Communication in Nursing

COMMUNICATION IN NURSING Aspects of Communication Receiver – Receiver – physiological/psychological  physiological/psychological components Feedback – Feedback – receiver’s response to the sender Influences – Influences – culture,  culture, education, emotions and other factors involved Factors Affecting the Communication Process 1) Perception – Perception – person’s sensing and understanding of the world *Unique and varies from person to person *Influenced by culture, socialization and educational experience 2) Cultural Context – Context – *since  *since behavior is learned -- non-behavioral communication from culture to culture 3) Helping and Communicating Helping – Helping – growth  growth facilitating process Person assists another to solve problems and to face crises in the direction the assisted person chooses (Browner 1998). This relationship forms CARING – CARING  – the  the hallmark of the nursing process. It is a dynamic, ever-changing relationship with another human being whose welfare is the focus of the interaction. Keys of a Helping Relationship 1) Development of Trust and Acceptance betwee n the nurse and the client 2) Underlying beliefs that the nurse cares about and wants to help the client Characteristics of a Helping Relationship 1) Warmth – Warmth – exhibiting  exhibiting positive behaviors towards client Warmth is projecting positive friendly attitudes without whelming the client with a false reassurance of cheerfulness. Approachable and available yet maintains objective boundaries. 2) Hope – Hope – anticipating  anticipating the future by helping the c lient realistically at their potential. It is the energy source that allows individual to plan, act and achieve. 3) Rapport – Rapport – bond  bond and connection between two people that is based on mutual trust. The nurse action shows that the client is considered important, interesting with the family and significant others. 4) Empathy – Empathy – understanding other’s perception of the situation. This validates client’s experience. 5) Trust  –   –  being consistently consistently trustworthy is an expression of a nurse’s professional/personal integrity and builds foundation of nursing efficiency. 6) Acceptance – Acceptance – accepting  accepting the client as a person worthy of dignity and respect. 7) Active Listening – Listening – listening  listening that focuses on the feeling of t he individual who is speaking. This requires the nurse to turn down inner dialogue and that total attention must be focused on what the client is saying. 8) Humor – Humor – medium  medium for sharing. It can be used to strengthen the therapeutic acceptance manner. Acting on a belief that everyone e qually deserves care. 10) Self-awareness – Self-awareness – being aware of one’s feelings; knowledge of one’s self. 11) Non-judgmental Approach – Approach  – acting  acting without biases, stereotype or preconce ptions. 12) Flexibility – Flexibility – ready  ready for the unexpected. Knowing that every day is full of unplanned events and situations; can adopt and make necessary adjustment. 13) Risk-taking – Risk-taking – giving  giving self permission to try something new. It is to step out of the ordinary and not be bound by tradition or fear.

Nurse-Client Communication Involve therapeutic communication  Influence by both nurse and client.  3 PHASES: 1) Pre-intervention Phase Nurse has the information about the client before the first face to face meeting. *(Planning for the first interaction may generate an anxious feeling for the nurse.) 2) Introduction Phase (Orientation Phase/Pre-helping Phase) *Fairly short; expectations clarified; mutual goals set. *It sets the tone for the rest of the relationship. *3 Stages: 1) Opening the relationship 2) Clarifying the problem 3) Structuring and formulating contract (obligations to be met by nurse and client) - must look into: a) Restrictive behaviors: those that inhibit involvement, cooperation or change b) Testing behaviors: those that examine the nurse’s interest and sincerity c) Trust: reliance in someone without doubt or question 3) Working Phase Caring is sharing deep and genuine concern about the welfare of another person.  Working: major portion of the interaction; used to accomplish goals outlined in the  introduction phase; feedback from client is essential. *2 Stages: 1) Exploring and understanding thoughts and feelings, needed skills. a) Therapeutic Empathy – it is a learned, conscious way of responding in which the nurse uses various communication techniques to convey understanding of the client’s reality. b) Respect c) Genuineness *Components of Genuineness: 1) the genuine helper does not take refuge to the role of the counselor 2) the genuine person is spontaneous 3) the genuine person is non-defensive 4) the genuine person displays few discrepancies d) Concreteness e) Self-disclosure f) Confrontation 2) Facilitating and Taking action *Termination – Nurse asks if client has questions. Summarizing the topic is also one way of to indicate closure. Determinant Factors in Communication A nurse’s communication is affected by: a) Past Experience b) State of Health c) Home Situation d) Workload e) Staff Relations A client’s communication is affected by:

a) Social Factors b) Religion c) Family Situation d) Level of Consciousness e) Stage of Illness f) Visual, Hearing, and Speech Ability g) Language Proficiency Therapeutic Communication Sometimes called effective communication, it is purposeful and goal-oriented, creating a  beneficial outcome for the client. To help the person explore and clarify the problems of his life that helps or hinders the  satisfaction of his needs. Facilitate the establishment of nurse-client relationship and fulfill the purpose of nursing.  To obtain or provide information.  To develop trust.  To show caring.  To explore feelings.  Techniques of Therapeutic Communication a) Silence  –  accepting pauses of silence that may extend for several seconds or minutes without interjecting any verbal response. b) Providing general needs – using statements or questions that: