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Communication PDF

The document discusses the importance of communication in nursing, emphasizing its role in establishing and maintaining nurse-patient relationships. It outlines various definitions, purposes, characteristics, principles, and types of communication, highlighting the need for effective verbal and non-verbal communication skills. Additionally, it details the communication process, including elements such as sender, message, channel, decoding, receiver, and feedback.
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0% found this document useful (0 votes)
32 views18 pages

Communication PDF

The document discusses the importance of communication in nursing, emphasizing its role in establishing and maintaining nurse-patient relationships. It outlines various definitions, purposes, characteristics, principles, and types of communication, highlighting the need for effective verbal and non-verbal communication skills. Additionally, it details the communication process, including elements such as sender, message, channel, decoding, receiver, and feedback.
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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UNIT IV - COMMUNICATION AND NURSE PATIENT RELATIONSHIP

Communication is the basic element of human interactions that allows people to


establish, maintain and contacts with others.
Communication refers not only to content but also to feelings and emotions that people may
convey in a relationship. The communication skill is regarded as a basic component of human
relationships.
The term communication is derived from Latin word "communicare" or "communico" both of
which means "to share or to impart". The word communication originates from Greek word
communis', meaning 'to make common'. Therefore, Communication is the process of sharing
thoughts, ideas, and feelings with each other in commonly understandable ways.

Communication in nursing is vital to quality and safe nursing care. It is the fundamental element
of the nurse-client relationship, client teaching, case management, staff development, and all the
activities performed by nurses. Communication is the foundation of the relationship between
nurse and other members of the health team. Poor working relationships and failure to
communicate can lead to serious problems for the nurse and patient.

DEFINITIONS
 Acc. to Webster's Dictionary, communication is define as a process by which information
is exchanged between individuals through a common system of symbols, signs or
behaviour.
 Acc. to Paul Leagens, "Communication is a process by which two or more people
exchange ideas, facts, feelings or impressions in ways that each gains a common
understanding of meaning, intent and use of a message."
 Communication is the process of transmitting thoughts, feelings, facts, and other
information,includes verbal and nonverbal behaviour.
 Acc. to Keith Davis, communication is the transfer of information and understanding
from one person to another person. It is a way of reaching others with facts, ideas,
thoughts and values.
 Communication is the process of exchanging the information, and the process of
generating and transmitting meanings, between two or more individuals.
 Communication is commonly defined as the exchange of thoughts, ideas, feelings,
information, opinions, and knowledge". It also involves mutuality of understanding.
 Communication is defined as an exchange ot facts, ideas, opinions or emotion by two or
more persons.
PURPOSE OF COMMUNICATION
 To obtain information
 To collect assessment data
 To initiate interventions
 To evaluate outcome of intervention
 To initiate change which helps in promoting health .
 To take measures for preventing legal problems associated with nursing practice
 To analyse factors affecting the health team
CHARACTERISTICS OF COMMUNICATION
 Communication is a two-way process.
 Communication process happens between/among two or more parties
 Communication involves at least two persons-the sender and the receiver
 It involves the transfer of ideas, facts, emotions, gestures, symbols and action
 It involves exchange of information, thoughts and knowledge.
 Communication involves mutuality of understanding between Sender and Receiver
 Communication is a continuous process.
 Communication is a dynamic process, that is, it grows and develops.
 Communication may be intentional or unintentional.
 Communication is systematic, that is, every component of the process is affected by
every other component.\

PRINCIPLES OF COMMUNICATION
1. Communication should have objective and purpose.
2. Should be appropriate to situation.
3. Systematic analysis of the message, i.e., the idea, the thought to be communicated, so that one
is clear about it.
4. Selection and determination of appropriate language and medium of communication according
to its purpose.
5.Organizational climate, including appropriate timing and physical setting to convey the desired
meaning of the communication.
6.Consultation with others for planning of communication; involves special preparation.
7.message should convey something of value to the receiver in the light of his needs and
interests.
8.The communication action following a communication is important in effective
communication as this speaks more than his/her words.
9.Sender has to understand the receiver's atitude and reaction by careful, alert and proper
listening to ensure that desired meaning of message has been comprehended by the receiver.
10. Communication programme should make use of existing facilities to the great extent possible
and should avoid challenging them unnecessarily.

LEVELS OF COMMUNICATION
 Intrapersonal Communication: Intrapersonal communication occurs within an
individual.
It can be defined as communication with one's self, and that may include self-talk,acts of
imagination and visualization, and even recall and memory. It is self talk or an internal dialoque
that occurs constantly and consciously.
Nurse use self-talk to enhance positive interaction with the patients and family.the
communication is crucial because it affects the nurses behavior.

 Interpersonal Communication: Interpersonal communication is the interaction that


occurs between two people or in a small group with a goal of exchange of verbal and non
verbal messages:it is face to face communication.Healthy interpersonal communication
allows problem solving,sharing of ideas,decision making and personal growth.
 Public Communication: Public communication is interaction with the large group of
people.Giving a lecture to students is an example of public communication. The channel
for public communication is the same as group communication. The opportunity for
feedback is limited. This level of communication is complex because of both the number
of people communicating intrapersonally and interpersonally and the combinations of the
people involved.

ELEMENTS OF COMMUNICATION/COMMUNICATION PROCESS


The communication is a dynamic process that begins with the conceptualizing of ideas by the
sender who then transmit the message through a channel to the receiver, who in turn gives the
feedback in the form of some message or signal with in the given time frame the main focus of
communication is to get a response.

Thus, communication is a an ongoing and multidimensional process.

Sender: The communication process begins when a person, known as the source/encoder,
generates a message or interpersonal communication. The person who sends the message is
called as sender or the person who initiates conversation or sending message. It suggests that
source/ sender must have an idea or feelings into a form that can be transmitted. Encoding
includes choosing a sign or symbols to transmit the message.
Encoding: The sender begins with the encoding process wherein he uses certain words or non
verbal methods such as symbols, signs, body gestures, etc. to translate the information into a
message. The sender s knowledge, skills, perception, background, competencies, etc. has a great
impact on the success of the message.
Message: The second element of communication is message. The message is a stimulus
produced by a sender and responded to by a receiver. Messages may be verbal, nonverbal,
written materials, and arts intended to convey information to the receiver and require
interpretation by the persons.
Channel: The channel is the medium through which a message is conveyed or transmitted. The
message having unique elements, structure, content, treatment and codes are transmitted along
channels. There are three major communication channels: visual, auditory, and kinesthetic. The
more channels the nurse uses to send a message, the better the client will understand.
Decoding: Here, the receiver interprets the sender message and tries to understand it in the best
possible manner. An effective communication occurs only it the receiver understands the
message in exactly the same way as it was intended by the sender.
Receiver: The receiver is the person who intercepts the sender's message. The receiver is also
Called the decoder. Observer who interprets message based on his or her own communication
Skills, attitudes, knowledge and socio-cultural systems. Correct interpretation of the message
depends on the similarities in knowledge experience and socio-cultural back ground of the
sender and receiver.
Feedback: Feedback is the information the sender receives about the receiver's reaction to the
message. It is also known as response which may be verbal or non-verbal. The receiver's verbal
and non-verbal response sends feedback to the sender to reveal the receiver's understanding of
the and message.

TYPES OF COMMUNICATION
The process of passing any information from one person to the other person with the aid of some
medium is termed as communication.

Based on Relationship
Based on the relationship or style of communication, there can be two broad categories of
communication, which are formal and informal communication that have their own set of
characteristic features
Formal Communication :Formal communication includes all the instances where
communication has to occur in a set formal format. The style of communication in this form is
very formal and official and between officials on various positions in any organization or
institution.
Formal communication can also occur between two strangers when they meet for the first time.
Informal Communication - Informal communication requires two people to have a similar
wavelength and hence occurs between friends and family. Informal communication does not
have any rigid rules and guidelines. There is no formality in delivering the message among
people.

Based on Channel/Method Used


Classified as verbal communication and non-verbal communication.
Verbal Communication - Verbal communication is a type of communication where the
information flows through verbal medium like words, speeches, presentations etc.
Verbal communication is further divided into written and oral communication. The oral
communication refers to the spoken words in the communication process. Oral communication
can either be face-to-face communication or a conversation over the phone or on the voice chat
over the Internet. The other type of verbal communication is written communication. Written
communication can be either via snail mail, or email.
Non-Verbal Communication - Any communication made between two people without words
and simply through body posture, facial expressions, gestures or hand movements is called as
non-verbal communication. In other words, it is a speechless communication where content is
not put into words but simply expressed through expressions. Non-verbal communication can
also be in the form of pictorial representations, signboards, or even photographs, sketches and
paintings.

Based Upon Flow/Direction


Downward Communication - It is the communication which occurs from top to bottom such as
Communication from superior to subordinate.
For example; communication between nursing superintendents to staff nurses.
Upward Communication - Upward Communication occurs from bottom to the top. Active
upward communication is important for problem solving.
Common means are: Face to face discussions, open door policies of meeting higher officials,
staff meetings etc.
Horizontal Communication - The communication flows horizontally between departments or
personnel on almost same level of hierarchy
One Way Communication - It is the flow of communication from sender to receiver only.
There is no participation or feedback from the receiver or listener. One way communication
always flows in one direction only.
Two Way Communication - It is the flow of communication from sender to receiver and again
from receiver to sender. There is participation of the receiver or learner/listener.
Other method
Visual Communication- In visual commuunication, the recipient receives information from
signboards, displays, hoardings, banners, maps etc.
Tele Communication - It is the process of communicating in distant places with help of
electromagnetic appliances. For example; television, Radio, Internet etc
Meta Communication - This communication occurs in deeper sense. It conveys message within
a message. For example; one lady is doing praise of her daughter-in-law.

MODES OF COMMUNICATION
Mode means the way by which communication occurs. The message can be sent verbally
(talking) or non verbally (gestures).
There are two modes of communication, i.e. Verbal and Non verbal. These are described as
follows

VERBAL COMMUNICATION
It includes all the words, the speaker speaks. Talking is most common activity. It is the primary
tool of instruction while speaking. Source/sender communicates beliefs, values, perception,
meaning, interest and also understands it. The various aspects of verbal communication are
following:

i. Vocabulary : For the effective communication, sender as well as receiver should have
similarity in language, understanding. Because person belonging to different culture, ethnic
group may find difficulty to understand and interpret the message.

ii. Pacing: Using pause at right time in order to make communication effective. Sender must
speak slowly, clearly and use pauses to stress particular point.
e.g. While giving Health education on importance of "Balanced diet" Nurse should give
high weightage to the well Balanced diet and also use pauses at right time. Pace of speech in-
dicates interest, anxiety, boredom or fear.

iii) Dennotative and Connotative meaning


The Dennotative meaning is shared by individuals who use common language.
e.g. Punjabi people using language "Punjabi".
Connotative Meaning is the interpretation of words' meaning, influenced by the thoughts,
feelings or ideas people have about the word.
iv)Simplicity
For effective verbal communication, sender must use simple language, easily understood words,
brevity and complete words. Language/message conveyed by nurse should be so simple that it
could be interpreted easily by a layman. Thus, nurse should avoid using medical terminology.
For this, nurse need to learn the commonly used terms based on the age, knowledge, culture and
education of client.
Example : Instead of saying "Your leg will be cut". It can be stated as "Due to gangrene for-
mation, part of lower limb will be cut by keeping you unconscious".

v)Clarity and Brevity


Conveyed message should be very simple and clear, short to minimize confusion. Sender uses
simple words and direct to make communication effective. Brevity means using few necessary
words tor making message easily understood.

vi)Timing and Relevance


If the message conveyed is in simple language, less time will be consumed for understanding it.
Even the timing for interaction also matters.
e.g. if client is undergoing for appendectomy in emergency situation. It is not appropriate time to
collect information regarding his family, interest etc.
Relevancy of message is equally important. For example: Discussing the complications of
surgery is irrelevant for client admitted in medicine ward with Typhoid fever.
.
vii)Adaptability
Spoken message should be modified as per client's behavioral clues. This adjustment is known as
Adaptability.
For example Nurse must know how to speak and express her gestures while interacting with an
elated client or depressed client. As per client behavior, nurse should alter her tone of speech and
expression.
For example: "On the death of client in ward, Nurse should express sad expression.

viii)Credibility
Credibility means worthiness of belief, trust worthiness, reliability. Nurse fosters credibility by
being consistent, dependable and honest. For this nurse must be knowledge able as well as skilful
and should provide accurate information to client. By doing so she can gain trust of client.

(ix) Humor
Humor is useful in case, client finds loneliness in Hospital/having painful situation.
Humor helps in promotinga sense of wellbeing

NON VERBAL COMMUNICATION


Non verbal communication includes use of body language such as gestures, gait, use of touch,
physical appearance. It helps in expression of feelings better than the spoken words. Observing
and interpreting client's non verbal behavior efficiently is an essential skill for effective
communication.
For example: Client with en- dotracheal intubation, on ventilator can't speak. He can express his
feelings by writing on copy.
i)Physical Appearance
Clothing, dressing, grooming, hygiene provides information regarding social, financial status,
culture, religion, group association and even the self-concept.
Change in client's dressing sense gives a clue regarding his health status. Nurse can validate this
by asking the client.

ii)Body Language;Posture and Gait


“Actions speak more than words" is a well known saga.Body movements, posture, gait of client
depicts client's current mood, health status as well as about his self concept. Erect posture,
puposeful stride reveals a healthy well being.
Whereas slouched posture and a slow shuffling gait suggests depression or physical discomfort.
Tense posture, rapid movements reflects anxiety. After observing body language, nurse verifies
her interpretation by asking to client.

iii)Gesture
Gestures means use of hands, body parts in explaining the things. Gestures are in- valuable way
of communication for client with deafness, tracheotomy, intubated. Client may blink his eyes or
move his eyes side by side to convey his "Yes" or "no" response. Nodding the head, raising
index finger etc. are the gestures commonly used by such clients.

iv)Eye contact:
Eye contact maintenance during interaction shows the confidence and willingness of client to
listen. Lack of eye contact may reflect anxiety, discomfort in communication.
Even eye movements reveal feelings and emotions. Wide eyes express frankness, terror
Raised upper eyelids reveal displeasure. Constant staring may be associated with hatred or
coldness. Looking down on a person establishes authority while interacting at the same level
indicates equality in relationship

v)Observable Autonomic Physiological Responses


such as increased respiration, sweating, pupil dilatation, blushing, paleness also reflect client's
mental as well physical health status
Physical characteristics such as height, weight, physique, complexion, blueness of lip, nail
reflects the lack of 02 in tissues. Weight and muscle tone reflects the weakness level. Paleness
reflects anaemia /anxiety level of client.

vi)Voice related behavior


Voice Tone (happy - good), pitch level (high pitch - aggressiveness, hyperactivity), intensity of
voice (high in pain), stuttering (in anxiety), pause (can't express), silence (not interesting),fluency
reflects hyperactivity among client.

Facial expression: Frown, smile, grivances, yawn, pursed lip, tongue movement.

FACTORS INFLUENCING COMMUNICATION


 Development: The rate of language development is directly correlated with the patienť's
neuralgic competence and cognitive development. Language and communication skills
develop through various stages; infant/ toddlers rely on nonverbal communication, children
may use pictures as an adjunct to verbal language to communicate, adolescents/adults rely on
verbal language and older adults may use visual communication methods for hearing
impaired, or aural communication for visually impaired.
 Gender: Men and women poses differing communication styles and might give different
interpretation to the same conversation. Males use communication to establish independence and
negotiate status within a group and females use communication to seek confirmation, minimize
differences& establish or reinforce intimacy. The same communication may be interpreted
differently by a man and a woman.
 Socio-Cultural Characteristics: Culture, education, economic level can influence
Can influence communication. Body language, eye contact, and touch are influenced by cultural
beliefs about appropriate communication behaviour. Many people use the internet or e-mail to
communicate but not everyone can afford a computer or have access to one.
 Values and Perceptions: Each person has unique personality traits, values, and life
experiences.
Every human being perceives and interprets message according to his personality trait, values,
experience.
 Territoriality: lndividuals are most comfortable in areas they consider their own. This urge
to maintain an exclusive right to certain space is termed territoriality. Nurses need to obtain
permission from clients to remove, rearrange, or borrow objects in their hospital area.
 Personal Space: Personal space is the distance maintained by persons in interaction with
others.
The nurse should maintain a distance of 18inches or 4 feet while interviewing the patient. The
space between people is very important when communicating because little space between two
can make a person uncomfortable
 Environment: People usually communicate effectively in a comfortable environment.
Temperature extremes, excessive noise, and a poorly ventilated environment can all interfere
with communication. Calm and non-threatening environment helps in easy exchange of needed
communication. It prevents distraction and ensures privacy.
 Roles and Relationships: Roles and relationships between sender and receiver affect the
content and responses in the communication process. Choice of words, sentence structure,
message content and channel, body language, and tone of voice vary considerably from role
to role.
 Interpersonal Attitudes: Attitudes are communicated convincingly and rapidly to
others.Attitudes such as caring, warmth, respect, and acceptance facilitate communication.
Whereas the lack of interest, coldness inhibit the communication and ultimately relationship.
 Congruence: Congruent communication is a communication pattern in which the person
sends the same message on both verbal and nonverbal levels. Congruence helps the client to
more readily trust the nurse and helps prevent miscommunication.
METHODS OF EFFECTIVE COMMUNICATION / THERAPEUTIC
COMMUNICATION TECHNIQUES
One of the main ways nurses establish trust with patients is through communication. Nurses can
utilize proven therapeutic communication techniques that promote quality care.
 Bilateral: Effective communication is bilateral. The person sending the message also
becomes the receiver of messages, and vice versa. Nurses should be conscious of this
message sending and be aware of taking on both roles during conversations.
 Good Relationships: "The therapeutic relationship is an important prerequisite to effective
communication between health professionals and patients". Good relationship encourages
patients to share information candidly to their nurses and other health professionals and
ensure that patients receive the information their nurses impart.
 Active Listening: Listening is an active process of receiving information and examining
reaction to the messages received. By using nonverbal and verbal cues such as nodding and
saying "I see," nurses can encourage patients to continue talking. Active listening involves all
the nurse's senses.
 Restating: Nurse is repeating of the main thought the patient has expressed. It also indicates
that the nurse is listening, validating, reinforcing or calling attention to what has been said.
Usually a part of patient's statement is repeated. When restating patient should not feel the
nurse is reassuring, judgmental or defending.
 Seeking Clarification: Similar to active listening, asking patients for clarification when they
say somemething confusing or ambiguous is important. Without clarification the nurse may
make invalid assumptions and miss valuable information
 Using Silence: At times, it's useful to not speak at all. Silence is particularly useful when
people are confronted with decisions and require much thought. Silence may be especially
therapeutic during times of profound sadness or grief. It may give patients the time and space
they need to broach a new topic.
 Requires Accuracy: A message can easily become distorted when it passes from one person
to another. Nurses should speak directly with the people with whom they need to
communicate.
.
 Sharing Observations: This technique can help to start a conversation with quite or
withdrawn person. Nurse makes observation by commenting on how the other person looks,
sounds or acts.The nurse must remain objective and non-judgmental in many situations.
 Sharing Empathy: Empathy is vital for good communication. Empathy is the ability to
understand and accept another person's reality to accurately perceive feelings and to
communicate this understanding to the other. To express empathy the nurse reflects
understanding of the importance of what has been communicated by the other person on
feeling level.
 Sharing Humour: Humour helps nurses deal effectively with difficult situations and clients
and creates a sense of cohesiveness between nurse and their clients and also among nurses
themselves. It helps to decrease client's anxiety, depression and embarrassment. Nurses needs
to avoid using humour to mask own fears and discomforts or their inability to communicate
with others. This technique can keep patients in a more positive state of mind
 Sharing Perceptions: It involves asking the patient to verify the nurse's understands of what
the patient is thinking or feeling. For patients experiencing sensory issues or hallucinations, it
can be helpful to ask about them in an encouraging, non-judgmental way. For example, nurse
is interviewing an alcoholic patient.
 Accepting: Sometimes it's necessary to acknowledge what patients say and affirm that
they’ve been heard. Acceptance isn't necessarily the same thing as agreement; it can be
enough to simply make eye contact and say "Yes, I understand." Patients who feel their
nurses are listening to them and taking them seriously are more likely to be receptive to care.
 Giving Recognition: Recognition acknowledges a patient's behaviour and highlights 1t
without giving an overt compliment. A compliment can sometimes be taken as
condescending especially when it concerns a routine task like making the bed. However,
saying something like noticed you took all of your medications" draws attention to the action
and encourages it without requiring a compliment.
 Summarizing: It's frequently useful tor nurses to summarize what patients have said after the
fact. This demonstrates to patients that the nurse was listening and allows the nurse to
document conversations. Summarizing brings a sense of satisfaction and closure to an
individual conversation and is especially helpful during the termination phase of a nurse
client relationship.
 Reflecting: By reflection nurse is directing back the patient's ideas, feeling, questions or
content. Reflection lets the patient know that the nurse has heard what was said and
understand the content. Reflection of the feelings let the patient know that the nurse is aware
of what the patient is feeling. It signifies understanding, empathy, interest and respect for the
patient.
 Informing: Informing information is nurse shares simple facts with the patient. This skill is
use in patient education like when to take medication, necessary precautions and side effects.
 Broad Openings: Here the nurse is encouraging the patient to select topics for discussion.
Patient should be welcomed to the communication with warmth and respect. Patient should
feel that nurse is ready to listen. Open-ended questions result in fuller, more revealing
answers.
 Focusing: Sometimes during a conversation, patients mention something particularly
important. When this happens, nurses can focus on their statement, prompting patients to
discuss it further. It helps the patient talk about life experiences or problem areas and accepts the
responsibility for improving them.
 Confronting: Confrontation involves anger and agsression.Nurses should only apply this
technique after they have established trust. It can be vital to the care of patients to disagree with
them, present them with reality, or challenge their assumptions. Confrontation can help patients
break destructive routines or understand the state of their situation.
 Paraphrasing: It is restating another's messages more briefly using one's own words.
Practice is acquired to paraphrase accurately. If the meaning of the message is changed
 Encouraging Comparisons: Often, patients can draw upon experience to deal with current
problems. By encouraging them to make comparisons, nurses can help patients discover
solutions to their problems.
 Role Playing: Role playing involves acting out a particular situation. It increases patient's
insight in to human relations can deepen the ability to see the situation from another person's
point of view. Role playing can be used for attitude change and to promote self-awareness.
BENEFITS OF EFFECTIVE COMMUNICATION IN NURSING
 Immediate understanding of a patient's condition and needs
 Understanding the emotional state of patients
 Understanding the social determinants of health
 Tracking changes in care
 ldentifying specialized needs

PROFESSIONAL COMMUNICATION

Professional communication refers to the oral, written, visual, and digital forms of delivering
information in the context of a workplace. Effective communication ensures a smooth flow of
ideas, facts, decisions, and advice.
The term professional communication refers to the various forms of speaking, listening, writing,
and responding carried out both in and beyond the workplace, whether in person or
electronically.
Effective communication plays an instrumental role throughout a patient's entire healthcare
experience, and a large portion of the responsibility falls on nurses. Good communication
between nurses and patients have many benefits. It greatly contributes to the ability to provide
patients with individualized care.
Nurse and patient communication begin at first contact; at the initial moment of patient care.
This communication lasts the duration of the care cycle. For the most benefit, the patient must
feel comfortable, which requires a peaceful and private environment and confidentiality.
To achieve health care goals and achieve patient satisfaction, effective communication skills by
nurses require good interpersonal skills, understanding of patient needs, training and continuing
education of nurses in matters relating to the proper technique to enable them to respond
adequately and humanely to the expectations of patients.

Purposes of Professional Communication in Nursing:


 Understand the patient's circumstances, experience and needs:
The nurse enquires methodically but sensitively about the patient's circumstances,
experience and needs to determine what illness and treatment mean to them.

 Discuss treatment options with the patient:


The patient may have various treatment options available to them and needs to
understand their benefits and risks so they can make an informed decision about their
care.
 Develop a rapport with the patient:
The nurse demonstrates that they have understood the patient's experience and needs, and
therefore trust develops.
 Delineate issues and challenges with the patient
The nurse and patient determine potential issues and challenges together. The nurse needs
to understand why the patient may perceive something as an issue or challenge.
 Plan care with the patient
The nurse negotiates realistic goals and agrees responsibilities with the patient, as well as
sharing available resources between patients in an equitable manner.
 Evaluate progress with the patient
Progress may be measured using a range of criteria, agreed goals, the patients
expectations, or outcomes achieved by other patients with comparable diagnoses.

Features of Professional Communication

Accuracy: Accuracy is one of the most vital features of professional communication. The nurse
is must provide the correct information to the client.

Clarity: Professional communication needs to be brief and to the point. They will feel more
comfortable with short letters designed to convey the message quickly.

Distinctiveness: The more specific the message is, the more the target audience is likely to
understand it and the more it meets the desired objective.

Two-Way Traffic: Communication is a two-way traffic. After conveying information to the


client the nurse must give him/her some time to share their idea and feeling.

Professional Communication skills


When it comes to developing professional communication skills, there are several things one can
Try -
 Always put the patient first
 Practice active listening
 Ask for feedback
 Learn from others
 Talk with heart

HELPING RELATIONSHIPS-NURSE PATIENT RELATIONSHIP


Definitions:

 Nurse-patient relationship is defined as an interaction in which the nurse fulfills her role
by using her professional knowledge and skill in such a way that she is able to help the
patient physically, socially, and emotionally.

 Nurse-patient relationship is defined as an interaction process between two person in


which the nurse offers a series of purposeful activities and practices that are useful to
particular patient.

 A therapeutic nurse-patient relationship is defined as a helping relationship that's based


on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and
others, and assisting with the gratification of your patient's physical, emotional, and
spiritual needs through knowledge and skill.
Purposes of Nurse - Patient Relationship

 Helps to cope with the current problems


 Helps to understand the problems
 Helps to try out new patterns of behaviors
 Helps to communicate
 Helps to socialize
Remaining -ppt

COMMUNICATING EFFECTITVELY WITH PATIENT, FAMILIES AND TEAM


MEMBERS
Good communication is at the heart of better patient care, safety, satisfaction, and outcomes.
Patients who understand their care plan are more likely to follow treatment, modify lifestyle
choices and behaviors, and adhere to instructions. Communication technology supports patients
and their loved ones throughout the healthcare experience by facilitating effective patient
effective patient already engagement before, during and after a hospital stay.

Communicating with Patient and Families


 Gather clues: Talk to the health care team members and observe the patient. Be careful
not to make assumptions. Patient teaching based on incorrect assumptions may not be
very effective and may take more time.
 Get to know patient: Introduce yourself and explain your role in patient's care. Review
their medical record and ask basic get-to-know-you questions.
 Establish a rapport: Make eye contact when appropriate and help your patient feel
comfortable with you. Pay attention to the person's concerns.
 Gain trust: Show respect and treat each person with compassion and without judgment.
 Learn the patient's perspective: Talk to the patient about worries, fears, and possible
misconceptions. The information you receive can help guide your patient teaching.
 Determine patient's readiness to learn: Ask patients about their outlooks, attitudes, and
motivations.
 Involve others: Ask if the patient wants other people involved with the care process. It is
possible that the person who volunteers to be involved in patient's care may not be the
person patient prefers to be involved.
 ldentify barriers and limitations: You may perceive barriers to education and patient
may confirm them. Some factors, such as low health literacy may be more subtle and
harder to recognize.
 Take time to establish rapport: Do a comprehensive assessment. It is worth it, because
your patient education efforts will be more effective.
MAINTAINING EFFECTIVE HUMAN RELATIONS AND COMMUNICATION WITH
VULNERABLE GROUPS (CHILDREN, WOMEN, PHYSICALLY AND MENTALLY
CHALLENGED AND ELDERLY)

COMMUNICATING WITH CHILDREN


Effective communication with children requires styles and behavior appropriate to the child's
age.
Communication with a child requires special considerations so that the nurse can develop
working relationship with both the child and family. Adults must communicate in a way that
relates to the age and interests of the child.

Infant
 Infants communicate with coos, gurgles and grunts, facial expressions, cries, body
movements like cuddling or back arching, eye movements, and arm and leg movements.

 Quickly respond to infant communication (e.g., Comfort a crying baby, smile at a smiling
infant, and relax if a baby turns her head to the side).

 Use a sing-song, high-pitched tone of voice, exaggerated facial expressions and wide-
open eyes when interacting with young infants.

 Pay attention to an infant's style of expressing emotions, preferred level of activity and
tendency to be social.
Toddlers
 The child communicate verbally and nonverbally. Respond quickly and predictably to
toddlers' communicative efforts.
 Give toddlers one direction at a time, and provide warnings before transitions.
 Toddlers communicate with a combination of gestures and grunts, one- and two-word
sentences, positive and negative emotional expressions, and body movements.
 Expand on toddlers' one- and two-word communications, and build sentences around
their words.
 During play with toddlers, follow their lead and let them create the play. Describe for
toddlers what they are doing during play and let them have control.

 The nurse use simple, short and familiar words while communicating with toddler.
Preschoolers

 The child communicate verbally. Preschoolers begin to talk in full sentences that are
grammatically correct.
 Encourage preschoolers to talk about their feelings- both positive and negative - and
discuss the possible causes for those emotions.
 Ask preschoolers questions about past events; probe for details and provide new words to
enhance description of experiences.
School- Age
 School-age children's speech is primarily verbal and talk in full sentences.
 Encourage children to talk about their feelings and the possible reasons for their
emotions.
 The child allowed to express fears and concerns.
 The child is concerned about body integrity.

Adolescent

 Adolescents are interested in talking in-depth about themselves and think abstractly.
 Children at this age want to talk about how they are different from their parents, and they
are beginning to recognize that their parents are imperfect people.
 Stay interested, and gently ask questions and seek explanations for their behavior douo
 The nurse should avoid imposing values and judgment.

COMMUNICATING WITH PHYSICALLY AND MENTALLY CHALLENGED


Failure of health care providers to communicate effectively and appropriately with people with
disabilities is a major barrier to delivery or quality health care for people with disabilities.

Communicating with All persons with disabilities

 Talk to persons With disabilities in the same way and with a normal tone of voice no
shouting) as you would talk to anyone else.
 Avoid being self-conscious about your use of wording such as "Do you see what I mean?
when talking to someone with vision impairment.
 Talk to people with disabilities as adults and talk to them directly rather than to an
accompanying person.
 Ask the person with a disability if assistance is needed; do not assume that help is needed
until you ask.
 Use "people-first language": refer to "a person with a disability" rather than "the disabled
person" or "the disabled".
 When communicating with a person with a disability, it is important to take steps to
ensure that effective communication strategies are used. This includes sitting or standing
at eye level with the patient and making appropriate eye contact.

Communicating with Patients with Mobility Limitations

 Keep in mind that the personal space of a person with a disability includes the person's
wheelchair, scooter, crutches, walker, cane, or other mobility aid.
 Do not push or move a person's wheelchair or grab a person's arm to provide assistance
without asking first.
 When speaking to a person seated in a wheelchair or scooter, sit so that you and the
person are at the same eye level.
 When giving directions to people with mobility limitations, consider distance, weather
conditions, and physical obstacles such as stairs, curbs, and steep hills.
 Shake hands when introduced to a person with a disability. People who have limited hand
use or who wear an artificial limb do shake hands.

Communicating with Patients with Vision Loss

 Identify yourself when you approach a person who has low vision or blindness. Introduce
anyone with you to the person with vision loss.
 If the person uses glasses, ensure that they are readily available to the person and that he
or she uses them.
 Touch the person's arm lightly when you speak so that he or she knows to whom you are
speaking before you begin.
 Face the person and speak directly to him or her. Use a normal tone of voice.
 When offering directions, be as specific, 1.e., "Left about 10 feet" or "Right 2 yards." Use
clock cues, if the person is accustomed to using this approach: "The door is at 10’o
clock."
 Explain when you are leaving the environment.
 When you offer to assist someone with vision loss, allow the person to take your arm.
When a5S1stance the person to a chair, place the person's hand on the back or arm of the
seat.
 Never pet or otherwise distract a canine companion or service animal unless the owner
has given you permission to do so.

Communicating with Patients with Hearing Loss

 Ask the person who is hard of hearing, deaf, or deaf-blind how he or she prefers to
Communicate and eliminate or minimize background noise and distractions.
 It the person uses an assistive hearing device (hearing aid), ensure that it is readily
available to the person and in working order and that he or she uses it.
 If you are speaking through a sign language interpreter, pause occasionally to allow the
interpreter time to translate completely and accurately.
 Talk directly to the person who is assisted by a sign interpreter, not to the interpreter,
even if the person is looking at the interpreter and does not make eye contact with you.
 Before you start to speak, get the attention of the person you are addressing. Visual
(wave) or tactile signals (light touch) can be used to get the person's attention.
 Speak without exaggerating your words. Do not raise your voice, unless you are
specifically requested to do so. Speak in a normal tone without shouting.
 If the person lip reads, face the person and keep your hands and other objects away from
your mouth. Maintain eye contact. Do not turn away or walk around while talking.
 Consider that written English may not be the primary language for some people with
disabilities and make appropriate accommodations in communicating with them.
 Anticipate that only 30% of lip reading (speech reading) will be understood because of its
level of difficulty; be prepared to repeat information or questions.
 If you do not understand something that is said, ask the person to repeat it or to write it
down. Do not pretend to understand if you do not.
Communicating with Patients with Speech Disabilities or Speech Difficulties

 Talk to people with speech disabilities as you would talk to anyorne else; use your
regular tone of voice without shouting.
 Be patient because it may take the person extra time to communicate. Do not speak for
the person or complete the person's sentences.
 Give the person your undivided atterntion and eliminate background noise and
distractions.
 If the person uses a communication device, such as a manual or electronic
communication board, ask the person the best way to use it.
 Do not pretend to understand if you do not. 'Tell the person you do not understand what
he or she has said and ask the person to repeat the message, spell it, tell it in a different
way, or write it down. Use hand gestures and notes.
 Repeat what you understand and note the person's reactions, which can indicate if you
have understood correctly.
 Develop a specific communication strategy that is consistent with the person's abilities:
nod of head or blink to indicate agreement or disagreement with what you have asked or
said.
 To obtain information quickly, ask short questions that require brief answers or a head
nod.Avoid insulting the person's intelligence with oversimplification.

Communicating with Patients with Psychiatric/Mental Health Disabilities

 Approach the person as you would anyone else; speak directly to the person, using clear,
simple communication.
 Treat persons who are adults as adults. Do not patronize, condescend, or threaten when
communicating with the person.
 Do not make decisions for the person or assume that you know the person's preferences.
 Offer to shake hands when introduced. Use the same good manners in interacting with a
person who has a psychiatric/mental health disability that you would with anyone else.
 Make eye contact, and be aware of your own body language. Like others, people with
psychiatric/mental health disabilities will sense your discomfort.
 Listen attentively, and wait for the person to finish speaking. If needed, clarify what the
person has said.
 Do not pretend to understand if you do not. Ask the person to repeat what was said. Be
patient, flexible, and supportive.
 Recognize that a person with psychiatric/mental health disabilities often has the same
wants, needs, dreams, and desires as anyone else.

Communicating with Seriously Ill Patients

 Interacting with seriously ill patients takes special care and attention. The Commission
recommends following these principles:

1. Spend at least a moment giving the patient your complete, undivided attention.
2. Start with the patient's agenda.
3. Track both the emotion and the cognitive data you get from the patient.
4. Stay with the patient and move the conversation forward one step at a time.
5. Articulate empathy explicitly.
6. Talk about what you can do before you talk about what you can't do.
7. Start with big-picture goals before talking about specific medical interventions.

COMMUNICATING WITH ELDERLY

 Start with the Right Body Language: A seated position directly opposite the patient
improves communication by reducing distractions.
 Exercise Patience: Care providers must exercise patience when treating seniors. Older
patients may also take longer to react during conversation.
 Show Proper Respect: While many have heard the phrase "respect your elders," the
sentiment proves indispensable during treatment
 Practice Active Listening: When treating seniors, it's important to actively listen to their
dialogue and remember that both parties may have difficulty expressing ideas to each
other.
 Build Rapport: To build patient rapport, health organizations must make sure that all
personnel create positive interactions. Strong rapport also leaves clients With a positive
overall impression of the organization.
 Show Sincerity: During visits, care providers should ask appropriate questions about
clients' living conditions and social circles.
 Recognize Sensory Challenges: Distractions, such as accompanying caregivers,
cognitive impairments, or hearing loss, can make communication difficult,
 Ensure Comfort: Physical comfort is important for both patients and their family
members. Alleviating physical discomfort reduces distractions during treatment.
 Use Plain Language: As patients grow older, their physiology changes considerably.
Using plain language makes it easier for senior clients to understand new concepts.
 Show Empathy: Sincere empathy builds rapport. Patients should feel as though care
providers understand and identify with their concerns.

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