NUSC 1P10 Fall 2023 Professional & Therapeutic Communication PDF

NUSC 1P10 | Fall 2023 Land Acknowledgement Brock University acknowledges the land on which we gather is the traditional territory of the Haudenosaunee and Anishinaabe peoples, many of whom continue to live and work here today. This territory is covered by the Upper Canada Treaties and is within th...

NUSC 1P10 | Fall 2023 Land Acknowledgement Brock University acknowledges the land on which we gather is the traditional territory of the Haudenosaunee and Anishinaabe peoples, many of whom continue to live and work here today. This territory is covered by the Upper Canada Treaties and is within the land protected by the Dish with One Spoon Wampum Agreement. Today this gathering place is home to many First Nations, Métis and Inuit peoples and acknowledging reminds us that our great standard of living is directly related to the resources and friendship of Indigenous people. NUSC 1P10 | Fall 2023 Introduction to NUSC 1P10 Welcome to Nursing 1P10 After today’s class you will be able to: • List the learning objectives of this course • Describe the ways these learning objectives will be met • List the evaluation methods in this course • List ways to contact the teaching team • Access course resources on the course Brightspace page • Describe the basic elements of relationships and communication • Describe the significance of relationships to nursing Introductions – story of your name In groups of 2-3: • introduce yourself • share the story of your name • e.g., what does your name mean? who named you? do you have a preferred name? etc. Course Objectives 1. Analyze the influence of personal beliefs, values and experiences on communication 2. Demonstrate self-reflection to increase self-knowledge 3. Understand and demonstrate the principles and techniques required for: • Therapeutic nurse-client relationships • Communication with health professionals 4. 5. 6. 7. Effectively provide and receive feedback Describe selected group and collaboration skills Explain how culture influences communication Begin to conduct a cultural self-assessment How you can achieve the goals of this course… • Review course syllabus & Brightspace course site • Complete readings and preparation activities • Attend lectures & participate is class discussion • Attend labs – and engage in activities & practice exercises • Ask questions • Practice Practice Practice Evaluation Measures 1. Lab Preparation & Engagement – 30% • Midterm Evaluation – 15% • Final Evaluation – 15% 2. Reflective Practice – 15% 3. Interpersonal Process Recording – 25% 4. Final Exam – 30% Detailed instructions and grading criteria are in the syllabus and posted on Brightspace How to contact the teaching team Lectures • Dr. Vanessa Silva e Silva • Email [email protected] • Office hours by appointment Labs • Dr. Danielle Dunwoody • Email [email protected] • Office hours by appointment • Lab TAs Course Q&A • Discussions on Brightspace Accessing resources on Brightspace Communication Labs • Run every other week – opposite lecture • Preparation & engagement is required • Discuss course concepts introduced in readings & class • Understand, practice, and demonstrate the skills and techniques required for nurse-client relationships and communication with health professionals • Gain competence & confidence in relational nursing practice Pause & Think • I can contribute to this course by… • I can be successful in this course by … NUSC 1P10 | Fall 2023 Interpersonal Process Think, Pair & Share • What is communication? • Why do we communicate? What is communication and why do we do it? • A process by which information is exchanged between individuals through a common system of symbols, signs, or behavior (Merriam-Webster, 2020) • We communicate to: • • • • Meet our physical needs Shape our identity Socialize Meet our practical needs The Communication Process Early models: • Simplistic • Linear • Unidirectional Later models: • More interactional • Resembled turn taking • Still sequential Who is sending/receiving? Who is sending/receiving? The Transactional Communication Model Source: Adler, R.B. et al. (2020). Interplay: The process of interpersonal communication. New York, NY: Oxford University Press. Page. 9. The Transactional Communication Model • Sending and receiving are simultaneous • Involves verbal and non-verbal messages Source: Adler, R.B. et al. (2020). Interplay: The process of interpersonal communication. New York, NY: Oxford University Press. Page. 9. Metacommunication Source: Arnold, E.C. & Boggs, K.U. (2019). Interpersonal relationships: Professional communication skills for nurses (8th ed.) Elsevier. Page. 93. Verbal Style Factors • Pitch and tone • Language use (consider meaning) • Denotation—generalized meaning • Connotation—personalized meaning Non-verbal Style Factors • Use of silence • Congruence • Body language • • • • Posture Facial expression Eye contact Gestures • Touch • Proxemics (perception of proper distance) • Attending to patient’s nonverbal body cues Other Style Factors That Influence Relationships • Medical terminology • Openness of participants • Roles of participants • Context of the message • Involvement in the relationship • Use of humour The Transactional Communication Model • Meaning exists among people • Environments affect communication Context Historical Sociopolitical Material/ Economic Social and health care contexts shape each nursing encounter (Doane & Varcoe, 2021) Physical Linguistic/ Discursive How might environment or context affect this communication? The Transactional Communication Model • Noise can interfere with communication • 3 types: • External noise • Physiological noise • Psychological noise Pause & Think • What examples of noise are you experiencing right now? The Transactional Communication Model Channels: • • • • • • • Face-to-face Telephone Voicemail Email Instant message Social media Print media or messages Consider the channel… Source: https://www.reddit.com/r/me_irl/comments/8ruzu4/me_irl/ Communication Accommodation Theory (CAT) People adapt or adjust their speech, vocal patterns, language, word choice, and gestures to accommodate others (Mallette & Yonge, 2022) Communication Accommodation Theory Communication adjustment – people adapt their verbal and nonverbal behavior in context: • is fundamental to interaction • serves to establish common ground for coherent interaction • manages social distance between individuals • may be in response to others or initiated by the speaker • is often unconscious or automatic (Gasiorek, 2016) Communication Accommodation Theory Types of adjustment: • Convergence • Divergence • Maintenance Communication Accommodation Theory Accommodation Strategies: • Approximation • Interpretability • Discourse management • Interpersonal control • Emotional expression Pause & Think Have you noticed yourself using communication adjustment or accommodation in your clinical setting? Did you notice what type or strategy to employed? What was the purpose of accommodation? Understanding CAT in Practice (Jones et al, 2018) Aim: to examine nurses’ perceptions of effective and ineffective interactions with typical parents, culturally and linguistically diverse parents (CALD), and adolescent parents in neonatal nurseries. Methods: Interviews with 42 NICU nurses were coded for communication strategy and accommodative stance, using a coding system based on CAT. Findings: • CALD focused mostly on comprehension and cultural differences – limited mention of other strategies • Adolescent involved greater focus on face management and demonstrated less empathy Conclusions: CAT strategies associated with person and family centre care principles are limited in interactions with families with minority groups Pause & Think What are the implications of this research? Principles of Communication • Transactional • We communicate with others • Intentional or unintentional • Even the absence of behaviour has communicative value • Irreversible • Words said or deeds done are irretrievable • Unrepeatable • Even the same words are different each time they are spoken • Content + relational dimensions • The information explicitly discussed vs. how you feel about the other person Communication Competence A balance between effective communication and appropriate communication Effective communication à getting what you want Appropriate communication à enhancing relationships Communication Competence • Motivation and open-mindedness • No one best or right way • Depends on the situation and context • Requires mindfulness/awareness of self and others • Can be learned What is communication and why do we do it? • A process by which information is exchanged between individuals through a common system of symbols, signs, or behavior (Merriam-Webster, 2020) • We communicate to: • • • • Meet our physical needs Shape our identity Socialize Meet our practical needs Self-concept Self-concept – the thoughts, feelings, attitudes and beliefs that individuals have about themselves (Adler et al., 2020) • Does not exist at birth • Is a product of social interaction • Develops in a larger social context • Age, gender identity, sexual orientation … Development of Self-concept • Forms in a social environment • Impacted by various life factors (e.g., disease, poverty) • Associated with cultural/ethnic identity • Learned along with gender behaviors • Two theories: • Reflected Appraisal • Social Comparison Reflected Appraisal Reflected appraisal – the theory that a person’s self-concept matches the way the person believe others regard them (Adler et al., 2020). • Supportive messages à feel appreciated and valued • Critical signals à feel less valuable Social Comparison Social comparison – an evaluation of oneself by way of comparison to others (Adler et al., 2020). • Compare ourselves to reference groups e.g., peers, social groups • Problematic when unrealistic reference groups are used for comparison (e.g., professional athletes). Impression Management Impression Management – the communication tools people use to influence how others view them • Perceived self • Presenting self • Face • Facework (Adler et al., 2020) Think, Pair & Share Why do nurses learn about communication? Why learn about communication? • The core of nursing is the therapeutic nurseclient relationship • Effective communication strategies and interpersonal skills are required for therapeutic relationships • Effective communication is central to patient safety (Mallette & Younge, 2022; College of Nurses of Ontario (CNO), 2006) What is the Nurse-Client relationship? • Knowledge and skill • Caring attitudes and behavior • Trust, respect, professional intimacy, empathy, and appropriate use of power • May be individuals, families, groups or communities (CNO, 2006) Standards & Therapeutic Nurse-Client Relationships Standards (CNO, 2006) 1. Therapeutic communication - Nurses use a wide range of effective communication strategies and interpersonal skills to appropriately establish, maintain, re-establish and terminate the nurse-client relationship. 2. Client-centred care - Nurses work with the client to ensure that all professional behaviours and actions meet the therapeutic needs of the client. 3. Maintaining boundaries - Nurses are responsible for effectively establishing and maintaining the limits or boundaries in the therapeutic nurse-client relationship. 4. Protecting the client from abuse - Nurses protect the client from harm by ensuring that abuse is prevented or stopped and reported. Nurse-client Relationships & Health Douglass et al. 2003 Participants: • 120 women • HIV seropositive • 18-49 years old • Able to become pregnant • Not currently pregnant • English speaking Nurse-client Relationships & Health • Purpose: To identify factors associated with difficulty in taking medications • Self-report measures: • • • • • • • • • • Patient-Primary Health Care Provider (PHCP) relationship Difficulty taking medications HIV-specific emotional support HIV-specific tangible support Present life satisfaction Family functioning HIV-related symptoms AIDS beliefs and perceptions Medication side-effects Hope Nurse-client Relationships & Health • Statistically significant correlations • Patient – PHCP relationship • Present life satisfactions • Strong patient – PHCP relationships à improved health outcomes • Supports interventions that lead to a positive therapeutic relationship e.g., Primary Health Care Nurse Practitioners in HIV+ women’s health care Nurse-client Relationships & Health NUSC 1P10 | Fall 2023