UNIT-IV Communication

FACULTY
SHAMS UDDIN

THE BIGEST COMMUNICATION PROBLEM IS WE DO NOT

LISTEN TO UNDERSTAND. WE LISTEN TO REPLY.
STEPHEN R.COVEY
Objectives
At the end of this unit students will be able to
1. Define communication, elements of the communication process, ways of
communication.
2. Identify the characteristics of the effective verbal communication
3. Describe the factors that's facilitate and interfere with the effective
communication
4. Define ways to respond therapeutically
5. Identify non therapeutically respond
6. Discuss the legal aspects of documentation
 INTRODUCTION
• Communication is the basic element of human interactions that allows people to
establish, maintain and improve contacts with others.

• Communication is an integral part of the nursing process .Nursing use communication

skills in each phase of the nursing process. Communication is also important when caring
for clients who have communication problems. Communication skills are even more
important when the client has sensory ,language, or deficits.

DEFINITION
• "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
Communication
Communication is regarded as a two- way process of exchanging
ideas, feelings, emotion and information so as to
• To increase knowledge
• To change existing patterns of behavior & attitudes
• To acquire new skills.
It has two main purposes:
• To influence others
• To gain information
COMMUNICATION PROCESS
It has the following main components

Sender (source, communicator)

Receiver (Audience)

Message (content)

Channels (medium or pathway)

Feedback (effect)
The Communication Process

Message

Barrier
SENDER RECEIVER
(encodes) (decodes)
Barrier

Feedback/Response
COMMUNICATION PROCESS:
communication is a two way process involving the sending and
the receiving of a message.

1)SENDER:
The sender a person or person or group who wishes to convey a
message to another, can be considered the source encoder.

2)MESSAGE :The second component of the communication

process is the message itself what is actually said or written
.Talking face to face with a person ,telephoning or writing a
message ,recording message etc.
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Components of Communication
3. Channel:
• A channel is a medium through which a message is sent or received
between two or more people.
• Several channels can be used to send or receive the message, i.e
seeing, hearing, touching, smelling, & tasting.
• While selecting channels of communication, several factors must be
considered: availability of channels , purpose, suitability, types of
receivers, types of message, preference of sender & receivers,
communication skills of the sender, cost, etc.
 Components of Communication
Classification of channels of communication:

• Visual channel: Facial expression, body language, posture, gestures, pictures &
written words, electronic mails, mass media, etc.

• Auditory channel: Spoken words, sounds, telephone or mobile communications, delivering

audio content (radio, voicemail), etc.

• Tactile channel: Touch sensations, therapeutic touch, etc.

• Combined channel: Audiovisual media, consoling a person with touch & spoken words.
 CONT….
4) RECEIVER :The receiver ,the third component of the
communication process ,is the listener, who must listen
,observe and attend .This person is the decoder .

5) FEEDBACK/RESPONSE :last component of the

communication process ,the response is the message that
the receiver returns to the sender .It is also called feedback
Feedback either verbal or non verbal
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 Types of Communication

1. One way communication

2. Two way communication

3. Verbal communication

4. Non-verbal communication

5. Formal and informal communication

6. Visual communication

7. Telecommunication and internet

One Way Communication
• The flow of communication is “one-way” from the communicator to
the audience.

• Example - Lectures in classroom

Two Way Communication
• Two-way method of communication in which both communicator and
audience take part.

• Learning is active
• More likely to influence behavior.
Verbal Communication
• In Verbal communication, Spoken words are used. It includes face-to-
face conversations, speech.

• The words used vary among individuals according to culture,

socioeconomic background, age, and education.
Characteristics of effective verbal communication

• Simplicity Use of commonly understood words

• Clarity Say exactly what it means

• Timing and relevance

This involves being sensitive to the clients' needs and concerns

• Adaptability Spoken message needs to be altered in accordance with

behavioral cues from the receiver

• Credibility
the quality of being trusted & believed
Nonverbal communication
• Communication can occur even without words.

• It includes whole range of bodily movements, postures, gestures and facial

expression.

• Silence is non verbal communication, it can speak louder than words.

Visual communication
The visual form of communication comprise ;
• Charts
• Graphs
• Pictograms
• Tables
• Maps
• posters
Telecommunication and internet

• Telecommunication is the process of communication over distance

using electromagnetic instruments designed for the purpose.

• For example radio, TV, internet , telephones, satellite etc

Levels of communication

• Intrapersonal communication

• Interpersonal communication

• Transpersonal communication

• Small group communication

• Public communication
Intrapersonal communication
• It occurs within an individual. This level of communication is also
called self talk, inner thought and inner dialogue.
Interpersonal communication
• It is one to one interaction between the nurse and another person
that often occurs face to face.
• Meaningful interpersonal communication results in exchange of
ideas, problem solving, expression of feelings, decision making and
personal growth.
Transpersonal communication
• It occurs within a person’s spiritual domain. Many persons use prayer,
meditation religious rituals to communicate with their higher power.
Small group communication
• It occurs when a small number of persons meet together. It is usually
goal directed and requires an understanding of group dynamics.
Public communication
• It is the interaction with the audience. Nurses have opportunities to
speak with groups of consumers about health related topics, present
scholarly work to colleagues at conferences or lead classroom
discussions
 Therapeutic Communication
“In therapeutic communication the nurse directs the
communications towards the patient to identify his
current health problem, plan, implement &
evaluation the action taken.”

Therapeutic communication is a purposeful use of

communication to build and maintain helping
relationships with patients. It enhances patient care
and promotes emotional, psychological, and physical
well-being.
 Therapeutic Communication Techniques
• 1. Active Listening:
• Paying close attention to the patient’s words, tone, and body language.
Example: Nodding, maintaining eye contact, and saying “I’m listening.”

• 2. Silence:
• Allowing time for the patient to think or express emotions.
• Example: Sitting quietly while a patient processes feelings about a diagnosis

• 3. Open-Ended Questions:
• Encouraging the patient to express themselves freely.
• Example: “Can you tell me more about how you’re feeling today?
• 4. Paraphrasing:
• Restating the patient’s message in your own words.
• Example: Patient: “I’m really anxious about my surgery.”Nurse: “You’re feeling
nervous about what will happen during the surgery.

• 5. Clarification:

6.Summarizing

• 7. Offering Self: Showing availability and support.

• Example: “I’ll sit with you for a while if you’d like.

• 8. Focusing
• Providing Information (Surgery)
Therapeutic Communication Techniques
• Offering self
• Giving broad opening
• Silence
• Exploring
• Focusing
• Providing general leads
• Giving information
• Restating
Technique purpose example

Using silence Sitting quietly (or walking

Accepting pauses or silences that with the client) and
may extend for several seconds or waiting attentively until
minutes without the client is able to put
any verbal response. thoughts and feelings into
words.
Providing Using statements or questions that “Where would you like to
general leads (a) encourage the client to verbalize, begin?”
(b) choose a topic of conversation,
and (c) facilitate continued “And then what?”
verbalization.
Broad Initiates conversation; Tell me something
Opening Encourage the patient to select About your family?
Topics for discussion. What would you like to
discuss?
eg; “What are you
thinking about?”
Technique purpose example

Offeringself Making oneself I‟ll stay with you until

Available on an I‟ll be hear till 12.00
Unconditional basis, Clock.
increasingclient‟s “I’ll stay with you until your family
Feelingof self-worth members arrives.”

Restating Repeating the main thought Eg; “You say that your mother left
expressed by the patient. you when you were five years old.”

Giving Providing, in a simple and direct

information manner, specific Your surgery is scheduled for 11
factual information the client may or AM tomorrow.”
may not “You will feel a pulling sensation
request. When information is not
when the tube is removed
known, the nurse
from your abdomen.”
states this and indicates who has it “I do not know the answer to that,
or when the but I will find out from
nurse will obtain it. Mrs. King, the nurse in charge.”
Technique purpose example

Exploring “Tell me more about

that.”
delving further “Would you describe it
into a subject or an idea more
fully?”
“What kind of work?”
Focusing Concentrating on a single point. “This point seems worth
looking at more closely.”
Factors influencing communication process

• Person Socio cultural background

• Language
• Age
• Education
• Ability of communication
• Time and setting
• Emotions and self esteem
Nontherapeutic response

• Not listening properly

• Rejection (refusing from discussion)

• False hopes

• Too much probing into personal matters

• Changing the subject

• Sharing personal or work related problems

• Reveal confidential information

Legal Aspects of Documentation
Legal Aspects of Recordkeeping
• Legally, the documentation of the care given to a patient must be
completed.
• If no documentation is recorded, no care was given at all.
• Hospital accreditation agencies will carefully evaluate the medical
records of patients.
Legal Aspects of Recordkeeping
• If documentation is not done the hospital and the practitioner could
be accused of patient neglect.
• Proper documentation of care is valuable only in reference to
standards and criteria of care.
Legal Aspects of Recordkeeping
• For each standard, criteria must be outlined so that adequacy of
patient care be measured.
• Documentation will reflect the standards of the department.
Practical Aspects of Recordkeeping
• Recordkeeping is one of the most important parts of our duties.
• Documentation must be done for each medication, treatment, and
procedure.
• Accounts of patient’s condition and activities must be charted
correctly and be very clear.
• Briefness is important, although a complete account of each patient
encounter
General Rules for Recordkeeping
• Legible. Print or hand write entries in chart.
• Begin with date and time, then enter order and sign
the chart:
• Errors? Don’t erase, or use correction tape. If a
mistake, drawn a line through it, write date and write
the word error above it, with your initials
• Chart patient complaints and general behavior
General Rules of Recordkeeping

• Leave no blank or empty lines. Draw a line through the center of the
empty space in order to prevent someone else from signing in your
area.
• Use Standard abbreviations
• Spell Correctly
• Document conversations with patient and healthcare providers that
you feel are important
References
• Andrea Ackermann, Mount St. Mary College, Critical-thinking-the-
nursing-process 2001.
• http://www.umanitoba.ca/nursing/courses/128,(2005)
• Sara-jo Wiscombe, Nursing Process ,Wallace Community College ,May
22,2001.
• Tucker C, MODULE A INTRODUCTION TO NURSING Process, August
21, 2002 .