COMMUNICATION Module D Communication Definition Consists of five elements –Encoder, or sender...

COMMUNICATION

Module D

Communication

Definition Consists of five elements

– Encoder, or sender– Message– Sensory channel– Decoder– The feedback, or return

• This indicates the degree of understanding of the message

Communication (cont.)

Levels of Communication– Intrapersonal– Interpersonal– Public

Forms Of Communication

Verbal– Vocabulary– Denotative meaning– Connotative meaning– Pacing– Intonation– Clarity & Brevity– Timing & Relevance

Forms of Communication (cont.)

Non-verbal– *adds cues & meaning to verbal

communication– Personal appearance– Posture & gait– Facial expression– Eye contact– Gestures– Territoriality & Space

Forms of Communication

Therapeutic- Communication that is beneficial in developing a nurse-client helping relationship (Ex. Active listening- SOLER, empathy, humor, touch)

Non-Therapeutic- Communication that is not beneficial or helpful to people involved Ex. Personal questions, personal opinions, changing the subject.

Zones of Personal Space

Intimate (0-18 in) Personal (18-4ft) Social (4- 12 ft) Public (12 ft or greater)

Zones of Touch

Social ( permission not needed) Consent (permission needed) Vulnerable (special care needed) Intimate (great sensitivity needed)

The Nurse-Client Helping Relationship The Nurse-Client Helping Relationship Helping relationships are created through

the nurse’s:– Application of scientific knowledge– Understanding of human behavior and

communication– Commitment to caring

*Therapeutic communication doesn’t happen. You have to work at it.

Building and Maintaining Nurse-Client Helping Relationships Pre-interaction Phase Orientation Phase Working Phase Termination Phase

Pre-interaction Phase

Before meeting client Review data available ( diagnosis, medical

history Assign appropriate room Anticipate concerns or needs

Orientation Phase

Introduce yourself Set a positive tone

with a warm empathetic manner

Assess client health status

Prioritize needs and goals of your client

Clarify client’s and your roles

Let the client know when to expect the relationship to end

Working Phase

Encourage and help the client express feelings

Encourage and help client set goals Take action to meet the goals set the client

Termination Phase

Remind client that termination is near Evaluate goal achievement Help to achieve a smooth transition to other

caregivers

Techniques for improved therapeutic communication Professionalism Courtesy Confidentiality Availabilty Trust Empathy Sympathy

Acceptance Respect Silence Hope Encouragement Socializing Gender/Cultural

sensitivity

Barriers to Effective Communication Inattentive listening Medical vocabulary Giving personal

opinions Being defensiveness Showing disapproval

Cultural differences

Be aware of language barriersSensory impairments

WHAT CAN WE DO TO OVERCOME THESE BARRIERS?

Documentation- What is it and why do we do it?????? Documentation is defined as anything

written or printed within a client record. A record is a permanent legal written

document. NOT CHARTED NOT DONE!!!!!!!!! Documentation provides written record of

the care given to the patient.

Documentation:

Financial record of care. Used for clinical research Used for professional development

What do we chart?

Assessment Vital signs Any change in pt

condition If verbal order taken Procedure done PRN medication Intake & output

What is in “The Chart”? Admission sheet-

demographic data, in case of emergency, etc..

Physician’s order sheet- record of MD orders( meds, Tx,etc.)

Nurses admission assessment- Nsg summary of Hx & Physical

Graphic/ Flowsheet- VS, Daily wts, I/O

Med Hx & Exam- Initial exam and hx taken by MD

RN notes- record of RN assessments, treatments, etc. What we did!!!

“The Chart” cont

Med Record- MAR Tells Who, What, When, and Where!!

Client education record- Documentation of teaching done, response, if reinforcement needed, how it was done.

Physician’s progress notes- Updated record of how the pt is doing,response to tx, and any changes.

Healthcare discipline records- all areas of healthcare have a place to chart their specifics (resp, PT)_

More…

Discharge summary- Summary of the pt’s

condition upon D/C, meds, prognosis, F/U care, teaching needs, etc.

Types and Categories of Information Flowsheets Graphics Sheets Computerized charting Charting by exception SOAP Narrative Careplans

POMR PIE Focus charting Critical pathways DRGS-for

reimbursement Kardex

Reporting and Documenting

REPORTING – Change of Shift Report Types Purpose Information to include Information to omit

REPORTING – Transfer Report

Name, age, primary physician, medical dx Summary of medical progress up to time of

transfer. Current health status (physical & psycho-

social) Current nsg. Dx or problems & care plans Any critical assessments or interventions Need for any special equipment

Telephone Orders and Reports

Complete info given to MD Verbal or telephone order- given to RN by

MD and written by RN that takes order. Note as TO or VO. Repeat order back to MD After receiving it. MD must sign w/in 24hrs or by hosp policy

TO should be used only when necessary not for convenience. WHY?

Professional Communication

Courtesy Use of names Privacy Confidentiality Trustworthiness Autonomy Responsibility Assertiveness