Nursing Fundamentals Chapter 10 Communication

Factors that Promote Effective Communication

Dispositional traits Rapport builders Dispositional T: Warmth and friendliness vOpenness and respect vEmpathy vHonesty, authenticity, trust vCaring vCompetence Rapport Builders vSpecific objectives vComfortable environment vPrivacy vConfidentiality vPatient vs. task focus vUtilization of nursing observations vOptimal pacing

Carl Rogers (1961) studied the process of therapeutic communication. Through his research, the elements of a "helpful" person were described. They include all of the following except which choice?

Empathy, positive regard, and a comfortable sense of self were among the key ingredients. Empathy is an objective understanding of the way in which a patient sees his or her situation, identifying with the way another person feels, putting yourself in another person's circumstances, and imagining what it would be like to share that person's feelings. Communication is crucial because it affects the nurse's behavior and can enhance or detract from positive interactions or regard with the patient and family. Comfortable sense of self is part of the nursing confidence in caring for clients. Analysis is part of the nursing process and not the key elements of therapeutic communication.

The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist?

Interpersonal

Name the components in the communication process

Source (encoder) Message-verbal, non-verbal Receiver (decoder) Feedback and environment Channel: visual, auditory, kinesthetic

Factor influencing Communication

vDevelopmental level vGender vSociocultural differences vRoles and responsibilities vSpace and territoriality vPhysical, mental, and emotional state vValues Environment

Which is a skill appropriate to use in therapeutic communication?

Conversation skills used in therapeutic communication include controlling the tone of one's voice so that exactly what is intended is conveyed and not any hidden message.

metacommunication

Interpersonal bridge between personal and non personal communication

A nurse gives a speech on nutrition to a group of pregnant women. Within the model of the communication process, what is the speech itself known as?

Message

The nurse makes a contract with the client during which phase of the nurse-client relationship?

Orientation phase The orientation phase of the relationship represents the first phase of therapeutic work and involves signing of formal contracts. Formal contracts in this setting are a therapeutic tool to help a client develop more insight and control over the client's own behavior. The working phase is when the nurse assists clients in this process by helping them to describe and clarify their experiences, to plan courses of action and try out the plans, and to begin to evaluate the effectiveness of their new behavior. The termination phase is the final phase and the period when a client's goals are assessed and the relationship comes to an end. There is no intimate phase.

Phases of helping relationship

Orientation phase: The patient will call the nurse by name, The patient will accurately describe the roles of the participants in the relationship, the patient and nurse will establish an agreement about: Goals of the relationship Location, frequency, and length of the contacts Duration of the relationship. Working phase: The patient will actively participate in the relationship. The patient will cooperate in activities that work toward achieving mutually acceptable goals. The patient will express feelings and concerns to the nurse. Termination phase:vThe patient will participate in identifying the goals accomplished or the progress made toward goals. v vThe patient will verbalize feelings about the termination of the relationship.

the client is talking to the nurse about recent health problems of immediate family members and the strain the client has been under trying to care for them. The client begins to cry. What response by the nurse demonstrates the most empathy?

the response, "Just take your time. I am listening." allows the client permission to collect thoughts while also expressing emotion and lets the client know the nurse is there for the client. Using appropriate periods of silence rather than "talking away" the client's feelings is empathetic. The response "I know how you feel" does not focus on the client's feelings. Stating "It's okay to cry" or "Take some time for yourself" suggests that the nurse is granting the client permission to experience the client's own feelings, which the client does not need.

Summary

vCommunication is accomplished only when feedback has occurred. vMental and emotional state are factors that influencing communication. vThe nurse and patient should establish mutual goals in the helping relationship. vThe nurse who provides care in a caring and competent manner is more likely to establish effective communication with patients.

Developing conversation skills

vControl the tone of your voice. vBe knowledgeable about the topic of conversation. vBe flexible. vBe clear and concise. vAvoid words that might have different interpretations. vBe truthful. vKeep an open mind. Take advantage of available opportunities.

Interviewing techniques

vOpen-ended questions or comments vClosed questions/comments vValidating questions/comments vClarifying questions/comments vReflective questions/comments vSequencing questions/comments vDirecting questions/comments

Developing listening skills

vSit when communicating with a patient. vBe alert and relaxed and take your time. vKeep the conversation as natural as possible. vMaintain eye contact if appropriate. vUse appropriate facial expressions and body gestures. vThink before responding to the patient. vDo not pretend to listen. vListen for themes in the patient's comments. vUse silence, therapeutic touch, and humor appropriately.