Fundamentals of Nursing First Term 2024/2025 Communication PDF

Fundamentals of Nursing First Term 2024/2025 Communication  Learning objectives After completing this lecture, the student will be able to: Describe factors influencing the communication process. Discuss nurse-client communication as a dynamic process. Describe four...

Fundamentals of Nursing First Term 2024/2025 Communication  Learning objectives After completing this lecture, the student will be able to: Describe factors influencing the communication process. Discuss nurse-client communication as a dynamic process. Describe four phases of the helping relationship. Identify features of effective groups. Identify types of groups helpful in promoting health and comfort Discuss how nurses use communication skills in each phase of the nursing process State why effective communication is imperative among health professionals.  Introduction Communication is a dynamic process used to gather assessment data, to teach, and to express caring and comfort. It is an integral part of the helping relationship.  Definition Communication is any means of exchanging information, ideas or feelings between two or more people; it is a two way process involving the sending and the receiving of a message. Communication is a basic component of human relationships in nursing. Methods of communication includes: talking, listening, writing or reading.  Types of communication 1. Intrapersonal communication (self-talk)  Is the internal thought of the communicator. Occurs within the self she/he carry out personal dialogue.  Both the sender and the receiver of a message usually engage in self-talk.  It involves thinking about the message: before it is sent, while it is being sent, after it is sent, and it occurs constantly.  Examples are day dreams, talking to yourself.  Types of communication 2. Interpersonal communication  Examples: Communication between the nurse and patient, Communication among Health Professionals: Nurse and Physician Communication  Effective communication is important among health professionals.  Communication Problems cause of most client errors  Nurse and Physician Communication: Nurses are taught to be descriptive both verbally and in writing. Physicians are taught to be brief, to the point, and focused.  Types of communication 3. Group communication Group  Two or more people with shared needs and goals  Exists to help people achieve goals that would be unattainable by individual effort alone  Group dynamic  Communication between any members of a group, affecting the group process  Each member has effect on dynamics.  For a group to be effective, it must:  Maintain a degree of unity, cohesion  Develop, modify structure to improve effectiveness  Accomplish its goals  Element of Communication Process 1. Sender  Person or group who wishes to communicate a message to another.  There should be an idea, feeling or reason for communicating and must put the idea or feeling into a form that can be transmitted (encoding).  Encoding: is the selection of specific signs, symbols (codes) to transmit the message. (Like; which language or words use, how to arrange the words & what tone of voices or gesture to use).  Message  Method use to convey the message can target any of the receiver senses.  Methods of transmitting messages: talking face to face, telephoning, writing, recording, & the nonverbal channel of touch.  Channel of communication  The channel is the medium through which the sender transmits the message  Main communication channel:  Visual channel involves sight, which in turn allow for visual observation and perception.  Auditory channel consists of spoken words and other verbal cues.  Kinesthetic channel refers to physical sensation mediated by touch.  Receiver  The listener who must listen, observe & attend  The decoder, who perceive what the sender intended to Decode (relate) the message perceived to the receivers’ knowledge & experience & sort out meaning of message.  Response or feedback  The message that returns to sender, can be verbal, nonverbal or both Characteristics of effective feedback  Specific rather than general.Descriptive  Provided in a supportive, nonthreatening manner.  Given in a timely manner  Practical and appropriate for the individual client  Clear and unambiguous  Direct and honest  Modes of communication Verbal communication:  Is the use of sounds and words to express yourself, especially in contrast to using gestures or mannerisms (non-verbal communication).  An example of verbal communication is saying “No” when someone asks you to do something you don't want to do. Factors to be Considered When Choosing or Write Words  Pace and intonation: The manner of speech, as in the pace or rhythm and intonation, will modify the feeling and impact of the message. For example, speaking slowly and softly to an excited client may help calm the client.  Simplicity: using common/understood words  Clarity and brevity: direct and simple; Clarity-saying precise what is meant, Brevity-using the fewest words necessary.  Timing and relevance: involves sensitivity to the clients needs & concern  Factors to be Considered When Choosing or Write Words  Adaptability: adjustment of spoken messages in accordance with behavioral cues from the patient.  Credibility: worthiness of beliefs, trustworthiness by being consistent, dependable and honest.  Humor: can be positive and powerful tool in the nurse-patient, can help patient adjust to difficult & painful situation.  Nonverbal communication Is less conscious  It includes body language  Doesn’t use words, and tells others more about what a person is feeling.  Is controlled less consciously than verbal behavior.  Called ”Body Language” and may includes:  Gestures  Body movements  Use of touch  Physical appearance  Personal appearance  Posture  Gait  Facial expression  Electronic Communication e-mail by computer (most common) Factors influencing the communication Process 1. Development:  Knowledge of the client’s developmental stage will allow the nurse to modify the message accordingly. 1. Gender:  Females & males communicate differently.  Girls: use language to seek confirmation, minimize differences & establish intimacy  Boys: use language to establish independence & negotiate status within a group  Factors influencing the communication Process 1.Values and Perception: (individual differences).  Values: are standard that influence behavior.  Perception: Is the personal view of an event. 1.Personal Space:  Distance people prefer in interactions with others.  Distance of communication Intimate: Touching to ½ feet (15Cm)  Personal: 1 1/2 to 4 feet (.5 to 1.2 Meter)  Social: 4 to 12 feet (1.2 to 3.7 Meter)  Public: 12 to 15 feet (3.7 to 4.5 Meter)  Factors influencing the communication Process 1. Territoriality  Concept of the space and things that an individual considers as belonging to the self. 1. Roles and Relationship  Choice of words, sentence structure & tone of voice vary from role to role, specific relationship between the communicator is significant 1. Environment: Communication may interfere by:  Excessive noise  Ventilation  Privacy  Extreme temperature  Factors influencing the communication Process 1. Congruence:  Verbal and non-verbal aspects of message match that help to prevent miscommunication 1. Interpersonal attitudes:  Conveys beliefs and feelings about people & events (caring, respect & acceptance) 1. Boundaries:  limits in which a person may act or refrain from acting within a designated time or place.e.g. gift giving, spending more time than necessary with client  Therapeutic communication Therapeutic communication is the purposeful communication that creates a beneficial outcome for the client.  Is an interaction between a nurse and a patient that helps advance the physical and emotional health of the patient.  Therapeutic communication is an active process.  Therapeutic communication relies on two types of communication: verbal and nonverbal  Promotes understanding and can help establish constructive relationship between the nurse and the client.  It is client and goal directed Principles of therapeutic communication * Time and place: Not only the amounts of time the nurse spend with each client, but also the timing of an interaction has a significant impact on the outcome of the interaction. The nurse can help physical environment to be comfortable and private as possible by inquiring about the temperature, ventilation, positioning of the client and making any necessary adjustment. * Setting the stage: Having established an appropriate time and place, the nurse should introduce herself and clarify the purpose of the interaction and expected duration. * Accepting the client: A judgmental approach to any interaction will limit the ability for mutual understanding  Active listening Is a method of listening where you reflect back your understanding of what a person says to you. Active listening communicates your acceptance of the person’s thought and emotion and is an important element of therapeutic communication.  Nurse client communication as dynamic processes  Therapeutic Communication  Attentive listening  Physical Attending  Attentive listening  Is listening actively using all senses  Is an active process that requires energy & concentration.  Involves paying attention to the total message, both verbal and nonverbal.  It is absorbing both the content and feeling of the person is conveying without selectively.  Attentive listening conveys an attitude of caring and interest thereby encourage the client to talk.  Nurses must NOT respond to the message quickly , must take time to think about the message before responding.  How to be active listener  Silent pause: encourage the speaker to continue.  Attentiveness is indicated by comments such as: Yes, go on  Restatement: repeating what was said..  Clarifying: asking the speaker what was meant.  Reflecting: responding to the feeling communicated.  Summarizing: reviewing the major points made.  Physical Attending Actions of Physical Attending:  Face the other person squarely. (increase the (degree of involvement)  Adopt an open posture.  Non defensive position : arms or legs are crossed  Lean toward the person.  Closer to the patient  Maintain good eye contact.  Eye level denotes willingness to maintain communication  Try to be relatively relaxed.  Taking time in responding, allowing pauses as needed, natural gesture Barrier to therapeutic communication * Language: Even when two people speak the same language, it may be difficult for them to understand each other; the nurse can enhance the client’s understanding by seeking common ground. * Culture: Culture differences in communication transcend spoken language. * Gender: Men and women sometimes differ in their communication style. * Health status: The client who is in pain or is preoccupied with his condition may have difficulty communicating effectively. Communication blocks:  Barrier to therapeutic communication * Reassuring Ex: You will feel better soon * Agreeing Ex: I agree * Approving Ex: That’s good * Defending Ex: Doctor Ali is a good doctor * Using yes or no questions Ex: Did you sleep well? * Judging Ex: I don’t like that, a stern look  Barrier to therapeutic communication * Blaming Ex: If you hadn’t moved, I would have been able to complete the dressing * Advising Ex: I think you should do something for yourself for a change. * Rejecting Ex: Let’s not talk about that right now. * Disapproving Ex: That’s bad. * Probing Ex: Why do you feel this way? Communication among health professionals Communication is an important aspect within and between the various health professions and their practitioners, but especially between the nurse and the physician as well as between the nurse and patient. Communication between Nurses and Physicians There are no available guidelines for verbal communication between doctors and nurses. As a consequence, this has contributed or resulted in many medications’ errors. Nurses’ prefer to focusing their communication more on the “narrative and descriptive” aspect; while physician ns focus mainly on the “need or problem” of patients by “ruling out alternatives”. Critical Thinking in Nursing  Definition  Critical thinking is an active, organized, and cognitive process which an individual reviews data and considers potential explanations and outcomes before forming an opinion or making a decision.  Critical thinking is the ability to apply knowledge and skills to a new situation and to think about situations from different perspectives.  Critical thinking: An intentional higher level reasoning process  Components of Critical Thinking Critical thinking is composed of three primary components: 1. Mental operations: include activities such as decision making to find or create meaning, planning and evaluating one’s thinking. The result of these mental operations is creative, appropriate problem solving. 2. Knowledge: in order to think critically, to solve problems, and to make decisions, nurses must develop a broad base of knowledge.. 3. Attitudes: Certain attitudes enhance a person’s ability to think critically. One of the most important attitudes needed by a critical thinker is a sense of curiosity. Strategies that promote the development and application of critical thinking  Identify goals.  Determine what knowledge is required.  Assess the margin for error.  Determine the amount of time available for decision-making.  Identify available resources.  Recognize factors (i.e., biases, fatigue) that may influence decision making  Critical Thinking Requires  Cognitive skills  Ask questions  Remain well-informed  Be honest in facing personal biases  Be willing to reconsider and think clearly about issues  Characteristics of critical thinker  Understand the logical connections between ideas  Detect inconsistencies and common mistakes in reasoning  Solve problems systematically  Recognize our own assumptions, prejudices, biases, or point of view  Open-mindedness: remain open to alternative interpretations  Accept a new explanation  Benefits of critical thinking  Help to determine the best nursing action.  Help to identify patient needs  Enhance clinical decision making  Help to find a solution that is more likely to work  Help to come up with correct answers and solutions because you examine all the evidence before you decide anything  Critical thinking can lead to  Sound clinical decisions  Using the Nursing Process to guide patient care  Evidence-Based Practice (EBP). Thank you