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The Art of Communication in Nursing. Cathy Groggel Nursing 450. Objectives:. To understand the basic components and forms of communication. To understand the importance of effective communication in the healthcare environment.

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The art of communication in nursing

The

Art of Communication

in Nursing

Cathy Groggel

Nursing 450


Objectives
Objectives:

  • To understand the basic components and forms of communication.

  • To understand the importance of effective communication in the healthcare environment.

  • Discuss what approaches and techniques are useful for nurses in communicating with their patients and families.

  • Understand the barriers in communication and how improvements can be made in nursing.


Communication
Communication

The Who?

What?

Where?

When?

Why?

  • How?


Communication

“Effective communication is the creation of meaning in communication in which patients and healthcare providers exchange information so that patients are able to actively participate in their care.”

Boykins, 2014, p. 40


Root cause analysis
Root Cause Analysis

MeasurementMaterials Method

Patient Satisfaction Written Verbal

NDNQI Content Non-Verbal

Training/Skills Medical Jargon Manner

Time Brochures Emotions

Safety Reports Cue-Cards Feelings

Errors Interpreters Task Approach

Medication Respect/Dignity

Noise Nurse EMR

Lighting Physician Email

Home Unlicensed Personnel Telephone

Hospital Patient Texting

Privacy Family Members Social Media

Readiness Age Web

Distractions Socio-economic Status

Environment Manpower Machine

Communication Breakdowns


Sherwood & Zomorodi, 2014, p. 17


“…suggest that an estimated ‘70-80% of healthcare errors are caused by human factors associated with poor team communication and understanding.’”

Bleakley& Marshall, 2013, p. 128


“The nurse should be able to build communication and leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality care.”

Boykins, 2014, p. 42


SMR leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

Communication

  • It’s the Right thing to do!

  • The Joint Commission includes Patient-Centered communication as a Standard for Hospitals.

  • ANA Standards of Professional Nursing Practice.

  • Quality and Safety Education for Nursing (QSEN).

  • AACN

Assessment

Implementation

Collaboration

Environmental Health


leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality The nurse caring for the acutely and critically ill patient uses skilled communication to collaborate withthe team of patient, family, and healthcare providers in providing patient care in a safe, healing, humane,and caring environment.”

AACN, p.16


Basic Components of Communication leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

“Human communication is a two-person process in which both individuals influence and are influenced by each other.”

Kearney-Nunnery, 2008, p. 124


SMRC Model by David Berlo in 1960 leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

  • Source/Encoder

  • Message

  • Channel

  • Receiver


Kearney-Nunnery, 2008, p. 125 leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

Source-Message-Channel-Receiver Model


Health communications model types of relationships kearney nunnery 2008 p 125

Health Communications Model leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

Types of Relationships

Kearney-Nunnery, 2008, p. 125

Professional/Professional

Professional/Client

Professional/Significant other

Client/Significant other


Health communications model
Health Communications Model leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

Transaction Types

Verbal

Non-verbal

Contexts

Setting

One on one

Group

Kearney-Nunnery, 2008, p. 127


Forms of communication
Forms of Communication leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

  • Metacommunication

  • Verbal

    • Vocabulary

    • Meaning

    • Intonation

    • Pacing

    • Clarity/Timing


“Nurses should also demonstrate leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality credibility, which is defined as a sense of trustworthiness, sincerity, reliability, and integrity. The nurse must be dependable and believable.”

Kearney-Nunnery, 2008, p.129


Non verbal communication
Non-Verbal Communication leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

  • Body Language

  • Cultural differences

    • Personal space

    • Gestures

    • Eye contact

    • Touch

  • Use of space

  • Appearance

    Kearney-Nunnery, 2008, p. 130-132


Approaches in communication
Approaches in Communication leadership skills in practice settings, to function effectively within nursing and other interprofessional teams, to foster open communication, to demonstrate mutual respect, and to engage in shared decision making to achieve quality

  • Involvement of Patient

    • Patient-centeredness

  • Sensitivity in Providing Information and Explanations

    • Quality

    • Readiness

  • Task Approach

  • Manner of Approach

    • Rapport

    • Tone

    • Pleasant


  • “The words people say are important, but the way they are said is important too. When we talk to someone, we choose the words to use and modify the way they are used on the basis of an unconscious appraisal of that person.”

    Draper, 2014, p. 276


    Communication techniques
    Communication Techniques said is important too. When we talk to someone, we choose the words to use and modify the way they are used on the basis of an unconscious appraisal of that

    • Tools

      • Question types

  • Active listening

    • Interest

    • Attention

    • Restatement/Reflection

  • Questioning

    • Open-ended

    • Close-ended

    • Circular

    • Goal oriented

  • Understanding

    • Elaboration

    • Alternatives

  • Non-Verbal

  • Silence


  • Communication barriers

    • Distractions said is important too. When we talk to someone, we choose the words to use and modify the way they are used on the basis of an unconscious appraisal of that

      • Nurse

      • Sensory

  • Knowledge Level

    • Deficits

  • Interpretation

    • Language

    • Cultural

    • Literacy level

  • Communication Barriers


    Communication barriers1

    • Training said is important too. When we talk to someone, we choose the words to use and modify the way they are used on the basis of an unconscious appraisal of that

      • Inadequate Nurse Training

      • Poor planning

  • Emotions

    • Regulate

  • Time

  • Communication Barriers

    Yoder-Wise, 2014, p. 350-351


    “...pitfalls in communication comprise actions, behaviors, and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for patients.”

    Yoder-Wise, 2014, p. 351

    Communication Pitfalls


    Improving Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    • Speak-Up

      • https://www.youtube.com/watch?v=rOlCMLbOm6c


    Improving communication
    Improving Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    • Share stories

      • Near-misses

      • Simulated learning

  • Change Behavior

    • Classes

    • Scripting

    • Emotions

    • Be accountable


  • Improving communication1
    Improving Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    • Use Standard Methods of Communication

      • Bedside Handovers

      • SBAR

      • Read-Backs

      • Briefings/Huddles

      • Huddles

      • Interdisciplinary Rounds

      • Nurse Liaison

  • Research in Nursing


  • Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    • Face to face


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Written


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Email


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Electronic Health/Medical Records


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Telephone


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Text Messaging


    Types of Communication and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Social Media


    Future communications

    Future Communications and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    Nursing Impact

    Improving patient outcomes

    Enhancing patient connection

    Improving efficiencies

    Decreasing costs

    Strengthen communication

    Informed decision making

    Standardizing report

    Engaging patients


    References
    References and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    American Association of Critical-Care Nurses. (n.d.). Standards. In American Association of Critical-Care Nurses. Retrieved June 22, 2014, from http://www.aacn.org/WD/Practice/Content/standards.content?menu=Practicetww.aacn.org/WD/Practice/Contenstadards.content?menu=Practice

    American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.)

    Silver Spring, MD: Nursebooks.org.

    Bleakley, A., & Marshall, R. (2013). Can the science of communication inform the art of the medical humanities?. Medical Education, 47(2), 126-133. doi:10.1111/medu.12056

    Boykins, D. (2014). Core Communication Competencies in Patient-Centered Care. ABNF Journal, 25(2), 40-45.

    Davies, N. (2014). Empathic nursing: going the extra mile. Practice Nursing, 25(4), 198-202.

    Draper, P. (2014). Words, words, words: conversation as a tool to promote wellbeing. Nursing & Residential Care, 16(5), 275-277.

    Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4th ed.). Philadelphia, PA: F. A. Davis Company.


    References1
    References and words that create distrust, are dishonoring, and decrease the feelings of self-worth in the receiver and can lead to poor outcomes for

    • Leef, B. L., & Hallas, D. (2013). The Sensitivity Training Clown Workshop: Enhancing Therapeutic Communication Skills in Nursing Students. Nursing Education Perspectives, 34(4), 260-264.

    • McGilton, K., Boscart, V., Fox, M., Sidani, S., Rochon, E., & Sorin-Peters, R. (2009). A systematic review of the effectiveness of communication interventions for health care providers caring for patients in residential care settings. Worldviews On Evidence-Based Nursing, 6(3), 149-159. doi:10.1111/j.1741-6787.2009.00155.x

    • O'Hagan, S., Manias, E., Elder, C., Pill, J., Woodward-Kron, R., McNamara, T., & Webb, G., & McColl, G. (2013, October). What counts as effective communication in nursing? Evidence from a nurse educators' view and clinicians' feedback on nurse interactions with simulated patients. Journal of Advanced Nursing, 70(6), 1344-1356.

    • Sherwood, G., & Zomorodi, M. (2014). A New Mindset for Quality and Safety: The QSEN Competencies Redefine

    • Nurses' Roles in Practice. Nephrology Nursing Journal, 41(1), 15-72.

    • Spruce, L. (2014). Back to Basics: Speak Up. AORN Journal, 99(3), 407-415. doi:10.1016/j.aorn.2013.10.020

    • Tremayne, P. (2014). Using humour to enhance the nurse-patient relationship. Nursing Standard, 28(30), 37-40.

    • Yoder-Wise, P. S. (2014). Leading and managing in nursing: Revised reprint (5th ed.). St. Louis,

    • MO: Elsevier Inc.


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