NRSG 110- Exam 4

The process exchanging information and generating and transmitting meanings between two or more individuals - communication What are the elements of the communication process? - 1. source (encoder) 2. message 3. channel 4. receiver (decoder) The communication process is initiated based on a ___, in this case a patient needs that must be addressed. - stimulus The ___ of the message is the person or group who initiates or begins the communication process - source (encoder) The ___ is the actual communication product from the source; speech, interview, conversation, chart, gesture, memorandum, or nursing note. - message The ___ of communication is the medium the sender has selected to send the message - channel Messages can be sent to the receiver through the following channels: - 1. auditory 2. visual 3. kinesthetic Channel; spoken words and cues - auditory Channel; sight, observations and perception - visual Channel; touch - Kinisthetic The ___ must translate and interpret the message sent and received. - receiver (decoder) Confirmation of a message provides ___ (i.e. evidence) that the receiver has understood the intended message - feedback Factors that distort the quality of a message - noise ___ is an exchange of information using words, including both the spoken and written word. - verbal communication Verbal communication depends on ___, or a prescribed way of using words so that people can share information effectively; includes a common definition of words and a method of arranging the words in a certain way - language The transmission of information without the use of words is termed ___, also known as body language. - nonverbal communication Information is exchanged through nonverbal communication in various ways. It is generally accepted that nonverbal communication expresses more of the true meaning of a message than verbal communication. What are the different forms? - touch eye contact facial expression posture gait gestures personal appearance dress/grooming sounds silence ___ is viewed as one of the most effective nonverbal ways to express feelings or comfort, love, affection, security, anger, frustration, aggression, excitement and many others. - touch Communication often begins with ___. In many cultures this suggest respect and a willingness to listen and to keep communication open; it's absence often indicates anxiety or defenselessness, or avoidance of communication; Asian and Native American cultures consider this invasion of someone's privacy - eye contact The face is the most expressive part of the body. Examples of the various messages ___ conveys are anger, joy, suspicion, sadness, fear, and contempt. - facial expressions The way a person holds and positions the body; people in good health with a positive attitude usually hold their bodies in good alignment; depressed / tired people slouch; provides nonverbal cues concerning pain and physical limitation - posture Certain ___ are associated with illness. For example, patients recovering from recent abdominal surgery usually walk slightly bent over, slowly, and might needs assistance - gait ___ using various parts of the body can carry numerous messages; thumbs up = victory; kicking an object = anger; often used extensively when two people speaking in different languages attempt to communicate with each other - gestures Most illnesses cause at least some alterations in ___. Observing for changes in appearance is an important nursing responsibility for detecting illness or evaluating the effectiveness of care and therapy. Ex: dull sunken eyes = poor muscle tone; skin that wrinkles easily = dehydration. On the other hand good health tends to radiate healthy status through general appearance. - general physical appearance A person's ___ practices carry significant nonverbal messages. For example, healthy people pay attention to details of dress and grooming, whereas people feeling ill show little interest in appearance. - dress/grooming Crying, moaning, gasping and sighing are oral but nonverbal forms of communication. Such ___ can be interpreted in numerous ways. Ex: Crying = sadness or joy; Sigh = reluctant or relief - sounds Periods of ___ during a conversation often carry important nonverbal messages. Might indicate complete understanding of each other or angry with each other. - Silence ___ are web-based technologies that allow users to create, share, and participate in dialogue in virtual communities and networks; Avoid posting anything that will be considered a HIPPA violation - social media What are the levels of communication? - Intrapersonal communication Interpersonal communication Group communication ___, or self talk, is communication within a person. This communication is crucial because it affects the nurse's behavior and can enhance or detract from positive interactions with the patient and family. Avoid negative self talk. - intrapersonal communication ___ occurs between two or more people with a goal to exchange messages. Most of the nurses's day is spent communicating with patients, family members and members of HC team. - Interpersonal communication ___ includes small group and organization group communication. - group communication ___ communication occurs when nurses interact with two or more people. To be functional members must communicate to achieve same goal. Ex. staff meetings, patient care conferences, teaching sessions, support groups. - Small-group ___ communication occurs when people and groups within an organization communicate to achieve established goals. Ex: nurses on a practice council meeting to review unit policies, nursing working with interdisciplinary groups on strategic planning or quality assurance, use this to achieve their aims. - organization ___ involve how individual group members relate to one another during the process of working towards the group goals. - group dynamics Please list some factors that influence communication? - developmental level gender sociocultural differences roles/responsibilities space/territoriality physical, mental & emotional state values environment SBAR which stands for ___, provides a consistent method for hand-off communication that is clear, structured, and easy to use. The S&B provide objective data whereas the A&R allow for presentation of subjective data. Shift reports, conversations with physicians and transfers of patients - Situation Background Assessment Recommendation I-SBAR-R. Allows a nurse to clearly introduce oneself and the patient when communicating with a caregiver during patient hand-offs or conversations with physicians. - Introduce Self Situation Background Assessment Recommendation Readback A ___ exists among people who provide and receive assistance in meeting human needs. It sets the climate for the participants to move towards common goals; Relationship between nurses and patients - helping relationship What are characteristics of helping relationship? - dynamic purposeful and time limited What are the 3 phases of a helping relationship? - 1. Orientation phase 2. Working phase 3 Termination Phase In the ___ phase the tone and guidelines for the relationship are established. In this phase roles are clarified, agreement or contract established, patient provided with an orientation. - Orientation ___ Phase of Helping Relationship: - patient will call the nurse by name - patient will accurately describe the roles of the participants in the relationship - patient and nurse will establish an agreement about goals, location, frequency and length of the contact and duration of relationship. - Orientation The ___ is usually the longest phase of the helping relationship. During this phase the nurse works together with the patient to meet the patient's physical and psychological needs. Interaction is the essence of this phase. - Working ___ phase of helping relationship: - patient will actively participate in relationship - patient will cooperate in activities that work toward achieving mutually acceptable goals - patient will express feelings and concerns to the nurse - work together - assist with goal achievement - teach & counsel - working The ___ phase occurs when the conclusion of the initial agreement is acknowledged. This might happen at change of shift time, patient being discharged, or when a nurse leaves on vacation or for employment elsewhere - Termination ___ phase of helping relationship: - patient will participate in identifying goals accomplished or the progress made towards the goals patient will verbalize feelings about the termination of the relationship - examine goal attainment - make suggestions - express emotions - termination ___ is identifying with the way another person feels. - empathy A ___ is a characteristic or customary way of behaving. Nurses who consistently demonstrate warmth and friendliness, openness and rapport, empathy, honest, authenticity and trust, caring and competence and genuineness are well disposed to communicate effectively. - dispositional traits ___, a feeling of mutual trust experienced by people in a satisfactory relationship , facilitates open communication. This can be achieved by paying attention to the following variables: specific objectives, comfortable environment, privacy, confidentiality, patient vs. task focus, using nurse observations, optimal pacing and providing personal space. - rapport What are the communication skills needed to develop therapeutic communication? - Conversation Listening Silence Touch Humor ___ Skills: - Control the tone of your voice; tone should indicate interest rather than boredom, patience rather than anger, acceptance rather than hostility - Be knowledgeable about topic of conversation and have accurate information - Be flexible - Be clear and concise - Avoid words that might have different interpretations - Be truthful - Keep an open mind - Take advantage of available opportunities - Conversation ___ Skill: - Involves both hearing and interpreting what the other says. Requires attention and concentration - When possible, sit when communicating with a patient, do not cross arms or legs - Be alert and relaxed - Keep the conversation as natural as possible - If culturally appropriate, maintain eye contact - Use appropriate facial expressions to indicate you are paying attention - Think before responding - Do not pretend to listen - Listen for themes of the patient's comments - Listening ___ Skills: - This can be used appropriately to wait for the patient to initiate or to continue speaking. - Periods of this can carry a variety of meanings, including the following: * Patient comfortable and content in nurse-patient relationship, continuous talking is unnecessary * The patient might be trying to demonstrate stoicism an the ability to cope without help * Patient's culture may require longer pauses * Patient might be angry * Patient might be fearful * Patient may need some time to think - Silence ___ (Communication Skill): - powerful means of communication with multiple meanings - can connect people, provide affirmation, reassurance and stimulation; decrease loneliness, increase self esteem and share warmth, intimacy, approval, and emotional support - Touch ___ (Communication Skill): - Increasingly valued as both an interpersonal skill for the nurse and a healing strategy for patients. - Can be used effectively to maintain a balanced perspective in their work and to encourage patients to do the same - Be aware of how various cultures perceive the use of this in the presence of illness - Know limitations - Humor During the interview, you'll use ___ to obtain needed information while remaining flexible in approach. - interviewing techniques Which interview technique? when obtaining a nursing history, use ___ to allow the patient a wide range of possible responses. Ex. What did your physician tell you about your need for this hospitalization? - open ended questions Which interview technique? the ___ provides the receiver with limited choices of possible responses and might often be answered by one or two words, "yes" or "no." Used to gather specific information from a patient and the allow the nurse and patient to focus on a particular area. Often a barrier to effective communication. Ex. What medicines have you been taking at home? - closed question Which interview technique? This type of question or comment serves to ___ what the nurse believes he or she has heard or observed; Understood what was said Ex. At home, you have been taking both a water pill and a blood pressure pill every day. Did you take them today? - Validating Which interview technique? The use of the ___ question or comment allows the nurse to gain an understanding of a patient's comment; Additional information is needed Ex. Is this the first health problem you have had? - Clarifying Which interview technique? The ___ question technique involves repeating what the person has said or describing the person's feelings. Encourages patient's to elaborate. Ex. Patient: I've been really upset about my blood pressure and have to take these pills Nurse: You've been upset... - Reflective Which interview technique? ___ is used to place events in chronological order or to investigate a possible cause and effect relationship between events. Ex. Your tiredness began after you started taking your medicine? - Sequencing