1
Chapter 3 Communication and Collaboration
Communication and Collaboration
Communication
• Interaction between two or more people
• Sender
• Receiver
Verbal Communication
➢ Verbal
o Spoken and written
o Tone, volume, and cadence of voice
➢ What cultural differences might the nurse encounter?
➢ What is an example of a communication barrier?
➢ How does developmental level affect verbal communication?
Nonverbal Communication
o Body movement
o Appearance
o Personal space
o Touch
Patient-Centered Care
o Improves communication
o Promotes patient involvement in care
o Creates positive relationships with nurse
o Results in treatment compliance
o Include patients/family in collaboration
o Respect cultural differences
Evidence-Based Practice
❖ Children and adolescents with cancer
o Use communication strategies
❖ Mentally ill patients
o Information and technology promotes compliance
❖ Cancer patients
o Effective communication helps reduce psychological stress
❖ Older adults
o Establish interpersonal connections
❖ Printed materials
o Results in behavioral changes
,2
❖ Collaborate and communicate
o Ensures appropriate exchange of information and coordination of care
Safety Guidelines
Establishing the Nurse-Patient Relationship Skill 3-1
o Goal of therapeutic communication: to promote wellness and personal growth in patients
o When is personal self-disclosure appropriate?
Nurse-Patient Relationship
❖ What does empathy mean?
❖ Why are open-ended questions useful?
❖ Describe components of the three phases that characterize the nurse-patient relationship:
o Orientation
o Working
o Termination
Delegation and Collaboration
❖ The skill of establishing therapeutic communication cannot be delegated to nursing assistive
personnel (NAP)
❖ The nurse directs NAP about:
• Proper interaction
• Patient confidentiality
• Arrangement of the environment
• Special considerations
Recording and Reporting
,3
Special Considerations
❖ Teaching
• Use gestures, pictures, role playing
• Individualize patient teaching
❖ Pediatric
• Understand child’s feelings and thought processes
• Use age-appropriate communication techniques
❖ Gerontological
o Be aware of impairment
o Avoid stereotyping
❖ Home care
o Adjust techniques for patient’s primary caregiver
o Incorporate communication into daily activities
Communicating with Patients Who Have Difficulty Coping Skill 3-2
❖ Goal: help patient decrease/manage ineffective coping through effective communication
❖ Four stages of anxiety
• Mild, moderate, severe, panic
❖ Anger de-escalation
❖ Depression
Delegation and Collaboration
❖ The skill of communicating with an anxious patient cannot be delegated to NAP
❖ The nurse instructs NAP about:
• Needed communication skills for anxious or depressed patients
• Their role when the nurse uses de-escalation techniques
• Safety measures
Recording and Reporting
Special Considerations
❖ Teaching
• Identify sources of anxiety
• Identify contributing factors to angry outbursts
• Coping skills for anger
• Identify sources of depression
❖ Pediatric
, 4
• Anxiety signs are physical/behavioral
• Set limits for inappropriate behavior
• Symptoms of depression are different than adults
❖ Gerontological
• Anxiety is common
• Socially isolated adults are more likely to be anxious/depressed
• Higher suicide risk
❖ Home care
• Anticipation of home care visit can increase patient anxiety
• Personal nurse safety
• Manage depression based on presenting behaviors
Communicating with a Cognitively Impaired Patient Skill 3-3
❖ Goal: communicate with cognitively impaired patients creatively and clearly to ensure that messages
are sent and received
❖ Types of cognitive impairment
• Acute
• Chronic
Delegation and Collaboration
❖ De-escalation is a skill that cannot be delegated to NAP
❖ The nurse instructs NAP about:
• Proper communication skills to interact with the cognitively impaired patient
• Signs and symptoms of cognitive impairment
Recording and Reporting
Special Considerations
❖ Teaching
• Use various methods for communication
• Modify teaching according to patient’s cognitive status
❖ Pediatric
• Impairments may be metabolic or neurological
• Consider developmental level when communicating
❖ Gerontological
Chapter 3 Communication and Collaboration
Communication and Collaboration
Communication
• Interaction between two or more people
• Sender
• Receiver
Verbal Communication
➢ Verbal
o Spoken and written
o Tone, volume, and cadence of voice
➢ What cultural differences might the nurse encounter?
➢ What is an example of a communication barrier?
➢ How does developmental level affect verbal communication?
Nonverbal Communication
o Body movement
o Appearance
o Personal space
o Touch
Patient-Centered Care
o Improves communication
o Promotes patient involvement in care
o Creates positive relationships with nurse
o Results in treatment compliance
o Include patients/family in collaboration
o Respect cultural differences
Evidence-Based Practice
❖ Children and adolescents with cancer
o Use communication strategies
❖ Mentally ill patients
o Information and technology promotes compliance
❖ Cancer patients
o Effective communication helps reduce psychological stress
❖ Older adults
o Establish interpersonal connections
❖ Printed materials
o Results in behavioral changes
,2
❖ Collaborate and communicate
o Ensures appropriate exchange of information and coordination of care
Safety Guidelines
Establishing the Nurse-Patient Relationship Skill 3-1
o Goal of therapeutic communication: to promote wellness and personal growth in patients
o When is personal self-disclosure appropriate?
Nurse-Patient Relationship
❖ What does empathy mean?
❖ Why are open-ended questions useful?
❖ Describe components of the three phases that characterize the nurse-patient relationship:
o Orientation
o Working
o Termination
Delegation and Collaboration
❖ The skill of establishing therapeutic communication cannot be delegated to nursing assistive
personnel (NAP)
❖ The nurse directs NAP about:
• Proper interaction
• Patient confidentiality
• Arrangement of the environment
• Special considerations
Recording and Reporting
,3
Special Considerations
❖ Teaching
• Use gestures, pictures, role playing
• Individualize patient teaching
❖ Pediatric
• Understand child’s feelings and thought processes
• Use age-appropriate communication techniques
❖ Gerontological
o Be aware of impairment
o Avoid stereotyping
❖ Home care
o Adjust techniques for patient’s primary caregiver
o Incorporate communication into daily activities
Communicating with Patients Who Have Difficulty Coping Skill 3-2
❖ Goal: help patient decrease/manage ineffective coping through effective communication
❖ Four stages of anxiety
• Mild, moderate, severe, panic
❖ Anger de-escalation
❖ Depression
Delegation and Collaboration
❖ The skill of communicating with an anxious patient cannot be delegated to NAP
❖ The nurse instructs NAP about:
• Needed communication skills for anxious or depressed patients
• Their role when the nurse uses de-escalation techniques
• Safety measures
Recording and Reporting
Special Considerations
❖ Teaching
• Identify sources of anxiety
• Identify contributing factors to angry outbursts
• Coping skills for anger
• Identify sources of depression
❖ Pediatric
, 4
• Anxiety signs are physical/behavioral
• Set limits for inappropriate behavior
• Symptoms of depression are different than adults
❖ Gerontological
• Anxiety is common
• Socially isolated adults are more likely to be anxious/depressed
• Higher suicide risk
❖ Home care
• Anticipation of home care visit can increase patient anxiety
• Personal nurse safety
• Manage depression based on presenting behaviors
Communicating with a Cognitively Impaired Patient Skill 3-3
❖ Goal: communicate with cognitively impaired patients creatively and clearly to ensure that messages
are sent and received
❖ Types of cognitive impairment
• Acute
• Chronic
Delegation and Collaboration
❖ De-escalation is a skill that cannot be delegated to NAP
❖ The nurse instructs NAP about:
• Proper communication skills to interact with the cognitively impaired patient
• Signs and symptoms of cognitive impairment
Recording and Reporting
Special Considerations
❖ Teaching
• Use various methods for communication
• Modify teaching according to patient’s cognitive status
❖ Pediatric
• Impairments may be metabolic or neurological
• Consider developmental level when communicating
❖ Gerontological
