Transcript Ch_4_PPT_Schuster Nykolyn

Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Chapter 4
Creating Common Meaning
to Attain
Transformational Outcomes
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Creation of Common Meaning
 The process of negotiating mutually shared understanding
between communicators
 The creation of common meaning is the result of purposeful
conveyance, channeling, and reception of messages
 Selection of verbal language and nonverbal behaviors to
convey messages
 Selection of channels to send messages
 Receive and respond to messages using the listening
process and effective listening responses
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Verbal Language
 Words are often misunderstood
 What you hear is not necessarily the message conveyed
 Meanings are negotiated through feedback to clarify and verify the
meaning of a message
 Meanings are personal
 Confusion, misunderstanding, and conflict in relationships are most
often the result of differences in meanings
 Do not assume that words mean the same thing to different
individuals
 Clarify meaning by asking questions
 Actively seek feedback to help others interpret your messages
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Convey Messages Using Clear and
Precise Words
 Use concrete words to increase clarity
 Avoid ambiguous messages
 Slang words/medical jargon
 Generalizations/stereotypes
 Introductory disclaimers/tag questions
 Opinions posed as questions
 Hidden agendas
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Nonverbal Behavior
 Actions speak louder than words
 Gesture, frown, smile, touch, clothing
 Conveys the intended meaning
 Tone of voice means more than the words
 Communicates the relational aspects of the message
 How communicators feel about the subject and each other
Note: Pay attention to incongruence between words and nonverbal
behavior. If there is incongruence, believe the nonverbal behavior
rather than the spoken words. Seek feedback to clarify and verify your
assigned meaning to create common meaning.
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Pay attention to important nonverbal
behaviors
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Facial expressions
Eye contact
Paralanguage
Gestures
Clothing
Proxemics
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Intimate comfort zone
Personal comfort zone
Social comfort zone
Public comfort zone
Touch
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Meaning of Nonverbal Behaviors
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Convey emotions and feelings
Free of deception
“A picture is worth a thousand words”
Shorthand for words
Regulate conversation
A safe way to express emotions
Reinforce verbal message
Replace words
Provide emphasis
Solve incongruence between verbal and nonverbal behaviors (believe the
nonverbals)
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
The Listening Process
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Hearing
 Electrophysiological trigger
Attending
 Select stimuli
Understanding
 Assign meaning
Remembering
 Transfer the meaning to memory
Responding = Demonstrate active listening
 Provide feedback that listening has occurred
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Listening Risk Factors
 Physiological factors
 Hearing or cognitive impairment, anxiety, fatigue, pain, sedation, etc.
 Information overload
 Cannot process additional information; unable to absorb additional
data
 Brain processing
 Plan what to say while the other is speaking and not focused on
creating common meaning
 External physical factors
 Physical distractions, unfamiliar sounds, interruptions
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Blocking the Expression of Thoughts
and Feelings
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Claiming another’s feelings as your own
Denying others the right to their feelings
Showing disapproval
Challenging statements
Giving false reassurance
Minimizing the situation
Imposing guilt
Giving advice
Reacting with defensiveness
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Active Listening Responses:
Patient-Safe Communication Strategies
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Paraphrasing
Listening with silence
Questioning
Summarizing
Supportive statements
Analytical statements
Evaluative statements
Empathy
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Recognize patient’s strong feelings
Imagine how the patient might be feeling
State your perception of the feeling
Legitimize the feeling
Respect the patient’s effort to cope
Offer support and partnership