midterms

• Communication


  • Interchange of information between two or more people
  • Exchange of ideas or thoughts
  • Any means of exchanging information or feelings between two or more people
• Nurses who communicate effectively

  • Are better able to collect assessment data
  • Initiate interventions
  • Evaluate outcomes of interventions
  • Initiate change that promotes health
  • Prevent the safety and legal problems associated with nursing practice

  
• Nurse-client relationship


  • The communication process is built on a trusting relationship with a client and support people
  • Effective communication is essential for the establishment of a nurse–client relationship
• Levels of communication


  • Intrapersonal
  • Interpersonal
  • Group
• Intrapersonal communication


  • Communication that you have with yourself
  • Another name is self-talk
• Both the sender and the receiver of a message usually engage in self-talk
• Intrapersonal communication involves thinking about the message before it is sent, while it is being sent, and after it is sent, and it occurs constantly
• Intrapersonal communication can interfere with a person's ability to hear a message as the sender intended
• The communication process


  1. Face-to-face communication involves a sender, a message, a receiver, and a response, or feedback

  2. Communication is a two-way process involving the sending and the receiving of a message
• Sender


  • A person or group who wishes to communicate a message to another, can be considered the source-encoder
  • The person or group sending the message must have an idea or reason for communicating (source) and must put the idea or feeling into a form that can be transmitted
• Encoding


  The selection of specific signs or symbols (codes) to transmit the message, such as which language and words to use, how to arrange the words, and what tone of voice and gestures to use
• The nurse must not only deal with dialects and foreign languages but also cope with two language levels—the layperson's and the health professional's
• Message


  • What is actually said or written, the body language that accompanies the words, and how the message is transmitted
  • The method used to convey the message can target any of the receiver's senses
  • It is important for the method to be appropriate for the message, and it should help make the intent of the message clearer
• Receiver


  • The listener, who must listen, observe, and attend
  • The decoder, who must perceive what the sender intended (interpretation)
  • Perception uses all the senses to receive verbal and nonverbal messages
  • To decode means to relate the message perceived to the receiver's storehouse of knowledge and experience and to sort out the meaning of the message
• Whether the message is decoded accurately by the receiver, according to the sender's intent, depends largely on their similarities in knowledge and experience and socio-cultural background
• Ineffective communication occurs when the receiver misinterprets the sent message
• Response


  • The message that the receiver returns to the sender
  • Also called feedback
  • Feedback can be either verbal, nonverbal, or both
• Verbal communication


  • Spoken or written word
  • Largely conscious because people choose the words they use
  • The words used vary among individuals according to culture, socioeconomic background, age, and education
• Factors to consider when choosing words


  • Pace and intonation
  • Simplicity
  • Clarity and brevity
  • Timing and relevance
  • Adaptability
  • Credibility
  • Humor
• Nonverbal communication


  • Other forms, such as gestures or facial expressions, and touch
  • Sometimes called body language, includes gestures, body movements, use of touch, and physical appearance, including adornment
  • Often tells others more about what a person is feeling than what is actually being said, because nonverbal behavior is controlled less consciously than verbal behavior
• Observing and interpreting the client's non verbal behavior is an essential skill for nurse to develop
• Aspects of nonverbal communication to observe


  • Personal appearance
  • Posture and gait
  • Facial expression
  • Gestures
• Personal appearance


  • Clothing and adornments can be sources of information about a person
  • How a person dresses is often an indicator of how the person feels
• Posture and gait


  • The ways people walk and carry themselves are often reliable indicators of self concept, current mood, and health
  • Erect posture and an active, purposeful stride suggest a feeling of well being
  • Slouched posture and a slow, shuffling gait suggest depression or physical discomfort
• Facial expression


  • No part of the body is as expressive as face
  • Feelings of surprise, fear, anger, disgust, happiness, and sadness can be conveyed by facial expressions
• Gestures


  • Hand and body gestures may emphasize and clarify the spoken word, or they may occur without words to indicate a particular feeling or to give a sign
  • For people with special communication problems, such as the deaf, the hands are invaluable in communication
  • Ill individuals who are unable to reply verbally can similarly devise a communication system using the hands
• Electronic communication


  • Common form is e-mail, in which an individual can send a message, by computer, to another person or group of people
  • Computers are playing an increasing role in nursing practice
  • Many health care agencies are moving toward electronic medical records where nurses document their assessments and nursing care
  • E-mail can be used in health care facilities for many purposes: to schedule and confirm appointments, report normal lab results, conduct client education, and for follow-up with discharged clients
• Advantages of e-mail


  • It is a fast, efficient way to communicate, and it is legible
  • It provides a record of the date and time of the message that was sent or received
  • Some health facilities provide information to their clients on how they can reach, via e-mail, specified staff members
  • It improves communication and continuity of client care
  • E-mail promises better access, and evidence has shown that clients and health care providers are willing to use Internet-based technologies
• Disadvantages of e-mail


  • Concern by both clients and primary care providers regarding privacy, confidentiality, and potential misuse of information
  • Protection of client privacy remains an issue when transferring information electronically
  • Not everyone has a computer, and even if people have access to computers at, say, a public library, not everyone has the necessary computer skills
  • Other forms of communication will be needed for clients who have limited abilities with speaking English, reading, writing, or using a computer
• Factors influencing the communication process


  • Development
  • Gender
  • Values and perception
  • Personal space
  • Territoriality
  • Roles and relationship
  • Environment
  • Congruence
• Development


  • Language, psychosocial, and intellectual development move through stages across the life span
  • Knowledge of the client developmental stage will allow the nurse to modify the message accordingly
• The use of dolls and games coupled with simple language may help explain a procedure to an 8 year old
• With adolescents who have developed more abstract thinking skills, a more detailed explanation can be given, whereas a well-educated, middle-aged business executive may wish to have detailed technical information provided
• Older clients are apt to have had a wider range of experiences with the health care system, which may influence their response or understanding
• With aging also come changes in vision and hearing acuity that can affect nurse–client interactions
• Gender


  • Girls tend to use language to seek confirmation, minimize differences, and establish intimacy
  • Boys use language to establish independence and negotiate status within a group
  • These differences can continue into adulthood so that a man and a woman may interpret the same communication differently
• Values and perception


  It is important for the nurse to be aware of a client's values and to validate or correct perceptions to avoid creating barriers in the nurse-client relationship
• Personal space


  • The distance people prefer in interactions with others
  • Proxemics – is the study of distance between people in their interactions
  • Communication thus alters in accordance with four distances, each with a close and a far phase
• Distances in personal space

  • Intimate - Touching to 1 1⁄2 feet
  • Personal - 1 1⁄2 to 4 feet
  • Social - 4 to 12 feet
  • Public - 12 to 15 feet
• Environment


  • People usually communicate most effectively in a comfortable environment
  • Temperature extremes, excessive noise, and a poorly ventilated environment can all interfere with communication
  • Lack of privacy may interfere with a client's communication about matters the client considers private
  • Environmental distraction can impair and distort communication