K & E Ch 26 Comunicating

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Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Audrey Berman • Shirlee Snyder
Communicating
26
Learning Outcomes
Describe the components of the communication process.
Discuss the various aspects that nurses need to consider when using the different forms of communication.
Describe factors influencing the communication process.
Learning Outcomes (cont'd)
Recognize barriers to communication.
Learning Outcomes
Identify types of groups helpful in promoting health and comfort.
Discuss how nurses use communication skills in each phase of the nursing process.
Learning Outcomes (cont'd)
State why effective communication is imperative among health professionals.
Describe the following disruptive behaviors and how they affect the health care environment and client safety: incivility, lateral violence, and bullying.
Learning Outcomes
Discuss the differences between nurse and physician communication and how to address these differences.
Differentiate the major characteristics of assertive and nonassertive communication.
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The Communication Process
The source-encoder
A person or group who wishes to communicate a message to another
Message
The Communication Process (cont'd)
Modes of Communication
Nonverbal
Makes up majority of communication
Electronic
E-mail
Verbal Communication
Nonverbal Communication
Personal appearance
Electronic Communication
E-mail advantages
Fast, efficient
Provides record
Electronic Communication (cont'd)
Socioeconomics
Factors Influencing the Communication Process
Development
Gender
Social (4 to 12 feet)
Public (12 to 15 feet)
Factors Influencing the Communication Process
Territoriality
Factors Influencing the Communication Process (cont'd)
Interpersonal attitudes
Therapeutic Communication
Promotes understanding
Five actions
Box 26-1 Actions of Physical Attending
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Barriers to Communication
Need to recognize
Placing nurse’s needs above client’s needs
Nurse-Client Relationships
Helping Relationship
Growth-facilitating process
Become better at helping themselves in their everyday lives
Keys to Helping Relationships
Development of trust and acceptance
Underlying belief that the nurse cares about and wants to help the client
Influence the Helping Relationships
Influence the Helping Relationships (cont'd)
Ethnic and cultural background
Phases of the Helping Relationship
Preinteraction
Introductory
Preinteraction Phase
Name, address, age, medical history, and/or social history
Anxious feelings in the nurse
Identifies specific information to be discussed
Positive outcomes can evolve
Introductory Phase
Orientation phase
Develop trust and security
Resistive behaviors may display
Introductory Phase (cont'd)
Can be overcome
Working Phase
Once caring develops, empathy increases
Exploring and understanding thoughts and feelings
Facilitating and taking action
Working Phase (cont'd)
Help client plan a program of action to meet preestablished goals
Exploring and understanding thoughts and feelings
Empathetic listening and responding
Empathy
The ability to experience, in the present, a situation as another did at some time in the past
End result of empathy
Helping healing relationship
The responsibility belongs to the client
Nurse collaborates in these decisions, provides support, may offer options or information
Termination Phase
Nurse and client accept feelings of loss
Client accepts the end of the relationship without feelings of anxiety or dependence
Comparative Features of Effective Groups
Atmosphere comfortable and relaxed
Leadership and member participation
Comparative Features of Effective Groups (cont’d)
Cohesion
Types of Health Care Groups
Task groups
Teaching groups
Self-help groups
Self-awareness/growth groups
Therapy groups
Communication and the Nursing Process
Assessing
Communication style
Language varies with age and development
Diagnosing
Anxiety
Powerlessness
Planning
Impaired Verbal Communication
Outcome is to reduce or resolve the factors impairing the communication
Specific nursing interventions planned for the stated etiology
Implementing
Educating the client and support person
Evaluating
Communication and the Nursing Process (cont'd)
Evaluating
Analyzed in content and meaning of interaction
Increase awareness and insight
Communication and the Nursing Process (cont'd)
Effective communication is important among health professionals
Communication problems
Nurses have reported
Communication Among Health Professionals (cont'd)
Disrupted behavior have had a negative impact
Disruptive Behaviors
Incivility
Disruptive Behaviors (cont'd)
Recipient feels upset, threatened, humiliated, or vulnerable
Occurs repeatedly for at least 6 months
Nurse and Physician Communication
Nurses are descriptive in verbal and written
Physicians are brief, to the point, and focused on a problem
SBAR
Situation
Background
Assessment
Recommendations
Nurse and Physician Communication (cont'd)
Emotional Intelligence
Assertive Communication
Nonassertive Communication
Box 26-7 SBAR: Situation, Background, Assessment, Recommendation Model
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Assertive Communication
Honest, direct and appropriate
Use of the “I” statements versus the “you” statements
Assertive Communication (cont'd)
“You” statements place blame and put the listener in a defensive position
“I” statements encourage discussion
Submissive communication
Allow their rights to be violated by others
Meet the demands and requests of others without regard to own feelings and needs
Believe own feelings are not important
Are insecure and try to maintain self-esteem by avoiding conflict
Aggressive communication

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K & E Ch 26 Comunicating