Communication ! Purpose: establish nurse-client relationship ! ! - express concern/interest for patient/family ! ! - provide health care info

! SEND and RECEIVE verbal and non-verbal messages !

! - channel = means of communication! - feedback = message understood by patient

! Sender = nurse ! Receiver = patient

! Levels: Intrapersonal = people talk to themselves by forming thoughts that ! ! ! influence perceptions ! ! Interpersonal = occurs 2 people or groups ! ! Public = one person with a crowd of people (conference) !! Non-verbal Communication= 85% of communication! ! ! - use of gestures, expressions, behaviors (body language) ! ! ! ! ex: personal appearance ! ! ! ! - posture and gait ! ! ! ! - facial expression ! ! ! ! - eye contact ! ! ! ! - gestures

- territorially and space

Fundamentals - Test 1

!Zones of Touch ! - Social zone ! - Consent zone (permission needed) ! - Vulnerable zone (special care needed) ! - Intimate zone (great sensitivity needed)

Communication within Caring Patients ! - Professionalism ! - Courtesy ! - Confidentiality ! - Trust ! - Acceptance and respect ! - Availability ! - Socializing

Therapeutic Communication ! = PURPOSEFUL & GOAL-ORIENTED ! = Creates a beneficial outcome for the client

! Goals: obtain and provide information ! ! - develop trust ! ! - show caring ! ! - explore feelings

! - Use: attentive listening = use of all senses; receives total messages ! ! - help patient express thoughts and feelings ! ! - encourage conversation and elaboration

! Techniques: Empathy ! ! ! - Active listening ! ! ! - Use of touch ! ! ! - Use of humor

Communication Techniques ! - Clarifying/validating ! - Asking open-ended questions ! - Using indirect statements ! - Reflecting ! - Paraphrasing ! - Summarizing ! - Focusing ! - Silence

NO-NOs of Communication ! - Closed questions ! - False reassurance ! - Judgemental responses ! - Defensive reflex ! - Agree/disagreeing or approving/disapproving ! - NEVER Give ADVICE ! - Request an explanation ! - Changing the subject ! - Talking to much ! - Interrupting ! - NOT LISTENING = MOST HARMFUL

Gestures = must be sensitive to cultural variances !Time = important in the US

Cultural Values = important to know when assessing patients ! ! ! - be aware

Determinant Factors ! =Social Factors ! - Religion

- Family Situation ! - Level of Consciousness ! - Stage of Illness ! - Visual, hearing, and speech ability ! - language proficiency !Ways of Communication: 1) Oral ! ! ! ! 2) Written ! ! ! ! 3) Self-reflection

Keep Communication Clear ! - Ask for clarification ! - Restate ! - Seek validation ! - Place events in chronological order

Ethics = the principles of right and wrong, virtue vs. vice, good vs. evil, etc. !! Identify =own personal values and morality ! ! - professional values and ethics ! ! - Know institutional policies ! ! - know legal guidelines of healthcare

Professional Values - Altruism = the belief in concern for the well-being of others.- Autonomy = self- values (independence) - Human dignity = dignity for every human being - Integrity = the quality of being honest and having strong moral principles- Social Justice

Principles of Healthcare Ethics ! - Beneficence = doing good! - Nonmaleficence = we should act in ways that do not inflict evil or cause harm to ! ! others ! - Respect of Autonomy ! - Justice

Ethical Rules in Professional-Client relationship ! - Fidelity = loyalty ! - Veracity = telling the truth ! - Privacy ! - Confidentiality

To practice ethically, the nurse should FOLLOW the American Nurses Association Code of Ethics for Nurses

Patients Bill of Rights! 1) High-quality hospital care ! 2) Clean and safe enviornment ! 3) Involvement in care ! 4) Protection of your privacy ! 5) Help prepare you for discharge ! 6) Help with billing and insurance claims

Nurses Bill of Rights

! 1) Practice in a manner that fulfills their obligation to society and patients ! 2) Work in environments supportive of ethical practice ! 3) Advocate (self and patient) ! 4) Fair compensation ! 5) A safe environment (self and patient) ! 6) Negotiate conditions of employment

Law = standard or rule of conduct established and enforced by government ! - Federal Law = regulates relationships between individuals and government! - Private Law = regulates relationships among people through court decisions! - Criminal Law = state and federal criminal statuses ! ! Crime - wrong against a person or property ! ! Tort - a wrong committed by a person against another person or property ! ! ! (un/intentional) !! Intentional ! ! ! ! ! Unintentional ! -Assault/battery ! ! ! ! - Negligence ! - defamation of character!! ! - Malpractice ! - Invasion of privacy ! - False imprisonment

Teaching = interactive process consisting of actions that help a learner gain new ! knowledge, behaviors, attitudes or skills Learning = attainment of new knowledge, attitudes, behaviors or skills

Domains of Learning ! Cognitive = Intellectual behaviors that require thinking ! Affective = expressing feelings and accepting attitudes, opinions and values ! Psychomotor = attaining skills that require brain and muscles to work together !Purpose of patient education: ! - Health promotion and illness prevention ! - Restoration of health ! - Coping with impaired function

What percentage of elders on their own consume less than 1000 calories per day?! = 16%

How many elders in the US are estimated to be mistreated every year? ! - 700,000-1.2 millions cases/yr.

Which group of individual in the elderly population are more likely to be widowed?- Elderly women

Signs of Depression with elders ! - Persistent depressed mood every day for 2 weeks ! - loss of interest ! - Significant change in weight or appetite ! - problems sleeping ! - suicidal ideation

Dementia (signs and Symptoms) ! - Irreversible confusion ! - Delirium (acute confusion) ! - Language deficits ! - Impaired communication

When youre doing an assessment on a Alzheimers patient, which type of health promotion would you be giving?

- Validation therapy

If the physician has ordered a high does of medication, and you need to be safe, what do you do? ! - You verify the medication ! - Are you sure you want to give 10x the dose to the patient? ! ! = due to your ethics, you know that you should not do this.

What is a living will? - a written statement detailing a person's desires regarding their medical

treatment in circumstances in which they are no longer able to express informed consent, especially an advance directive.

A primary health maintenance concern for adolescences is: LIVER ! - due to alcohol consumption = educate them about the liver

What topic of education would you focus on to an elder? ! - Exercise: this can prevent a lot of potential problems