Chapter 4
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| 🇬🇧 | 🇬🇧 |
| Communication | Can be describer simply as the exchange of information |
| Sender | The one who conveys the message |
| Receiver | 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) |
| Jargon | 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 |
| Gestures | Are movements people use to emphasize the idea they are attempting to communicate |
| Posture | 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 |
| Assertiveness | 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 |
| What is destructive and nontherapeutic | Agressive communication |
| 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) |
| Restating | Repeating to the patient what is believed to be the main point that the patient is trying to convey |
| Paraphrasing | Restatement of the patients message in the nurse own words in the attempt to verify that the nurse has interpreted the patient message correctly |
| Clarifying | 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 |
| Focusing | Is also used when more specific information is needed to understand the patients message accurately (message to vague) |
| Reflecting | 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 |
| Summarizing | 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 |
| What does total relaxation, slouching in chair convey | A message of disinterest |
| From face to about 18" away is what space | Intimate space |
| 18" to 4 feet away is what space | Personal space |
| 4-12 feet from a person is what space | Social space |
| Beyond 12 feet from a person is what space | Public space |
| 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) |
| Defensiveness | 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) |
| Arguing | 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 happens if nonverbal cues are inconsistent or incongruent with the verbal message | The non verbal message is most likely the one received |
| 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 |
| How does some cultures such as Latin American, asian, native North American,view eye contact | Impolite, aggressive, or improper |