self and others - Final exam review.docx

Self and Others - Final exam review Review assertive, aggressive, and passive communication Assertiveness is communicating and expressing your thoughts, feelings, and opinions in a way that makes your views and needs clearly understood by others, without putting down their thoughts, feelings, or o...

Self and Others - Final exam review Review assertive, aggressive, and passive communication Assertiveness is communicating and expressing your thoughts, feelings, and opinions in a way that makes your views and needs clearly understood by others, without putting down their thoughts, feelings, or opinions (hardest form of communication) Aggressive communication is described as expressing your feelings and opinions strongly and as they occur. Passive Communication- Not expressing feelings or needs; Know the concept of empathy and how it is displayed and/or communicated by the nurse Empathy: the ability to understand the feelings of others Clinical empathy: a tool or skill that is consciously and deliberately employed to achieve a therapeutic intervention Nurses provide empathy by responding appropriately and clarifying (reflecting) the patients feelings Review how the nurse forms a non-judgmental attitude through self awareness and withholding value statements Concepts of genuineness and presencing Genuineness and how important it is to develop a relationship Being totally present with the client (presence) How does the nurse know if self disclosure is appropriate? Professional Relationship - used to show clients you understand them because of your similar thoughts, feelings, and experiences to increase their comfort level to be empathic/empathetic - deepen the bond in nurse-client relationship Non-verbal communication and how it is used in active listening Functions: Repeating Substituting Complementing Regulation Contradiction The Five Non-Verbal Interaction Systems Kinesics .................body language Proxemics...............space Chronemics.............time Haptics....................touch Vocalics...................tone, pitch, loudness Know how to reflect the client’s thoughts and feelings back to them using empathy Acknowledge and validate the persons experiences Helps person gain clarification around what exactly they feel Increases patients self-awareness and helps them gain insight Paraphrases the main idea contained in a persons statement Observe non-verbal behaviour Review attending behavior and its importance in helping the nurse convey interest in the client Non verbal communication can be increased to communicate with clients with speech deficits Barriers to communication including interrupting and focusing only on physical treatments Noise Developmental stage Pathophysiological process Cognition Language/speech Word choice/jargon/colloquialisms Personal emotional response Time demands Premature reactions Anxiety Stress within the situation Being judgmental Review communication techniques including clarification and paraphrasing LOTS OF DEFENCE MECHANISMS ON TEST Know common defense mechanisms are and how they are used Are ways to deal with stressful situations. Regression – involves returning to earlier modes of behaviour and interests (nocturia) Sublimation – the process where by the ego channels a drive, modifying its aim or object to a more socially acceptable one (painting) Displacement – this involves changing the object by which a drive can be satisfied (transferral) Denial– a person fails to recognize an awareness of some aspect of reality – very common (we all do it) Rationalization – person seeks to justify actions by stating logical reasons. Socially acceptable explanations are offered for acts or decisions resulting from unconscious or unverbalized impulses (justify actions) Repression and Suppression - are similar. Repression is the involuntary exclusion from awareness of thoughts or impulses that are painful, threatening, or conflicting. These thoughts often threaten the self concept or the person. Suppression is the conscious, intentional exclusion of thoughts and information from consciousness. Reaction Formation – an original attitude or set of feelings is replaced in the consciousness by the opposite attitude or feeling. This mechanism represents going to the opposite extreme in an attempt to overcompensate for unacceptable impulse Zones of touch and how touch can be used with clients Social zone- Permission not needed- Arms, hands, legs Consent Zone- Permission is needed- Mouth, wrists, feet Vulnerable Zone- Permission is needed- Mouth, wrists, feet Intimate Zone- Special care needed- Face, neck, front of body Review all of the types of questions (e.g. follow-up, focused, etc.) Closed - ended questions: can be answered with either a single word or a short phase Open - ended questions: is likely to receive a long answer such as an essay answer, eliciting knowledge necessary for proper patient care Focused questions: limits the response to certain information area, but more then a “yes” or “no” answer Circular questions: focuses on the interpersonal context in which an illness occurs Follow up questions: utilized to elicit more information Know the benefits and drawbacks of open and close-ended questions Closed-ended questions: Benefits: gives you facts, easy to answer, quick to answers, keeps control of the conversation Drawbacks: not much information being told, limits what can be said, gives you the answer of that specific question Open-ended questions: Benefits: respondent ist able to think and reflect, they will elicit opinions and feelings, hand control of the conversation to therespondent; and, find out more about a person Drawbacks: can get off topic, can be very general rather than specific, can open up to a variety of answers Opened ended questions allow questions to be asked of the speaker, and close ended questions take questions away from the speaker. Leading questions assume an outcome. Questions used in open inquiry demand more than yes or no. Review the pitfalls of leading questions Might not only return unhelpful responses but could also produce misleading or untrue results. Review how nurses can use timing, relevance and silence in their communication with clients Allows the nurse to step back and process what she has heard It can be a sign to the nurse that she has touched on an important point for the client →respect the client's silent moment It is very useful when clients are confronted with decisions that require much thought, e.g. sharing about a decision about chemotherapy They allow patient and nurses time to collect their thoughts and reflect on what has been expressed. They provide an opportunity for either patient or nurse to change direction of the conversation. They slow the pace of interaction. Nurses should look for congruency between verbal and non verbal communication Know the difference between passive and active listening Active listening: active process of taking in, absorbing, and eventually understanding what is being expressed Passive listening: hearing without concentrating or attending Be familiar with reflective and contemplative practices Nonverbal interaction systems (proxemics, haptics, etc)The majority of communication is non-verbal Chronemics: Non-verbal time communication: How one uses time with a patient, how much time one has for a patient versus another patient, how we time our day (call bells), how one wastes time Proxemics: Personal Space: Intimate Zone 0-45 cm, Personal Zone 45 cm – 1 m, Social Zone 1 –4 m, Public Zone 4 meters plus Vocalics: Non-verbal Sound Communication: Tone, loudness, pitch, rate, duration, quality, regulation, articulation, pronunciation, and silence. Sounds such as sighs, moans, groans, or sobs communicate feelings and thoughts. Haptics: non-verbal touch communication: Touch communicates: anger, interest, trust, warmth, love, fear, etc. Certain acceptable patterns / degrees of touch (culturally determined). Sexual harassment in the workplace. Zones of touch Kinesics- Body language Proxemics- Space Chronemics- Time Vocalics- Tone, pitch, loudness Haptics- Touch Non verbal communication can either contradict or enforce verbal communication while having many factors Symptoms of Burn out Often, it occurs slowly over a long period of time. It may express itself physically or mentally Feeling of lack of control over commitments Incorrect belief that you are accomplishing less A growing tendency to think negatively Loss of a sense of purpose and energy Increasing detachment from relationships. This may cause further conflict and stress, adding to the problem Therapeutic communication is done on purpose Self awareness is essential for nurse to recognize their own barriers Barriers to communication Hearing loss – in children and older adults Vision loss Speech and language deficits Aphasia Different language Impaired cognition or learning delay Serious mental illness Past experiences is one of the big barriers Know what empathy is The ability to see and understand the internal and external world as seen by other people and to communicate this to him/her The act of communicating to our fellow human beings that we understand how they are feeling and what makes them feel that way Involves perception and communication Put oneself into the client’s position Barriers to empathy Lack of....... time trust privacy support from other professional colleagues Being non judgmental, knowing your own biases and opinions Creating a therapeutic relationship - Key word EMPATHY and RESPECT Respond to feeling- make sure theres a feeling word, not a thought word Attending bahavour is a way of being there for your client Active listening is about suspending judgement Communication breakdown happens because of interrupting Review the communication techniques (paraphrasing) Reaction formation, projection, Different ways silence can be used (powerful listening, thinking) Passive listening (when your not taking it in on a deeper level) 2 on reflective practice (self care) thinking back on your experiences Contemplative practice is something that changes your relationships with yourself, others and world