Basic Nursing: Foundations of Skills

1
Basic Nursing Foundations of Skills Concepts
Chapter 8

• COMMUNICATION

2
Communication

• The sending and receiving of a message.

3
Aspects of Communication (i)

• Sender - the one who conveys the message to
  another person.
• Message - the thought idea or emotion conveyed.
• Channel - how the message is sent.

4
Aspects of Communication (ii)

• Receiver - physiological/ psychological
  components.
• Feedback - the receivers response to the sender.
• Influences - Culture education emotions and
  other factors involved.

5
Methods of Communication

• Verbal - Speaking Listening Writing Reading.
• Nonverbal - Gestures Facial Expressions Posture
  and Gait Tone of Voice Touch Eye Contact
  Body Position Physical Appearance.

6
Influences on Communication

• Age
• Education
• Emotions
• Culture

• Language
• Attention
• Surroundings

7
Congruency of Messages

• Verbal and nonverbal communication must be
  congruent or in agreement.

8
Listening and Observing

• Listening and observing are two of the most
  valuable skills a nurse can have.
• These two skills are used to gather the
  subjective and objective data for the nursing
  assessment.

9
Active Listening

• The process of hearing spoken words and noting
  nonverbal behavior.
• Active listening takes energy and concentration.

10
Therapeutic Communication

• Sometimes called effective communication it is
  purposeful and goal-oriented creating a
  beneficial outcome for the client.

11
Goals of Therapeutic Communication

• To obtain or provide information
• To develop trust
• To show caring
• To explore feelings

12
Enhancing Communication

• Self-Disclosure.
• Caring.
• Genuineness.
• Warmth.
• Active Listening.
• Empathy (the capacity to understand anothers
  feelings).
• Acceptance and respect.

13
Communication Techniques

• Clarifying/validating.
• Asking open questions.
• Using indirect statements.
• Reflecting.
• Paraphrasing.
• Summarizing.
• Focusing.
• Silence.

14
Barriers Communication

• Some barriers include
• Closed questions.
• False reassurance.
• Judgmental responses.
• Defensive reflex.
• Agreeing/Disagreeing or Approving/ Disapproving.
• Giving advice.
• Requesting an explanation.
• Changing the subject.

15
Psychosocial Aspects of Communication

• Style.
• Gestures.
• Meaning of time.
• Meaning of space.
• Cultural values.
• Political correctness.

16
Style

• Three types of style
• Passive - apologetic weak makes little eye
  contact often fidgety.
• Aggressive - haughty angry demanding shows
  no concern for anyone elses feelings
• Assertive - honest direct firm makes eye
  contact confident respectful of others.

17
Gestures

• Movements of the hands and arms.
• Nurses must be sensitive to cultural variances
  with regard to gestures.

18
Meaning of Time

• In the U.S. great emphasis is placed on time and
  schedules. Being on time is very important.
• In other cultures such emphasis is not placed on
  time.

19
Meaning of Space

• Human beings all observe rules around comfort
  zonesthe distance observed between two people.
  Such comfort zones include
• Intimate touch to 18 inches
• Personal 18 inches to 4 feet
• Social 4 feet to 12 feet
• Public 12 feet or more

20
Cultural Values

• A nurse should be familiar with the cultural
  values of the people in the nurses region of
  employment.
• A nurse needs to be aware of those times when her
  values differ from the values of the dominant
  culture.

21
Political Correctness

• To be politically correct in communication means
  to use language sensitive to those who are
  different from oneself.

22
Nurse-Client Communication

• Almost every nurse-client interaction should
  involve therapeutic communication.
• Nurse-client communication is influenced by both
  the nurse and the client.

23
Three Phases of Nurse-Client Communication

• Introduction Fairly short expectations
  clarified mutual goals set
• Working Major portion of the interaction used
  to accomplish goals outlined in introduction
  feedback from client essential.
• Termination Nurse asks if client has questions
  summarizing the topic is another way to indicate
  closure.

24
Determinant Factors in Communication

• A nurses communication is affected by
• Past Experience
• State of Health
• Home Situation
• Workload
• Staff Relations
• Self-Awareness

25
Determinant Factors in Communication

• A clients communication is affected by
• Social Factors
• Religion
• Family Situation
• Level of Consciousness
• Stage of Illness
• Visual Hearing and Speech Ability
• Language Proficiency

26
Communication within the Health Care Team

• Providing care is a team effort.
• To ensure efficiency and effectiveness effective
  communication is necessary.
• This communication may be oral or written.

27
The Nurses Ways of Communication

• Oral
• Written
• Self-Reflection

28
Oral Communication

• Nurses communicate within many different
  relationships each with their own rules.
• Nurse-Nurse
• Nurse-Nursing Assistant
• Nurse-Student Nurse
• Nurse-Physician
• Nurse-Other Health Professionals
• Group Communication (I.e. client-care conferences)

29
Written Communication

• Nurses communications are often written
• On charts
• Requisitions for x-rays and other tests and
  services
• Electronic communications via computer
• Telemedicine the use of communications
  technology to transmit health information from
  one location to another.

30
Self-Reflection

• Nurses often engage in internal dialogue
• Positive self-talk Saying positive thoughts
  aloud thinking saying and hearing positive
  statements about yourself
• Negative self-talk Self-destructive. Your
  self-image is lowered by your own criticism.

31
Communicating With Yourself

• Positive self-talk Saying positive thoughts
  aloud thinking saying and hearing positive
  statements about yourself
• Negative self-talk Self-destructive. Your
  self-image is lowered by your own criticism.