Communication Process & Therapeutic Communication

Components of the Communication Process

• Sender, message, receiver, and feedback are components of the communication process.
• Client education is an application of communication, not a component itself.
• Encoding converts messages into an understandable format for the receiver, like words, gestures, or writing.
• Effective communication is achieved with the receiver's knowledge, clarity of message, and the sender's tone along with nonverbal cues.

Forms of Communication

• Facial expressions and touch exemplified nonverbal communication like facial expressions, gestures, posture, and touch.
• Such forms often convey more meaning than words.

Electronic Communication

• Refrain from using email to send sensitive patient information.
• HIPAA guidelines and facility policies should always be followed to maintain patient confidentiality.
• Email is not always secure

Therapeutic Communication

• Therapeutic communication includes active listening, using open-ended questions, and allowing silence for reflection.
• These methods help foster patient trust and understanding.
• Therapeutic communication does not include giving personal opinions.

Barriers to Communication

• Elderspeak makes older adults feel disrespected and infantilized.
• It involves patronizing speech patterns.
• Barriers include complex medical terminology, interruptions, and false reassurance.
• These hinder understanding and trust.
• Layman's terms and simple explanations improve comprehension when patients don't understand medical terms.

Therapeutic Communication Techniques

• Open-ended questions encourage detailed responses by prompting the patient to elaborate.
• When a patient expresses fear, encouraging them to share what scares them provides emotional support.
• Effective nurse-patient communication is promoted through active listening, appropriate silence, and clear information.

Professional Communication In Healthcare

• Assertive communication is the most effective style
• It is clear, respectful, and maintains professional boundaries.
• SBAR communication with a physician should include a clear recommendation for action
• The "R" in SBAR stands for "Recommendation."

Professional Boundaries

• Maintaining focus on a patient’s needs demonstrates professional boundaries.
• Professional boundaries ensures that care focuses on patient needs, not personal relationships.

Phases of a Helping Relationship

• The helping relationship begins with the orientation phase where trust and goals are established.
• During the working phase, the nurse implements interventions and assists the patient in meeting their goals.
• In the termination phase, the nurse summarizes progress made and prepares the patient for discharge.

Assertive vs. Nonassertive Communication

• Expressing feelings clearly while respecting both parties demonstrates assertive communication
• e.g. "I feel uncomfortable when you speak to me that way. Let's find a solution together."
• Characteristics of assertive communication include using "I" statements, maintaining eye contact and respecting the opinions of others

Communication in the Nursing Process

• An assessment phase collects data through interviews, observations, and history-taking.
• Effectiveness is determined by asking the patient to teach-back instructions.
• The method ensures patient understanding of information.

Special Communication Considerations

• Medical interpreters ensure precise translation for non-English speaking patients preventing miscommunication.
• Strategies for hearing-impaired patients include facing the patient, speaking clearly, and using written communication which enhances understanding.
• Avoid covering the mouth as it hinders lip-reading.
• Describing actions as well as surroundings is most helpful for visually impaired patients.
• For patients with expressive aphasia, use simple “yes” or “no” questions, to make responding easier.
• Short, simple sentences is most effective way to talk to a patient experiencing anxiety.
• Anxiety impairs comprehension

Nurse as Educator

• The primary teaching role is to help clients and families make informed health decision.
• Education should be continuous, individualized, and adapted to patient needs and preferences.
• Most important when planning a teaching session is assessing the client's readiness, ability and willingness to learn.
• Using visual aids, simple language, plus demonstrations improve comprehension for patients who have low literacy.
• To help clients focus, use a calm tone and short simple sentences.
• Clients with anxiety can have impaired learning.
• The best way to determine whether a patient at discharge understood the instructions is to watch as they repeat and demonstrate the instructions.
• Asking questions enables engagement and allows for the nurse to clarify when teaching a client about a new medication.
• Comprehension for clients who have hearing impairments can be ensured with visual aids and written instructions.
• Nurses offer patients options to support informed decision-making, instead of imposing personal beliefs when promoting health.
• Assessing the client's learning needs is the first thing when developing an education plan.
• The ideal teaching technique for visually impaired individuals includes using verbal instructions and tactile methods.
• Learning is promoted by the affective domain that includes emotions, attitudes, and motivation.
• Experiencing the physical aspect of the psychomotor domain assists diabetic clients practicing glucose use.
• Clients engage more when lessons are relevant to their daily lives for health education

Effective Online Health Information

• Sources ending in .gov, .org, or .edu are more likely to provide accurate, evidence-based health information.

Leader versus Manager

• Leaders inspire and influence, while managers focus on planning, organizing, and directing.
• Autocratic leadership is one where the leader has complete control, expects orders to be met and doesn't take staff input into consideration.
• Democratic leadership encourages the team in the decision-making and they promote collaboration.
• A transformational leader motivates team to achieve a common goal
• Key managerial functions are planning, organizing, leading, and controlling to ensure effective team performance.
• Informal leaders can influence through their knowledge, skills, and mentoring.
• Nurse managers ensure effective team performance and resource allocation as a main responsibility.
• Delegation is essential in nursing management, and requires delegating tasks to qualified staff.
• Essential characteristics are strong communication, combined with making strategic decisions.
• A laissez-faire leader gives little supervision which is what allows staff to manage themselves.
• A transactional leader focuses on rewarding employees for good performance while maintaining the structure.
• A leader managing change is best done when communicating with the staff clearly, combined with involving them in the process.
• Appropriate delegation based on staff competency is important in terms of workload and quality care.
• The five rights of delegation: include right task, right person, right circumstances, right communication, and right supervision.
• Leaders promote teamwork through open communication, along with encouraging collaboration and cooperation.

Nursing Delegation

• Nursing delegation involves transferring a task while the nurse retains patient outcomes accountability.
• RNs can assign CANs non-invasive tasks like assisting with bathing and hygiene.
• Improving efficiency and teamwork are key benefits when delegating nursing tasks.
• The delegatee must be competent to complete a delegated task safely.
• The five rights of delegation ensure proper steps in effective and safe delegating.
• Nurses must provide feedback with guidance to improve future task completion.
• LPNs can perform certain procedures such as wound dressing changes under supervision of a RN.
• Delegation should be decided based on patient needs, rather than to eliminate personal preference/avoidance.
• With delegation, the RN retains accountability that the task is done safely.
• Determining a delegatees level of training and competency is important to ensure appropriate knowledge and skillset.
• Pain assessment requires critical thinking, and cannot be assigned to unlicensed staff (UAP).
• Always seek assistance from experienced staff when unsure.
• Wound care is restricted for licensed nurses only.
• Evaluate tasks and determine the appropriate assignment based on what is both safe and delegated.
• Optimizes resources and maintains high-quality patient care.

Health, Wellness, and Illness

• WHO defines health as physical/mental and social well-being, as well as not being infirm.
• Primary prevention is demonstrated by promoting healthy eating as well as exercise.
• Genetic disposition is thought to be an internal part of health, beliefs and practices.
• Rehab is a level of tertiary intervention and prevention.
• The role performance model is when health is shown as the ability to fulfill different parts of society.
• Smoking is a modifiable Lifestyle factor that can be changed to prevent against disease.
• Routine cholesterol screenings is secondary prevention.
• Encouraging health promotion and enhancement includes behaviors that are both proactive and involve wellbeing.
• Perceived barriers decides if treatment and preventive actions are followed and implemented.
• When there is self-responsibility paired with growth, is when wellness is involved.
• Seeking encouragement from the healthcare provider is the medical care contact stage for illness.
• Having supernatural forces can show health based magic systems.
• Long-term disease management is something shown in various conditions like diabetes.
• Determining readiness for behavior requires changing the nurses assessment.
• To have wellness, there needs to be a balance of both the body, mind, and spirit.
• Acute illness is not something that is long-term as one of the requirements.
• The third and final layer of preventing illness is rehab to bring the body back as much as possible.
• When there are consistent and severe symptoms and a reluctance to seek care, this is illness behavior.
• Genetics is an example of a "internal determinant"
• Primary prevention includes smoking cessation.
• In both beliefs and personal practices, external factors like culture will impact actions and beliefs.
• Adjusting to changes in the environment requires an adaptive model.
• Physical and social environments influence a persons overall health and well-being.
• One of the largest goals for health is enhancement and health promotion.
• Food, water and basic needs need to be met first to be able to fulfill higher-level needs according to Maslow's.
• Community based prevention is when you reach out to communities.
• Showing self-management towards their own beliefs, can improve health.
• Treating the whole person to not worsen symptoms falls in line with emotional, social, and spiritual wellness.
• Using the strategies that you learn can help someone with stress by teaching and using management.
• Reducing factors is important, especially when preventing Illness.

Vital Signs

• All, including Pulse, respiration, blood pressure, oxygen saturation, temperature and pain level provide an indicator of a patients health status
• 48 beats per minute adult patient is considered Bradycardia, heart rate that is below 60 bpm.
• Using a cuff that is too large may cause a falsely low blood pressure reading.
• Elderly patients trend to have lower baseline body temperatures.
• Assess Apical pulses and find irregular heart rhythms.
• Respiratory rate of patient trending high is tachypnea, respiratory rate trends faster than 20 bpm.
• Disappearance has to show for readings as diastolic pressure.
• Doppler ultrasound can amplify weak pulses, making them easier to assess.
• Rectal temps for core body temps are most accurate.
• Positioned arms that trend too low can skew blood pressure (BP).
• Hydration decreases fever, in addition to preventing dehydration.
• Taking blood pressure after a workout of heavy exercise elevates, as well as trends.
• Pressure for blood trends downward due to hypotensive changes.
• Breathing should have a patient not being told to prevent being observed.
• Oximetry assesses adequate saturation, paired with proper arterial pressure.
• Normal pressure is about 40.
• Carotid shows the most, especially when you test for emergencies.
• Hypothermia in patients who trend too low is not good.
• Slow rates will tell for hypothermia.
• Document blood pressure readings with numbers as they are heard.
• Tympanic shows best assessment of bodies, due to temperature.
• Before further assessments, reassess when accuracy starts to trend down.

Asepsis and Infection Prevention

• Sterile technique must be used during insertion.
• HAIs comes from within to care.
• Preventing and protecting the spreads of infection includes proper hygiene with water and soap.
• The CDC recommends scrubbing as long as 20 seconds to eliminate microbes.
• Airborn can be spread via TB and airborne contact.
• Contact follows direct rules for gown and gloves.
• Cleaning is spread via bacteria from spores.
• The correct PPE doff order: gloves followed by the gown, and ending with the mask
• A systematic infection impacts the ENTIRE body.
• Hygienic practice is important for not infecting the system or area when completing sterile procedures.

Safety

• For fall preventions best step is to enhance the hallway lights.
• Ensure good reach always.
• Pull and look at the base.
• Assess patients prior to moving.
• Bed lowest minimizes risk because falls.

Application of Responsibilities

• Apply healthcare to proper provider, especially for requirements.
• Patients are at risk, especially when having cognitive or physical impairments that inhibit a persons safety.
• Take action and act especially in the face of danger.
• If you give a hot or scalding product then you cause increased risk.
• If they have increased seizing activities or impairments on side, place them in supported laying position.
• To transport the weak properly, use support, such as a belt.
• Weak patients who need assistance needs to be ensured because both balance with standing is needed.
• Assessment is also needs to ensure and take great ability.
• Reduce causes without pain.
• Always consider if the plan is at risk.
• Do not keep patients alone for help

Care and Electrical Cords

• Care about the system or the patient and report as needed - and make sure that is marked for needed repairs.
• Always focus and reduce aspiration when helping at-risk.
• Install assistance to prevent the risks of patients.
• Ensure stability in the long-term, especially at discharge.
• Do not put it near the railing, especially when safety may be harmed.