COMMUNICATING

 Latin – Communicare ( to share )

 Process of understanding and sharing meaning.
 Exchanging information or feelings between 2 or more people.
Process – dynamic activity, it changes
Understanding – to perceive, interpret and to relate our perception and interpretation.
Sharing – doing something together. It occurs when you convey thoughts, feelings, ideas or insights to others.
Intrapersonal communication – sharing it to yourself. Bringing ideas to your consciousness.
Meaning – what we share through communication. We can discover the shared meaning of the word and
understand the message.

PURPOSES
 To influence others
 To gain information

FORMS of COMMUNICATION
1. Intrapersonal Communication
 Communication with oneself. It involves one person.
 Often called “self-talk” ex.voice within you--- I can do it!
 It can be positive or negative. – I cannot do it! – and directly influence how you perceive and react to
situations and communication with others

2. Interpersonal Communication
 Communication with others. Normally involves 2 people and can range from intimate and very personal to
formal and impersonal
 Loved one or work – both involve interpersonal communication but are different in terms of intimacy
Loved one- implies a trusting relationship established over time b/n two caring individuals
 Work – implies some previous familiarity and its really more about acknowledging each other than any
actual exchange of information
3. Group Communication
 A small number of people engage in communication. Involves 3-8 people. The larger the group the more
likely it is to breakdown into smaller groups.

4. Public Communication
 One person speaks to a group of people.
 The speaker may ask questions and engage the audience in a discussion. Ex. Public speaking – the group
normally listens to the speaker
 Involves personal and intrapersonal communication

5. Mass Communication
 Mass media is a powerful force used in our society now
 Involves sending a single message to a group, it allows us to communicate our message to a large number of
people but we are limited to our ability to tailor our message to specific audiences, groups or individuals.

COMMUNICATION PROCESS
 Transmission of a message from a sender to a receiver in an understandable manner
 Process involves steps that we have to take in order to successfully communicate. So the communication
process itself is the foundation for oral and written communication, whether it be a face to face
communication or over internet, chat, via audio etc. the communication process remains the same. Ex. Zoom
Skype

 The sender begins the communication process deciding that there is a need to relay information to the
receiver. The information takes the form of the message. The receiver responds with feedback, the receivers
reply to the sender is called the feedback

MODES OF COMMUNICATION
1. Verbal Communication
 Communicating with words, spoken or written. The written word often stands in place of the spoken word,
people often say it is good to hear from you when they receive an email or a letter when in fact they didn’t
hear the message bc they read it.
 Oral and written forms of communication are similar in many ways. They both rely on the basic
communication process
2. Nonverbal Communication
 Use of body language or body movement
 “Actions speak louder than words”
3. Electronic Communication
 Email could be the most common form of electronic communication. Email has many positive advantages, it
is a fast efficient way to communicate and it is legible. It provides a record of date and time of the message
that was sent or received, this improves communication and continuity of client care. Email promises better
 access and evidence has shown that clients and healthcare providers are willing to use internet based
technologies
**DISADVANTAGES—
1. problems on privacy, confidentiality and misuse of information. Protection of client privacy
remains an issue when transferring information electronically. The healthcare agency needs to have an email
__system to ensure security.
2. Socio economic – not everyone has a computer, and even if people has access to computers, not
everyone has the necessary computer skills.

***Other forms of communication would be needed for clients who have limited abilities with speaking
English, reading, writing or using a computer.

CRITERIA FOR EFFECTIVE VERBAL COMMUNICATION

1. Pace and intonation
The manner of speech, as in the rate or rhythm and tone will modify the feelings and impact of a
message. The tone of words can express enthusiasm, sadness, anger or excitement. Rapid speech may
indicate anxiety or fear, for example speaking slowly and softly to an agitated or excited client may help calm
the client.
2. Simplicity
Includes the use of commonly understood words. Nurses need to learn to select appropriate,
understandable and simple terms based on the age, knowledge, culture and education of the client
3. Clarity and Brevity- Congruence
Message that is direct and simple will be effective. Clarity is saying what is meant and brevity is
using few words as necessary. The result is a message that is simple and clear. When we speak of
congruence, when the nurses’ behavior or nonverbal communication matches the word spoken. When the
nurse says I am interested in hearing what you have to say. The nonverbal behavior would include the nurse
facing the client making eye contact and leaning forward. The goal is to communicate clearly so that all
aspects of the situation are understood.
 To ensure clarity in communication, nurses need to pronounce carefully
4. Timing and relevance
Nurses need to be aware of both relevance and timing when communicating with clients. No matter
how clearly or simply words are stated or written, timing needs to be appropriate to ensure that words are heard.
Moreover, the messages need to relate to the persons interest and concern.
5. Adaptability
The nurse needs to alter spoken messages in according to the behavior of the patient, this
adjustment is referred to as adaptability. When the nurse says and how it is said, must be individualized and
carefully considered. This requires assessment and sensitivity on the part of the nurse, for ex. A nurse who usually
smiles appears cheerful and greets the client with enthusiastic saying HI!, notices that the patient is not smiling and
appears distressed. It is important for the nurse then to modify her tone of speech and express concern by facial
expression while moving toward the client

6. Credibility
 Trustworthiness and reliability.
 Maybe the most important criterion of effective communication. Nurses foster credibility by being
consistent, dependable and honest. The nurse needs to be knowledgeable about what is being discussed and
to have accurate information. Nurses should convey confidence and certainty in what they are saying while
being able to acknowledge their limitations
7. Humor
 Use of humor can be a positive and powerful tool in the nurse client relationship. It can be used to help
client adjust in difficult and painful situations. An act of laughter can promote a sense of well being

EFFECTIVE NONVERBAL COMMUNICATION

1. Posture
  The way people walk and carry themselves are often reliable indicators of self-concept, current mood and
health. Ex.
 Erect posture- may suggest a feeling of well being
 Slouch posture and a slow shafting gait – suggest depression or physical discomfort
 Tensed posture and rapid gait – suggest anxiety or anger

2. Hand shake or hugs

3. Eye Contact
 Another essential element of facial communication
4. Smile
5. Gestures (hand and body)
 May emphasize and clarify the spoken word
6. Voice
 Pace, pitch, projection, pausing and intonation

THERAPEUTIC COMMUNICATION
 Face to face interaction that focuses on the patient’s physical and emotional being.
 A communication that pertains to treatment and healing.
 Nurses use therapeutic communication to provide support and information to patients.
 Therapeutic- means treatment and healing
**interpersonal Communication techniques are the tools of psychosocial intervention.

Characteristics of Therapeutic Communication

 It must be goal directed
 Focused on the clients needs
 Planned, time limited
 Professional

Basic Elements of Therapeutic N-P Relationship

 Trust
 Rapport
 Unconditional Positive Regard’
 Setting Limits
 Therapeutic Communication

TRUST
 One must feel confidence in the persons presence, reliability and desire to provide care
Rapport
 Be accepting, be open to the message being communicated, and that acceptance doesn’t necessarily mean
you agree with what is being said. Be nonjudgmental, you receive the message without judgment or
criticism. Set aside opinions, attitudes and beliefs.

POSITIVE REGARD
 Mutual respect and understanding. Acknowledge, let the other person know that you have listened to the
message and you listened attentively.

SET LIMIT
 Patient to know the expected behavior and learn to control behavior

THERAPEUTIC COMMUNICATION
 Techniques that facilitate and enhance communication between nurse and client
 Phases of a Therapeutic Nurse- Patient Relationship – (Developed by Hildegard Peplau)
 ORIENTATION PHASE
 getting to know you patient
 Task of the nurse is to develop a mutually acceptable contract. Introduce name eytc.

 WORKING PHASE
 Mutually planning and implement patient care.
 It is individualize, it is the longest and most productive phase of the nurse patient relationship. The
major task of the nurse is to identify and help the patient solve the problem.

 TERMINATION PHASE
 Nurse patient relationship is self-limiting
 Relationship ends when patient’s health problem are solved and yhis should be recognized in the
orientation phase.
 The major task of the nurse during this phase is to assist the pt to review what he has learned and
transfer his learning to his relationship with others.

CHARACTERISTICS / ELEMENTS OF THERAPEUTIC COMMUNICATION

 Active Listening
 Paying attention to what the person is saying to ensure understanding. AL can help us truly
understand what people are saying in a conversation. You ask specific questions, acknowledge
feelings, be patient and keep communication open and avoid interrupting.
 Build trust and rapport
 Ask specific questions

To facilitate active listening

1. Maintain eye contact with the speaker
2. Don’t interrupt
3. Focus your attention on the message
4. Restate the message in your own words and ask if you understand correctly
5. Clarify to communicate interest and gain insight

 Visibly tuning in
 Demonstrate concern and use brief verbal affirmations like “I see”

Therapeutic Communication Techniques used by nurses

-These are the common techniques used.
Communication Technique Example

Accepting indicate you heard the patient without Oh, I see.

judgment Uhm, go on.
Broad opening statement – allow patient to initiate What would you like to talk about?
conversation. Is there anything you want to talk about?
Clarifying - asking patient to elaborate/explain or give Nurse: Can you explain more about that to me?
example of feelings/ideas. Patient: I feel sick inside.
- Make vague topics clear. Nurse: What do you mean by feeling sick inside?
Patient: I'm feeling lost!
Nurse: Give me an example of "feeling lost."
Encouraging expression - asking the client to describe Tell me when you feel anxious?
her feelings. Tell me about your feelings.
Focusing putting attention into single topic Nurse: Let us talk about your relationship with your father.
Giving recognition - acknowledging, indicating Good morning ....
awareness. I notice that you combed your hair.
You look very nice.
Informing - giving information that the client needs.
Listening - to encourage patient to continue talking.
Listening attentively to ensure understanding
Making observation – verbalizing/tellng what the
nurse sees.
Offering self- making oneself available.
Reflecting direct patient’s thoughts and feelings back
to patient.
Restating (paraphrasing) - repeat the words of patient
to remind her of what she said, to let her know she is
heard.
Presenting reality -offering a view of what is real &
what is not without arguing with the patient.
Summarizing - organizing and summing up which was
said before.
My name is...
Visiting hours are...
The purpose of the activity is....
Go on, tell me about it
And then?
You appear nervous.
I see you are biting your lip.
I will sit with you.
I stay here with you.
Patient: My mother does not understand me at all.
Nurse: You seem not to be understood by your mother? What
made you think that way?
Patient: I'm going home soon.
Nurse: You are going home soon?
Patient: But my mother is not happy.
Nurse: Your mother was not happy to see you?
Patient: I hear voices of people trying to kill me.
Nurse: I don't hear voices but I know the voices are real to
you.
So far we have talked about....
Let's see, we had discussed about your family problems, their
effect in your schoolwork......

BARRIERS TO COMMUNICATION
 Belittling – ex. That is not important!
 Interrupting -
 Giving advice – telling the client what to do, just like, I think you should leave your husband | You sound
worried, I think you should better talk to your doctor.
 Moralizing
 Approving or agreeing
 Changing the subject
 Social response

NONTHERAPEUTIC COMMUNICATION
 False Reassurance
 Indicating that there is no reason for anxiety or feelings of discomfort.
 “Don’t worry. Everything will be alright”
 You are doing fine

 Stereotyped Comments
 Or offering meaningless cliché statement
 You will be better now
 You are very good

“Your mind is like a parachute, it only works when it’s open” – Jordan Maxwell

Learning Activity
In order to communicate with others, you need to know yourself. Because self-understanding is fundamental
to communication.