1
Q
Intrapersonal Communication
A
“Self-talk”
People’s thoughts and inner communications strongly influence perceptions, feelings, behavior, and self-esteem
2
Q
Interpersonal Communication
A
- One-on-one interaction between a nurse and another person that occurs face to face or electronic format.
- It is the level most frequently used in nursing situations and lies at the heart of nursing practice
3
Q
Small-group Communication
A
- Interaction that occurs when a small number of people meet
- Usually outcome oriented and requires an understanding of group dynamics
- Organized, concise, and complete
4
Q
Public Communication
A
- Interaction with an audience
5
Q
Electronic Communication
A
- Use of technology to create ongoing relationships with patients and their health care team
6
Q
Circular Transactional Model
A
Includes several elements in which the communication process occurs, feedback, and interpersonal variables.
7
Q
Referent
A
- Motivates one person to communicate with another
8
Q
Sender
A
- The person who encodes and delivers a message
9
Q
Receiver
A
- The person who receives and decodes the message
10
Q
Message
A
- Content of the communication
- Contains verbal and nonverbal expressions of thoughts and feelings
11
Q
Channels
A
- used to send and receive messages through visual, auditory, and tactile senses
12
Q
Feedback
A
- Message a sender receives from the receiver
- It indicates the extent to which the receiver understood the meaning of the senders message
13
Q
Interpersonal Variables
A
- Factors within both the sender and receiver that influence communication
14
Q
Environment
A
- The setting for sender-receiver interaction
15
Q
Verbal Communication
A
- Uses spoken or written words
16
Q
Personal Distance (18-40 inches)
A
- Sitting at a patient’s bedside
- Taking a patient’s nursing history
- Teaching an individual patient
16
Q
Nonverbal Communication
A
Includes the five senses and everything that does not involve the spoken or written word
17
Q
Intimate Distance (0-18 inches)
A
- Holding a crying infant
- Performing physical assessment
- Bathing, grooming, dressing, feeding, and toileting a patient
- Changing a patient’s surgical dressing
18
Q
Social Distance (4-12 feet)
A
- Giving directions to visitors in the hallway
- Asking whether families need assistance from the patient doorway
- Giving verbal report to a group of nurses
19
Q
Public Distance (12 feet and more)
A
- Speaking at a community forum
- Lecturing to a class of students
- Testifying at a legislative hearing
20
Q
Phases of Nurse-Patient Relationship
A
- Pre-interaction
- Orientation
- Working
- Termination
21
Q
Pre-Interaction Phase
A
(Before meeting a patient)
- Review available data
- Talk to other caregivers who have information about the patient
- Anticipate health concerns or issues that arise
- Identify a location and setting that fosters comfortable, private interaction
- Plan enough time for the initial interaction
22
Q
Orientation Phase
A
(When you and the patient meet and get to know each other)
- Set the tone for the relationship
- Clarify the patient’s and your roles
23
Q
Working Phase
A
(When you and a patient work together to solve problems and accomplish outcomes)
- Encourage and help the patient express feelings about health
- Provide information needed to understand and change behavior
- Take action to meet the outcomes set with the patient
24
Termination Phase
(During the ending of the relationship)
- Remind the patient that termination is near
- Evaluate achievement of expected outcomes with the patient
- Reminisce about the relationship with the patient
- Separate from the patient by relinquishing responsibility for care
- Achieve a smooth transition for the patient to other caregivers
25
Motivational Interviewing
- A technique that encourages patients to share their thoughts, goals, beliefs, fears, and concerns with the aim of changing their behavior
- Provides a way of working with patients who may not seem ready to make behavioral changes that are considered necessary by their health practitioners
26
SBAR
Situation
Background
Assessment
Recommendation
27
Lateral Violence
- Workplace bullying
- Withholding information, being hypercritical, raising blame, etc
28
Techniques for lateral violence
- Address it in a calm manner
- Describe how the behavior affects your functioning
- Ask for the abuse to stop
- Notify the manager to get support for the situation
- Avoid gossiping about the situation or the person with other staff
- Plan for taking action in the future
- Document the incidents in detail in your personal notes, not patient records
29
Autonomy
- Being self-directed and independent in accomplishing outcomes and advocating for others
30
Assertiveness
- Allows you to express feelings and ideas without judging or hurting others
31
Tips for communication with older adults who have hearing loss
- determine if the patient uses hearing aids, glasses, or other adaptive equipment
- face the patient at eye level, be sure that your face/mouth is visible, and do not chew gum
- speak clearly but do not exaggerate lip movement
- speak a little more slowly but not excessively
- choose a quiet, well lit environment with minimal distractions
- allow time for the patient to respond
- give the patient a chance to ask questions
- keep communication short and to the point
- ask one question at a time
32
Therapeutic Communication
- Specific responses that encourage the expression of feelings and ideas and convey acceptance and respect
33
Active Listening
- Being attentive to what a patient is saying both verbally and nonverbally
34
Empathy
- The ability to understand and accept another person's reality, accurately perceive feelings, and communicate this understanding to the other
35
Patients who do not speak English
- Speak to patient in a normal tone of voice
- establish method for patient to ask for assistance
- provide a professional interpreter as needed
- avoid using family members, especially children, as interpreters
- use communication board, pictures, or cards
36
Patients who have a hearing impairment
- check for hearing aids and glasses
- reduce environmental noise
- get the patient's attention before speaking
- face patient with mouth visible
- do not chew gum
- speak at a normal volume
- rephrase rather than repeat
- provide sign-language interpreter if indicated
37
Patients who are visually impaired
- check for use of glasses or contact lenses
- identify yourself when you enter or leave the room
- speak in a normal tone of voice
- do not rely on gestures of nonverbal communication
- use indirect lighting, avoiding glare
- use at least 14-point print
38
Patients who have cognitive impairment
- use simple sentences and avoid long explanations
- ask one question at a time
- allow time for patient to respond
- be an attentive listener
- include family and friends in conversations
- use picture or gestures that mimic the action desired
39
Patients who are unresponsive
- call patient by name during interactions
- communicate both verbally and by touch
- speak to patient as though he or she can hear
- explain all procedures and sensations
- provide orientation to person, place, and time
- avoid talking about patient to other in his or her presence
40
Patients who cannot speak clearly
- listen attentively, be patient, and do not interrupt
- ask simple questions that require yes or no answers
- allow time for understanding and response
- use visual cues
- allow only one person to speak at a time
- encourage patient to converse
- let patient know if you have not understood
- collaborate with speech therapist as needed
- use communication aids: letter boards, flash cards, computer-generated speech program
41
Teaching
- Concept of imparting knowledge through a series of directed activities
42
Learning
- conscious or unconscious permanent change in behavior as a result of a lifelong, dynamic process by which individuals acquire new knowledge, skills, and/or attitudes that can be measured and can occur at any time or in any place through exposure to environmental stimuli
43
Patient Care Partnership
- 2003
- to help patients understand what their expectations should be with regards to being patients within hospitals
44
Cognitive Learning
- occurs when an individual gains information to further develop intellectual abilities, mental capacities, understanding, and thinking processes
45
Affective Learning
- deals with learning how to express feelings and emotions and to develop values, attitudes, and beliefs needed toward improving health
46
Psychomotor Learning
- involves the development of manual or physical skills
47
Motivation
- is an internal state that helps arouse, direct, and sustain human behavior
48
Self-efficacy
- a concept included in social learning theory, refers to person's perceived ability to successfully complete a task
49
Readiness to learn
- based on a patients willingness to engage in learning
50
Grief
- a complex process that patients experience during illness and loss
- patients cannot learn when they are unwilling or unable to accept a loss or their illness
51
Attentional set
- the mental state that allows a learner to focus on and comprehend a learning activity
52
Infant - Teaching Methods
- keep routines consistent
- hold infant firmly while smiling and speaking softly to convey sense of trust
- have infant touch different textures
53
Toddler - Teaching Methods
- use play to teach procedure or activity
- offer picture books that describe story of children in hospital or clinic
- use simple words
54
Preschooler - Teaching Methods
- use role-play, imitation, and play to make learning fun
- encourage questions and offer explanations
- use simple explanations and demonstrations
- encourage children to learn together through pictures and short stories about how to perform hygiene
55
School-Age Child - Teaching Methods
- teach psychomotor skills needed to maintain health
- offer opportunities to discuss health problems and answer questions
56
Adolescent - Middle Adult
- help adolescent learn about feelings and need for self-expression
- use teaching as collaborative activity
- allow adolescents to make decisions about health and health promotion
- use problem solving to help make choices
57
Young or Middle Adult - Teaching Methods
- encourage participation in teaching plan by setting mutual goals
- encourage independent learning
- offer information so adult understands effects of health problem
58
Older Adult - Teaching Methods
- teach when patient is alert and rested
- involve adult in discussion or activity
- focus on wellness and person's strength
- use approaches that enhance patients reception of stimuli when there is a sensory impairment
- keep teaching lessons short
59
Health Literacy
- the cognitive and social skills that determine the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health
60
Those at risk for low health literacy
- older adults
- minority populations
- immigrant populations
- people of low income
- people without high school education
- people with chronic mental and/or physical health conditions
61
Telling teaching approach
- use this approach when there is limited time for teaching information
- if a patient is highly anxious but it is vital for information to be given
- the nurse outlines the task that a patient will perform with simple explicit instructions
- no opportunity for feedback
62
Participating teaching method
- the nurse and patient set objectives and become involved in the learning process together
- opportunity for discussion, feedback, mutual outcome setting, and revision of the teaching plan
63
Entrusting teaching approach
- proves a patient the opportunity to manage self-care
- to provide the knowledge and skills that enable a patient to accept responsibilities and perform tasks correctly and consistently
64
Reinforcing teaching approach
- requires the use of a stimulus to increase the probability of a desired response
- can be positive or negative
65
Demonstrations
- use when teaching psychomotor skills (preparing a syringe, bathing an infant, crutch walking, or taking a pulse)
- return demonstration
66
Analogies
- learning occurs when an educator translates complex language or ideas into words or concepts that a patient understands
- supplement verbal instruction with familiar images that make complex information more real and understandable
67
Role-playing
- people are asked to play themselves or someone else
- involves rehearsing a desired behavior
68
Simulation
- useful technique for teaching problem solving, application, and independent thinking
69
Teach-back
- communication technique that assesses patient retention of the information given during a teaching session
- ask the patient to explain material that was discussed
