Communication and Nursing Practice

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Questions and Answers

In the context of nursing, how does effective communication most directly contribute to patient care?

  • By prioritizing hospital administrative needs over direct patient interaction to optimize resource allocation.
  • By limiting patient input to streamline the care process, thereby reducing nurse workload.
  • By establishing nurse-patient relationships and facilitating patient-centered care, minimizing potential errors. (correct)
  • By ensuring all patients receive the same standardized treatment regardless of their individual needs.

A nursing instructor is teaching students about demonstrating caring to patients. Which action, if performed by a student nurse, would the instructor identify as the most representative of this concept?

  • Providing detailed explanations of the patient's diagnosis and treatment plan during discharge.
  • Administering medications on time to adhere to the prescribed treatment schedule.
  • Ensuring all documentation is accurate and up-to-date to facilitate efficient care coordination.
  • Actively engaging with the patient to understand their feelings and providing comfort and support. (correct)

Which strategy best enables nurses to apply theoretical knowledge effectively in patient interactions?

  • Prioritizing personal communication preferences to build rapport with patients.
  • Focusing on efficient task completion to manage time constraints in a fast-paced environment.
  • Employing critical thinking to integrate communication theories with insights gained from clinical experience. (correct)
  • Relying strictly on established protocols to minimize variability in care delivery.

In a team meeting, nurses are discussing ways to improve patient rounding efficiency. Which approach best balances efficiency with personalized patient care?

<p>Using bedside shift reports to facilitate focused communication about patient needs and concerns. (C)</p> Signup and view all the answers

Which of the following best illustrates the ‘referent’ element in the communication process within a healthcare setting?

<p>The patient's expressed request for pain medication due to post-operative discomfort. (A)</p> Signup and view all the answers

Considering the elements of the communication process, what demonstrates the most effective use of 'feedback' by a healthcare provider?

<p>A physical therapist demonstrates an exercise, then asks the patient to repeat it to ensure understanding. (A)</p> Signup and view all the answers

What is the most important aspect of considering vocabulary in verbal communication within healthcare?

<p>Adapting language to suit the patient's level of understanding and cultural background. (A)</p> Signup and view all the answers

In a culturally diverse healthcare setting, how should a nurse balance the need for clarity and brevity in communication?

<p>Adjusting communication style to cultural norms and language proficiency of the patient. (A)</p> Signup and view all the answers

How should a nurse use personal appearance as a nonverbal communication tool to build trust with patients?

<p>Ensuring attire is clean, professional, and appropriate to convey competence and respect. (D)</p> Signup and view all the answers

What action by a nurse best demonstrates active listening in a patient interaction?

<p>Maintaining eye contact, nodding, and summarizing the patient's statements to confirm understanding. (D)</p> Signup and view all the answers

During the orientation phase of a therapeutic relationship, which approach is most effective for a nurse to build trust with a patient?

<p>Clearly outlining the roles, responsibilities, and expectations of both the nurse and the patient. (D)</p> Signup and view all the answers

A nurse is attempting to apply motivational interviewing with a patient struggling to adhere to a new dietary regimen. What reflects the most effective approach?

<p>Collaboratively exploring the patient's feelings and reasons for resistance, focusing on their personal goals. (C)</p> Signup and view all the answers

When using SBAR to communicate a patient's condition to a physician, what step is most crucial for ensuring an effective conversation?

<p>Clearly stating a targeted recommendation based on the situation analysis. (B)</p> Signup and view all the answers

During a rapid response event, a nurse uses SBAR to communicate critical information about a patient to the responding team. Which component of SBAR is demonstrated when the nurse states, 'I believe the patient is experiencing a pneumothorax and needs immediate evaluation'?

<p>Assessment (A)</p> Signup and view all the answers

A nurse is caring for a patient who constantly expresses feelings of hopelessness and despair. Which therapeutic communication technique would best support this patient?

<p>Validating the patient's feelings while gently instilling hope by highlighting their strengths and past successes. (A)</p> Signup and view all the answers

When managing end-of-life discussions, a nurse is faced with a conflict between the patient's desire for comfort measures only and the family's insistence on aggressive treatment. Which ethical principle should guide the nurse's actions?

<p>Autonomy, by respecting the patient's right to make decisions about their care, even if conflicting with family wishes. (B)</p> Signup and view all the answers

During a patient's admission interview, the patient states, “I’m really worried about how I’m going to afford my medications.” What is the most appropriate initial nursing response that applies the technique of paraphrasing?

<p>“So, you're concerned about the financial burden of your medications?” (A)</p> Signup and view all the answers

A nurse is caring for a patient from a different cultural background who is visibly upset but refuses to make eye contact. Understanding cultural differences, what is the most appropriate nursing intervention?

<p>Modifying communication techniques to reduce directness and respect the patient's cultural norms. (A)</p> Signup and view all the answers

What nursing action best demonstrates the ethical principle of veracity in patient care?

<p>Revealing the complete details of a terminal diagnosis to a patient, despite knowing it might cause distress. (A)</p> Signup and view all the answers

In a situation where a patient is competent to make decisions but refuses a life-saving intervention, what is the nurse's primary ethical responsibility?

<p>To respect the patient’s autonomy and ensure the decision is informed, offering support without coercion. (B)</p> Signup and view all the answers

A nurse suspects a colleague is diverting narcotics but is unsure of the facts. What demonstrates the most appropriate course of action?

<p>Reporting the concern to the nurse manager or appropriate authority, adhering to institutional policies and ethical guidelines. (B)</p> Signup and view all the answers

A nurse is providing care to an undocumented immigrant who does not speak the same language. What strategy best ensures effective communication despite language barriers?

<p>Using professional interpreter services to facilitate accurate and respectful communication. (A)</p> Signup and view all the answers

During a home visit, a nurse observes that a patient's living conditions are unsanitary and potentially harmful to their health. What is the nurse's ethical obligation?

<p>To educate the patient on safer living conditions while respecting their autonomy and cultural values. (B)</p> Signup and view all the answers

What patient care situation best demonstrates the nurse's role in upholding the ethical principle of justice?

<p>A nurse allocates resources and attention equally among all patients, regardless of their socioeconomic status or background. (C)</p> Signup and view all the answers

A nurse uses a shared treatment decision-making approach to assist a patient in selecting the best therapeutic measure for a health problem. How does the nurse apply the ethical principle of autonomy?

<p>By providing the patient with all of the options and supporting them as they decide what treatment course is best for them. (C)</p> Signup and view all the answers

A charge nurse on a busy hospital floor sees that one of the nurses is having difficulty with time management. Patients assigned to that nurse have not been having their needs met in a timely manner. Which of the following interventions by the charge nurse would align with the ethical principle of fidelity?

<p>Talk to the nurse to find out their stressors and provide teaching as needed so the patients' needs may be better met. (C)</p> Signup and view all the answers

A mother brings her child to the Emergency Department. She states that she is aware he needs a blood transfusion, but as a Jehovah's Witness she refuses to allow him to have one. The health care workers know he will likely die without the transfusion. How should the health care team respond?

<p>You should seek a guardian ad litem so that the child will live. (A)</p> Signup and view all the answers

A nurse on a cardiac floor goes to lunch with a friend. During their conversation, her friend asks her patient questions such as which patients are difficult so that she knows who to avoid if she is ever hospitalized. What ethical principle did the nurse violate?

<p>Confidentiality (D)</p> Signup and view all the answers

You are caring for a transgender patient. Your agency is short on rooms so you are deciding whether to place them on the women's floor or the men's floor. As a leader, what would be the most appropriate action?

<p>Place them where you would want to be depending on how you identify. Be an advocate and provide them with the choice to make the decision. (A)</p> Signup and view all the answers

Which of the following are aspects of cultural competence?

<p>cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. (B)</p> Signup and view all the answers

What defines cultural awareness?

<p>Cultural awareness is the self-examination of one's biases toward other cultures and an in-depth exploration of one's own cultural and professional background. (B)</p> Signup and view all the answers

A nurse encounters the need to gather information for a patient's nursing history. While collecting a patient history, which of the following skills would be beneficial?

<p>Providing language assistance, inform of the availability of language assistance, ensure competence of those providing language assistance, and provide multimedia materials in languages. (C)</p> Signup and view all the answers

While acting as a leader, you note that one of your team members is not completing tasks for patients of a specific nationality. What should you do?

<p>Talk to your team member and explain to them their personal experiences and explain the importance of interacting. (B)</p> Signup and view all the answers

Which of the following is an example of the implementation of the ethical principle of beneficence?

<p>Prioritizing pain management interventions and administering prescribed medications in a timely manner to relieve patient suffering and improve comfort. (A)</p> Signup and view all the answers

What are some examples of nontherapeutic communication techniques that a person should not use?

<p>Asking personal questions and providing personal opinions (A)</p> Signup and view all the answers

During preinteraction what is one action that should be done?

<p>Gather information prior to meeting the client. (B)</p> Signup and view all the answers

During which phrase are goals being planned?

<p>Plan (A)</p> Signup and view all the answers

A nurse is preparing to use SBAR to communicate a patient's deteriorating condition to a physician. Which action exemplifies the most effective 'Situation' component?

<p>Clearly and concisely stating the patient’s current critical vital signs and immediate concerns. (C)</p> Signup and view all the answers

A nurse is engaging in motivational interviewing with a patient who is ambivalent about adhering to a complex medication regimen. What approach would most effectively foster the patient's intrinsic motivation for adherence?

<p>Exploring the patient's own reasons for and against adherence, and supporting their self-identified goals. (C)</p> Signup and view all the answers

During a multidisciplinary team meeting, a conflict arises regarding a patient’s plan of care. To promote a collaborative environment, which communication strategy should the nurse prioritize to reconcile the differing viewpoints?

<p>Actively listening to each team member's concerns, seeking clarification, and identifying common goals. (D)</p> Signup and view all the answers

A patient with limited health literacy is preparing for discharge after a complex surgical procedure. Which nursing intervention would most effectively ensure the patient’s comprehension of crucial post-operative care instructions?

<p>Employing the ‘teach-back’ method, where the patient demonstrates their understanding of specific instructions. (B)</p> Signup and view all the answers

A nurse is communicating with a patient who has a different cultural background than their own. What action best demonstrates cultural sensitivity and enhances effective communication?

<p>Adapting communication strategies to match the patient's cultural values, beliefs, and communication styles. (A)</p> Signup and view all the answers

In advocating for a patient’s end-of-life preferences, a nurse encounters resistance from family members who insist on aggressive treatment against the patient’s documented wishes. Which ethical principle should primarily guide the nurse's actions?

<p>Autonomy (C)</p> Signup and view all the answers

A nurse suspects that a colleague is consistently providing inadequate pain management, potentially causing unnecessary suffering to patients. What action demonstrates the nurse's primary ethical responsibility in this situation?

<p>Documenting specific instances of inadequate pain management and reporting the concerns through appropriate channels. (A)</p> Signup and view all the answers

During a patient interaction, a nurse notices the patient is avoiding eye contact and has closed body language. How might the nurse adapt their communication style to establish greater trust?

<p>By using open-ended questions and respecting the patient's need for personal space and comfort. (D)</p> Signup and view all the answers

A nursing unit is implementing strategies to improve interprofessional communication. Which approach would most effectively foster a culture of mutual respect and shared decision-making?

<p>Creating regular forums for open dialogue, shared goal-setting, and collaborative problem-solving. (B)</p> Signup and view all the answers

Following a critical incident, a healthcare team is conducting a debriefing session. What strategy would best promote honesty and psychological safety during the discussion?

<p>Establishing a non-punitive environment that encourages open sharing of concerns and lessons learned. (C)</p> Signup and view all the answers

Flashcards

Communication

A lifelong learning process that is essential for establishing nurse-patient relationships, reducing errors and maintaining effective relationships.

Therapeutic communication

Communication that promotes personal growth and helps patients reach their health-related goals.

Nursing caring

Demonstrating caring by being with, doing for, and enabling patient well-being.

Intrapersonal communication

Conscious internal dialogue, sometimes positive or negative.

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Interpersonal communication

Communication between two or more people.

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Small group communication

Communication with many people at the same time.

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Public communication

Unique form of group communication.

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Referent

Motivates one to communicate with another.

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Sender and receiver

One who encodes and decodes the message.

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Message

The content of the message.

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Channels

Means of conveying and receiving messages.

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Feedback

Message the receiver returns.

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Interpersonal variables

Factors that influence communication.

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Environment

The setting for sender-receiver interactions.

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Verbal communication

Use of words and their meaning during communication.

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Denotative/Connotative

Meaning of words.

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Pacing

Rate of speech.

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Intonation

Tone of voice.

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Clarity & brevity

Clear, simple and direct communication.

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Timing & relevance

Appropriate moment for communication.

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Nonverbal communication

Non-spoken communicaton.

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Caring relationships

Therapeutic relationship foundation.

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Preinteraction phase

Nurse gathers client information.

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Orientation phase

Meeting and establishing rapport.

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Working phase

Part of nurse relationship.

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Termination phase

End of relationship.

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Motivational interviewing

Encourages sharing thoughts and fears.

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Nurse-family relationships

One on one helping.

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Team relationships

Affects safety/environment.

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SBAR

Tool gives important info.

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Courtesy

Professional communication elements.

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Use of names

Helps building relationship.

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Trustworthiness

Important when building

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Autonomy & responsibility

Independent ethical decisions.

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Assertiveness

Confidently stands up

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Communication barriers.

Diagnose communicate.

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Involve family

Includes family in plan.

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Active listening

Important therapeutic communication.

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Share empathy

Share empathy when dealing

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Sharing hope

Optimism.

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Humor

Gives the patient support.

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Using touch

Shows caring

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Using silence

Allows to come up with response.

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Providing information

Clear, correct health.

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Clarifying

Correct any misunderstand.

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Purpose of ethical principles

Ethical principles function.

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Beneficence

Making ethical based decision.

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Nonmaleficence

Do no harm.

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Veracity

Ethical truth telling manner.

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Fidelity

Meeting commitments.

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Study Notes

Communication and Nursing Practice

  • Communication is an ongoing learning experience.
  • Effective communication forms the basis for nurse-patient relationships.
  • Patient-centered care is facilitated through good communication.
  • Reduced errors and maintained relationships are benefits of communication.
  • Therapeutic communication enables personal growth.
  • Patients’ health goals are achieved through therapeutic communication.

Communication and Interpersonal Relationships

  • Caring is shown when nurses are present, supportive, and empowering.
  • Sensitivity and support for oneself and others are essential.
  • Presence and positive/negative feeling expression should be encouraged.
  • Establishing caring relationships is an important aspect of nursing.
  • Hope and faith should be instilled by the nurse.
  • Teaching and learning should be promoted interpersonally.
  • Providing supportive nursing care addresses patient needs.
  • Nurses should show respect and allow for spiritual expression.

Developing Communication Skills

  • Nurses who possess critical thinking skills are often effective communicators.
  • Gathering thorough patient information begins with therapeutic relationships.
  • Combining theoretical knowledge with clinical experience improves communication.
  • Patient understanding, accurate information, and care planning are achieved by interpreting messages.

Levels of Communication

  • Intrapersonal communication refers to internal dialogue or self-talk, which can be either helpful or harmful.
  • Interpersonal communication occurs between two or more individuals.
  • Small group communication involves simultaneous interaction among multiple people.
  • Public communication describes a distinct type of group interaction.
  • Electronic communication represents another level.

Elements of the Communication Process

  • Referent: Motivates communication.
  • Sender and receiver: Those who encode and decode the message.
  • Message: Content being conveyed.
  • Channels: How messages are conveyed and received.
  • Feedback: The receiver's response.
  • Interpersonal variables: Factors that influence communication.
  • Environment: The context of the communication.

Forms of Communication

  • Verbal communication includes: vocabulary, denotative/connotative meaning, pacing, intonation, clarity, brevity, timing and relevance
  • Nonverbal communication includes: Appearance, posture, gait, expressions, eye contact, gestures, sounds, and territoriality.

Professional Nursing Relationships

  • Caring relationships with patients is the base of nursing because they are formed on skill and trust
  • The four phases of the helping relationship are:
  • Preinteraction: Information gathering.
  • Orientation: introductions and establishing trust.
  • Working: Active engagement in the relationship.
  • Termination: End of shift or discharge of patient.
  • Encouraging the sharing of thoughts and feeling is motival intervieweing
  • Family relationships use those same principles as the patient
  • Impacts to the work emvironment and patient saftey will come from effective health team relations
  • Hand off reports and SACCIA/SBAR

SBAR

  • SBAR is a tool to reduce the threat of ineffective communication.
  • SBAR is used to to communicate important information in a short amount of time
  • Key communication issues are the cause of sentinel events in hospitals
  • Exchanging information between nurses and physicians prevents medical errors and promotes a safe environment.

Elements of Professional Communication

  • Courtesy
  • Use of names
  • Trustworthiness
  • Autonomy and responsibility
  • Assertiveness

Nursing Process

  • Assessment- factors to review-Physical, emotional, developmental, sociocultural and gender
  • Communication Barriers- Difficult coping, powerlessness and impaired socialization all contribute
  • Planning- Involve the family. Allow adequate time for practice , Set goals and outcomes that will be specific and measureable. Prioritize teamwork and collaboration to be effective.
  • Implementation using communication techniques of active listening, non verbal and verbal with empathy, humor, sharing hope, feelings and touch.
  • Therapeautic communication includes-Providing information, Clarifying, Focusing,Paraphrasing, Validation,Asking relevant questions,Summarizing,Self-disclosure and Confrontation
  • Non-theraputic -Asking personal questions,Giving personal opinions,Changing the subject,Automatic responses,False reassurance,Sympathy, Asking for explanations,Approval or disapproval,Defensive responses,Passive or aggressive responses,Arguing
  • adapt for special needs

Ethical Principles

  • The purpose of ethical principles is to:
  • Establish common ground for discussions.
  • Allow people to keep certain positions.
  • Set an analytical framework for evaluating issues

Ethical Principles (cont'd)

  • Nurses are responsible for:
  • Respect, truth, agreements, and being judmental

Cultural Awareness and Knowledge

  • Include in your history the summary of all domains Collecting a patient history by providing language assistance
  • Asses literacy and understand if they can obtain healthcare/treatment
  • Be culturally sensitive

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