Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 21 Communicator

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins o8&feature=share&list=TLOdAuLDgJKdchttp:// o8&feature=share&list=TLOdAuLDgJKdc

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Five Parts of the Communication Process (Berlo) The stimulus or referent The sender or source of message (encoder) The message itself The medium or channel of communication The receiver

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Components in the Process of Communication

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Four Levels of Communication Intrapersonal Interpersonal Small-group Organizational

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question A nurse who reassures herself that she is prepared to speak in front of a group of her peers is using which of the following types of communication? A. Intrapersonal B. Interpersonal C. Group D. Organizational

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: A. Intrapersonal Rationale: Intrapersonal communication is self-talk that happens within the individual. Interpersonal communication occurs between two or more people to exchange messages. Group communication includes small-group and organizational group communication.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Roles of Group Members Task-oriented—focus on work to be done Group building or maintenance—focus on well-being of people doing work Self-serving—advance the needs of individual members at group’s expense

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question An individual who dominates a group meeting to promote his own personal agenda is performing which of the following group-member roles? A. Task-oriented B. Group building C. Maintenance D. Self-serving

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Answer: D. Self-serving Rationale: Self-serving roles advance the needs of individual members at the group’s expense. Task-oriented roles focus on the work to be done (e.g., information giver/seeker, coordinator, delegator) Group-building and maintenance roles focus on the well- being of the people doing the work (e.g., listener, trust builder, supporter).

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Influencing Communication Developmental level Gender Sociocultural differences Roles and responsibilities Space and territoriality Physical, mental, and emotional state Environment

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Forms of Communication Verbal (language) Nonverbal (body language) –Facial expressions, touch, eye contact –Posture, gait –Gestures –General physical appearance –Mode of dress and grooming –Sounds, silence

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. Touch is a personal behavior that means the same thing to all persons. A. True B. False

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: B. False Touch is a personal behavior that means different things to different people.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins The Helping Relationship Does not occur spontaneously Characterized by an unequal sharing of information Built on the patient’s needs

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Characteristics of the Helping Relationship Dynamic Purposeful and time limited Person providing assistance is professionally accountable for the outcomes

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Phases of the Helping Relationship Orientation phase Working phase Termination phase

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following activities generally occurs during the orientation phase of the helping relationship? A. An agreement or contract about the relationship is established. B. The nurse provides any assistance needed to achieve patient goals. C. The nurse provides patient counseling and teaching. D. The patient and nurse examine the goals of the helping relationship for indications of attainment.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: A. An agreement or contract about the relationship is established Rationale In the orientation phase a contract is made defining the goals of the relationship, frequency, location, length of contacts, and duration of the relationship. The nurse provides assistance needed to achieve patient goals, counseling and teaching in the working phase. The patient and nurse examine the goals of the helping relationship for indications of attainment in the terminations phase.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Goals of the Orientation Phase Establish tone and guidelines for the relationship. Identify each other by name. Clarify roles of both people. Establish an agreement about the relationship. Provide the patient with orientation to the healthcare system.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Goals of the Working Phase Work together to meet the patient’s needs. Provide whatever assistance is needed to achieve each goal. Provide teaching and counseling.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Goals of the Termination Phase Examine goals of helping relationship for attainment. Make suggestions for future efforts if necessary. Encourage patient to express his or her emotions about the termination.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors that Promote Effective Communication Dispositional traits Rapport builders

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Dispositional Traits Warmth and friendliness Openness and respect Empathy Honesty, authenticity, trust Caring Competence Genuineness

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Rapport Builders Specific objectives Comfortable environment Privacy Confidentiality Patient vs. task focus Utilization of nursing observations Optimal pacing Providing personal space

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. A nurse should respect a patient’s personal space by remaining outside an arm’s length of the patient and refraining from touching the patient unnecessarily. A. True B. False

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: B. False A nurse should respect a patient’s personal space by assessing this space through careful observations of nonverbal communication.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Methods of SBAR Communication Posters Stickers on phones Peer observation Inclusion of SBAR in orientation and safety training

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Developing Conversation Skills Control the tone of your voice. Be knowledgeable about the topic of conversation. Be flexible. Be clear and concise. Avoid words that might have different interpretations. Be truthful. Keep an open mind. Take advantage of available opportunities.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Developing Listening Skills Sit when communicating with a patient. Be alert and relaxed and take your time. Keep the conversation as natural as possible. Maintain eye contact if appropriate. Use appropriate facial expressions and body gestures. Think before responding to the patient. Do not pretend to listen. Listen for themes in the patient’s comments. Use silence, therapeutic touch, and humor appropriately.

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Using Therapeutic Touch to Convey a Message

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Interviewing Techniques Open-ended questions or comments Closed questions or comments Validating questions or comments Clarifying questions or comments Reflective questions or comments Sequencing questions or comments Directing questions or comments

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Basic Components of Assertiveness Having empathy Describing one’s feelings or the situation Clarifying one’s expectations Anticipating consequences

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Blocks to Communication Failure to perceive the patient as a human being Failure to listen Inappropriate comments and questions Using clichés Using closed questions Using questions containing the words “why” and “how” Using questions that probe for information

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Blocks to Communication (cont.) Using leading questions Using comments that give advice Using judgmental comments Changing the subject Giving false assurance Using gossip and rumors Using aggressive interpersonal behavior

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Tell whether the following statement is true or false. An open-ended question or comment serves to validate what the nurse believes is heard or observed. A. True B. False

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer Answer: B. False A validating question or comment serves to validate what the nurse believes is heard or observed.