Communication:Clients & Colleagues

Definition Dynamic social process involving the exchange

of ideas between two or more people Behavior to express feelings System of operations that include language,

gestures, or symbols to convey intended meanings

Method by which information is transmitted, received and understood

Mutual transactional process to facilitate a relationship with others

Essential element in the establishment of the nurse-client relationship

Therapeutic Nurse-Client Relationship

Special form of interacting that has a health-related purpose and develops as a continuous flow of interaction between nurse and client, with input from both contributing to its nature and progression

Social vs. Therapeutic Occurs at any time, not time-

limited Structure and conduct

responsibility of both parties Spontaneous and not

necessarily goal-directed Needs of both can receive equal

consideration Purpose for both greater

intimacy Self-disclosure acceptable for

both parties Social decorum and adherence

to rules of etiquette are expected

Occurs within designated time frames and terminates when therapeutic goals are achieved

Responsibility for structure and conduct of the conversation is ultimately the nurse’s.

Communication is purposeful and directed toward mutually established goals

Focus always on the patient only

NO self-disclosure by nurse other than special circumstances

Not always follows rules of social etiquette

Formally terminates with end of session or purpose of relationship

Collegial Communication Among colleagues in the professional

work setting Professional nursing groups Purpose is professional collaboration Effective collaboration has the advantage

of breaking through power issues and competition that may arise when teams of professionals are brought together

No member is more important than another member or the group as a whole

Elements

Stimulus Sender Message Medium Receiver Feedback

Types

Written Verbal Cultural Nonverbal

Written - Documentation Facilitate care planning and delivery Identify individual patterns or norms

so that deviation can be noted ASAP Direction Prove interventions were done, how,

response so care can be evaluated Legal and accounting record Evidence for outcomes

Cultural

Different languages create and express different personal realities

Culture expressed through language, shapes the personalized meaning & experience of illness and health

Some words do not have exact match in another language

Culture: Paralanguage Dialect Voice volume, Emphasis points and inflections Eye contact Facial expression Space needs Body posture Diet Behavior Expectations Gestures

Stereotypes Exercise

American Indians African Americans Asians Hispanics Homosexual men Homeless AIDS victims People on welfare Elderly Mentally Ill Southerners New Yorkers

Verbal Spoken language

Dialect Mannerisms Inflection Tone, volume,

rate, Inflections Slang Jargon

Influences Age Race Socioeconomic

Group Educational

background Gender Situation

Factors: Other

Perception Personal space and territoriality Values Roles & Relationships Emotions Environment Physical Condition

Self-Awareness The thing I like best about myself is The thing I like least about myself is My favorite activity is When I am in a group, I It would surprise most people if they knew The most important value to me is I like I most dislike I feel most self-confident when I Five years from now I see myself as

Healthy Self-Concept

Self

Satisfaction with Role Performance

Spiritual well-being

Distinct Sense of Identity

Emotional Stability

Realistic Life Goals

Satisfaction with Body Image

High Self-Esteem

Congruence between Real and Ideal Self

Cognitive distortions and Self-Concept

“All or nothing” Personalizing Overgeneralizing Mind-reading “Should” / “Ought to” “Awfulizing”

Anxiety and Communication Mild

Heightened alertness, Increase alertness

Moderate Decreased sensory

perceptions Severe

Greatly diminished perceptions

Panic All internal: No

external perceptions

Active listening Honesty Slow, calm Clear, firm, NOT

LOUD Reasonable limits Therapeutic touch

*** Breathing &

relaxation

Nonverbal Actions speak louder than words Context Used to enhance, disguise, negate,

or modify verbal messages 90% of meaning of a message

comes from the NON-VERBAL Proxemics Appearance

Nonverbal

Facial expression Clothing Posture Movement Vigorous Slow

Caring Integral to nursing Must be communicated!! Can be a purposeful activity

integrated into each nurse experience with a (client, patient, consumer, member, colleague)

Respect Polite decorum

Caring: Exercise

What constitutes communication of Caring?

Communication TechniquesTherapeutic Silence Accepting Recognition Offering self Broad openings General leads Making observations Reflecting Restating Focusing Giving information Seeking clarification Summarizing Encouraging descriptions

Non-Therapeutic False reassurance Approval/Disapproval Advise giving Defending “WHY”??????????? Stereotyped Comments Change of subject with NO explanation “What”???????????? External source

Types of communication

Assertive Nonassertive Aggressive

Nurse-Patient Trust

Respect Individualization Appropriate eye-contact Flexibility Consistency Honesty Limits Follow through on commitments Control distractions Attending posture Time Active listening

Nurse Patient Empathy

What is it? Compassion

What is it? Sympathy

What is it? Presence

What is it?

Nurse-Patient Relationship Bridges

Caring Trust Empathy Mutuality Confidentiality

Barriers Anxiety Stereotyping Space Violation

Nurse Client Relationship Purpose Focus Boundaries Phases

Pre-orientation Orientation Working Termination

Diagnoses

Physical Breathing patterns, impaired Communication, impaired verbal Confusion, acute/chronic Fatigue Memory, impaired Sensory/perecptual alterations

Diagnoses Mental/Emotional

Anxiety Denial Family (Individual) coping, ineffective Fear Hopelessness Knowledge deficit Powerlessness Spiritual distress Social interaction, impaired Thought processes, altered Violence, risk for