GOOD AFTERNOON!!!

COMMUNICATION

D.R.LIM,RN,MAN,Ph.D

COMMUNICATION Is any means of exchanging information or feelings between two or more people. It is a basic component of human relationship, including nurses.
FOR NURSES:

BEDSIDE MANNER

THERAPEUTIC COMMUNICATION

Promotes understanding and can help establish a constructive relationship between the nurse and the client

PROXEMICS
Is the study of distance between people in their interaction
1. INTIMATE touching to 1 feet 2. PERSONAL 1 to 4 feet 3. SOCIAL 4 to 12 feet 4. PUBLIC 12 to 15 feet

2 PURPOSES OF COMMUNICATION: a.To influence others b.To obtain information

- Communication can be described as HELPFUL OR UNHELPFUL:

HELPFUL if it encourages a sharing of information, thoughts, or feelings between two or more people

UNHELPFUL if it hinders or blocks the transfer of information and feelings

Effective communication is essential for the establishment of a

NURSE-CLIENT RELATIONSHIP

Communication can occur on an intrapersonal level within a single individual as well as on an interpersonal and group levels.

INTRAPERSONAL is the communication that you have with yourself (SELF-TALK).

SELF - TALK It involves thinking about the message before it is sent, while it is sent, and after it is sent; it occurs constantly

Interpersonal communication
Is the interaction between two people or in a small group. It is often face-to-face and is the type most frequently used in nursing.

ELEMENTS OF THE COMMUNICATION PROCESS:

Interpersonal Variables Channels

Referent
Sender
Message

Referent
Receiver

Feedback
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ELEMENTS OF COMMUNICATION
1.REFERENT or stimulus which motivates the person to talk ( idea,emotion)

ELEMENTS OF COMMUNICATION

2.SENDER - A person or group who wishes to convey a message to another, can be considered the SOURCE-ENCODER

ENCODING involves 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.

ELEMENTS OF COMMUNICATION 3.MESSAGE -What is usually said or written, the body language that accompanies the words

ELEMENTS OF COMMUNICATION 4.CHANNEL the medium used to convey the message and it can target any of the receivers senses.

TOUCH

nonverbal communication is often highly effective.

ELEMENTS OF COMMUNICATION 5.RECEIVER --Is the listener, who must listen, observe, and attend

DECODER to decode means to relate the message perceived to the receivers storehouse of knowledge and experience and to sort out the meaning of the message.

INEFFECTIVE COMMUNICATION

is misinterpreted by the receiver

-when the message sent

ELEMENTS OF COMMUNICATION 6.RESPONSE/FEEDBACK --Is the message that the receiver returns to the sender.

MODES OF COMMUNICATION A. VERBAL COMMUNICATION

Uses spoken or written word Words use vary depending on ones culture socioeconomic background, age and education

When choosing words to say or write, nurses need to consider:

1.PACE AND INTONATION
2. SIMPLICITY 3. CLARITY & BREVITY

4. TIMING & RELEVANCE

5. ADAPTABILITY

6. CREDIBILITY
7. HUMOR

effective verbal communication techniques Vocabulary Communication is unsuccessful if the receiver is unable to translate the senders words and phrases A message in spoken in terms the receiver understands makes communication more effective

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effective verbal communication techniques Denotative and connotative meaning

A denotative meaning is one shared by individuals who use a common language. A connotative meaning of a word reflects the shade or interpretation of a words meaning rather than the definition.

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effective verbal communication techniques Clarity and brevity

Clarity is best achieved by speaking slowly and enunciating clearly Effective communication is simple, short and direct Vague phrases such as you know add a little clarity to the message Brevity is best achieved by using words that express an idea simply
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effective verbal communication techniques

Pacing
Verbal is more successful when expresses at an appropriate speed or pace. Pauses should be used to accentuate or stress a particular point, giving the listener to time to hear and the speaker to think what to say.
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effective verbal communication techniques Timing and relevance Timing is critical to reception of a message. A person is more likely to communicate when a message is important or relevant.

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effective verbal communication techniques Humor Can be a powerful tool in promoting well-being. The phrase, laughter is the best medicine applies when it helps to adjust to stress imposed by different kinds of stressor
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B.NONVERBAL COMMUNICATION
BODY LANGUAGE

It includes gestures, facial expressions, touch, physical appearance, adornment

 PERSONAL APPEARANCE FACIAL EXPRESSION POSTURE & GAIT

GESTURES

Non verbal cues:

Personal appearance The general impression formed of another person influences the response to that person Intonation The tone of the speakers voice can have a significant effect on a messages meaning Voice tone can be a cue to a persons emotional state and energy level

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non verbal cues...

Facial expression The face has a rich communication potential A mutual glance or communication of eyes between two people can set the tone for an interpersonal encounter.

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non verbal cues...

Posture and gait
The way that people stand and move is visibly form of self expression. Posture and gait reflects attitudes, emotions, self concept and physical wellness

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non verbal cues

Gestures Are used to illustrate an idea that is difficult or inconvenient to describe in words. Touch
Is a personal form of non verbal communication. Various messages such as affection, emotional support, encouragement, tenderness, and personal attention conveyed by touch.

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ELECTRONIC COMMUNICATION
E-MAIL most common form of electronic communication Advantage efficient way to communicate and legible -facilitate communication and continuity of care -better access

E-MAIL Disadvantage

Risk to client confidentiality Socioeconomics Not every one has the necessary computer skills

When not to use E-MAIL When the information is urgent and clients health is in jeopardy High confidential information ( HIV status , mental health , chemical dependency) Abnormal lab data, confusing information , it is better to call the client

PHASES OF COMMUNICATION 1. ORIENTATION PHASE

Tone and guidelines for the relationship are established. Nurse and client meet and learn to identify each other by names.

 interaction this time are purposeful to achieve mutual goals and objective
2.WORKING PHASE

3. TERMINATION PHASE

conclusion of the initial agreement is acknowledged.

BARRIERS TO COMMUNICATION
1.STEREOTYPING generalized and oversimplified beliefs about groups of people that are based on experiences.

2.AGREEING AND DISAGREEING 3. BEING DEFENSIVE

Attempting to protect a person or health care services from negative comments. These responses prevent the client from expressing true concerns.

4. CHALLENGING Giving a response that makes clients prove their statement or point of view.

5. PROBING

Asking

for informations chiefly out of curiosity rather than with the intent to assist the client.

Asking why ?

6. TESTING Asking questions that make the client admit to something.

7. REJECTING
Refusing to discuss certain topics with the client.

8. CHANGING TOPICS AND SUBJECTS

Directing the communication into areas of self-interest rather than considering the clients concerns.

9. UNWARRANTED REASSURANCE

Using clichs or comforting statements of advice as a means to reassure the client.

10. PASSING JUDGEMENT

Giving opinions and approving or disapproving responses, moralizing, or implying ones own values.

11. GIVING COMMON ADVICE Telling the client what to do. These responses deny the clients right to be an equal partner.

THERAPEUTIC COMMUNICATION

THERAPEUTIC COMMUNICATION TECHNIQUES

1. USING SILENCE

Accepting pauses or silences

that may extend for several seconds or minutes without interjecting any verbal response.
ex. Sitting quietly and waiting attentively until the client is able to put thoughts and feelings into words

To be an attentive listener, the nurse uses the following skills: Face clients while they speak. Maintain natural eye contact to show willingness to listen. Assume an attentive posture. Avoid crossing legs and arms because this conveys a defensive posture.

To be an attentive listener, the nurse uses the following skills: Avoid distracting body movements, such as wringing hands, tapping feet, or fidgeting with an object in the hands. Nod in acknowledgement when clients talk about important points of look for feedback. Lean toward speakers to communicate involvement.

2. PROVIDING GENERAL LEADS Using statements or questions that encourage the client to verbalize or choose a topic of conversation, and facilitated continued conversation.

ex. Can you tell me how it is for you?

3. BEING SPECIFIC AND TENTATIVE

Making statements that

are specific rather than general, and tentative rather than absolute.
ex. Rate your pain on a scale of 0-10. (specific statement)

4. USING OPEN-ENDED QUESTION

Asking broad question that lead or invite the client to explore ex. What is your opinion?

5. USING TOUCH
Providing appropriate form of touch to reinforce caring feelings.

ex. Putting an arm over the clients shoulder. Placing your hand over the clients hand.

6. RESTATING

Repeating the main idea expressed by the client saying the same key words that he just had spoken. ex. Client: I couldnt manage to sleep last night Nurse: You were not able to sleep last night?

7. PARAPHRASING

Stating in newer and fewer

words the basic content of the clients message.

ex. Client: I couldnt manage to eat any dinner last night not even the dessert. Nurse: You have difficulty eating yesterday?

8. SEEKING CLARIFICATION
Helping client clarify their own thoughts and maximize mutual understanding between the client and the health provider.

ex. Im puzzled.

9. PERCEPTION CHECKING OR SEEKING CONSENSUAL VALIDATION

a method similar to clarifying that verifies the meaning of specific words rather than the overall meaning of a message.

10. OFFERING SELF suggesting ones presence,

interest or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurses attention.

ex. Ill stay with you until your daughter arrives.

11. GIVING INFORMATION providing in a simple and direct manner, specific factual information that the client may or may not request

ex. Your surgery is scheduled for 11 AM tomorrow

12. ACKNOWLEDGING giving recognition in a nonjudgmental way, of a change of behavior, an effort the client has made, or a contribution to a communication.
. You walked twice as far today with your walker.
ex

13. CLARIFYING TIME AND SEQUENCE helping the client clarify an event, situation, or happening in relationship to time.
ex. Nurse: Was that after breakfast?

14. PRESENTING REALITY

helping

the differentiate real unreal.

client from

15. FOCUSING
helping the client expand on and develop a topic of importance.

16. REFLECTING
directing
ideas, feelings, questions, or content back to clients to enable them to explore their own ideas and feelings about a situation.
ex. Client: What can I do? Nurse: What do you think would be helpful?

 Bringing together important points discussion to enhance understanding

17. SUMMARIZING AND PLANNING

ex. During the past half our we have talked about...

SUMMARY
COMMUNICATION THERAPEUTIC COMMUNICATION PROXEMICS 2 PURPOSES OF COMMUNICATION COMMUNICATION PROCESS ELEMENTS OF COMMUNICATION MODES OF COMMUNICATION ELECTRONIC COMMUNICATION PHASES OF COMMUNICATION BARRIERS TO COMMUNICATION

Thank you..

Are there any question??

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Review for 5 minutes..

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DAISY R. LIM,RN,MAN,Ph.D