| Communication | Exchange of information |
| sender | one who conveys the message |
| receiver | person or people to whom the message is conveyed |
| one way communication | limited use in the nurse-patient relationship |
| two way communication | requires that sender and the receiver participate in the interaction |
| verbal communication | involves the use of spoken or written words or symbols |
| connotative meaning | subjective and reflects the individual"s perception or interpretation |
| denotative meaning | refers to the commonly accepted definition of a particular word |
| jargon | common place "language" or terminology unique to people in a particular work setting |
| What are 2 ways of communication? | Verbal and Nonverbal communication |
| nonverbal communication | messages transmitted without the use of words(oral or written) |
| What are ways of nonverbal communication | Voice, Eye Contact,& physical appearance |
| gestures | movement people use to emphasize the idea they are attempting to communicate |
| posture | way that individual sits, stands, and move |
| open posture | when taking a relaxed stance with uncrossed arms and legs while facing the other individual |
| closed posture | more fomral, distance stance, generally with the arms, and possibly the legs, tightly crossed |
| assertiveness | one's ability to confidently and comfortable express thoughts and feelings while she stilll respecting the legitimate rights of the patient |
| assertive communication | interaction that considers the feelings and needs of the patient yet honors the nurse's rights as an individual |
| aggressive communication | when an individual interacts with anther person in an overpowering and forceful manner |
| unassertive communication | the nurse agrees to what the patient request |
| What will unassertive communication cause? | Problems for the nurse and resentment |
| What are some nonverbal cues? | Voice |
| What is the largest consent of use of communication? | Non verbal communication |
| one of the most important aspects of care in nursing | communication |
| what are the 2 requirements for communication | sender & receiver |
| What way of communication is limited in nursing? | 1 way communication |
| What way of communication establishes a trusting relationship? | 2 way communication |
| What is the purpose of 2 way communication? | To meet needs of nurse to patient relationship |
| Tone or Volume | Voice |
| Provides interaction | Eye Contact |
| Gestures or Postures | physical appearance |
| What are the type of styles of communication? | Assertive, Aggressive, Unassertive |
| Communication assertively means | Being able to express your needs while being aware of others' needs |
| What does an assertive nurse do? | Appears self-confident |
| In which ways does a nurse demonstrate a therapeutic relationship? | Caring, sincerity, empathy,& trustworthiness |
| Making sure a patient is focused of each interaction is what? | Establishing a therapeutic relationship |
| What is essential to effective nurse-patient interaction? | Trust |
| What is also a must in a therapeutic relationship? | Confidentiality |
| Being distant, not connected or genuine | is not building a therapeutic relationship |
| What are the two techniques of communication? | Therapeutic and non therapeutic communication |
| Therapeutic communication | an exchange of information that facilitates the formation of a positive nurse-patient relationship and actively involves patient in all areas of care |
| Nontherapeutic communication | blocks the development of a trusting and therapeutic relationship |
| What are some non therapeutic communication techniques? | Listening, Silence & Touch |
| What are 2 types of listening? | Active & Passive |
| Active Listening | full attention to what patient is saying |
| Passive Listening | indicates nonverbal eye contact & nodding as 'uh-huh' & 'I see' |
| What does passive listening show? | nurse is interested and listening to what is being said |
| Silence | also part of passive listening & nonverbal therapeutic |
| Touch | an example of non verb therapeutic showing understanding & comfort |
| Conveying Acceptance | nurse acceptance & willingness to listen to patient without judgement is key to therapeutic nurse patient relations |
| Provides opportunity to bring about change in health behaviors while helping the patient to maintain personal integrity | Conveying Acceptance |
| Minimal encouragement | subtle therapeutic technique that communicates to the patient that the nurse is interested and wants to hear more |
| What does minimal encouragement involve? | nonverbal cues, maintain appropriate eye contact, nodding occasionally and verbal comments such as "yes go on" to encourage the patient to continue |
| What are the therapeutic communication techniques? | Closed Questioning |
| Closed Questioning | seeking particular answer (1 or 2 word answers) |
| Open Ended Question | Do not require specific response, Allows patient to explain ("How do you feel?") |
| Restating | Let patient know you heard what was said |
| Paraphrasing | Restating patient message in your own words; verification you understand |
| Clarifying | Allows patient to verify that the message received was understood |
| Focusing | To gather more specific info when patient is too vague |
| Reflecting | Making the patient feel their message is important; promotes independent decision making |
| Summarizing | Focus on key issues and patient planning |
| Use of humor | Can help put nurse & patient at ease: never laugh at patient but with |
| Factors That Affect Communication | Posturing & Positioning |
| Posture & Positioning | Patient and nurse should be at same level for communication; can reveal patients current mood |
| What are the 4 zones of space? | intimate, personal, social, & public |
| intimate space | face to 18 inches away |
| personal space | 18 inches to 4 feet |
| social space | 4 to 12 feet from face |
| public space | beyond 12 feet |
| Environment | surrounding an interaction often has a significant intact on the interaction's effectiveness; privacy |
| Level of Trust | to provide positive experience; effective nurse-patient interaction |
| Language Barrier | speak slowly, using images, remain eye level, no jargon; can pose a major threat to effective nurse-patient relationship |
| Culture | understand beliefs & regulations |
| Age & Gender | using correct identification; different barriers for different ages |
| Physiologic Factors | may interfere with the patient being able to communicate effectively; if in pain may make it hard to focus |
| Psychosocial Factors | a multitude of factors placing patients under stress |
| Altered Cognition | another physiologic factor that frequently hinders effective communication; dementia, stroke, etc. |
| impaired hearing | another common physiologic factor that impedes communication |
| What are some things you should do with patients who are cognitively impaired? | Speak slowly, ask one question at a time, be attentive, use simple sentences, no distractions while talking with patient, be attentive |
| Communication with patients who have hearing impairment | Patient's attention, wearing proper hearing equipment, lip reading, face patient, no other noises, rephrase, speak at a normal volume, lower tone of voice, sign language |
| Grieving | result of actual or perceived lost; psychosocial factor |
| Block communication | techniques enhance the quality of an interaction |
| What are some ways of Block Communication? | False Reassurance |
| False assurance | using false comforting phrases in an attempt to other reassurance; "it will be okay" |
| Giving advice or personal opinions | making a decision for a patient; offering personal opinions; telling a patient what to do with phrases such as "if I were you I would..." |
| False Assumptions | making an assumption without validation; jumping to conclusions "your husband isn't very supportive." |
| Approval or disapproval | trying to impose the nurse's own attitudes, values, beliefs, and moral standards on a patient about what is right and wrong "you shouldn't even think that" |
| Automatic responses | stereotyped or superficial comments that do not focus on what the patient is feeling or trying to say "the doctor knows best" |
| Defensiveness | responding negatively to criticism; often in response to feelings of anger or hurt on your part; usually involves making excuses "I'm doing the best I can" |
| Arguing | challenging or arguing against the patient's statements or perceptions "how can you say you didn't sleep all night? you were sleeping every time I came into your room" |
| Asking for explanations | asks the patient to explain her or his actions, beliefs, or feelings with "why" questions; "why do you feel that way" |
| Changing the subject | inappropriately focusing the discussion on something other than the patient's concern "we'll worry about that later. it's time for you to go to physical therapy" |
| you promise something that will not occur or is unrealistic | false reassurance |
| Takes decision making away from the patient; impairs decision making; creates doubt; encourages blaming the nurse if decision has unwanted outcome | Giving advice or personal opinions |
| Easily leads to a wrong conclusion; often viewed as accusatory or argumentative | False assumptions |
| Easily leads the patient to doubt personal values; creates feelings of guilt and resentment; causes friction between you and the patient | Approval or disapproval |
| Tends to belittle the individual's feelings and minimize the importance of the message; communicates the message that you are not taking the patient's concerns seriously | Automatic responses |
| implies that the patient has no right to an opinion; results in ignoring or minimizing the patient's concerns; displays defensive behavior | Defensiveness |
| Denies that the patient's perceptions are real and valid; implies that patient is not being truthful, is mis informed, or educated | Arguing |
| Frequently viewed by the patient as an accusatory; puts patient on the defensive; risks causing resentment, insecurity, and mistrust of the nurse | Asking for explanations |
| Rude and shows lack of empathy; blocks further communication, and sometimes makes the patient feel uncomfortable about expressing feelings; interrupts thoughts, and often inhibits the sharing of important information | Changing the subject |
| Compromised verbal communication | abilities to express and support the identification of the patient problem of difficulty with verbal communicating |
| Alternatve methods of communication | when the patient is unable to produce sound, it essential to identify and implement |
| Communication board | includes the alphabet, commonly used phrases, pictures or combination of all three |
| Aphasia | a deficient or absent language function that results from ischemic insult to the brain, such as stroke (cerebrovascular accident), brain trauma, or anoxia |
| expressive aphasia | unable to send the desired verbal message |
| receptive aphasia | an inability to recognize or interpret the verbal message being received |
| What are ways to communicate with a person with aphasia? | avoid childish phrases |
