1. Chapter 7 Patient Safety Risk Factors Affecting Communication Climates

2. Communication Climate Defined
The tone,
emotions, and
attitudes of
individuals in
relationships

3. Patient-Safe Strategy
Before interrupting or joining a conversation between two or more people, assess the communication climate

4. Communication Risk Factors Potentially Create Negative Communication Climates
Emotional risk factors
Fear of the unknown
Anxiety
Sadness, grief, loss
Anger and resentment
Physiological risk factors
Physical disability
Sensory impairment/memory loss
Sedation
Fatigue

5. Patient-Safe Strategies to Promote Positive Communication Climates Confirming Messages
Recognition
Acknowledgement
Endorsement
Complement
Empathy

6. Avoid Disconfirming Messages
Unreceptive
Interruption
Irrelevant
Tangential
Impersonal
Ambiguous
You are wrong; I am right

7. Illness: Affects Communication Climate
Illness threatens self-esteem and self-worth, resulting in high risk for negative communication climates
Illness threatens livelihood, role performance, and life itself
Illness results in alterations in tone, emotions, and attitudes of patients, family members, and nurses

8. Impact of Illness on Communication Climate
Physical stages of illness: Onset, course, prognosis
Psychosocial stages: Damage to self-esteem and feelings of worthlessness associated with loss
Transition to illness
Acceptance
Convalescence
Patient responses to dependency and the sick role are unique, based on bio-psycho-social-cultural-spiritual makeup of the patient/family

9. Transforming Negative Climates
Encourage emotional release by empathy
Recognize emotions; acknowledge and accept emotional responses
Create an atmosphere of safety and trust through patient-safe communication process

10. Empathic Conversations Between Patient and Nurse
Patients and families must believe nurse understands their physical and emotional needs
Nurse must clearly communicate to the patient that the message sent was interpreted correctly
Nurse must clearly communicate what needs to be done next to manage the current situation

11. Patient-Safe Communicators
Solicit feedback— verify all messages
Observe body language —actions speak louder than words (face and body)
Assess appearance —clues to physical and emotional state (clothing and hygiene)
Respond to the real message- “It’s not what you say, but how you say it….”

12. Patient-Safe Strategy of Empathy Verbally and nonverbally recognize emotions Offer support: “We’ll work on this together,” “I’m here for you”

13. Empathy vs Sympathy Empathy means you remain emotionally separate from the other person: you can still be objective

14. What is Sympathy?
Taking on the other’s problems as if they were your own
Lose objectivity
Can no longer solve problems (nurses are paid to think)
No longer therapeutic

15. Managing Your Emotions to Promote Positive Communication Climates
Recognize your feelings
Cool off
Take responsibility for your feelings
Use “I” statements
Responding to a personal attack