Transcript Chapter 3*Communication Skills

Chapter
3Communication
Skills
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1. Apply your knowledge of communication
skills to enhance relationships with others.
2. Conduct periodic self-assessments in
communication skills.
3. Use techniques that enhance communication
with patients.
4. Communicate empathy in the health care
environment.
5. Avoid blocks to effective communication.
6. Use knowledge and resources to effectively
communicate with people with special needs.
OBJECTIVES
Communication takes place when one mind
so acts upon its environment that another
mind is influenced, and in that other mind
an experience occurs, which is like the
experience in the first mind, and is caused in
part by that experience.
 Communication is an exchange of
information.
 The more complex the information or
concept, the more difficult the task
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Definition of Communication
How effective is your
Communication Style?
Take the self
assessment
Quiz
On page 61
Communication Skills Assessment
Assessment of communication skills can tell
you what you may need to do to be a
better communicator.
 Ways to improve communication skills:
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Learn about how people communicate
Practice sending clear messages
Practice listening to messages from others
Learn about how to communicate with people
who have special needs
◦ Ask friends and teachers for constructive
criticism
The Communication Process
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Verbal (speaking or writing-the actual
words)
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Vocal (sound and tone of your voice)
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Nonverbal (signs, signals, symbols)
Components of Communication
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Verbal communication can be
◦ One-way (ex. News broadcast)
◦ Two-way (ex. Simple conversation-2 people)
◦ Multidirectional-more than 2 persons
(ex. Conversation about pt. care)
Components of Communication
Verbal
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Language expressed in speaking and writing
Seven parts:
◦ Source or sender
◦ Encoder (converts message-eardrum,
electric wires)
◦ Message (what is being communicated)
◦ Channel (face to face, or over wires or
cable)
Components of Communication
◦ Decoder (brain, television, radio, etc.,
converts codes into the message)
◦ Receiver (the person who is the recipient
of the message)
◦ Feedback (the recipient responds in
some way to the message)
Components of Communication
Components of Communication
Vocal Communication
The sound and tone of your voice
Habits can reduce your effectiveness as a
speaker
 Clear speaking is a learned skill
◦ Study the way you speak
◦ Face the person you are addressing
◦ Use words you are comfortable with
◦ Words, tone, rhythm, inflection, and
posture work together
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Nonverbal Communication
Includes signs (picture or drawing),
signals (shout for help), and symbols
(wedding ring)
 Includes body language
◦ Facial expressions
◦ Posture
◦ Body position
◦ Other actions that do not use words
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Components of Communication
Sending the Message (speaking and writing)
Information communicated from or to you
Think through electronic messages to
avoid misunderstandings and
misinterpretations
 Use the method most appropriate to the
situation
Speaking
 Use correct vocabulary, grammar, medical
terminology, and abbreviations
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The Process of Communicating
Sending a Message
•Speak clearly
•Use good judgment
•Express confidence
•Listen without interrupting
•Use accurate descriptions
•Follow guidelines to improve quality of
message
The Process of Communicating
Writing
A significant way of communicating
information in health care
 Charting as a direct influence on patient
care
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−Give facts, not opinions
−Use approved abbreviations
The Process of Communicating
Receiving the Message (reading and
listening)
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Reading
◦ An important vehicle for conveying
information and ideas
◦ Essentials of effective reading
How fast you read?
How well you understand what you read?
The Process of Communicating
Observe how you read
 Changing poor reading habits will make
learning easier
 Building a good vocabulary is an excellent
way to improve comprehensive
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◦ Common language
◦ Medical terms
The Process of Communicating
Listening
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Receiver’s role is to listen.
Hearing and listening are two distinct
activities.
−Hearing is biophysical
−Listening is an active process
Effective listening skills are necessary and a
major part of your expertise as a nurse.
 A good listener gains the confidence of the
speaker.
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The Process of Communicating
Egocentricity (focus on the self) conflicts
with needs for nurses to be exceptional
listeners
 Three steps to good listening:
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1. Focus attention on the speaker and what is
being said
2. Interpret what is said to understand
3. Restate what you thought you heard
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Being a good listener means being
receptive and open, but not playing the
role of advisor
The Process of Communicating
•Listen without interrupting
•Ask questions to show interest related to
what is being said
•Be courteous, interested, and
nonjudgmental
•Ineffective communication skills can lead
to errors in patient care.
The Process of Communicating
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Pay close attention to what patients say,
and how they say it
◦ Avoid frivolous conversations
◦ Respect patients and address them as
they prefer
◦ Be honest to develop trust
◦ Ask questions requiring more than
“yes” or “no”
◦ Restate what you thought you heard
Communicating with Patients
◦ Use clarifying phrases
◦ Have a purpose to your communication
◦ Keep confidentiality
◦ Write down important facts and
instructions
◦ Show by nonverbal communication that
you have time and want to listen
Communicating with Patients
Communicating Empathy
Nursing requires providing emotional
support, encouragement, and
understanding.
 Learn to provide compassionate care
without emotionally exhausting yourself.
 Conservation of physical and emotional
energy helps avoid exhaustion and loss of
interest.
 Empathy is intellectually but not
emotionally identifying with feelings,
thoughts, or attitudes of another person.
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Communicating with Patients
Sympathy goes beyond empathy because it
involves an emotional response.
 Being empathic helps to keep distance so
you can think and act in your patient’s best
interest.
 Being empathic helps to conserve emotional
energy.
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Communicating with Patients
Communicating with Patients
Blocks to Effective Communication
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Avoid using techniques that prevent knowing
what and how the patient feels and thinks
◦ Nonverbal barriers (posture, disinterest)
◦ Changing the subject (when uncomfortable)
◦ Stereotyped responses (“Everybody feels..”)
◦ Personal bias (expressing own feelings)
◦ Asking “yes” or “no” questions
◦ Belittling feelings or expressing
disapproval
Communicating with Team Members
Physicians
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Have all information needed to describe a
situation
Give facts, not personal opinion unless asked
Use tact to clarify written or verbal
communication
Supervisors
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Supervisor and legal liability for your actions
All rules for good communication apply to this
relationship
Nursing Team Members
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Good communication skills reduce
misunderstandings and conflicts.
Good communication is necessary in
planning and implementing nursing care.
Maintain a professional attitude
Show respect for the opinion of others
If you offend someone, apologize
GA #1
Communicating with Team Members
There have always been problems with
nurse–physician communication and
relationships throughout the history of the
profession. Search the Web for articles
about the effect of poor communications
between nurses and physicians on patient
care and some of the reasons why those
poor communications occur.
Group Assignment #1
. Students can enter “nurse–physician conflict” to find such
Web sites as the following:
 http://deepblue.lib.umich.edu/bitstream/2027.42/34675/1/7_ft
p.pdf
 http://findarticles.com/p/articles/mi_qa4102/is_200602/ai_n1
7170215/
 Students can enter “nurse–physician collaboration to find
such Web sites as the following:
 http://www.nursingworld.org/mods/mod775/article.pdf
 http://www.rmf.harvard.edu/files/documents/Forum_V26N2erickson.pdf
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Group Assignment #1
Communicating in Special Situations
Communicating with Culturally Diverse People
Avoid confusing or offending another person
 A chance to learn about other cultures and
people
 Cultural Competence
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Understand your own cultural values and biases
Respect the culture of others
Have an interest in learning about others
Have the ability to avoid judging others’ behavior
Communicating in Special Situations
Communicating with Non-English Speaking
People
Use printed information in other languages
 Broadcast informational television in different
languages
 Use interpreters
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◦ Know interpreter’s educational level
◦ Watch for nonverbal cues
Communicating in Special Situations
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When communicating without an interpreter
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Don’t shout
Greet the person by name
Give your name while pointing at yourself
Pantomime actions or procedures
Use preprinted list of phrases
Determine understanding of words, other
languages
◦ Use simple words and phrases
Communicating in Special Situations
Communicating with Hearing-Impaired People
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Speak slowly and face the person
Don’t move your head or position yourself
too far away
Repeat to clarify
Use bright lighting
Eliminate background noise
Make use of technology to assist in
communication
Communicating in Special Situations
Communicating with Vision-Impaired People
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Speak in a normal tone of voice
Announce yourself when entering a room
State your name and the person’s name
Continue talking as you work
Say what you are to do before you do it
Tell patients before you touch them
Communicating in Special Situations
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Tell patient what foods are on the tray and
where they are located
Put needed items within reach and tell
where they are
Keep room free of clutter
Don’t move furniture without telling
Use vocal tones to convey feelings
associated with the conversation
Communicating in Special Situations
Communicating with Speech-Impaired People
Be patient when communicating
 If the person can write:
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Provide paper and pencil or computer
Look at the patient as she writes the message
Don’t allow interruptions
Don’t be distracted
Communicating in Special Situations
Encourage pantomiming thoughts
Don’t shout
Take time to determine what the patient
needs
 Use picture cards to communicate basic
needs
 Ask other members of the team for tips and
techniques
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Is the following statement true or false?
Sending a message requires using signs,
signals, and symbols.
Question
False
 Rationale: Signs, signals, and symbols are
part of nonverbal communication and are
not always required when sending a
message.
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Answer
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Which of the following is true about
listening?
A. Listening is biophysical
B. You must interrupt to understand
C. Restate what you thought you heard
D. Change the subject to a more pleasant
one
Question
C. Restate what you thought you heard
 Rationale: Restate what you hear to better
understand what has been said. Listening is
an active process involving the mind. You
should listen without interrupting. Do not
change the subject.
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Answer
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Is the following statement true or false?
Empathy is understanding intellectually
the feelings, thoughts, or attitudes of
another person.
Question
True
 Rationale: By understanding intellectually
and not emotionally, you will avoid
emotional exhaustion and loss of interest.
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DT#1
Answer
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You have been assigned to care for Mr. Penhaus, a
72-year-old retired German immigrant who lives
alone. Mr. Penhaus is a newly diagnosed diabetic
preparing for discharge, and you are to teach him
how to draw up and administer his insulin.
◦ What communication barriers will you want to
assess before beginning your teaching?
◦ How will you prepare yourself to teach Mr.
Penhaus?
DT#2
Discussion Topic #1
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You are the charge nurse on your shift this evening. Lisa, a staff
nurse discusses a patient whom she is working with is refusing to
take liquids. Her mucous membranes are dry and she shows poor
skin turgor. You check her 24 hour input and output records and
find she is not in good fluid balance. You call her doctor and tell
him, “Mrs. Jones is dehydrated. I think you should order
intravenous fluids for her.”
 Is this a good example of nurse to physician communication?
Why or why not?
Using this scenario, what information would you give to the
physician?
DT #3
Discussion Topic #2
1.
You are giving a bed bath to your patient and a fellow student
Joyce is providing care to your patient’s roommate, Beverly. You
hear Beverly say that she is concerned about the surgery she is to
have the next day. Joyce asks her what she is worried about, and
Beverly tells her that she is afraid she might not make it through
the operation. Beverly laughs and tells her that this is not a good
way to be thinking before having an operation, and that the
surgeon is very skillful. She tells her not to worry, and that
everything will be just fine.
 Describe the communication used by Joyce in responding to
Beverly’s concern?
 How would you have responded to Beverly?
Discussion Topic #3