Upload
dillan-langham
View
221
Download
0
Tags:
Embed Size (px)
Citation preview
Module 3
Communication & Interpersonal Skills
Maslow’s Hierarchy of Needs
Levels build upon each other Lowest level- Physiological Second level – Security Third level – Belonging Fourth level – Esteem Fifth level – Self Actualization
Recognize/Report Behaviors Reflecting Unmet Human Needs Physical Needs unmet:
– Irritable, cold, weak, c/o hunger or cold– Changes in VS & LOC
Psychological Needs unmet:– Anxious, depressed, aggressive, angry– Physical ailment with no apparent cause– Expresses feelings of loneliness & worthlessness
Unmet needs may result from illness, disease,or injury, but may also contribute to development of illness
CNA Response to Behavior
Look beyond the behavior – rude, uncooperative, demanding
Remember there is an underlying need for comfort & understanding
Respond with patience, caring, sympathy, concern, kindness, empathy
If problem continues, ask licensed nurse
Communication
Definition – sharing of ideas, thoughts, information, & feelings with at least one person, even if unspoken
Therapeutic communication – used to promote optimal wellness
Routes– Internal senses – see, hear, touch– External senses – spoken, written, gesture
Steps in Communication
Message Sender Receiver Interpretation What happens when you play the
telephone game?
Methods of Communication
Verbal – the spoken word Nonverbal – most honest
– Conscious vs. unconscious– Body language– Touch– Written – red dots, name tags, uniforms, falling
stars– Electronic – devices to create sound, computers,
touch pads
Reasons for Communication Breakdown Verbal barriers –
– Criticism– Value statements– Interruptions– Judgment– Language differences– Changing subjects– Excessive talking– Pat answers – “Don’t worry, I know how you feel”
Communication Breakdown
Non-verbal– Body language– Eye contact– Cultural differences
Communication Breakdown
Physiological/aging factors– Hearing loss– Vision loss– Response time– Medications
Communication Breakdown
Not listening– Lack of concentration – preoccupied,
distracting noises, monotone voice, negative attitude
Selective hearing Emotional response to word/situation
Effective Communication Skills
Introduce self Call person by formal name or request Explain all tasks Use short sentences, ask for feedback Eye contact Speak clearly, avoid criticizing Clarify information Use words that are understood Friendly/positive tone Ensure confidentiality
Effective Communication for Special Needs Language/cultural differences
– Ask for INTERPRETER– Know cultural beliefs – word use, gestures, touching
Visually impaired– Describe surrounding– Identify self, don’t touch until they’re aware– Explore room with resident, don’t rearrange– Explain, let resident know when finished– Keep doors open, don’t speak loudly– Monitor meals
Effective Communication for Hearing Impaired Gain attention of resident, may use touch Determine which ear has loss Check for hearing aid function Determine % or loss & high/low tone loss Face resident – don’t chew gum, eliminate
background noise, stand on side of better ear Speak slowly, directly, clearly, NOT LOUDLY Short sentences, simple words, repeat if need Watch nonverbal cues, ask to repeat info
Effective Communication for Aphasia (physically impaired) Provide writing materials if speech
difficulty Let use own words, give time to speak Use picture or point boards
Conflict IS
Occurs when what a person has & what a person wants are different
A pattern of energy Nature’s primary motivation for change
Conflict IS NOT
Always negative Always a contest Always a sign of poor management Able to take care of itself if left alone Always resolvable
Conflict Handling Modes
Competing– Assertive & uncooperative– Power-oriented– Useful for:
• Standing up for rights• Defending an important position• Trying to win
Conflict Handling Modes
Accommodating– Unassertive & cooperative– Involves self-sacrifice– Useful for:
• Charitable causes/ generosity• Obeying orders• Yielding to another point of view
Conflict Handling Modes
Avoiding– Unassertive & uncooperative– Does not address the conflict– Useful for:
• Diplomatic side-stepping• Avoiding until a better time• Withdrawing from a threatening situation
Conflict Handling Modes
Collaborating– Assertive & cooperative – seeks to satisfy
both sides– Useful for:
• Gaining additional insights• Avoiding negative competition for resources• Solving interpersonal problems
Conflict Handling Modes
Compromising– Somewhat assertive & cooperative– Solutions mutually satisfying – acceptable
to all– Middle ground mode– Useful for:
• Splitting the difference• Making concessions• Finding a quick middle ground position
Areas of Concern for Conflict
Attendance & Punctuality Safety – Personal & Resident Professional Behavior Attitude Appearance & Hygiene Performance
Lines of Authority
Communication with employee: Inquiry & Advocacy– Bracket – create an open mind so people can
listen to another point of view– Paraphrase – validate & confirm what they heard– Check perceptions – Reads between the lines,
helps to understand/empathize– Ask probing questions – get more information &
deepen understanding
Lines of Authority
Communication with first line supervisor: objective reporting
Timely reporting: when & where Plan for remediation
– Clarification of concerns– Goals setting for behavior changes– Expectations & Time frame for remediation– Follow-up
Line of Authority
Confidentiality Constructive Feedback
– Info given to & received by an individual about their performance
– Goal is to improve performance– Vehicle to promote constructive relationships– Monitors how things are going– Creates a way to review ongoing issues– Keeps lines of communication open
4 E’s of Constructive Feedback Engage – set the stage
– Preparation & link feedback to common goals– State what you want to discuss
Empathize– Environment & Timing
Educate– Describe observations & impact of behavior– Remain objective
Enlist– Elicit person’s response & guide towards sol’n
Touch as Communication
Cultural beliefs regarding touch– Modesty – covering face, arms, head– Touch of body after death– Hugging
Body Language– Hands, eyes– Gestures– Posture– Regression
Personal Space
Basic Defense Mechanisms
Regression – reverting to childish behavior (thumb sucking)
Rationalization – unconscious, developing socially acceptable reasons to explain behavior (can’t give up smoking because you might gain wt)
Projection – unconscious, places own intolerable feelings onto others (Cheater accuses others of cheating)
Basic Defense Mechanisms (cont) Displacement – substituting one innocent
person for another (mad at your mom so you hit your brother)
Denial – can’t believe that it is true (my children would never do that)
Conversion – substituting acceptable physical symptoms for unacceptable emotions (feel sick when it is time to take the test)
Basic Defense Mechanisms (cont) Repression – pushes thoughts & ideas
into the subconscious where they do not recall them (has fond memories of an abusive mother)
Sublimation – unacceptable emotions are expressed in socially acceptable way (exercises when angry)
Basic Defense Mechanisms (cont) Substitution – replacing an unattainable
goal with an acceptable one (can’t sing on tune so plays the guitar)
Identification – patterning self after another, hero-worship (I want to be just like Mrs. McGrory)
Family Communication
Family structures differ – single parent, two parents, primary caregiver, extended family, & appointed guardian, conservator, or responsible party
Show respect for all family structures– Listen, courteous, respectful, supportive– Avoid involvement in family matters – give privacy– Maintain confidentiality– Allow family to help with care
Family Communication
Family needs info– Telephone & visiting hours– Location of refreshments & business office– Gift shop & public restrooms– Orient to resident activity & appointment
areas– Use family as resource to gather info about
preferences
Socio-cultural Factors
Culture – characteristics of a group of persons (attitudes, beliefs, religion, values, likes, & dislikes)– Influences reaction of residents to health
care like food preference, family practices, hygiene habits, & clothing styles
– Rituals – beliefs, ceremonies– Beliefs about health care
Emotional reactions to illness
Stress as a result of illness– Individual differences
• Heredity, experiences, environment
Physical loss or disability– Many losses
• Spouse, family, friends• Homes, control of life, disease, meals, driving• Function & independence
Emotional response to illness Emotional reactions
– Anger, grief, dependency– Suspicion, loneliness, guilt– Uselessness, feelings of damage– Depression, helpless– Anxiety, frustration, fear
To help:– Observe for signs of stress & listen– Patience & understanding, promptly meet needs– Focus on abilities– Treat with dignity, be non-judgmental
Communication Patterns
Organizational chart of nursing unit– Methods of communication
• Verbal vs. nonverbal• Written – chart, Kardex/care plan, report sheets, ADLs.
What do you do when resident asks to see the chart?• Electronic – computer, fax, telephone, intercom
Legal aspects– Must document what is reported verbally to nurse– Must document statements from family or resident– Subjective vs. objective data
Effective Communication
Identify self Verbal reports – brief, organized
– Appropriate – diagnosis, changes, allergies, activity, elimination, special needs, diet, VS, code status
– Timing – when to report changes– Place & location
Effective Communication
Take notes when on telephone– Name of person the message is for– Correct spelling of caller’s name– Time called– Clarify message by repeating it &
telephone number to caller– Sign your name & title to the message
Answering call lights
Go to resident at once, quietly, and friendly manner
If on intercom, call resident by name, I.d. yourself, politely inquire to need
Make sure call light is ALWAYS within reach