Unit 1 Interpersonal Relationship in Nursing 2025 PDF

MOTIVATIONAL ACTIVITY PAPER SHAPES  HEA1032 HEALTH ASSESSMENT UNIT 1: INTERPERSONAL RELATIONSHIP IN NURSING PRESENTED SEMESTER 2 JAN 2025 BY: MRS. KERON JONES-FRASER, PhD CANDIDATE, MSCN, BSCN, CERT ED, RN  OBJECTIVES AT THE END OF THREE HOURS ADUL...

MOTIVATIONAL ACTIVITY PAPER SHAPES  HEA1032 HEALTH ASSESSMENT UNIT 1: INTERPERSONAL RELATIONSHIP IN NURSING PRESENTED SEMESTER 2 JAN 2025 BY: MRS. KERON JONES-FRASER, PhD CANDIDATE, MSCN, BSCN, CERT ED, RN  OBJECTIVES AT THE END OF THREE HOURS ADULT LEARNERS WILL: DESCRIBE THE COMMUNICATION PROCESS, OUTLINING FACTORS THAT INFLUENCE COMMUNICATION DISCUSS TYPES OF AND TOOLS USED IN EFFECTIVE COMMUNICATION. DESCRIBE THE METHODS OF COMMUNICATION USED BY MEMBERS OF THE HEALTH TEAM DEFINE THE HELPING RELATIONSHIP AND DESCRIBE COMMON COMPONENTS OF THE HELPING RELATIONSHIP IDENTIFY THE FOUR PHASES OF THE HELPING RELATIONSHIP DISCUSS THE BARRIERS TO EFFECTIVE NURSE-PATIENT RELATIONSHIP DISCUSS THE HEALTH HISTORY TAKING PROCESS  COMMUNICATION COMMUNICATION IS ANY MEANS COMMUNICATION IS INFLUENCED BY OF EXCHANGING INFORMATION OR THE SENDER, THE MESSAGE, AND THE RECEIVER. FEELINGS BETWEEN TWO OR MORE PEOPLE. IT IS THE BASIC EFFECTIVE COMMUNICATION ALSO INVOLVES FEEDBACK. COMPONENT OF HUMAN RELATIONSHIPS, INCLUDING IT IS A BASIC SKILL THAT CAN BE NURSING. LEARNED. KOZIER & ERBS, 2020 SENDING: (VERBAL COMMUNICATION & NON-VERBAL) RECEIVING: (INTERPRETATION OF THE MESSAGE)  COMMUNICATION PROCESS http://www.scout.org/var/corporate_site/storage/images/about_scouting/the_youth_programme/scoutpax/introduction_to_life_skills/the_communication_process/the_communication_process/117884-2-eng-GB/the_communication_process_imagelarge.png HTTP://WWW.SCOUT.ORG/EN/ABOUT_SCOUTING/THE_YOUTH_PROGRAMME/PEACE_EDUCATION/SCOUTPAX/LIFE_SKILLS/THE_COMMUNIC ATION_PROCESS/THE_COMMUNICATION_PROCESS  Message: (the written, oral, or nonverbal communication that the sender transmits). Your words and tone. Your method or organization. COMMUNICATION PROCESS The sound of your voice and its emotional impact. Your style of speaking. Seek to inform or convince.  VERBAL COMMUNICATION conscious use of spoken or written word Choice of words can reflect age, education, developmental level, and culture Feelings can be expressed through tone, pace, etc Giving oral reports to other nurses. Writing care plans and recording patient progress in the patient’s chart.  Use of gestures, expressions, behaviors (body language). Nonverbal communication is less conscious than verbal. It either reinforces or contradicts what is said. Requires systematic observation and valid interpretation Nurse must be aware of personal style NON-VERBAL COMMUNICATION  NON-VERBAL COMMUNICATION 1. Posture & Gait 2. Facial expression 3. Hand movements and gestures  NON-VERBAL COMMUNICATION  Touch is viewed as one of the most effective nonverbal ways to express feelings of comfort, love, affection, security, anger frustration, aggression and excitement.  Eye contact suggests respect and a willingness to listen and to keep communication open.  A blank stare can indicate daydreaming or inattentiveness.  In some cultures, people are taught to avoid eye contact or, out of respect, not to make eye contact with a superior.  Facial expressions convey anger, joy, suspicion, sadness, fear and contempt.  Gestures, using parts of the body can carry numerous messages (thumbs up means victory, biting nails indicates anxiety). Gestures often used extensively when two people speaking in different languages NON-VERBAL attempt to communicate with each other. COMMUNICATION General physical appearance is often altered in most illnesses. Observing for changes in appearance is an important nursing responsibility for detecting illness or effectiveness of therapy.  NON-VERBAL COMMUNICATION Mode of dress and Silence – periods of grooming – a healthy Sounds – crying, moaning, silence during a person with high self- gasping and sighing are conversation often carry esteem tend to pay oral but nonverbal forms important nonverbal attention to details of of communication. messages. dress and grooming. Posture provides Gait – a bouncy nonverbal clues concerning purposeful walk usually pain and physical carries a message of well limitations. being. ACTIVITY: COMMUNICATION HTTPS://WWW.YOUTUB E.COM/WATCH?V=W1RY_ 72O_LQ LIST ALL BREACHES OF GOOD COMMUNICATION OBSERVED, IF ANY, AND DISCUSS. THE HELPING RELATIONSHIP THE HELPING RELATIONSHIP Referred to also as interpersonal relationships and therapeutic relationships. These relationships may develop within minutes, or over the course of weeks of interacting with a client.  THE HELPING RELATIONSHIP DESCRIBES A NURSE-CLIENT RELATIONSHIP WHICH RESULTS IN HARMONY AND HEALING. CLIENTS ARE HELPED with managing problems and effectively developing unused or underused opportunities more fully. to become better at helping themselves in their everyday lives.  THE HELPING RELATIONSHIP THE ROLE OF THE NURSE ?  THE HELPING RELATIONSHIP THE ROLE OF THE NURSE INVOLVES: Being sensitive to self and others, Assisting with the gratification of the patient's physical, emotional, and spiritual needs through the nurse’s knowledge and skill.  THE HELPING RELATIONSHIP THE ROLE OF THE NURSE INVOLVES FOSTERING: The development of mutual trust, respect and acceptance between nurse and client The underlying belief that the nurse cares about the client and wants to help. the nurturing of faith and hope.  THE HELPING RELATIONSHIP LIMITATIONS OF THE NURSE:  REQUIREMENTS OF THE HELPING RELATIONSHIP ?  REQUIREMENTS OF THE HELPING RELATIONSHIP  REQUIREMENTS OF THE HELPING RELATIONSHIP HELPING CLIENT TO IDENTIFY HIS/HER FEELING ACTIVE LISTENING EMPATHY SYMPATHY  REQUIREMENTS OF THE HELPING RELATIONSHIP NON-JUDGEMENTAL RESPONSE ESTABLISHING TRUST USE OF SELF REQUIREMENTS OF THE HELPING RELATIONSHIP ESTABLISHING TRUST  PHASES OF THE HELPING RELATIONSHIP THERE ARE FOUR SEQUENTIAL PHASES, EACH CHARACTERIZED BY IDENTIFIABLE TASKS AND SKILLS. PROGRESSION THROUGH THE STAGES IN SUCCESSION IS NECESSARY AS EACH PHASE IS THE FOUNDATION FOR THE NEXT.  PHASES OF THE THE HELPING RELATIONSHIP ESTABLISHING TRUST  PHASES OF A HELPING RELATIONSHIP DURING THE PRE-INTERACTION PHASE Data gathering about the client occurs, including: name, address, age, medical history, social history. Plans for interaction with client are developed with any area of potential concerns considered  PHASES OF A HELPING RELATIONSHIP DURING THE INTRODUCTORY/ORIENTATION/PRE-HELPING PHASE THE NURSE/CLIENT RELATIONSHIP IS INITIATED opening of the relationship, clarification of the problem, and structure and formulation of the contract (obligations to be met by both nurse and client) occurs  PHASES OF A HELPING RELATIONSHIP DURING THE WORKING PHASE EXPLORATION AND UNDERSTANDING OF THOUGHTS AND FEELING OCCUR TAKING ACTION IS INITIATED  PHASES OF A HELPING RELATIONSHIP DURING THE TERMINATION PHASE THE HELPING RELATIONSHIP IS DISSOLVED, AND THE CLIENT IS GIVEN THE TOOLS NECESSARY FOR INDEPENDENCE, OR OCCASIONAL SUPPORT, AND OR REFERRALS  PHASES OF THE THE HELPING RELATIONSHIP  FACTORS INFLUENCING COMMUNICATION Ability of the communicator Values & Perceptions Developmental level Personal space Roles and relationships Time Environment Attitudes Emotions & self-esteem  BARRIERS TO THE HELPING RELATIONSHIP Change of environment Unfamiliar people, places, language, activities Change of role and status COMMUNICATION TECHNIQUES VIDEO HTTPS://YOUTU.BE/W5 4YHHZ9DOQ  COMMUNICATION TECHNIQUES Open-Ended Questions (what, how, tell me, when)  Asks for narrative information.  It states the topic to be discussed but only in general terms.  Use it to begin the interview, and whenever the person introduces a new topic.  Is unbiased; it leaves the person free to answer in any way.  Builds and enhances rapport.  COMMUNICATION TECHNIQUES Closed or Direct Questions:  Asks for specific information.  Elicit a short a yes or no answer.  Use direct questions after the person’s narrative to fill in any details he or she left out.  Use when you need specific facts.  Limits rapport and leaves interaction neutral.  THERAPEUTIC COMMUNICATION TECHNIQUES  Accepting—indicating reception “Yes.” “I follow what you said.” Nodding  Broad openings—allowing the client to take the initiative in introducing the topic  Encouraging expression— asking the client to appraise the quality of his or her experiences  Exploring— delving further into a subject or idea  Focusing— concentrating on a single point THERAPEUTIC  Giving information— making available the facts COMMUNICATION that the client needs TECHNIQUES  Giving recognition— acknowledging, indicating awareness  Making observations— verbalizing what the nurse perceives  Offering self— making oneself available  Presenting reality— offering for consideration that which is real  Reflecting— directing client actions, thoughts, and feelings back to client  THERAPEUTIC COMMUNICATION TECHNIQUES  Restating— repeating the main idea expressed  Seeking information— seeking to make clear that which is not meaningful or that which is vague  Silence— absence of verbal communication, which provides time for the client to put thoughts or feelings into words, to regain composure, or to continue talking  Summarizing— organizing and summing up that which has gone before  INEFFECTIVE COMMUNICATION  Failure to perceive the patient as a human being  Failure to listen  Inappropriate comments and questions  Using clichés  Using questions requiring only a yes or no answer  Using questions containing the words why and how  Using leading questions  Using judgemental comment  Changing the subject  Aggressive interpersonal behaviour  Providing assurance or reassurance – “now don’t worry. I am sure you’ll be all right” Giving advice – know when to give it and when to refrain from giving it. Using authority – “your doctor knows best” INEFFECTIVE COMMUNICATION Using avoidance language – the use of euphemisms to avoid reality or to hide feelings (passed on). Engaging in distancing – the use of impersonal speech to put space between the self and a threat. Using professional jargon – using medical jargon in a paternalistic way.  USING LEADING OR TALKING TOO MUCH – A INTERRUPTING – AIM FOR ASKING “WHY” BIASED QUESTIONS – GOOD RULE FOR EVERY A SECOND OF SILENCE QUESTIONS – THE ADULT’S ASKING “YOU DON’T INTERVIEWER IS TO LISTEN BETWEEN THE PERSON’S USE OF WHY QUESTIONS SMOKE DO YOU?”. MORE THAN YOU TALK. STATEMENT AND YOUR USUALLY IMPLIES BLAME NEXT RESPONSE. AND CONDEMNATION; IT PUTS THE PERSON ON THE DEFENSIVE. INEFFECTIVE COMMUNICATION SCENARIO You are a nursing/ midwifery student present at a meeting held between the physician, nurse and your client’s wife. The meeting was held to update Mrs. M on her husband’s present medical condition. Having had surgery to remove a large malignant mass from the abdomen, Mr. M is now a candidate for chemotherapy. The physician advised that Mr. M’s prognosis is guarded because of the stage of the cancer. Following the discussion, Mrs. M looks away, closes her eyes, and only nods her head. As the physician leaves the room, the nurse approaches Mrs. M, sits next to her, and puts her arm around Mrs. M, who begins to cry. The nurse uses a soothing voice to tell Mrs. M that is okay to cry and assures her she will remain with her. The nurse remained with Mrs. M until she was able to express her feelings. The nurse listens to Mrs. M attentively. The nurse later offered Mrs. M a cup of tea and asked if there is anything she can to assist her during this difficult time.  SCENARIO Discussion questions: 1. Interpret Mrs. M’s non-verbal behaviour in response to the news of her husband’s present medical condition. 2. Evaluate the nurse’s response toward Mrs. M based on the concepts of caring and comforting. 3. Why is it important for the nurse to effectively communicate with Mrs. M currently? 4. The nurse was described as listening attentively to Mrs. M. Cite the actions that portray attentive listening.  COMMUNICATING WITH OTHER MEMBERS OF THE HEALTH TEAM Effective communication among health professionals is as important as the promotion of therapeutic communication between the nurse and client.  COMMUNICATING WITH OTHER MEMBERS OF THE HEALTH TEAM Tools include:. Records Conferences Communication may be formal or Reports and report writing informal Consultations Referrals Patient rounds Follow-up care HEALTH HISTORY TAKING  HEALTH HISTORY TAKING PRIOR TO TAKING A CLIENT’S HEALTH HISTORY IT IS IMPORTANT TO ENSURE THAT THE TIME AND PLACE SELECTED FOR THE INTERVIEW ARE APPROPRIATE (FOR EXAMPLE PRIVACY, PATIENT COMFORT). Purpose: Gather complete and accurate data Establish rapport and trust INTERVIEWING Teach the client about the health state Build rapport for continuing therapeutic relationship Begin teaching for health promotion and disease prevention  INTERVIEWING Planning for the Interview: Review all available information e.g. lab reports, admission notes, health history… Review agency data re information to collect Use interview guide to remember what to ask Include list of topics & sub-topics rather than questions e.g. family health history Take everything you need to the place selected to have the interview Maintain a professional attitude: this evokes confidence in the client  HEALTH HISTORY TAKING A HEALTH HISTORY IS A CURRENT COLLECTION OF ORGANIZED INFORMATION UNIQUE TO THE INDIVIDUAL PATIENT. THIS IS CALLED SUBJECTIVE DATA Subjective (symptoms, covert data) – refers to the feelings or experiences of the client for example, itching, pain, and fear. HEALTH HISTORY AIDS WITH… DIAGNOSIS, TREATMENT DECISIONS, AND ESTABLISHMENT OF TRUST AND RAPPORT BETWEEN PATIENT AND HEALTH PROFESSIONALS.  HEALTH HISTORY TAKING FEELINGS; PERCEPTIONS; DESIRES PREFERENCES; BELIEFS; IDEAS; VALUES PERSONAL INFORMATION PROVIDES CLUES TO PHYSIOLOGIC, PSYCHOLOGICAL AND SOCIOLOGICAL PROBLEMS OBTAINED FROM CLIENT, FAMILY MEMBERS OR SIGNIFICANT OTHERS SENSATIONS OR SYMPTOMS  A CLIENT’S HEALTH RECORD INCLUDES BIOGRAPHIC DATA, CHIEF COMPLAINT, HEALTH HISTORY OF PRESENT COMPLAINT, PAST MEDICAL HEALTH HISTORY, FAMILY HISTORY, HISTORY SOCIAL HISTORY, DRUG HISTORY (INCLUDING RECORD ALLERGIES), PHYSICAL EXAMINATION, LABORATORY AND DIAGNOSTIC TEST RESULTS.  SUBJECTIVE DATA? OR OBJECTIVE DATA? 1. Patient in bed eye closed HEALTH 2. Arouses to verbal stimuli HISTORY 3. Denies pain 4. States loose bowel movement yesterday 5. Speech without slurring HEALTH SEQUENCE: HISTORY BIOGRAPHICAL DATA COMPONENTS REASON FOR SEEKING CARE PRESENT HEALTH OR HISTORY OF PRESENT ILLNESS PAST HEALTH HISTORY FAMILY HISTORY REVIEW OF SYSTEMS FUNCTIONAL ASSESSMENT OR ACTIVITIES OF DAILY LIVING (ADLS)  HEALTH HISTORY COMPONENTS General information/ Biographic data Chief complaint(s)-Clear, chronological details of chief complaint and reasons for seeking care. Present illness – >Medications >Allergies > Alcohol and drug use  HEALTH HISTORY COMPONENTS Past illness - Family history- General health status All members of family, and Pertinent childhood illness the illnesses they have Surgical history Obstetric/gynecologic history Injuries and accidents Psychiatric  REVIEW OF SYSTEMS Review of systems – Review each item in each category. Mention each item, whether the client has the problem or denied having the problem General - usual weight, height, recent weight change, weakness, fatigue, fever  Skin - rashes, lumps, itching, dryness, color change, changes in hair or nails, biopsies or other tests, lice, ticks, scabies, changes in moles (color, size, shape, use of sunscreen REVIEW OF Head - headache, head injury, tests and results SYSTEMS Eyes - vision, glasses or contact lenses, date of last eye examination & results, other tests, pain, redness, excessive tearing, double vision, glaucoma, cataracts  REVIEW OF SYSTEMS Ears - hearing, tinnitus, vertigo, earaches, infection, discharge Nose & sinuses - frequent colds, nasal stuffiness, hay fever, nosebleeds Mouth & throat - condition of teeth and gums, bleeding gums, last dental examination & results, sore tongue, frequent sore throats, hoarseness  REVIEW OF SYSTEMS Neck - lumps in neck, swollen "glands", goiter, pain in neck Breast - lumps, pain, nipple discharge, self-examination and frequency, timing of exam with menses, last exam by health care provider and results, date of last mammogram (if appropriate) and results Respiratory - cough, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue, shortness of breath, sputum (color, quantity), hemoptysis, wheezing, asthma, bronchitis, emphysema, pneumonia, tuberculosis, last chest x-ray and results, other tests with results  Cardiac - heart trouble, high blood pressure, rheumatic fever, heart murmurs, chest pain, palpitations REVIEW Gastrointestinal - trouble swallowing, heartburn OF and treatments, appetite, nausea, vomiting, vomiting blood, indigestion, frequency of bowel SYSTEMS movements, change in bowel habits, Urinary - usual bladder habits, change in bladder habits, frequency of urination, polyuria, nocturia, dysuria, hematuria, urgency, hesitancy, incontinence,  Genito reproduction – Male: discharge from or sores on penis, history of sexually transmitted disease and its treatment, hernias, testicular pain or masses, frequency of intercourse, libido, sexual difficulties REVIEW Female: age at menarche; regularity, frequency OF and duration of periods; amount of bleeding, bleeding between periods or after intercourse, last SYSTEMS menstrual period; dysmenorrhea, age of menopause, menopausal symptoms, post- menopausal bleeding, discharge, itching, sexually transmitted disease and its treatment, last Pap smear and results, number of pregnancies  Musculoskeletal - intermittent claudication, cramps, varicose veins, thrombophlebitis, tests and results. REVIEW Peripheral vascular - intermittent claudication, cramps, varicose veins, OF thrombophlebitis, tests and results. SYSTEMS Neurological - fainting, blackouts, seizures, paralysis, local weakness, numbness, tingling, tremors, memory problems, tests and results.  REVIEW OF SYSTEMS Psychiatric - nervousness, tension, moodiness, depression Endocrine - thyroid trouble, heat or cold intolerance, excessive sweating, diabetes; excessive thirst, hunger or urination; tests with results Haematologic - anemia, easy bruising or bleeding, date and number of past transfusions and possible reactions  REVIEW OF SYSTEMS Skin Gastrointestinal Proper use of antacids & Sun exposure: laxatives How to care for skin Need for water intake and hair Regularity and completeness of dietary Sunscreen lotions intake Sunglasses Relaxation during meals Proper mastication of food  REVIEW OF SYSTEMS Mouth Breast Pattern of daily dental care Monthly self breast exam Flossing by males and females Cancer risk with chewing or smoking tobacco  LIFESTYLE & HEALTH PRACTICES Usual daily Habits: smoking, Hours of sleep schedule-hourly alcohol, other account drugs, caffeine Modes of relaxation: Diet Social supports exercise, hobbies  Kozier, B., Erb, G., Berman, A., & Snyder, S. (2018). Fundamentals of nursing: Concepts, processes, and practice. Pearson Prentice Hall. REFERENCE Weber, J., & Kelley, J. (2018). Health assessment in nursing. Lippincott, Williams & Wilkinson.