Transcript 07. Communication

Communicating with
patients and families
A Communication Model
Communication
► Communication
is the very heart of the nursepatient relationship
 Nurses often must communicate with patients and
families when they are stressed and dealing with
intensely difficult situations- not an easy job
 Failure to communicate effectively can jeopardize the
nurse’s credibility with the patient and family
Doctors vs. nurses
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Patients expect doctors to speak in fancy medical
terminology…
Patients expect that nurses will speak so that they can
understand what is being said
Patients expect that doctors may be aloof and distant…
Patients expect that nurses will demonstrate caring and
empathy in their demeanor
Communication consists of a sender,
a message, a receiver, and feedback.
Methods of Communication
► Verbal
- Speaking, Listening, Writing,
Reading.
► Nonverbal
- Gestures, Facial
Expressions, Posture and Gait, Tone of
Voice, Touch, Eye Contact, Body
Position, Physical Appearance.
Influences on Communication
► Age
► Language
► Education
► Attention
► Emotions
► Surroundings
► Culture
Factors Influence
Communication Process
► Development
& gender
► Sociocultural characteristics
► Values and perception
► Personal space and territoriality
► Roles and relationships
► Environment
► Congruence
► Attitudes
Development
► Language
and communication skills develop
through stages
► Communication techniques for children
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Play
Draw, paint, sculpt
Storytelling, word games
Read books; watch movies, videos
Write
Gender
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Females and males communicate differently from early age
Boys  establish independence, negotiate status
Girls  seek confirmation, intimacy
Communication Channels
Intrapersonal Communication
A Nurse Communicating with Client on the
Interpersonal Level
Team Conference
Impressions are everything
It doesn’t matter to families
that the nursing staff may have
performed the most advanced
lifesaving techniques for the patient…
if the nursing staff comes across
as cold and distant,
the patient and family will not feel
cared for.
Non-verbal communication
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Don’t underestimate the power of non-verbal
communication!
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Watch for nonverbal cues that don’t match what the
person is saying Patient says “I’m fine” but is holding on to the side
rails with a death grip and rocking in pain
 Nurse says “I’m here to help you” while rolling her
eyes and scowling
Touch
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Be very careful when using touch to communicate
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Touching a patient who has neuropathy can be very
painful, especially hands and feet
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Certain cultures forbid men and women to touch, while
other cultures frown upon shaking hands
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Warn patients before you touch them, and describe what
to expect- “this will feel tight around your arm”
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Also be careful with gestures- what is acceptable to one
culture may be offensive to another
Be honest
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Don’t lie to patients- if what you are going to do will hurt,
say so!
 Patients (especially kids) really resent hearing phrases
like “it’s just a little poke” before a shot- it’s going to
hurt and they know it.
 When the nurse does this, the patient loses trust in the
nurse and then disregards everything else that the
nurse has to say.
Giving news over the phone
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Sometimes nurses have to inform family members that
someone has been injured or has died
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Make sure that you have the correct person on the other
end of the line!
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Introduce yourself and keep the conversation simple while
conveying your message
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Try to keep the conversation short- extensive explanations
can usually wait until the family comes to the hospital
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If the family asks if the patient has died, be honest but
wait to give details in person
Putting a good face on…
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Shortly after I started working on an oncology unit at a
metro Detroit hospital, a very good friend was diagnosed
with a very malignant brain cancer.
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My husband and I saw him over the weekend, and found
out that he would probably die in the next year or two.
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When I went to work on Monday, I had to care for a
patient with cancer that had spread to her brain- she was
having seizures and could no longer talk. Seeing her, I
could only imagine that my friend would soon be in the
same state.
Putting a good face on…
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Even though I was in turmoil over my friend’s cancer
diagnosis, I still had to be a professional, caring nurse for
my patient and her family.
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Yes, it was terribly difficult!
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I knew that it would be painful to continue working on the
oncology unit after that, so I soon transferred to a
supervisory position instead in the hospital.
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My friend died 2 years later.
Putting a good face on…
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No matter how you may be feeling inside, you always must
put forth a professional, caring demeanor for patients and
their families
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You will sometimes see horrible-looking wounds or
experience nasty smells when working with patients- you
absolutely cannot let the patient know how you really feel
about it.
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Sometimes nurses have to put on Oscar-winning
performances to hide negative feelings- but it’s part of
being a professional, respectful, and empathetic caregiver
As you get started…
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Listen. You may hear someone talking, but are you
listening? Too often nurses don’t listen to what a patient
or family member is saying, but instead are busy forming
a response.
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Maintain eye contact. When you are listening, be
sure to observe body gestures for signs of contradiction
to what he or she is saying verbally.
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Speak with the family members as well as the
patient. Try to encourage family interaction and
questions, especially if a family member is the primary
caregiver for the patient.
As you get started…
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Don't be judgmental. Listen attentively but don’t show
excessive emotion to what the patient or family members
is saying. Don't ever say that the person's idea is silly.
Respond gently instead- suggest that there may be
another way to address the issue and the new approach
may work better.
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Listen carefully. You can learn much from a patient who
is willing to share how he or she addresses and copes with
chronic illness or difficult situations. Listening can be a
tremendous educational experience, especially when
starting a nursing career.
As you get started…
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Speak clearly. This will also help you speak more slowly,
making it easier for patients and families to understand
you.
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Skip the medical terminology. This only confuses
patients and families. Use terms that are easy to
understand.
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Allow periodic moments of silence. Silence provides
an opportunity for the patients and families to mull over
information that formulate new questions for the nurse
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Respect cultural differences. Use caution with touch
and humor.
Getting down to a patient’s level can help
improve communications on a pediatric call.
An open
stance
A closed
stance
Interpersonal Zones
Eye Contact
► Use
eye contact as much as possible.
► Remember to remove sunglasses while
working with patients.
Use an appropriate compassionate touch to
show your concern and support.