COMMUNICATION DEFINED

Communication is the basic element of human interactions.

Communication allows people to establish, maintain, and improve contacts with others.

Communication is an ongoing, dynamic series of events in which meaning is generated & transmitted.

COMMUNICATION DEFINED (cont’d)

Communication is a complex process that involves behaviors & relationships & allows individuals to associate with others & the world around them.

Communication occurs at the intrapersonal, interpersonal, and public levels.

INTRAPERSONAL COMMUNICATION

Occurs within an individual. It is self-talk or an internal dialogue

that occurs constantly & consciously. Goal: self-awareness, which is

influenced by self-concept & feelings of self-worth (efficacy).

INTERPERSONAL COMMUNICATION

The interaction between 2 people or in a small group.

It is often face-to-face. Most commonly used communication

level in nursing situations. Individuals are continuously aware of

one another.

INTERPERSONAL COMMUNICATION

Healthy interpersonal communication allows problem solving, sharing of ideas, decision making, and personal growth.

It is the heart of the nursing practice. A nurse can help a patient by

communicating at a meaningful interpersonal level.

PUBLIC COMMUNICATION Interaction with large groups of people

(lecture style). Being a competent communicator with

an audience requires the ability to envision oneself speaking to a group.

Special platform skills (posture, body movements, tone of voice) help the speaker to express their ideas.

ELEMENTS OF COMMUNICATION

STIMULUS (Referent): Motivates a person to communicate with another. It may be an object, experience, emotion, idea, or act.

ELEMENTS (cont’d) SENDER (encoder): The person who

initiates the interpersonal communication or message. The sender puts the stimulus/referent into a form that can be transmitted and assumes responsibility for the accuracy of the content and the emotional tone of the message.

ELEMENTS (cont’d) MESSAGE: The information that is

sent or expressed by the sender. The most effective message is clear and organized and is expressed in a manner familiar to the person receiving it.

CHANNELS: Means of conveying messages (visual, auditory, tactile).

ELEMENTS (cont’d) RECEIVER (decoder): The person to

whom the message is sent. The receiver must perceive or become aware of the message. The receiver defines the communication message.

ELEMENTS (cont’d) FEEDBACK: Helps to reveal whether

the meaning of the message is received. Mere intent to communicate is insufficient to ensure that a message is accurately received. Constructive feedback helps communicators change their language styles to meet each person’s needs.

MODES OF COMMUNICATION

Language is a code that conveys meaning. People send messages in the verbal and

nonverbal modes, which are closely bound together during interpersonal interaction.

We express ourselves thru movement, tone of voice, facial expressions, and general appearance.

VERBAL COMMUNICATION

Involves spoken or written words. Words are tools or symbols used to express

ideas or feelings, arouse emotional responses, or describe objects, observations, memories, or inferences.

Words may also convey hidden meanings, test the other’s interest or degree of concern, or express hostility, or fear.

VERBAL TECHNIQUES CLARITY AND BREVITY: Effective

communication is simple, short, and direct. Fewer words spoken result in less confusion.

VOCABULARY: In nursing there are many technical terms/jargon. The client may become confused & unable to follow instruction or learn important information if the nurse does not chose his/her words carefully.

VERBAL TECHNIQUES DENOTATIVE MEANING: A meaning

shared by individuals who use a common language (i.e. baseball).

CONNOTATIVE MEANING: The meaning of the word reflects the shade or interpretation of a word’s meaning rather than the definition (i.e. serious).

VERBAL TECHNIQUES PACING: Verbal communication is

more successful when expressed at an appropriate speed or pace.

TIMING/RELEVANCE: Critical to reception of a message. Even though a message is clearly & concisely stated, poor timing can prevent it from being accurately received.

VERBAL TECHNIQUES HUMOR: Can be a powerful tool in

promoting well-being. Laughter serves as a psychological and physical release. Humor can enhance feelings of well-being, reduce anxiety, and increase pain tolerance.

NONVERBAL COMMUNICATION

The transmission of messages without the use of words.

One of the most powerful ways people convey messages to others.

We continuously communicate non-verbally in every face-to-face encounter.

NONVERBAL (cont’d) Gestures impart meanings that are

more significant than words. Nonverbal cues add meaning to the

verbal message.

NONVERBAL TECHNIQUES

METACOMMUNICATION: A message within a message that conveys a sender’s attitude toward the self and the message and the attitudes, feelings, and intentions toward the listener.

Example: Crying patient states, “I’m great, really I am.”

NONVERBAL TECHNIQUES

PERSONAL APPEARANCE: A person’s appearance is one of the first things noticed during an interpersonal encounter. Physical characteristics, dress, grooming, & the presence of jewelry & adornment provide clues to the person’s physical well-being, personality, social status, occupation, religion, culture, & self-concept.

NONVERBAL TECHNIQUES

PERSONAL APPEARANCE (cont’d): Physical characteristics, such as the condition of hair, color of skin, weight, energy level, & presence of a physical deformity, also communicate information about the level of health.

NONVERBAL TECHNIQUES

PHYSICAL APPEARANCE: The nurse’s physical appearance influences the patient’s perception of care received. Each patient has a preconceived image of a nurse.

It may become more difficult to establish a sense of trust & reliability if nurses don’t meet the patient’s image.

NONVERBAL TECHNIQUES

NURSE’S APPEARANCE: A neat, well-tailored look conveys the message of a competent professional. Conversely, a nurse who has bad breath or cigarette breath, “messy” hair, poorly manicured nails, dirty shoes, for example, may be considered unprofessional & may be taken less seriously than a nurse who has paid attention to these details of personal appearance and hygiene.

NONVERBAL TECHNIQUES

INTONATION: The tone of a speaker’s voice can express enthusiasm, concern, hostility, or indifference.

FACIAL EXPRESSION: Rich communication potential.The face & eyes send overt & subtle cues that assist in message interpretation. Due to cultural differences, their meanings may be difficult to judge.

NONVERBAL TECHNIQUES

EYE CONTACT: An important facial expression. Wide eyes are associated with frankness, terror, & Naivete. Downward glances reflect modesty or shyness. Raised upper eyelids reveal displeasure. Staring is often associated with anger and coldness.

Persons who maintain eye contact during a conversation are perceived as trust-worthy and believable.

NONVERBAL TECHNIQUES

TOUCH: Touch is an important part of the nurse-patient relationship, but it must be used with discrimination because strong social norms govern its use.

NONVERBAL TECHNIQUES

POSTURE/GAIT: The way people stand & move is a visible form of self-expression. Posture/gait reflect attitudes, emotions, self-concept, & physical wellness.

An erect posture & a quick, purposeful gait communicate a sense of well-being & assuredness.

NONVERBAL TECHNIQUES

POSTURE/GAIT (cont’d): Leaning forward to toward a person

conveys attention and interest to that person.

Leaning backward in a more relaxed manner shows less interest and caution.

NONVERBAL TECHNIQUES

GESTURES: Used to illustrate an idea that is difficult or inconvenient to describe in words.

Visual enhancers, that emphasize, punctuate, & clarify the spoken word.

NONVERBAL TECHNIQUES

TOUCH: A personal form of communication. Because touch is more spontaneous than very communication, it generally seems more authentic.

Affection, Support, Encouragement, Respect Tenderness, & Personal attention, are conveyed through touch.

LISTENING One of the most effective therapeutic

communication techniques Nonverbal method to convey interest

in the patient’s needs, concerns, and problems.

Attempts to understand the entire verbal & nonverbal message that a person is communicating.

LISTENING (cont’d) Requires the nurse’s complete

attention. Hearing is a passive, neurological

process of receiving information. Listening is an active, learned process. Listening requires as much effort &

energy as the presentation of information requires.

TOOLS FOR EFFECTIVE LISTENING

Face patient while they speak. Maintain natural eye contact to show

willingness to listen. Assume an attentive posture. Avoid crossing legs/arms because this

conveys a defensive posture. Lean toward patient to communicate

involvement.

TOOLS FOR EFFECTIVE LISTENING (cont’d)

Avoid distracting body movements, such as wringing hands, tapping feet, or fidgeting with an object.

Nod in acknowledgment when clients talk about important points.

Look for and encourage patient feedback with the communication process.

THERAPEUTIC COMMUNICATION

Process in which the nurse, utilizing a planned approach, learns about the patient.

Focuses on the patient, but is planned and directed by the professional.

An interpersonal relationship between a patient and a nurse.

THERAPEUTIC COMMUNICATION

This process involves significant skill, since the nurse must pay attention to multiple interacting and nonverbal behaviors.

Therapeutic communication conveys confidentiality.

SOCIAL COMMUNICATION Messages conveyed are superficial in that

neither the nurse nor the patient discusses deeply personal matters of concern.

Tends to be based on intuitive, unthinking, & automatic responses.

Makes patients feel safe because the discussion has no hidden intent for pers

SOCIAL COMMUNICATION A nurse often uses superficial social

interaction at the beginning of a conversation with a patient to lay a foundation for a closer relationship.

Skillful nurses do not allow social interaction to dominate a conversation but does maintain a congenial and warm style to build the patient’s trust.

SOCIAL COMMUNICATION Goal: To help the patient feel

comfortable in sharing attitudes and feelings.

COMMUNICATION BARRIERS

Interpersonal communication is made more complex because each person is influenced differently by variables.

Intrapersonal variables make each interpersonal communication unique.

BARRIERS/VARIABLES DEVELOPMENTAL STAGE: Lead to

varied capacity levels of understanding PERCEPTIONS: Personal view of

events VALUES: What a person considers

important in life and thus influence expression of thoughts and ideas.

BARRIERS/VARIABLES EMOTIONS: A person’s subjective

feelings about events. SOCIOCULTURAL BACKGROUND:

The sum total of learned ways of doing, feeling, & thinking; it is a form of conditioning that shows itself through behavior. Language, gestures, values and attitudes reflect cultural origin.

BARRIERS/VARIABLES GENDER: Men & women have

different communication styles & each influences the communication process uniquely. GIRLS use language to seek confirmation, minimize differences, & establish or reinforce intimacy. BOYS use language to establish independence & negotiate status.

BARRIERS/VARIABLES KNOWLEDGE: Communication can be

difficult when the persons have different levels of knowledge.

ROLES/RELATIONSHIPS: People communicate in a style appropriate to their roles/relationships. People feel more comfortable expressing ideas to others whom they have developed positive, satisfying relationships. (Example: Students talk differently with friends than they do with instructors.)

BARRIERS/VARIABLES ENVIRONMENT: People tend to

communicate better in a comfortable environment. A warm room free of noise & distraction is best. Noise & lack of privacy or space may create confusion, tension, or discomfort.

BARRIERS/VARIABLES SPACE/TERRITORIALITY:

Territoriality defines the meaning of a person’s right to an area of space & surroundings. It is important because it provides people with a sense of identity, security, & control.

BARRIERS/VARIABLES Giving an opinion. Offering false reassurance. Being defensive. Showing approval of disapproval. Stereotyping. Asking why. Changing the subject inappropriately.

HOW TO IMPROVE COMMUNICATION

Listen attentive Convey Acceptance Ask related questions Paraphrase Clarify Focus State observations

HOW TO IMPROVE COMMUNICATION

Offer information Maintain silence Use Assertiveness Summarize

DIMENSIONS OF THERAPEUTIC TALK

Common features of a therapeutic relationship are trust, empathy, caring, autonomy, and mutuality.

They are essential if the nurse wants to establish positive & supportive relationships with patients.

TRUST The belief that other people will

provide help in times of need and distress.

EMPATHY vs SYMPATHY EMPATHY: The ability to try to

understand and enter the patient’s frame of reference. Sensing, comprehending, & sharing the patient’s frame of reference, beginning with the patient’s problem.

It is a fair, sensitive, & objective look at what another person experiences.

EMPATHY vs SYMPATHY SYMPATHY: The expression of one’s for

own feelings about another’s predicament. It is the concern, sorrow, or pity shown by

the nurse for the patient in which the needs of the patient are seen as the nurse’s needs.

May cause problems by preventing the development of an effective helping relationship.

CARING Having a positive regard for another

person.

AUTONOMY & MUTUALITY AUTONOMY: The ability to be self-

directed. MUTUALITY: Involves sharing with

another. Both important because the nurse and

the patient work as a team, participating in care.

MORE NURSE TOOLS Connect with the patient. Appreciate the patient’s situation. Respond to the patient. Empower the patient.