Nurs 105: Communication

sharing empathy

The nurse makes statements that are neutral and nonjudgmental and reflects understanding of the importance of what has been communicated by the other person on a feeling level. "It must be frustrating to know what you want to say, but not be able to verbalize it."

trustworthiness

communicate warmth and demonstrate consistency, reliability, honesty, competence, and respect.

Active listening

demonstrates interest in the client's needs, concerns, and problems. Listening can be facilitated by maintaining eye contact, remaining relaxed, and by using appropriate touch techniques

conveying acceptance

demonstrates the interviewer's willingness to listen to the client's beliefs, values, and practices without being judgmental.

mutuality a belief that the nurse pt relationship is a partnership and both sides are equal

effective interpersonal communication requires ...............

focusing

eliminates vagueness in communication, limits the area of discussion for the client, and helps the interviewer direct attention to the pertinent aspects of a client's message.

closed-ended questions

limit answers to one or two words such as "yes" or "no" or a number or frequency of a symptom. They require short answers and clarify previous information or provide additional information, and do not encourage the patient to volunteer more information than you request.

Critically think

nurses who develope ______ __________ skills make the best communicators

recommendations

part of SBAR that ask what actions or interventions should be initiated to alleviate the problem

situation

part of SBAR that ask what is happening right now?

background

part of SBAR that asks what led up to the current sitaution

facial expression

part of nonverbal communication convey emotions such as surprise, fear, anger, happiness, and sadness. Patients closely observe nurses. Although it is hard to control all facial expressions, try to avoid showing shock, disgust, dismay, or other distressing reactions in a patient's presence.

posture and gait

part of nonverbal communication •gait (manner or pattern of walking) are forms of self-expression. The way people sit, stand, and move reflects attitudes, emotions, self-concept, and health status.

sounds

part of nonverbal communication such as sighs, moans, groans, or sobs also communicate feelings and thoughts

gestures

part of nonverbal communication that emphasize, punctuate, and clarify the spoken word. they alone carry specific meanings, or they create messages with other communication cues

meta communication

part of nonverbal communication that is a broad term that refers to all factors that influence communication. Awareness of influencing factors helps people better understand what is communicated.

territoriality

part of nonverbal communication that •is the need to gain, maintain, and defend one's right to space. is important because it provides people with a sense of identity, security, and control.

personal appearance

part of nonverbal communication that describes •appearance includes physical characteristics, facial expression, and manner of dress and grooming. These factors communicate physical well-being, personality, social status, occupation, religion, culture, and self-concept.

courtesy

part of professional communication saying hello and goodbye, always introduce yourself

paraphrasing

provides an opportunity for the interviewer to validate information from the client without changing the meaning of the client's statement. is the interviewer's formulation of what the client has said in more specific words. The message is restated using one's own words. Care should be taken so that the meaning of the message is not changed or distorted

sharing observations

provides the client with feedback about how the interviewer observes the client's behavior, action, facial expression, or activities

theory of proxemics

the study of the spatial requirements of humans and animals

symmetrical relationship

these are relationships that are more equal

complementary role relationships

they function with one person holding an elevated position over the other person

hearing impaired patients

this includes hearing aids, written communication, adequate lighting, provide interpreters use gestures, raise voice.

physcially or cognitively impaired patients

this includes quadriplegic patients, ppl with intellectual disabilities, semi-comatose or postoperative patients, effective to use touch and gestures, look for nonverbal communication, and avoid confrontation

sender and reciever

this is part of the circular transaction model that encodes and one who decoded the message

circular transactional model of communication

•includes several elements: the referent, sender and receiver, message, channels, context or environment in which the communication process occurs, feedback, and interpersonal variables. •In this model, each person in the communication interaction is both a speaker and a listener and can be simultaneously sending and receiving messages. Both parties view the perceptions, attitudes, and potential reactions to a sent message. •Feedback from the receiver or environment enables the communicators to correct or validate the communication. This model also describes the role relationship of the communicators as complementary and symmetrical.

socialization

•is an important initial component of interpersonal communication. It helps people get to know one another and relax. It is easy, superficial, and not deeply personal; whereas therapeutic interactions are often more intense, difficult, and uncomfortable.

SBAR

(situation, background, assessment, and recommendation) is a widely accepted method of handoff communication that involves interpersonal communication designed to enhance patient safety and outcomes

sharing hope

The nurse offers encouragement and positive feedback. The nurse makes comments on the positive aspects of the patient's behavior, performance, or response. "I have witnessed your courage and creativity. I believe this will help you as you search for ways to fact your situation."

autonomy

is being self-directed and independent in accomplishing goals and advocating for others. Professional nurses make choices and accept responsibility for the outcomes of their actions.

verbalize

what is the best way to stop abuse..

visually impaired patients

´Typically, blind patients have heightened auditory and olfactory senses. ´Use anticipatory communication. ´Use analog clock reference for position of food on a plate and orienting to hospital room. ´Use large-print, Braille, audio, or e-books. ´Gentle physical contact, such as a light touch on the arm, alerts the blind patient that someone is present.

communication

•A lifelong learning process •Essential for establishing nurse-patient relationships and delivering patient-centered care •Helps to reduce the risk of errors •Maintains effective relationships

nurse health care teams relationships

•Affects patient safety and the work environment •Hand-off reports •SACCIA/SBAR

providing information

The nurse should give information to the patient that will help them make decisions. Knowledge helps lessen anxiety and helps the patient feel safe and secure. Provide information at a pace the patient can absorb and in terms they can understand. Don't use medical jargon rather lay terms instead

sharing humor

The nurse uses this technique to reduce stress and tension and to ease anxiety. This technique may help to contribute to a feeling of togetherness, closeness, and friendliness and it minimize the effects of negative factors.

summarizing

This helps to clarify expectations and allows for additional information to be added if not covered. condenses the data into an organized review. It validates data because the client has the opportunity to confirm that the data are correct.

sharing feelings

This technique allows the patient to express thoughts and perceptions. The nurse intervenes by observation, acknowledgement of patient expressions, giving the patient permission to express negative emotions, and modeling healthy emotional self-expression. It makes the nurse seem more human.

using silence

This technique allows time for the nurse and patient to reflect on what is being communicated, to observe each other, to sort out feelings, and to think of a response. This therapeutic technique gives the nurse time to observe non-verbal messages and shows that the nurse is patient and willing to wait for a response

using touch

This technique is a potent form of communication for the nurse. It conveys tenderness, emotional support, and encouragement and should be presented in a comforting and non-threatening manner. This technique should be used with caution with angry or highly suspicious persons.

Asking relevant questions

Used when the nurse needs more information. This technique should be used in moderation to avoid dehumanizing the patient. Open-ended questions should be used to allow the patient to lead the conversation. Allow the patient time to answer before moving on.

´Asking personal questions ´Giving personal opinions ´Changing the subject ´Automatic responses ´False reassurance Sympathy

What are nontherapeutic communication techniques?

offering information

allows the interviewer to clarify treatments, initiate health teaching, and identify and correct misconceptions.

related questions

are planned in which the nurse uses words and word patterns in the client's normal sociocultural context.

active listening

being attentive to what a patient is saying verbally and nonverbally

carlifying

facilitates correct communication of information. It is achieved by asking the client to restate the information or by providing an example.

use of names

failure to do to acknowledge a patient creates uncertainty about the interaction and conveys an impersonal lack of commitment or caring

half zones of interaction

formed by Anthropologist Edward Hall affects communication in cross cultural settings •Nurses interact with patients within each of these distances. •Nurses must become increasingly comfortable with and sensitive to interacting within the intimate-distance area while providing direct care. developed theory of proxemics

form theraputic relationsjips to gather info about pt draw theoretical knowledge about communication and integrate this knowledge with personal experience interpret messages recieved to obtain new info, correct misinfo, and promote patient centered care

how can we develop good communication skills?

ADET

in the hospital as a communication method that provides patients with information about you, what you are about to do to them, what to expect and how long will it take. It establishes trust if you keep your word when telling the patient you will get them coffee, or take them for a walk.

Implementation

includes active listening and SURETY Model

nonverbal communication

includes the five senses and everything that does not involve the spoken or written word •unconsciously motivated and more accurately indicates a person's intended meaning than spoken words.

intrapersonal communication

is a powerful form of communication that you use as a professional nurse. This level of communication is also called self-talk. People's thoughts and inner communications strongly influence perceptions, feelings, behavior, and self-esteem.

silence

is helpful for making observations about the client and provides the client with time to organize thoughts and to present complete information to the interviewer.

interpersonal communication

i•s one-on-one interaction between a nurse and another person that often occurs face to face. It is the level most frequently used in nursing situations and lies at the heart of nursing practice.

verbal communication

this includes vocab, denotative and connotative meaning, pacing, intonation clarify and brevity, and timing with relevance

health care team

this is a source of data You frequently communicate with other health care team members to assess patients. In the acute care setting, the change-of-shift report, bedside rounds, and patient hand-off are ways that nurses from one shift communicate information to nurses on the next shift. Every member of the team is a source of information for identifying and verifying essential information about the patient

nurses experience

this is a source of data that Through clinical experience you observe other patients' behaviors and physical signs and symptoms; track trends and recognize clinical changes; and learn the types of questions to ask, choosing the questions that will give the most useful information

Family and Significant Others

this is a source of data that are primary sources of information for infants or children, critically ill adults, and patients who are mentally handicapped or have cognitive impairment. In cases of severe illness or emergency situations, families are often the only sources of information for health care providers.

medical records

this is a source of data that is a source for the patient's medical history, laboratory and diagnostic test results, current physical findings, and the primary health care provider's treatment plan. The record is a valuable tool for checking the consistency and similarities of data with your personal observations.

planning

this is involving the family allowing adequate time for practice goals and outcomes setting priorities teamwork and collaboration

assessment

this is part of SBAR that ask what is identified problem, concern, or need?

patient

this is part of source of data that is usually your best source of information. Patients who are conscious, alert, and able to answer questions without cognitive impairment provide the most accurate information. An older adult may require more time for assessment than someone younger if hearing or cognitive deficits exist.

interpersonal variables

this is part of the circular transaction model that have factors that inflence communiction

channels

this is part of the circular transaction model that means conveying and recovering messages

referent

this is part of the circular transaction model that motivates one to communicate with another

message

this is part of the circular transaction model that the content of the message

feedback

this is part of the circular transaction model that the message the receiver returns

enviroment

this is part of the circular transaction model that the setting for the sender reciever interactions

narrative interaction

this is sharing of stories through listening to stories you begin to understand the context of others lives and learn what is meaningful fort them from their perspectives

evaluation

this is through the patients eyes nurse and patients need to determine where the plan of care is successful interventions are evaluated to determine effective strategies

cultural considerations

this is used to gather a complete assessment of your patient must be able to respect different views and situations between you and your patient•understand these differences; and do not impose your own attitudes, biases, and beliefs. •Having a genuine curiosity about a patient's beliefs and values lays a foundation for a trusting patient-nurse relationship. •Avoid making stereotypes; draw on knowledge from your assessment, and ask questions in a constructive and probing way to allow you to truly know who the patient is. •Do not make assumptions about a patient's cultural beliefs and behaviors without validation from the patient.

simple linear model

this model works in very complex processes within the circular transactional model of communication

nurse family relationships

use the same principles as one on one helping relationships

through patients eyes physical and emotional factors developmental factors sociocultural factors gender

what are factors of nursing assesment?

´Communication barrier ´Difficult coping ´Powerlessness ´Impaired socialization

what are factors of nursing diagnosis for communication?

observation open ended questions leading questions back channeling direct closed ended questions

what are some interview technigques?

´Patients who cannot speak clearly ´Cognitive impairment ´Hearing impairment ´Visual impairment ´Unresponsive ´Patients who do not speak English (or your language)

what are some reasons for adapting communication techniques?

´Becoming sensitive and supportive to self and others. ´Being present and encouraging the expression of positive and negative feelings. ´Developing caring relationships. ´Instilling faith and hope. ´Promoting interpersonal teaching and learning. ´Providing for nursing care needs in a supportive way. ´Respecting and allowing for spiritual expression.

what are some ways a nurse can communicate and interpersonal relationship build?

intimate personal social public

what are the 4 specific distances of proxemics?

courtesy use of name trustworthiness autonomy and responsibility assertiveness

what are the elements of professional communication?

motivational interviewing effective comm. interview prep phases of interview orientation and setting working phrase termination

what are the stages and steps of patient centered care

´Providing information ´Clarifying ´Focusing ´Paraphrasing ´Validation ´Asking relevant questions ´Summarizing ´Self-disclosure ´Confrontation

what are therapeutic communication techniques?

lateral violence

•Calmly address the behavior when it occurs. •Describe how the behavior affects your functioning. •Ask for the abuse to stop. •Notify the manager to get support for the situation. •Plan for taking action in the future. •Document the incidents in detail.

nurse patient caring relationships

•Caring relationships are the foundation of clinical nursing practice; they are created with skill and trust

motivational interviewing

•Encourages patients to share their thoughts, beliefs, fears, and concerns with the aim of changing their behavior

nurse community relationships

•Formed by participating in local organizations, volunteering, or becoming politically active

therapeutic communication

•Promotes personal growth •Helps patients reach their health-related goals

observation

•a patient's nonverbal communication such as use of eye contact, body language, or tone of voice, and determine whether the data you obtained are consistent with what the patient states verbally.

assertiveness

•allows you to express feelings and ideas without judging or hurting others. this behavior includes intermittent eye contact; nonverbal communication that reflects interest, honesty, and active listening; spontaneous verbal responses with a confident voice; and culturally sensitive use of touch and space.

leading questions

•are the most risky because of possibly limiting the information provided to what a patient thinks you want to know.

open-ended questions

•gives a patient discretion about the extent of his or her answer, and does not presuppose a specific answer. They prompt patients to describe a situation in more than one or two words.

back channeling

•includes active listening prompts such as "all right," "go on," or "uh-huh." These indicate that you have heard what a patient says, are interested in hearing the full story, and are encouraging the patient to give more details.

public communication

•is interaction with an audience. Nurses often speak with groups of consumers about health-related topics, present scholarly work to colleagues at conferences, or lead classroom discussions with peers or students.

patient centered interview

•is relationship based and is an organized conversation focused on learning about the well and the sick as they seek care.

small group communication

•is the interaction that occurs when a small number of people meet. This type of communication is usually goal directed and requires an understanding of group dynamics.

electronic communication

•is the use of technology to create ongoing relationships with patients and their health care team. Secure messaging provides an opportunity for frequent and timely communication with a patient's physician or nurse via a patient portal.

SBAR

•is used "to report to a health care provider a situation that requires immediate action, to define the elements of a handoff of a patient from one caregiver to another, such as during transfers from one unit to another or during shift report, and in quality improvement reports." • is often used by nursing as a handoff tool and as a structured method for all communications between providers. .communication requires the sharing of clear information focused on the four topical areas.