Hapter Ommunicator: EY Erms
Hapter Ommunicator: EY Erms
Hapter Ommunicator: EY Erms
KEY TERMS:
assertive behaviors – ability to stand up for oneself and others using open,
honest, and direct
communication
receiver (decoder) – person or group that must translate and interpret the
message sent
Posture for those in good health and positive attitude usually have good
alignment
- depressed or tired people are likely to slouch
- provides clues concerning pain and physical limitations
Space & Territoriality – people are most comfortable in areas they consider
their own
- the urge to maintain an exclusive right to certain space is being
territorial
- people have a sense of how much personal or private space is needed
and what distance between
individuals is optimum
Physical, Mental and Emotional State – degree to which people are physically
comfortable and mentally and
emotionally free to engage in interactions
- a full bladder, dull headache, crushing chest pain, anxiety about a
pending diagnosis or concern
about what is happening at home or work, and fear can all
negatively influence
communication
- cognitively impaired persons present special challenges
Values – the way people values themselves, one another, and the purpose of
any human interaction
Evaluating – verbal and nonverbal cues are used to verify whether patient
objectives or goals have been
achieved
DISCUSS THE THREE PHASES OF COMMUNICATION IN A HELPING RELATIONSHIP, INCLUDING THE GOALS OF
EACH PHASE
Orientation Phase – tone and guidelines for the relationship are established
- patient and nurse meet and learn to identify each other by name
- roles of both people in the relationship are clarified, with the nurse,
generally, assuming leadership
(does not mean control in a restrictive or manipulative sense, but
involves taking the
initiative to enlist the patient’s point of view)
- a simple verbal agreement or, occasionally, a written contract about
the relationship is established
- elements include the goals of the relationship; location,
frequency, and length of contract;
and duration of the relationship
- might also include the way in which personal information will be
handled
- orientation to the healthcare facility, its services, admission routines,
and any pertinent information
the patient requires to decrease anxiety
- one of the goals in the nurse-patient helping relationship
- a nurse’s openness and interest in the concerns of the patients pave
the way for development of
trust and communicate care and respect
Working Phase – actions that meet the goals; usually the longest phase
- nurse and patient work together to meet the patient’s physical and
psychosocial needs
- interactions are designed to ensure achievement of health goals or
objectives that were mutually
agreed upon
- the nurse provides whatever assistance might be needed to achieve
each goal
- the nurse also provides the patient assistance to perform
activities of daily living
- a goal is to build satisfactory sentiments and feelings between the
people that will be working
together
- satisfactory interaction preserves people’s integrity while
promoting an atmosphere
characterized by minimal fear, anxiety, distrust and tension
- nursing roles of teacher and counselor are performed primarily during
this phase
- motivating the patient to learn and to implement health
promotion activities, to facilitate the
patient’s ability to execute the plan of care, and to express
feelings about health problems,
nursing care, any progress or setbacks, and any other areas of
concern
DISCUSS FACTORS THAT ARE USED TO FACILITATE EFFECTIVE COMMUNICATION INCLUDING TECHNIQUES,
INTERPERSONAL COMPETENCIES AND ASSERTIVE SKILLS
Conversation Skills – the exchange of verbal communication as a social
interaction
- control the tone of your voice so that you are conveying exactly what
you mean to say and not a
hidden message
Listening Skills – involves both hearing and interpreting what another says
(requires attention and
concentration to sort out evaluate, and validate data)
- when possible, sit when communicating with a patient
- do not cross your arms or legs
- be alert and relaxed and take sufficient time
- keep the conversation as natural as possible and avoid sounding overly
eager
- if culturally possible, maintain eye contact with the patient, without
staring, in a face-to-face pose
- indicate that you are paying attention to what the patient is saying by
using appropriate facial
expressions and body gestures
- think before responding to the patient
- do not pretend to listen
- listen for themes in the patient’s comments (repeated themes and
behaviors, topics avoided,
inconsistencies and gaps)
Silence – can be used appropriately by taking the time to wait for the patient
to initiate or to continue
speaking
- silent times have many meanings, such as the patient is comfortable in
the nurse-patient
relationship, the patient might be trying to gather his/her inner
thoughts or feelings, the
patient may be fearful and uses silence as an escape, or the
patient might be angry and use
silence as a display of this emotion
Humor – valued as both an interpersonal skill for the nurse and a healing
strategy for patients
- provides the ability to laugh on oneself and accept failures, confront
the absurdities of everyday
practice without falling apart, and challenge patients to situate
their current dilemma within
the context of their larger life experiences
- laughter releases excess physical and psychological energy and
reduces stress, anxiety, worry,
and frustration
- a learned skill
Assertiveness – communication in a way that demonstrates respect for all
parties involved
- the key is to be open, honest and direct
- components include having empathy, describing one’s feelings or the
situation, clarifying one’s
expectations, and anticipating consequences
- characteristics include confident, open body posture; eye contact; use
of clear, concise “I”
statements; the ability to share honestly one’s thoughts, feelings,
and emotions; working to
capacity with or without supervision; the ability to remain calm
under supervision, the
freedom to ask for help when necessary, the ability to give and
accept compliments, and
honesty in admitting mistakes and taking responsibility for them
DISCUSS THE NANDA NURSING DIAGNOSIS IMPAIRED COMMUNICATION INCLUDING DEFINITION, MAJOR
AND MINOR CHARACTERISTICS, AND RELATED FACTORS
NANDA = North American Nursing Diagnosis Association
Hearing Impaired
- orient patient to your presence before initiating conversation
- talk directly to the patient while facing him / her
- be aware of nonverbal communication
- do not chew gum or cover your mouth
- demonstrate or pantomime ideas
- use sign language or finger spelling
- write any ideas that you cannot convey in another manner
- be sure hearing aids are clean, functioning, and inserted properly
Cognitively Impaired
- establish and maintain eye contact
- communicate important information in a quiet non-distracting
environment
- keep communication simple and concrete
- do not use pronouns or abstract terms
- use pictures or drawings when appropriate
- when possible, avoid open ended questions
- be patient and give the patient time to respond
Unconscious
- be careful what is said in the patient’s presence
- assume the patient can hear you
- speak with the patient before touching
- keep environment noises as low as possible