Chapter 24 Communication

1. Chapter 24Communication

2. Communication and Nursing Practice • A lifelong learning process for nurses • An essential attribute of professional nursing practice • Builds relationships with clients, families, and multidisciplinary team members

3. Communication and Interpersonal Relationships • The means to establish helping and healing relationships. • The ability to relate to others is important for interpersonal communication. • Developing communication skills requires both an understanding of the communication process and of one’s own communication experience. • Box 24-1 presents communication throughout the nursing process. • Box 24-2 presents challenging communication situations.

4. Levels of Communication

5. Basic Elements of the Communication Process

6. Forms of Communication • Verbal • Vocabulary • Denotative and connotative meaning • Pacing • Intonation • Clarity and brevity • Timing and relevance

7. Nonverbal Communication • Personal appearance • Posture and gait • Facial expressions • Eye contact • Gestures • Sounds • Territoriality and personal space

8. Other Forms of Communication • Symbolic • The verbal and nonverbal symbolism used by others to convey a meaning • Metacommunication • A broad term that refers to all factors that influence communication

9. Professional Nursing Relationships • Nurse-client helping relationships • Nurse-family relationships • Nurse-health team relationships • Nurse-community relationships

10. Elements of Professional Communication

11. Therapeutic Communication Techniques • Attentive (active) listening – SOLER • Sharing Observations, Empathy, Hope, Humor, Feelings • Using Touch • Using Silence • Providing Information • Clarifying

12. Therapeutic Communication Techniques • Focusing • Paraphrasing • Asking Relevant Questions - Seeking validation • Summarizing • Self-Disclosure • Confrontation • Summarizing

13. Non-Therapeutic Communication Techniques • Asking personal questions • Giving personal opinions • Changing the subject • Automatic response • False Re-assurance • Sympathy • Asking for Explanation • Approval or Disapproval

14. Non-Therapeutic Communication Techniques • Defensive Responses • Passive or Aggressive Responses • Arguing

15. Barriers to communication • Agreeing or disagreeing • Asking personal question • Changing the subject • Environment • Giving advice • Language and culture • Passing judgment • Physical limitation • Stereotyping • Testing

16. Adapting Communication Techniques for Client with Special Needs • Aging population and communication disability. • Cultural Difference • Impaired communication because requires special thought and sensitivity. • See Box – 24-10: Communicating With Clients Who Have Special needs • See Sample Communication Analysis. • Critical Thinking Exercises – page 359 • NCLEX Style Questions – page 359.

17. Communication Within the Nursing Process • Assessment • Physical and emotional factors • Developmental factors • Sociocultural factors • Gender

18. Communication and Nursing Process • Diagnosis • Many clients experience difficulty with communication • Lacking skills in attending, listening, responding, or self- expression • Inability to articulate, inappropriate verbalization • Difficulty forming words • Difficulty with comprehension

19. Communication and Nursing Process • Planning: • Goals and outcomes: • Specific and measurable • Setting of priorities • Continuity of care: • Collaboration with other health care providers

20. Communication and Nursing Process • Implementation: • Therapeutic communication techniques • Nontherapeutic communication techniques • Adapting communication techniques

21. Communication and Nursing Process • Evaluation: • Nurses and clients need to determine whether the plan of care has been successful. • Nursing interventions are evaluated to determine which strategies or interventions were effective. • If expected outcomes are not met, the plan of care needs to be modified.