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Basic Nursing: Foundations of Skills & Concepts Chapter 8. COMMUNICATION. Communication. The sending and receiving of a message. Aspects of Communication (i). Sender - the one who conveys the message to another person.

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Basic Nursing: Foundations of Skills & Concepts Chapter 8

COMMUNICATION


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Communication

  • The sending and receiving of a message.


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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.


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Aspects of Communication (ii)

  • Receiver - physiological/ psychological components.

  • Feedback - the receiver’s response to the sender.

  • Influences - Culture, education, emotions and other factors involved.


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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.


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Age

Education

Emotions

Culture

Language

Attention

Surroundings

Influences on Communication


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Congruency of Messages

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


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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.


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Active Listening

  • The process of hearing spoken words and noting nonverbal behavior.

  • Active listening takes energy and concentration.


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Therapeutic Communication

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


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Goals of Therapeutic Communication

  • To obtain or provide information

  • To develop trust

  • To show caring

  • To explore feelings


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Enhancing Communication

  • Self-Disclosure.

  • Caring.

  • Genuineness.

  • Warmth.

  • Active Listening.

  • Empathy (the capacity to understand another’s feelings).

  • Acceptance and respect.


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Communication Techniques

  • Clarifying/validating.

  • Asking open questions.

  • Using indirect statements.

  • Reflecting.

  • Paraphrasing.

  • Summarizing.

  • Focusing.

  • Silence.


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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.


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Psychosocial Aspects of Communication

  • Style.

  • Gestures.

  • Meaning of time.

  • Meaning of space.

  • Cultural values.

  • Political correctness.


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Style

Three types of style:

  • Passive - apologetic, weak, makes little eye contact, often fidgety.

  • Aggressive - haughty, angry, demanding, shows no concern for anyone else’s feelings

  • Assertive - honest, direct, firm, makes eye contact, confident, respectful of others.


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Gestures

  • Movements of the hands and arms.

  • Nurses must be sensitive to cultural variances with regard to gestures.


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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.


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Meaning of Space

  • Human beings all observe rules around comfort zones—the 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


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Cultural Values

  • A nurse should be familiar with the cultural values of the people in the nurse’s region of employment.

  • A nurse needs to be aware of those times when her values differ from the values of the dominant culture.


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Political Correctness

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


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Nurse-Client Communication

  • Almost every nurse-client interaction should involve therapeutic communication.

  • Nurse-client communication is influenced by both the nurse and the client.


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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.


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Determinant Factors in Communication

A nurse’s communication is affected by:

  • Past Experience

  • State of Health

  • Home Situation

  • Workload

  • Staff Relations

  • Self-Awareness


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Determinant Factors in Communication

A client’s communication is affected by:

  • Social Factors

  • Religion

  • Family Situation

  • Level of Consciousness

  • Stage of Illness

  • Visual, Hearing and Speech Ability

  • Language Proficiency


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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.


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The Nurse’s Ways of Communication

  • Oral

  • Written

  • Self-Reflection


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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)


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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.


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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.


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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.


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