
Nonverbal Communication: Haptics
Nonverbal behavior referring to the sense of touch Many believe that the act of touching and being touched are essential to a healthy life Touching may be used to indicate power or status -People with high status often touch or invade personal space at a higher rate than someone with less status would do
What do Nurses Do?
Nurses protect Nurses promote health & abilities Nurses alleviate suffering Nurses diagnose & treat Advocate
What is Nursing?
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations (ANA, n.d.)
First Impressions
Only about 7% of a person's understanding of your communications arise from your words. The remaining 93% of a person's understanding is based on verbal cues (like pitch, rate, and tone), and on nonverbal behaviors (like facial expressions and posture).
Effective Questioning Techniques
Open-ended questions: -tend to elicit more information and more detail. -help to thoroughly investigate the issues. -help clarify feelings. If the question you asked does not get the response you expected, restate the question or ask it in a different way. There is no perfect question. Good questioning techniques are an art, not an exact science, and depend on the speaker's response.
Active Listening
Paying attention Making an effort not only to hear but also to comprehend
Age Diversity: Generation
People who grew up during roughly the same time period and who have many of the same life experiences Generations overlap, but certain generations are identified with the historical conditions of their times
Age Diversity in the Workplace
People who grew up in different social and political climates may have different values and may prioritize differently They also have very different comfort levels with technology As with all types of diversity, it is important to avoid stereotypes and not make assumptions based on age
Mannerisms/Gestures
People's mannerisms can convey what they are thinking even though they think they are expressing something different. *Arms:* Having your arms *relaxed* often indicates that you are open to a conversation Arms *folded across the chest:* fear, close mindedness, superiority, anger or infringement of personal space, which might indicate to another person that you do not want them to come any closer. Some people tend to fold their arms out of habit or because they are cold, and this is often misinterpreted.
"At Risk" Populations (CDC)
Race & ethnicity Gender Sexual identity and orientation Disability status or special health care needs Geographic location (rural and urban) Socioeconomic status Age Other (immigrants & refugees, cancer survivors, incarcerated men & women, people who use drugs, pregnant women, veterans)
Nonverbal Communication: Kinesics
Refers to body position & body motions, including your face Humans have long communicated by gestures We use gestures to emphasize verbal communication and express feelings Gestures do not always translate across cultures
Nonverbal Communication: Chronemics
Refers to how we perceive and use time to define identities and interaction For example, in Western culture there is a norm that people with high status can keep others waiting and conversely, those with low status are expected to be punctual It reinforces the theory that some people's time is more valuable than others
Nonverbal Communication: Proxemics & Personal Space
Refers to the space around us & how we use it Each culture has its specific norms in relation to how people should use space, how close people should be to one another, and how much space different people are entitled to have
Clarifying
Repeating statements others have made so both parties are certain of understanding Especially good at discussing symptoms -Nurse: "you get the pain in your stomach & then it spreads to your chest? -Pt: "No, it starts in my chest first"
Paraphrasing/Restating
Repeating the main idea the patient has stated to you; in your own words, explain what the patient said -Pt says "I can't take this med" -Nurse says "_______"
For Example:
Robert, Catering Team member NO: made & decorated wedding cakes YES: Followed instructions and completed processes to create multi-tiered wedding cakes NO: created a process for keeping up with customer orders YES: learned attention to detail while developing a process for improved customer service
Principles of Verbal Communication: The meaning of language is subjective
Since words are layered with meaning, various interpretations can be drawn A person's self-esteem can affect how he or she constructs meaning from other people's words The process of constructing meaning is not a conscious effort - it is done on a continual basis
Transferable Skills
Skills you acquire and then transfer to future employment settings are called "transferable skills." Examples of transferable skills: interpersonal skills, organization skills, leadership skills, and communication skills
"Soft" Skills for Nurses
Specifically for Nurses... *Decision-making skills* Nurses have to use *good judgment* and make quick decisions about the patient's care. They decide when to administer treatments or medications that are prescribed "as needed," and they respond to unexpected patient needs throughout the day. Nurses have to use their judgment and balance what they know about the individual patient, that patient's needs and the likely consequences of their decisions.
Summarizing
Summing up your understanding of what the patient is saying Example: -"So your main concerns are about the baby going home in the car seat, and what to do if the baby cries in the car."
Skills for Nurses: Empathy
The World English Dictionary defines empathy as "the power of understanding and imaginatively entering into another person's feelings." In other words, empathy is the ability to put yourself in someone else's shoes. The World Health Organization identifies this soft skill as the most important element of communication with patients: "The key is to care about the patient as a person, to recognize that this is a human being like you, who is sick and perhaps in pain, who is in need of your help."
The Silent Generation
The generation born from 1925 - 1945 Grew up during the Great Depression Most of them have left the workplace
Posture
The way you carry yourself says a lot about you, and it may indicate quite a lot about your present mindset and mood. *Slouched Posture*- Depression or insecurity *Upright Posture* - Confidence & ready for any task Did you know... Practicing correct, upright posture while walking and sitting can sometimes even help you with your mood.
Therapeutic Communication Techniques
Therapeutic communication is purposeful, goal directed & focused. It requires conscious effort & considerable practice. Clarifying Paraphrasing/restating Reflecting Silence Pinpointing/focusing Questioning Summarizing Exploring
Nonverbal Communication
There are 9 types of nonverbal communication Reviewing these will help give you a better understanding of how we communicate, even when there are no words being spoken out loud
Nonverbal Communication: Environmental Factors
These are any element of a setting that affects how we act or feel These include: architecture, colors, room design, temperature, sounds, smells & lighting Culture has a large impact on environmental factors
Nonverbal Communication: Artifacts
These are personal objects that we use to announce our identities and heritage, and to personalize our environment In face-to-face communication, we craft our image by how we dress and what objects we carry around with us and use People use artifacts to express their experiences, relationships, values, and personalities
social media
Though many social media sites began as personal communication tools, the work world has caught on to the benefits of using these tools to promote their companies and recruit employees. Many companies now check the Facebook and LinkedIn pages of their applicants to determine whether the person will be a good fit for the company. LinkedIn is a more formal social network built for the purpose of allowing professional to connect. Think of LinkedIn as an interactive online resume. Keep it current and professional.
Pay attention to how words are said
Tone can change meaning
Basics of Communication Across Cultures
Use common words Follow basic words of grammar Avoid slang Repeat basic ideas *without shouting* Paraphrase important points Check for understanding
Non-therapeutic Communication: What NOT to do
Using Reassuring Clichés -"Everything will be all right," -"You don't need to worry," -"You're doing fine" Giving Advice -"What you should do is..." -Why don't you..." Giving Approval -"That's the right attitude" or "That's the thing to do." -Giving approval can sometimes create a block by shifting the focus of the discussion to the nurse's values or feelings, and by implying standards of what is and what is not acceptable Belittling the Patient's Feelings -"I know just how you feel" -Instead, try to simply acknowledging the patient's feelings. "This must be very difficult (upsetting, exhausting, annoying, etc.) for you." Disagreeing with the Patient -"You're wrong", "That's not true," "No, it isn't." -By contradicting the patient, the nurse indicates to him that what he has said has not been accepted. -Because the nurse's judgment may cause the patient to feel threatened they may refrain from expressing themselves further on the subject, or they may become defensive or angry. -When the patient makes a statement with which the nurse disagrees, the nurse can acknowledge the patient's feelings and opinions without agreeing with them, e.g., "Then you feel..." or "I hear what you are saying." Changing the Subject -Patient "I'd like to die" -Nurse: "Don't you have visitors this weekend?" or "by the way..." or "That reminds me..." -Generally, the nurse changes the subject to avoid discussing a topic which makes them uncomfortable
Dealing With Difficult People
We can all be difficult at times and in different situations. Some people, though, may seem more difficult than others Learning to work effectively with each of these types of people will help you be more successful in school, at work, and in life
Silence
When is this good to use?
How do I use Transferable Skills?
When you draft your resume, you will be looking at the transferable skills you have that will help you get the job. It makes a difference how you list your experience. Make your transferable skills concrete to the reader. Emphasize your achievements.
Ability to accept and learn from criticism
Will you be able to handle criticism? Are you coachable and open to learning and growing as a person and as a professional?
Acting as a team player
Will you work well in groups and teams? Will you be cooperative and take a leadership role when appropriate?
Bottom line
You have skills that can help you get your first job in your new field. Put some thought into which skills you have. Think about solid examples you can provide at your first interview when you graduate. Write them down NOW and add to the list as you think of others. Keep your list until you are asked, in a future class, to create your resume. Never lie, but take advantage of all of your experience.
Effective Communication at Work
Your coworkers will form opinions about you based on how they feel about you How can you make sure you're making a good impression? Thoughts? How do you go about making a good first impression every day?
Facial Expressions
Your face is extremely expressive and can communicate even when you don't have words to describe what you are feeling. A smile can mean several things- what does the rest of your face say? From a smile to a grimace to something as intricate as crying in pain, there are countless expressions that are conveyed by our faces. You may not even know that you are displaying a facial expression that may be interpreted as negative or inappropriate - have other people tell you what they see and help you correct it if it is a problem.
Emotional Intelligence
the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically "emotional intelligence is the key to both personal and professional success"