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Communication Communication is the means to establish an interpersonal-relationship with the client that is based on - dignity, mutual respect, caring

Good communication will empower the client and enable them to know themselves better - essential for the healing process Nurses must always remain positive when communicating because this is our foundation when we see people at their worst (vulnerable state). It is important to advocate and speak up for the client when they are not able to. When we communicate, its not about making decisions for them but its more about educating and providing knowledge so they have more of a broader perspective on health to make choices for themselves. Its crucial that we learn to earn a clients trust to develop a relationship, and use therapeutic techniques when we communicate. With the knowledge we learn, we integrate that with personal experiences and evaluate the situation with critical thinking. When it comes to interpersonal communication, we are subject to misinterpreting our client based on an individuals perception - perceptual biases: our tendencies that interfere with accurately perceiving and interpreting messages. We might think that others will think, feel, act/react and behave the same way we do. Nursing Process effective communcation Planning -planning interpersonal/small group session -have written documentation or referral to other Health team members of your assessment -write expected outcomes to compare later on Implementation -put plan into action -verbal, visual, auditory -record written documentation of clients progress through therapeutic techniques -contact with other health team members Therapeutic Communication Techniques Evaluation -comparison of expected outcome (planning) with actual results -acquisition of feedback -modifications, revisions of the plan

Assessment -verbal interviewing and taking notes on history -intuitive/visual observation of behaviour -gathering visual, tactile, auditory data during physical examination (or written medical records) -intrapersonal analysis/handwritten or computer-mediated documentation

Nurse-Client Helping Relationships (Therapeutic Techniques) Pre-interaction -review data (medical/nursing history). -talk to other caregivers who may have already encountered the patient -plan for initial contact -location/setting that will be comfortable Orientation -introduce and set the tone for creating a relationship -expect to get tested by the client for competence, commitment, observations -be ready to closely observe, listen, and make inferences from clients messages/behaviour -assess their health status -clarify each others role -prioritize clients problems and identify their goal -let client know when the relationship will be terminated (ex: discharge). -should also be setting the termination as well (tell client how long you will be with them). Working -while working together, encourage and help client to express feelings about their health - help with self-exploration -provide encouragement in setting goals -therapeutic communication to facilitate successful interactions -obtain cues about which parts require further in-depth investigation to meet clients needs Termination -remind client when termination is near -reflect, evaluate goal achievement with client -relinquish responsibility for their care

Therapeutic communication technique A form of communication to approach the patient as a whole, by encouraging the expression of feelings, open ideas and convey the nurses acceptance and respect. Nurses are accountable for 4 standard statements 1) therapeutic communication 2) client-centered care 3) maintaining boundaries 4) protecting client from abuse

As a nurse, it is important to create a helping relationship based on trust, care, nonjudgemental acceptance (also have patience). - never have to agree 100%; listening and acknowledging feeling is priority Do not try to relate with what the patient is experiencing, as a sense of pity may be perceived (sympathy). - instead, listen and comfort by asking if they want to talk about any problems anytime, if they feel the need to. Recognize that all behaviour has meaning to it. Always respect the clients belief and values (ex: religion) and integrate those aspect into your plan of care. Actively include the client and significant other (ex: family members, parents, etc) as partners in the care and identify any goals, wishes, or preferences the client may have. - the clients well-being and stay at the hospital will be affected by the nurses ability to establish/maintain a therapeutic relationship Active Listening

-SIT facing the client - show interest and that we want to hear what they have to share (give full attention)

-OBSERVE an OPEN posture -uncrossing legs and arms suggests that the nurse is OPEN to the client -if closed, it may be conveyed as a defensive stance

-LEAN toward the client -show that we are involved and interested in interacting with the client

-EYE contact -this suggests that we are involved and willing to listen to them

-RELAX -must be comfortable to show that we are comfortable talking and listening -restlessness indicates lack of interest and convey a feeling of discomfort

Forms of Communication Verbal Communications Vocabulary Interpreters may be required if nurse and client do not speak the same language Adjust accordingly; make sentences simple and clear (ex: medical terms)

Denotative & Connotative Select words carefully, so there is less misunderstanding - especially when explaining a medical condition or therapy

Pacing Speed of speech and enunciating each words to make it clear for clients - reduce rushing and pauses, um

Intonation Be aware of tone to avoid sending unintentional messages, as tones may provide information of a nurses emotional state

Clarity & Brevity Effective communication ~ brief, direct, and simple - avoid using you know, Okay?, of every sentence

Timing & Relevance Communicate when it is appropriate. If the client is sedated or just took medication, return at a different time. Discussing routines when the patient is ready (ex: emotionally distressed) at the right times Non-Verbal These include: 5 senses, personal appearance, posture & gait (appear confident), facial expression, eye contact, gesture, sounds, personal space