| Described simply as the exchange of information | Communication |
| The one who conveys the message | Sender |
| The person or people to whom the message is conveyed | Receiver |
| -conveying acceptance
-Qustioning: closed
-Restating
-Paraphrasing
-Clarifying
-focusing
-reflecting
-stating observations
-Offering Info
-Summarizing
-Use of humor | Verbal therapeutic techniques |
| The sender is in control and gets little reponse from the receiver; is of little use to the nurse-pt relationship; ex. lecturer | One-Way communication |
| The sender and receiver participate in the interaction | Two-Way communicaion |
| Two-way communication allows for exchange between the nurse and the pt, its purpose is to: | meet the needs of the nurse & pt; and to esablish a trusting relationship |
| In communication, it is important to always strive to:______ ; rather than simply talk to the pt | seek and accept the pt's input and feedback |
| Involves the use of spoken or written words or symbols | Verbal comunication |
| A word that is subjective and refelcts the indiv's perception or interpretation | Connotative meaning |
| Commonly accepted definition of a particular word "familiar to all" | Denotative meaning |
| Commonplace "language" or terminology unique to people in a particular work setting, or specific type of work | Jargon |
| One of the most important aspects of care in nursing | Communication |
| For communicaition to occur, a ______ and _______ of a message are necessary | Sender & receiver |
| Messages transmitted without the use of words (either oral or written) | Nonverbal communication |
| -Tone & Rate of voice
-Volume of speech
-eye contact
-physical appearance
-Use of touch | Nonverbal Communication |
| A high-pitched, loud voice and rapid speech may indicate that an indiv is: | Freightened |
| Generally _________ communicates an intention to interact | Eye contact |
| Optimal amount of time for eye contact | 2-6 seconds |
| This may indicate: Shyness, lack of confidence, disinterest, embarrassment, or hurt, or in contrast, deference of respect | Lack of eye contact |
| This form of nonverbal communication sometimes implies aggression and arouses anxiety | Extended eye contact |
| This includes attributes of size, color of skin, dress, grooming, posture, and facial expression | Physical Appearance |
| A professional appearance conveys: | Self-respect & Competence |
| Movements people use to emphasize the idea they are attempting to commnicate | Gestures |
| The way that an indiv sits, stands, and moves | Posture |
| This has the potential to convey warmth and acceptance or distance and disinterest | Posture |
| When taking a relaxed stance with uncrossed arsm and legs while facing the other indiv | Open posture |
| A formal, distant stance, generally with the arms, and possibly the legs, tithgtly crossed | Closed posture |
| How somone would interperet a closed posture | Disinterest, coldness, and even nonacceptance |
| Standing at the bedside looking down at the pt in bed places the nurse in a position of: | authority & control |
| Most people and communication experts believe that _______ communication is often more accurate and makes up the largest percentage of cour communication | Nonverbal |
| If nonverbal cues are inconsistent or incongruent with the verbal message, the _______ message is most likely the one received | Nonverbal |
| This that the nurse demonstrates is often what makes the difference between a positive or negative interaction | The style of communication |
| One's ability to confidently and comfortably express thoughts and feelings while still respecting the legitimate rights of the pt | Assertiveness |
| Interaction that considers the feelings and needs of the pt yet honors the nurse's rights as an indiv | Assertive Communication |
| This makes interactions more even and has positive benefits for all involved | Assertive Communication |
| Occurs when an indiv interacts with another in an overpowering and forceful manner to meet one's own personal needs at the expense of the other | Aggressive communication |
| this style of communication is destructive and nontherapeutic | Aggressive communication |
| This style of communication: the nurse agrees to do what the pt requests, even though doing so creates additional problems for the nurse | Unassertive communication |
| Use of this style sacrifices one's legitimate personal rights to the needs of the pt | Unassertive Communication |
| How does a pt/nurse feel when a nurse provides unassertive communication | resentment; neither party benefits |
| A relationship where the nurse-pt interaction is one in which the nurse demonstrates caring, sincerity, empathy, and trustworthiness | A Therapuetic nurse-pt relationship |
| If the pt senses that the nurse is not being _______, a therapuetic, trusting relationship does not develop | Genuine in conveying feelings toward the pt |
| Ensure that the ___ is the foucs of every interaction, not the ____ or _____ | Pt; Equipment; The task |
| The nurse is obligated to report a pt's statement of intent to: | Do self-harm or harm to others |
| This consists of an exchange of info that facilitates the formation of a positive nurse-pt relationship and actively involves the pt in all areas of care | Therapeutic communication |
| This usually blocks the development of a trusting and therapeutic relationship | Nontherapeutic communication |
| This requires the nurse to have an awarenes of he pt's feelings and the abillity to respond to the pt's needs through the use of verbal and nonverbal communication skills | Therapuetic communication |
| Nonverbal Therapeutic communication techniques | -Listening
-Silence
-Touch |
| This nonverbal communication technique is a behavior that conveys interest and caring towards the pt | Listening |
| It is possible to _____ without ______ | hear; listening |
| This requires full attention to what the pt is saying | Active listening |
| When listening to a speaker either nonverbally through eye contact and nodding, or verbally through encouraging phrases such as "uh-huh" & "I see" | Passive listening |
| Holding the pt's hand or placing one's hand non the shoulder of a pt or loved one when combined with silence conveys: | caring & concern |
| Factors of: the duration & intensity of contact, hte body part touched, gender, and the age of the pt and the nurse, the environment, and the stage of development of the relationship | Interpretation of touch |
| One of the most effective methods of therapeutic communication | listening, one of the most difficult to master |
| It is the responsibility of the nurse to monitor how effective the UAP are at | communicating |
| Two methods to help the UAP become better communicators are: | -role modeling effective communication techniques
-in-service education programs |
| Converys interest and caring; gives pt full attention; allows feedback to verify understanding of the message | Active listening |
| Allows time to organize thoughts and formulate an appropriate response; often conveys respect, understanding, caring and support; allows observation of pt's nonverbal resposes | Maintaining silence(often used in conjunction with touch) |
| Communicates that the nurse is interested and wants to hear more | minimal encouragement by nodding occasionally and maintaining eye contact (yes go on, then what happened) |
| Often conveys warmth, caring, comfort, support, and understanding | Touch |
| Demonstrates acceptance of pt's rights to current beliefs and practices without condoning them; nonjudgemental, therefore encourages honesty, and openness on the part of the pt; provides an opportunity to bring about change in health behaviors while still maintaining the pt's personal integrity | Conveying acceptance |
| The impulse does not always allow the people involved in an interaction time to organize their thoughts sufficiently to communicate their needs or response | Silence |
| Silence conveys: | support, compassion, & caring |
| The nurse's acceptance and willingness to listen and respond to what a pt is saying without passing judgement on the pt is key to: | the development of a therapeutic nurse-pt relationship |
| A subtle therapeutic technique that communicates to the pt that the nurse is interested and wants to hear more | Minimal encouragement |
| This indicates acceptance of the pt as a person | Conveying acceptance |
| This usually involves nonverbal cues, suchas maintaing appropriate eye contact, nodding occasionally, and verbal comments such as "yes go on" to encourage the ot to continue | Minimal encouragement |
| It is focused and seeks a particular answer; generally requires one or two words in response | Closed Question |
| This does not require a specific response and allows the pt to elaborate freely on a subject when replying; useful when assessing the pts feelings | Open-ended question |
| The nurse repeats to the pt that is believed to be the main point that the pt is trying to convey | Restating |
| This conveys the message that the nurse is interested in the pt as an individual and not just in obtaining information | Open-ended Qs |
| The restatement of the pt's message in the nurse's own words in an attempt to verify that the nurse has interpreted the pt's message correctly | Paraphrasing |
| When the nurse suggests to the pt some of his or her own ideas about what the ot is trying to communicate in a manner that asks the pt to verify that the nurse's understanding of the message is accurate | Clarifying |
| Used when more specific information is needed to understand the pt's message accurately | Focusing |
| If the message from the pt is to vague or strays from the topic being discussed, it is difficult for the nurse to idenify the actual message | Focusing |
| This is like restating but involves feelings and thoughts more than facts | Reflecting |
| This therapeutic technique is used to assist pt's to explore their own feelings, often about a choice that lies before them, rather than seeking answers or advice from someone else, such as the nurse | Reflecting |
| Communicating the nurses observations to the pt is called; and is often useful in validating the accuracy of observations | stating observations |
| This technique is helpful when the pts verbal and nonverbal cues are not matching | Stating observations |
| The nurse provides the pt with relevant data and asks for feedback to determine the pt's level of understanding | Offering Information |
| Ex of offering information | -pt teaching(preoperative teaching)
-diabetes education
-discharge instructions
(promotes informed decision making) |
| Allows the nurse to gather more specific information when the pt's message is too vague; focuses on specific date | Focusing |
| Providing a review of the main points covered in an interaction | Summarizing |
| this helps the pt to seperate the essential info from the "nice to know" info and gives a sense of clousre to the session | Summarizing |
| This helps reduce stress, anxiety, pain, and enhances the feelings of well-being | laughter |
| This can help put the nurse and pt at ease | Humor |
| It is never apporpriate to laugh ___ the pt; it is only appropriate to laugh ______ the pt | at; with |
| -Posturing & positioning
-Space & territoriality
-environment
-level of trust
-language barriers
-culture
-Age & gender
-physiologic factors
-Psychosocial factors | Factors that affect communication |
| the most therapeutic posture & positioning is: | The same position and level as the pt, or as close to it as feasible |
| What are the four zones of personal space? | -intimate space
-personal space
-social space
-public space |
| From the face to abut 18inches away | Intimate space |
| The area from 18 inces to 4ft away from a person | Personal space |
| 4-12ft from a person | Social space |
| Beyond 12ft from a person | Public space |
| An environment that is calm, relaxed atmosphere, and privacy | Key elements for a successful interaction |
| Without ______, the interaction does not progress past superficial social interactions | Trust |
| One way for the LVN to build trust is by demonstrating: | confidence & competence |
| This is a common example of Physiologic factors in communication | Pain |
| Another physiologic factor that frequently hinders effective communication | Altered cognition |
| If the pt lacks the cognitive ability to receive, process, and send information, then: | Communication is disrupted |
| -A cerebrovascular accient(stroke)
-sedative effects of medication
-dementia
-developmental delays | Examples of physiologic factors that have altered cognition |
| This is another common physiologic factor that impedes communication | Impaired hearing |
| When the pt is under stress they may respond with anger, impatience, or even withdrawl | Respond with info simple, basic, & concrete and offer only essential info |
| An illness often is accompanied by some degree of ______ as a result of actual or perceived loss | grieving |
| How o assist/communicate during the grieving process | silence, therapeutic touch, displaying warm & caring behaviors, using open-ended statements to help pt understand feelings |
| Communicating with pt's who are cognitively impaired | -allow time for pt to respond
-ask 1 Q at/time
-be attentive when listening to the pt speak
-get the pt's attention b4 speaking
-include family & friends in conversation
-reduce environmental distractions while talking with pt
-use simple sentences and avoid long explanations |
| Communicating with pt's who have hearing impairment | -face the pt
-speak at a normal volume rather than shouting
-get pt attention when entering room before speaking
-Ensure pt wearing hearing aids/glasses
-Ensure pt can see lips (lip reading)
-Stand near pt better hearing ear
-reduce environmental noise(tv/radio)
-Rephrase comments rather than repeat
-speak at lower tone
-use sign language or SL interpreter |
| The nurse needs to find different methods of communication that will work best for each indiv pt | When pt experiences difficulty with verbal communication |
| The loss of speech hampers the indiv abillity to express needs(such as with an endotracheal tube) | Compromised verbal communication |
| For any pt experiencing difficulty with verbally communicating; the pt will be able to communicate effectively with others by sending & receiving clear, concise, and understandable messages | The pt goal |
| This includes alphabet, commonly used phrases, pictures, or combo of all three | Communication board |
| Pt's with ventilator dependence | alternative methods of communication |
| When the pt is unable to produce soound, it is essential to identify and implement: | alternative methods of communication |
| Using falsely comforting phrases in an attempt to offer reassurance | False reassurance |
| Making a decision for a pt; offering personal opinions; telling a pt what to do with phrases such as "should do" "ought to" | Giving advice or personal opinions |
| Making an assumption without validation; jumping to conclusions | False assumptions |
| Trying to impose the nurse's own attitudes, values, beliefs, and moral standards on a pt about what is right and wrong | Approval or disapproval |
| Stereotyped or superficial comments that do not focus on what the pt is feeling or trying to say | Automatic responses |
| Responding negatively to criticism; often in response to feelings of anger or hurt on your part; usually involves making excuses | Defensiveness |
| Challenging or arguing against the pt's statments or perceptions | Arguing |
| Asks the pt to explain his or her actions, beliefs, or feelings with "why" Qs | Asking for explanations |
| Inappropriately focusing the discussion on something other than the pt's concern | Changing the subject |
| Responses that block communication | -False reassurance
-giving advise or personal opinions
-false assumptions
-approval or dissaproval
-automatic responses
-defensiveness
-arguing
-asking for explanations
-changing the subject |
| A deficit or absent language function that results from ischemic insult to the brain, sucha as stroke(cerebrovascular accident), brain injury, or anoxia | Aphasia |
| Pt that are unable to send the desired verbal message | Expressive aphasia |
| Pt with an inability to recognize or interpret the verbal message being received | Receptive aphasia |
| Messages placed at intervals around the clock face; clock hand scans the messages, and the ptpresses buttons to stop the hand on the desired message | Clock face communicator |
| Pt uses keyboard or type messages | Computer-assisted communication |
| Predetermined system in which the number of times a pt blinks in response to a Q indicates yes/no | Eye blinks |
| Pt mouths words to be interpreted by the receiver | Lip-reading |
| Pt moves letters around on board to spell words or phrases | Magnetic board w/plastic letters |
| Pt points to pictures on a board or poster of typical pt needs | Picture board |
| Pt writes messages or communicates needs w/writing | Pencil/paper, magic erase board |
| Hand and finger symbols used to indicate letters; used throughout the world for hearing-impaired pts | sign language |
| 3x5 cards w/words or pictures on them | word or picture cards |
| Alternative Methods of communicating with pt who are unable to speak | -clock face communicator
-computer-assisted communication
-eye blinks
-lip-reading
-magnetic boards w/plastic letters
-lip reading
-paper/pencil, magic erase
-picture board
-sign language
-word/picture cards |
