Communication
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Transcript Communication
Rachel Natividad, RN, MSN, NP
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Communication
Have you ever been nailed by nasty remarks from a
hostile friend, family member, or stranger?
Ever been bashed by comments and criticisms from
colleagues?
How did you react?
Did you gracefully defuse the situation?
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Define communication…
Describe a situation in which you did not
communicate effectively and the result.
Communication defined…
“The exchange of information which involves
both sending and receiving messages between
two or more people…”.(Timby, 2005)
“The process of sending and receiving messages
by means of symbols, words, signs, gestures, or
other actions”. (Smith, Duell, & Martin, 2004)
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Effective Communication in
Nursing
Increases patient satisfaction and health
outcomes
Decreases risk of complaints and litigation
Increases level of job satisfaction
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Elements of Communication
Sender
Message
Receiver
Feedback
Meaning (sender/receiver)
Communication Flow
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Communication can be
confusing!!!
Ambiguous Picture
Language is inherently
ambiguous…
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Communication Patterns
Verbal
Verbal
7%
Tone
Tone
38%
Nonverbal 55%
Nonverbal
Facial expressions
Gestures
Eye contact
Body language
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Face talks…
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Communication in Nursing
Nurse-client relationship - Therapeutic
Relationship-
Client-centered
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Case Study: The First
Encounter
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Phases of Therapeutic Relationship
Introductory phase - initiation or orientation
phase
Working phase– facilitating the relationship
Termination phase– relationship comes to an
end
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Case Study Resolution: The First
Encounter
Attempt to identify the source of hostility
Allow client to verbalize feelings, fears, concerns
Offer explanations and explain the purpose of
the procedures/medications.
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Case Study Resolution: The First
Encounter
Acceptable responses:
“You sound upset this morning.”
“Mrs. T, it is difficult to be a patient. You
haven’t had much time to yourself.”
“When would you like me to bring your
medicine?”
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Listen…
A poem by….
Anonymous
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Blocks to Therapeutic
Communication
Changing the subject
Invalidation
False reassurance
Overloading
Giving advice
Social Response
Incongruence
Underloading
Assumptions
Value judgements
SDM
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Therapeutic Communication
Techniques
Acknowledgement
Clarification
Feedback
Focus
Incomplete sentences
Listening
Mutual fit or congruence
Minimum verbal activity
Nonvrebal
encouragement
Open-ended questions
Reflection
Restatement
Validation
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Case Study: Cultural
Diversity (2)
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Cultural Diversity
Slang terms and colloquialisms
Stress of illness – different meanings in various
cultures
Eye contact, touch personal space – meanings
vary among cultures
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Let’s Communicate Transculturally!
Assess language needs
Pay attention to nonverbals
Approach patient slowly and
greet her/him respectfully
Try to mirror pt’s style of
communicating
Do not raise your voice to be
heard
Provide written material in
patient’s language if available
Allow sufficient time and a
quiet setting
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Are you culturally competent?
“…learn the language that a majority of your
clients speak – this will give you insight into the
culture…”(Gaskill, 2002)
Greet or say words and phrases in the client’s
language
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Case Study Resolution: Cultural
Diversity
Recognize impact of the client’s culture to
communication style, health care and
practices/beliefs
Consider cultural roots when continuing with
the plan of care
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Anxiety and Communication
How can stress/anxiety affect your communication
with your clients?
How can stress affect client’s communication with you?
What techniques do you use to decrease your stress
routinely? During exams?
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Levels of Anxiety
Communication Styles
Mild
Passive
Moderate
Assertive
Severe
Aggressive
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A confrontation with Ms. Madd
You have just finished the change of shift report
when Mrs. K confronts you at the nurses
station. Due to a serious fall, Mrs. K’s sister M.L
has sustained a cervical fracture that, in spite of
numerous efforts, has not yet been stabilized.
During the past few days…….(retrieved from
www.nurseweek.com 1/20/05)
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Help the anxious client
Be alert to s/s of anxiety
Assist pt to verbalize
feelings and concerns and
try to ID source of anxiety
Be understanding of pt’s
feelings
Avoid becoming tense or
defensive
Speak slowly and briefly,
avoid empty phrases that
does not help the situation
Offer explanations of info if
pt has misconceptions about
the situation
Assess the patient’s support
system
ID previously useful coping
mechanisms
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Rather than just defend yourself and
face the same problems over and
over like Wiley Coyote, say what you
are really feeling!
Ask for help when you need it!
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References
Timby, B. K. (2005). Fundamentals Nursing
Skills and Concepts. 8th Ed. Lippincott Williams
& Wilkins: Philadelphia, PA
Smith, S.F., Duell, D.J., & Martin, B. C., (2004).
Clinical Nursing Skills: Basic to Advanced Skills.
6th Ed. Pearson Education Inc.: Upper Saddle
River, NJ.
Sheldon, L.K. (2004). Communication for
Nurses: Talking with Patients. Slack Inc:
Thorofare, NJ.
www.nurseweek.com
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