Chapter 24 Communication
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Transcript Chapter 24 Communication
Communication and Nursing Practice
A lifelong learning process for nurses
An essential attribute of professional nursing
practice
Builds relationships with clients, families, and
multidisciplinary team members
Communication
and Interpersonal Relationships
The means to establish helping and healing
relationships.
The ability to relate to others is important for
interpersonal communication.
Developing communication skills requires both
an understanding of the communication
process and of one’s own communication
experience.
Box 24-1 presents communication throughout
the nursing process.
Box 24-2 presents challenging communication
situations.
Levels of Communication
1. Intrapersonal
A. One-to-one interaction
between two people
2. Interpersonal
B. Occurs within an
individual
3. Transpersonal
C. Interaction with an
audience
4. Small Group
D. Interaction within a
person’s spiritual domain
5. Public
E. Interactions with a
small number of people
Basic Elements of the Communication
Process
1. Referent
A. One who encodes and one
who decodes the message
2. Sender and receiver
B. The setting for senderreceiver interactions
3. Message
C. Message the receiver
returns
4. Channels
D. Motivates one to
communicate with another
5. Feedback
E. Means of conveying and
receiving messages
6. Interpersonal variable
F. Factors that influence
communication
7. Environment
G. Content of the message
Forms of Communication
Verbal
Vocabulary
Denotative and connotative meaning
Pacing
Intonation
Clarity and brevity
Timing and relevance
Nonverbal Communication
Personal appearance
Posture and gait
Facial expressions
Eye contact
Gestures
Sounds
Territoriality and personal space
Other Forms of
Communication
Symbolic
The verbal and
nonverbal symbolism
used by others to convey
a meaning
Metacommunication
A broad term that refers
to all factors that
influence communication
Professional Nursing Relationships
Nurse-client helping relationships
Nurse-family relationships
Nurse-health team relationships
Nurse-community relationships
Elements of Professional
Communication
Appearance, demeanor,
and behavior
Courtesy
Use of names
Trustworthiness
Autonomy and
responsibility
Assertiveness
Therapeutic Communication
Techniques
Attentive (active) listening – SOLER
Sharing Observations, Empathy, Hope, Humor,
Feelings
Using Touch
Using Silence
Providing Information
Clarifying
Therapeutic Communication
Techniques
Focusing
Paraphrasing
Asking Relevant Questions - Seeking validation
Summarizing
Self-Disclosure
Confrontation
Summarizing
Non-Therapeutic
Communication Techniques
Asking personal questions
Giving personal opinions
Changing the subject
Automatic response
False Re-assurance
Sympathy
Asking for Explanation
Approval or Disapproval
Non-Therapeutic
Communication Techniques
Defensive Responses
Passive or Aggressive Responses
Arguing
Barriers to communication
Agreeing or disagreeing
Asking personal question
Changing the subject
Environment
Giving advice
Language and culture
Passing judgment
Physical limitation
Stereotyping
Testing
Adapting Communication Techniques
for Client with Special Needs
Aging population and communication disability.
Cultural Difference
Impaired communication because requires special
thought and sensitivity.
See Box – 24-10: Communicating With Clients Who
Have Special needs
See Sample Communication Analysis.
Critical Thinking Exercises – page 359
NCLEX Style Questions – page 359.
Communication Within
the Nursing Process
Assessment
Physical and emotional factors
Developmental factors
Sociocultural factors
Gender
Communication and Nursing Process
Diagnosis
Many clients experience difficulty with
communication
Lacking skills in attending, listening, responding, or
self- expression
Inability to articulate, inappropriate verbalization
Difficulty forming words
Difficulty with comprehension
Communication and Nursing Process
Planning:
Goals and outcomes:
Specific and measurable
Setting of priorities
Continuity of care:
Collaboration with other health care providers
Communication and Nursing Process
Implementation:
Therapeutic communication techniques
Nontherapeutic communication techniques
Adapting communication techniques
Communication and Nursing Process
Evaluation:
Nurses and clients need to determine whether
the plan of care has been successful.
Nursing interventions are evaluated to determine
which strategies or interventions were effective.
If expected outcomes are not met, the plan of
care needs to be modified.