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Chapter 4

In English

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Tyresha Warren

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can be describer simply as the exchange of information

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91 questions
Can be describer simply as the exchange of information
The one who conveys the message
Is the person or people whom the message is conveyed
One-way communication
A lecture to a large audience (no response from receiver)
Two-way communication
Requires the sender and receiver participate in the interaction
Verbal communication
Involves the use of spoken or written words or symbols
Connotative meaning
A word is subjective and reflects the individual's perception or interpretation ( a word that can have multiple meanings by individuals, not a specific meaning)
What is the purpose of two way communication
Meet the needs of the nurse and the patient & establish a trusting relationship
Denotative meaning
Refers to the commonly accepted definition of a particular word (literal meaning of a word such as a phone is a phone can't mistake it)
Is common place "language" or terminology unique to people in a particular work setting, such as hospital, or nursing places
Nonverbal communication
Messages transmitted without the use of words ( either oral or written) constitute
What are non verbal cues
Voice, eye contact, physical appearance, gestures, posture
Are movements people use to emphasize the idea they are attempting to communicate
The way an individual sits, stands, and moves
Open posture
Taking a relaxed stance with uncrossed arms and legs while facing the other individual
Closed posture
Is more formal, distance stance, generally with the arms, and possibly legs, tightly crossed
Is ones ability to confidently and comfortably express thoughts and feelings while still respecting the legitimate rights of a patient
Assertive communication
Occurs when an individual interacts with another in an overpowering and forceful manner to meet one's own personal needs at the expense of the other
Unassertive communication
This style, the nurse agrees to do what the patient requests, even though doing so creates additional problems for the nurse
Therapeutic communication
The exchange of information that facilitates the formation of a positive nurse-patient relationship and actively involves the patient in all areas of care
Non therapeutic communication
Usually blocks the development of trusting and therapeutic relationship
Active listening
Requires full attention to what the patient is saying (hear the patient, interpret the meaning, gives feedback, indicate understanding of the message
Passive listening
Listening to the speaker is indicated either nonverbally through eye contact and nodding, or verbally through encouraging phrases (although the patient is unsure if the nurse understood accurately they know the nurse is interested)
What is therapeutic nurse-patient interactions
Nurse demonstrates caring sincerity, empathy trustworthiness
What can happen if the patient senses that the nurse is not being genuine
Trusting relationship is not built, if the nurse seems hurried or detached the patient will feel unimportant
Minimal encouragement
Is a subtle therapeutic technique that communicates to the patient that the nurse is interested and wants to hear more
Non verbal communication techniques
Closed question, open ended questioning, restating, paraphrasing, clarifying, focusing, reflecting, stating the observations, offering information, summarizing
Closed questioning
Focus and seek a particular answer
Open ended question
Does not require a specific response and allows the patient to elaborate freely ( can't be answered by yes or no)
Repeating to the patient what is believed to be the main point that the patient is trying to convey
Restatement of the patients message in the nurse own words in the attempt to verify that the nurse has interpreted the patient message correctly
Takes restating and paraphrasing a step further useful when the patients message is confusing or incomplete and does not go deeply enough into the area being explored
Is also used when more specific information is needed to understand the patients message accurately (message to vague)
Is like restating, but involves feeling and thought more than fact
Stating observations
Communicating the nurse observations to the patient and is often useful in validating the accuracy of observation
Offering information
Preparing a paient for what to expect before, during, and after a invasive diagnostic procedure
Means providing a review of the main points covered in an interaction
Standing at the bedside while a patient is laying in bed what message does that send
Message that the nurse has power and the patient does not
What does crossing the arms at the chest convey
The lack of openness to the patient
Altered cognition
Is a physiologic factor that frequently hinders effective communication (such as dementia, developmental delays)
Expressive aphasia
In which they are unable to send the desired verbal message
Receptive aphasia
Inability to recognize or interpret the verbal message being received
False reassurance
Using falsely comforting phrases in an attempt to offer reassurance (example: it will be okay)
Giving advice or personal opinions
Making a decision for a patient; offering personal opinions; telling a patient what to do with phrases such as " should do or ought to"
False assumptions
Making an assumption without validation; jumping to conclusions (example: it seems like you don't care to learn about your diagnosis)
Approval or disapproval
Trying to impose the nurses own attitude, values, beliefs, and moral standards on the patient about what's right or wrong (example: I don't agree with your decision to not try this treatment option)
Automatic responses
Stereotyped or superficial comments that do not focus on what the patient is feeling or trying to say ( expample: I don't make the rules I just follow them)
Responding negatively to criticism; often in response to feelings of anger or hurt on your part; usually involves making excuses ( example: you must have misunderstood what I said)
Challenging or arguing against the patients statements or perceptions ( example: how could your pain level be so high, you were just talking to your visitors fine)
Asking for explanations
Ask the patient to explain her or his actions, beliefs, or feelings with why questions ( example: why do you feel that way)
Change the subject
Inappropriately focusing the discussion on something other than the patients concern ( example: lets talk about something happier talking about your cancer diagnosis is making you to sad)
What are ways to communicate with patients who having cognitively impairments
Allow time for patients to respond, ask one question at a time, use simple sentences and avoid long explanations
What are ways to communicate with patients who have hearing impairment
Ensure patient can see your lips because they many read lips, face the patient, speak in a normal volume rather than shouting, lower your voice because hard of hearing individuals usually have difficulty with high pitched sounds and voices
Unresponsive patients
It is not certain whether, or how much, the unresponsive patient is able to hear or interpret verbal stimuli
What should you encourage around unresponsive patients from family and friends
Speak to the unresponsive individual as if he or she is awake
When giving care to unresponsive patient what should you do
Always explain to the patient any procedure or activity that involves the patient
What is a unique challenge when dealing with teenagers and communication
The vocabulary and expressions are often unique to their age group and include the use of slang terms
What is a unique challenge when dealing with older adults and communication
The have communication barriers because of hearing loss, cognitive barriers
If a patient wears hearing aids what should you do when communicating with them
Be sure its in place and working, eliminate background noise, don't shout, give patient time to process what was being said as well as time to respond
What is another word for stroke
Cerebrolvascular accident (CBA)
What is touch communication
Touch is another form of nonverbal communication that is inherent in the practice of nursing ( nearly every intervention of provident physical care calls for touch)
What is Aphasia
A deficient or absent language function that results from ischemic insult to the brain( such as stroke, cerebrovascular accident, brain trauma or anoxia)
What is anoxia
An absence or deficiency of oxygen reaching the tissue; severe hypoxia: death due to anoxia resulting from strangulation
What is the key to a therapeutic nurse patient relationship
The nurse willingness and acceptance to listening not pass judgement
What are some reasons a patient might be reluctant to give the nurse information
Values, beliefs, lifestyle, fear of disapproval, rejection
What does the interpretation of touch depend on
It must be used with discretion; as well as the duration, intensity, and body part being touched
Why are some nurses uncomfortable with touch communication
Fear of being inappropriate or misinterpreted
What would a patient feel if a nurse is not comfortable with touch communication
Patient feels as if the nurse tends to touch in a manner that shows hesitancy, reluctance, rejection, strong negative message
What would a patient feel if the nurse was comfortable with touch communication
Has the potential to convey warmth, caring, support, and understanding
What does a nurse do that has mastered the skill of listening
Quiet while the patient is talking, pays attention to verbal and nonverbal communication
What is silence in a therapeutic communication technique
Extremely effective and sometimes difficult
How does silence feel
Awkward, which leads to want to the desire to interrupt the silence by making conversation
What does silence do
Conveys support, compassion, and caring; holding a patients hand or placing hand on shoulder when combined with silence conveys caring and concern
Culture is a significant component of a patients psychosocial well being, what should the nurse remember
Attempt to seek information for cultural practices and beliefs for pt being cared for especially if the pt culture is different from the nurses
When a patient is experiencing stress what should the nurse do
Keep information simple, basic and concrete essential information
What are a few factors that can put a patient under stress
Frightened, pain, deprived of sleep, nauseated and a host of other factors
What does the style of communication do or mean
The style of communication the nurse uses is often what makes the difference between positive or negative communication
What doe communication experts believe
Non verbal communication is often more accurate and makes up the largest % of communication
What does extended eye contact sometimes imply
Sometimes implies aggression and arouses anxiety
What does 2 to 6 seconds of eye contact during interaction do
Helps involve the other person in what's being said without being threatening or intimidating
What does absence of eye contact communicate
Shyness, lack of confidence, disinterest, embarrassment, or hurt
What does culture have to do with eye contact
Most Americans view eye contact in a positive manner, some cultures may view eye contact different