Transcript nurse replies

Nursing Management of Clients with Stressors
that Affect
Communication
NUR101 Fall 2008
Lecture #2
K. Burger MSEd, MSN, RN, CNE
Elements of Communication
 Source
(encoder)
 Message
 Channel
 Receiver (decoder)
 Feedback
Nurses Role

Therapeutic
communication
 Helping relationship
between nurse and
patient
 Utilizes interviewing
techniques to gather
information
(assessing)
PHASES of HELPING
RELATIONSHIP

Orientation
 Working
 Termination
Factors that Influence Communication
 Developmental
 Space
Stage
 Gender
 Sociocultural
 Role/Occupation
 Physical
 Mental
 Emotional
State
Effective Communication
 Friendliness,
openness, respect
 Empathy, trust, caring,
competence
 Purpose, privacy, confidentiality,
comfortable environment,
personal space
Verbal Communication
 Transmitting
a message using the
spoken or written word
 Nurses
speaking to patients/
nurses/doctors or writing progress
notes/ nursing care plans
Nonverbal Communication
Transmission
without using
words
 Body language
 Touch
 Eye contact
 Facial
expressions
 Posture

Gait
 Physical
appearance
 Dressing/grooming
 Sounds
 Silence

Techniques Facilitating
Communication
Conversational
skills
 Tone of voice
 Knowledgeable
 Confidence
 Flexible
 Clear/Concise
 Avoid semantics

Listening skills
 Alert/relaxed
 Indicate
attentiveness
 Think before you
speak
 Listen for themes


Honesty/Authenticity
Facilitating Communication
 Silence
 Humor
 Touch
 Assertive
 Eye
 Utilize
contact
 Watch your
body language
opportunities

Use of supportive
statements
 Displaying empathy
Blockers to Communication
Not perceiving pt.
as a human
 Not listening
 Changing the
subject
 False
reassurance
 Being judgmental

Inappropriate
comments
 Clichés
 Asking yes/no
questions
 Giving advice
 Probing questions

Interviewing Techniques
Used by nurses to obtain information
about pt.
 Useful in the helping relationship


FIRST STEP = attentive listening!!!
ALSO NEED: privacy, comfortable environment

Open ended questions
“What brings you to the clinic today?”
Closed questions/comments – yes/no
 Validating questions/comments

“Tell me whether my understanding of what you said
is correct…..”
Interviewing Techniques
Clarifying
questions/comments
 Reflective (re-stating)
questions/comments
 Paraphrasing
 Direct questions
 Sequencing
 Re-focusing

AN EXAMPLE
During your shift in the ICU you have been
assigned to care for a man injured in a
motor vehicle accident in which he has
been charged with DWI.
The driver of the other car was killed.
The patient says to you:
“I feel so terrible about what has happened”
SUPPORTIVE STATEMENT
“I CAN IMAGINE HOW YOU FEEL”
“THIS MUST BE VERY DIFFICULT FOR
YOU”
CLARIFYING
“ARE YOU FEELING BAD ABOUT HAVING
BEEN DRINKING AND DRIVING?”
“ARE YOU FEELING BAD ABOUT HAVING
KILLED SOMEONE?”
“ARE YOU FEELING TERRIBLE ABOUT
YOUR INJURIES?”
“ARE YOU FEELING TERRIBLE ABOUT THE
FACT THAT YOU ARE GOING TO BE
ARRESTED AND GO TO JAIL?”
CONVEYING EMPATHY
USING CONGRUENT NON-VERBAL
COMMUNICATION TECHNIQUES:
TOUCH
EYE CONTACT
SILENCE
ALONG WITH:
SUPPORTIVE STATEMENTS
???????
NURSE REPLIES:
“YOU FEEL TERRIBLE?”
??????
NURSE REPLIES:
“WELL, YOU SHOULDN’T HAVE BEEN
DRINKING WHILE DRIVING”
??????
NURSE REPLIES:
“DON’T WORRY, I’M SURE
EVERYTHING WILL BE ALRIGHT”
Impaired Communication
 Hearing
impaired
 Visually impaired
 Language barriers
 Physical barriers
 Cognitively impaired
 Unconscious