Chapter 7 Patient Safety Risk Factors Affecting Communication Climates

1. Chapter 7Patient Safety Risk Factors Affecting Communication Climates

2. Communication Climate Defined The tone, emotions, and attitudes of individualsin relationships

3. Patient-Safe Strategy Before interrupting or joining a conversation between two or more people, assess the communication climate

4. Communication Risk Factors Potentially Create Negative Communication Climates • Emotional risk factors • Fear of the unknown • Anxiety • Sadness, grief, loss • Anger and resentment • Physiological risk factors • Physical disability • Sensory impairment/memory loss • Sedation • Fatigue

5. Patient-Safe Strategies to Promote Positive Communication ClimatesConfirming Messages • Recognition • Acknowledgement • Endorsement • Complement • Empathy

6. Avoid Disconfirming Messages • Unreceptive • Interruption • Irrelevant • Tangential • Impersonal • Ambiguous • You are wrong; I am right

7. Illness: Affects Communication Climate • Illness threatens self-esteem and self-worth, resulting in high risk for negative communication climates • Illness threatens livelihood, role performance, and life itself • Illness results in alterations in tone, emotions, and attitudes of patients, family members, and nurses

8. Impact of Illness on Communication Climate • Physical stages of illness: Onset, course, prognosis • Psychosocial stages: Damage to self-esteem and feelings of worthlessness associated with loss • Transition to illness • Acceptance • Convalescence Patient responses to dependency and the sick role are unique, based on bio-psycho-social-cultural-spiritual makeup of the patient/family

9. Transforming Negative Climates • Encourage emotional release by empathy • Recognize emotions; acknowledge and accept emotional responses • Create an atmosphere of safety and trust through patient-safe communication process

10. Empathic Conversations Between Patient and Nurse • Patients and families must believe nurse understands their physical and emotional needs • Nurse must clearly communicate to the patient that the message sent was interpreted correctly • Nurse must clearly communicate what needs to be done next to manage the current situation

11. Patient-Safe Communicators • Solicit feedback— verify all messages • Observe body language —actions speak louder than words (face and body) • Assess appearance —clues to physical and emotional state (clothing and hygiene) • Respond to the real message- “It’s not what you say, but how you say it….”

12. Patient-Safe Strategy of EmpathyVerbally and nonverbally recognize emotionsOffer support: “We’ll work on this together,” “I’m here for you”

13. Empathy vs Sympathy Empathy means you remain emotionally separate from the other person: you can still be objective

14. What is Sympathy? • Taking on the other’s problems as if they were your own • Lose objectivity • Can no longer solve problems (nurses are paid to think) • No longer therapeutic

15. Managing Your Emotions to Promote Positive Communication Climates • Recognize your feelings • Cool off • Take responsibility for your feelings • Use “I” statements • Responding to a personal attack