Chapter 26 communication notes

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Communication

is a means of exchanging information or feelings between two or more people.

Self

talk happens during the communication. It can be a deterrent to appropriate

communication.

Components of communication

Encoding

Decoding Self-talk

Feedback

Aspects of nursing communication

Verbal

Intonation

and pace: speak slowly but not so

much that it indicates to the client that you believe they are stupid. Avoid

being demeaning or condescending

Simplicity: Avoid medical speak

Clarity

and Brevity: Speak in short

clear sentences and reiterate frequently, request feedback from the client

frequently

Adaptability: Adjusting to the client’s responses

Timing

and Relevance: Avoid multiple

questions (allow the client to answer one before asking another). Insure that

you are in tune with what the client is feeling (nothing is distracting them

from what you are trying to teach them

Credibility: Always be honest but you must know

what you are telling them is appropriate. EX, if you know a client has a dx

which is going to cause them grief, frustration, anxiety, etc, avoid speaking

about it until the physician has fully dealt with it with the client. When

answering direct questions, it is always best to find out what the client knows

FIRST.

Humor: It is very important to know what the client finds humorous before

using humor with a client. Let the client guide this type of communication

until and unless you are sure.

Non-verbal

Personal

appearance: clothing can tell a lot

about both the patient and the nurse. (think about why the university insists

on “uniforms”.

Facial

movements: frowning,

scowling, darting eyes, glancing off at other things in the room indicate to

the patient that you are not fully engaged.

Posture/Gait: A forward sitting posture shows the client

that you are in the conversation with them.

Alternately, sitting with arms closed across the chest

potentially indicates that you would rather be somewhere else. One who walks

hunched over can indicate a lack of self-worth, depression or physical

discomfort

Positioning: Sitting close to the client (providing

their culture allows) shows the client that you are willing to share their

space as well as their concerns

*eye contact

*touch *(culturally)

Electronic: Pros: fast, efficient, legible, date

and time recorded

Cons:

puts client confidentiality at risk, not everyone has access or has the

necessary computer skills (potentially delaying the receipt of information by

the client)

Factors influencing communication

Development: Children hear and focus on different things

than do adults and even adolescents. A conversation appropriate for a 16 year

old may not be appropriate for a 6 year old, even though they are both

considered children. An adult patient with a handicap such as Down’s Syndrome,

may not have the same conversational ability as an adult without that dx or

even a late stage adolescent or young adult.

Gender: Men and women hear and perceive

conversations differently

Age: Baby talk/Elderspeak, age appropriate

conversation

Values

and Perceptions: Life

experiences change the way one perceives a situation. Ex. You are about to

teach a patient about a new dx of diabetes. Her mother had diabetes and went

through many hospitalizations, much illness, loss of her legs and ultimately

died. Will this affect her ability to hear that she can learn how to manage her

diabetes and avoid many of the pitfalls her mother experienced?

Page 469 Personal Space: Intimate Touching to 1 ½ feet

Personal 1 ½ to 4 feet

Social 4-12 feet

Public 12-15 feet

Techniques that facilitate communication and focus on client

concerns

Territory

Environment

Congruence

Attitudes: Caring and warmth; respect

Therapeutic Communication through active listening and physical attending Box 26-1 Page 472

Barriers to communication Box 26-3 page 474

Helping relationships Boxes 26-2 (page 475) and 26-4 (page 276)

Phase I

Phase

II

Phase

III

Phase

IV

Characteristics of an effectively functioning group

Groups that help promote health and comfort

Communication skills through the nursing process

Why effective communication is imperative

Incivility, Lateral violence and bullying: how the affect

the health care environment

Differences between nurse and physician communication: What

to do about it?

Assertive vs nonassertive communication: Differences and

similarities