Communication

What is the difference between a closed question and an open question?

-Closed-ended questions are those which can be answered by a simple "yes" or "no," while open-ended questions are those which require more thought and more than a simple one-word answer.

How are courtesy and the use of names elements of professional communication?

-Courtesy: To practice courtesy, say hello and goodbye to patients and knock on doors before entering. State your purpose, address people by name, and say please and thank you to team members. -Use of names: Always introduce yourself. Failure to give your name and status or acknowledge a patient creates uncertainty about an interaction an conveys an impersonal lack of commitment or carrying. Making eye contact and smiling recognize others. Addressing people by name conveys respect for human dignity and uniqueness. Nurses usually use a patient's last name in an initial interaction and then use the first name if the patient requests it. -professional behavior reflects warmth, friendliness, confidence, and competence

What are the elements of professional communication?

-Courtesy: common courtesy, knock, thank you, hello, goodbye -use of names: always introduce yourself, eye contact, smiling, use pts preferred name -trustworthiness: communicate warmth and demonstrate consistency, reliability, honesty, competence, and respect -autonomy and responsibility: self directed, independent, take initiative in problem solving and communicate in way that reflects the importance and purpose of a therapeutic conversation -assertiveness: to express feelings and ideas without judging or hurting others. intermittent eye contact; nonverbal comm that reflects interest, honesty, and active listening; spontaneous verbal responses with a confident voice; and culturally sensitive use of touch and space

What is a measurable criterion, and how is it used to evaluate goal achievement?

-Evaluate the effectiveness of your own communication by videotaping practice sessions with peers or by making process recordings -written records of your verbal and nonverbal interactions with patients. -Process recording analysis reveals how to improve personal communication techniques to make them more effective. -Analysis of a process recording enables you to evaluate the following: determine whether you encourage openness and allowed the patient to tell his story, expressing both thoughts and feelings, identify any missed verbal or nonverbal cues or conversational themes, examine whether nursing responses facilitated or block the patient's efforts to communicate, determine whether nursing responses were positive and supportive or superficial and judgmental, examined the type and number of questions asked, determine the type and number of therapeutic communication techniques used, discover any missed opportunities to use humor, silence, or touch

What is a denotative meaning?

-Individuals who use a common language shared denotative meaning, baseball has seen meaning for everyone who speaks English, but code notes cardiac arrest primarily to health care providers. -Denotations are simple and straightforward; everyone will arrive at the same meaning by using the dictionary. -Connotations are subjective and will differ from person to person based on their social experience with the words.

What are the zones of personal space? How could the nurse violate the pts personal space?

-Intimate zone: 0-8 in, head to toe, holding baby -personal zone: 18 in-4 ft, sitting at bedside, taking pts nursing history, teaching an individual pt -socio-consultative zone: 9-12ft, giving directions to visitors in hallway -public zone: (more than 12 ft) lecturing to class of students -touching, getting really close. intimate contact, involve a pts vulnerable zone

How does therapeutic communication include both verbal and non verbal cues?

-Messages are conveyed verbally and nonverbally, concretely and symbolically. As people communicate, they express themselves through words, movements, voice inflection, facial expressions comma and use of space. These elements work in harmony to enhance a message or conflict with one another to contradict and confuse it. -Verbal communication uses spoken or written words. Verbal language is a code that convey specific meaning through a combination of words. It uses vocabulary, denotative and connotative meaning , pacing, intonation, clarity and brevity, timing and relevance -nonverbal communication includes the five senses and everything that does not involve the spoken or written word. Nonverbal aspects of communication such as voice tone, eye contact and body positioning are often important as verbal messages. Thus nonverbal communication is unconsciously motivated and more accurately indicates a person's unintended meaning than spoken words. When there is incongruity between verbal and nonverbal communication comma the receiver usually hears the nonverbal message as the true message.

What are the phases of therapeutic helping relationships?

-Preinteraction phase: before meeting the pt. Ex) review data history, talk to other caregivers, anticipate health concerns, etc -Orientation phase: when nurse and patient meet and get to know one another Ex) be warm, empathetic, and caring, closely observe patient, assess patient's health status -Interaction phase: when nurse and patient work together to solve problems accomplish goals Ex) encourage and help patient express feelings, encourage and help patient w/ self exploration, use therapeutic comm. skills -Termination phase: ending the helping relationship Ex) remind patient termination is near, evaluate goal achievement with patient

What is the difference between providing a pt empathy vs sympathy?

-Sympathy is concern, sorrow, or pity felt for another person. A nurse often takes on patient problems as if they were his or her own. Sympathy is a subjective look at another's persons world that prevents a clear perspective of the issues confronting that person. -Empathy: -the ability to understand and accept another persons reality, accurately perceive feelings, and communicate this understanding to the other. -enables a nurse to understand a pts situation, feelings, and concerns. -To express empathy you reflect that you understand and feel the importance of the other person's communication. -Statements reflecting empathy are highly effective because they tell a person that you heard both the emotional and the factual content of the communication.

Know about SBAR communication and its use when a nurse contacts a pts physician.

-Use of a common language such as the SBAR technique for communicating critical information improves perception of communication and information about patients between health care provider. -SBAR is the acronym for situation, background, assessment comma and recommendation. The use of this easy to remember, orderly technique is to relay relevant information in a structured and timely manner. -Evidence identifies nursing actions that increase in effectiveness of nurse to nurse interaction an interprofessional communication. -Some organizations have added an introduction step ISBAR into the SBAR process. The introduction step is used when health care providers do not actively know each other. They start with an introduction, a description of their location comma and their role in caring for the patient.

What is an incongruent affect?

-affect is how a person appears to others. It is the physical presentation of their emotion matches what they subjectively express. -incongruent affect: in which the client's expression is of feelings opposite the ones appropriate for the context

What is humility and why is it important in pt care?

-an attitude for critical thinking -recognize when you need more information to make a decision. It is important to admit to any limitations in your knowledge and skill. -A patients safety and welfare are at risk if you do not admit your inability to deal with a practice problem. You have to rethink a situation, learn more, and use new information to form opinions, draw conclusions comma and take action.

How would a nurse adapt communication techniques for patients with special needs, such as sensory, motor or cognitive impairments?

-patients who cannot speak clearly- listen attentively, be patient, do not interrupt , ask simple questions that can be answered with a yes or no, allowed time for understanding in response, use visual cues when possible, allow only one person to speak at a time, encourage patient to converse, let patient know you have not understood them, use communication aids like letter boards, flash cards, computer generated speech programs -Patients who are cognitively impaired, use simple sentences, avoid long explanations, allow time for response, being attentive listener, include family and friends in the conversation, use pictures or gestures that mimic the action desired -patients who are hearing impaired , check for hearing aids, reduce environmental noise, get the patients attention before speaking, face patient with mouth visible, do not chew gum, speak at normal volume try not to shout, rephrase rather than repeat if misunderstood, provide a sign language interpreter when needed -patients who are visually impaired, check for glasses or contact lenses, identify yourself, speak in a normal tone of voice, do not rely on gestures or nonverbal communication, using direct lighting and avoid glare, use at least 14 point print -patients who are unresponsive, call by name during interactions, communicate verbally and by touch, speak as though he or she can hear, explain all procedures and sensations, provide orientation to person, place and time, avoid talking about patient to others and his or her presence

How should the nurse communicate with pts who have special needs, such as Alzheimer's disease?

-the nurse should use tools to their advantage -for pts that are cognitively impaired: use simple sentences, avoid long explanations, ask one question at a time, allow time for pt to respond, be an attentive listener, include fam and friends in convos, use pictures or gestures that mimic the action desired

What is empathy and how can a nurse convey empathy to patients?

-therapeutic communication technique -the ability to understand and accept another persons reality, accurately perceive feelings, and communicate this understanding to the other. -enables a nurse to understand a pts situation, feelings, and concerns. -To express empathy you reflect that you understand and feel the importance of the other person's communication. -Statements reflecting empathy are highly effective because they tell a person that you heard both the emotional and the factual content of the communication. -Empathetic statements are neutral and non judgmental 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.

What is clarifying, focusing, providing information, asking relevant questions and validation and how are they used in communicating with pts?

-therapeutic communication techniques used for specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. -Clarifying: To check whether you understand the message accurately, restate an unclear or ambiguous message to clarify the senders meaning. -Focusing: involves entering a conversation on key elements or concepts of a message. -Validation: This is a technique that nurses used to recognize and acknowledge it patients thoughts, feelings, and needs. -Relevant Qs: Nurses ask relevant questions to seek information needed for decision-making. -Providing relevant information: tells other people what they need or want to know so they are able to make decisions, experience less anxiety comma and feel safe and secure.

Why is trustworthiness in nursing important, and how can you build trust with a pt?

-trust is relying on someone without doubt or question -To foster trust, communicate warmth and demonstrate consistency, reliability, honesty, competence, and respect -trusting another person involves risk and vulnerability; but it also fosters open, therapeutic comm and enhances the expression of feelings, thoughts, and needs -Without trust, a nurse-pt relationship rarely progresses beyond social interaction and superficial care

What is active listening, and what part does reflection play in active listening?

-Being attentive to a patient is saying both verbally and nonverbally. -It facilitates patient communication. -Several non verbal skills facility attentive listening, using the acronym SOLER. (S: sit facing pt, O: open position, L: lean toward pt, E: eye contact, R: relax) -Reflection involves reflecting back to the speaker what it is you believe they mean. This technique increases your own understanding, helps the speaker to clarify his or her own thoughts, and can reassure them that you are interested in their point of view

How would a nurse demonstrate genuineness while communicating with a pt?

-Genuineness refers to the nurse's ability to be open, honest, and authentic in interactions with patients.

What is motivational interviewing, and how and when is it utilized? What are some of the benefits of using MI techniques?

-Motivational interviewing is a technique that holds promise for encouraging patients to share their thoughts, beliefs, fears and concerns with the aim of changing their behavior -For behavior change associated with medication adherence, dietary changes, smoking cessation comma and physical activity -MI provides a way of working with patients who may not seem ready to make behavior changes that are considered necessary by their health practitioners. It can potentially be used to evoke change talk, which links to improve patient outcomes. -The interviewing is delivered in a nonjudgmental, guided communication approach . -When using him IM, a nurse tries to understand a patient's motivations and values using an empathy empathic and active listening approach. The nurse identifies differences between the patient's current health goals and behaviors and his or her current health status. -Communication then focuses on recognizing the patient strengths and supporting those strengths in an effort to make positive changes. This can result in dramatic improvements in health outcomes and patient satisfaction

What are some implications for patient centered care when the nurse and the pt do not speak the same language?

-Speak to patient in normal tone of voice, establish method for patient to ask for assistance (call light or Bell)l, provide a professional interpreter as needed, avoid using family members especially children as interpreters, use communication boards pictures or cards, translate words from native language into English list for patient to make basic requests, have a dictionary available if patient can read

How can a nurse best verify the pts understanding of their teaching?

-use the teach back method

What are some non therapeutic communication techniques and how do they hinder communication?

-often cause recipient to activate defenses to avoid being hurt or negatively affected. Non therapeutic techniques discourage further expression of feelings and ideas and engender negative responses or behaviors in others. -Asking personal questions, giving personal opinions, changing the subject, automatic responses, false reassurance, sympathy, asking for explanations, approval or disapproval, defensive responses, passive or aggressive responses, arguing

What are some of the challenging communication situations that nurses may have to face?

-pic -Underlying causes: Environment, response to caregiver communication methods, psychologically distressed, low self esteem, lonely, recent major stressor, fearful diagnosis, past abuse, personality disorders, cultural differences, lack of trust , information or communication

What are the phases of the Helping Relationship, and what roles do the nurse and patient play?

-preinteraction phase: before meeting a pt -orientation phase: when the nurse and pt meet and get to know one another -working phase: when the nurse and pt work together to solve problems and accomplish goals -termination phase: during the ending of the relationship

Why are "why questions" and asking for explanations nontherapeutic?

-pts frequently interpret "why" questions as accusations or think nurses know the reasons and are simply testing them. -they can cause resentment, insecurity, and mistrust

What strategies should a nurse use to facilitate safe transition of care during a transfer to another facility?

-when pts move from one nursing unit to the another or from one provider to the other there is a risk for miscommunication to address this risk healthcare providers hand off reports at the end of shifts or when pts transfer off care unit to ensure that pts have a safe and smooth transition in care. -TJC Resources recommends that the entire healthcare team collab and coordinate during pt transition. Standardized or transfer procedures and forms reduce the risk of error during pt transitions. -Timely follow up after discharge or transfer is also encouraged.