GOOD AFTERNOON!!!

COMMUNICATION

D.R.LIM,RN,MAN,Ph.D

COMMUNICATION Is any means of exchanging information or feelings between two or more people. It is a basic component of human relationship, including nurses.
FOR NURSES:

“BEDSIDE MANNER”

THERAPEUTIC COMMUNICATION • Promotes understanding and can help establish a constructive relationship between the nurse and the client .

PERSONAL – 1 ½ to 4 feet 3. SOCIAL – 4 to 12 feet 4. PUBLIC – 12 to 15 feet .PROXEMICS Is the study of distance between people in their interaction 1. INTIMATE – touching to 1 ½ feet 2.

2 PURPOSES OF COMMUNICATION: a.To obtain information .To influence others b.

thoughts.Communication can be described as HELPFUL OR UNHELPFUL: HELPFUL – if it encourages a sharing of information.. or feelings between two or more people UNHELPFUL – if it hinders or blocks the transfer of information and feelings .

Effective communication is essential for the establishment of a NURSE-CLIENT RELATIONSHIP .

.Communication can occur on an intrapersonal level within a single individual as well as on an interpersonal and group levels.

INTRAPERSONAL – is the communication that you have with yourself (SELF-TALK). .

SELF . it occurs constantly .TALK It involves thinking about the message before it is sent. while it is sent. and after it is sent.

. It is often face-to-face and is the type most frequently used in nursing.Interpersonal communication Is the interaction between two people or in a small group.

ELEMENTS OF THE COMMUNICATION PROCESS: Interpersonal Variables Channels Referent Sender Message Referent Receiver Feedback 13 .

ELEMENTS OF COMMUNICATION 1.emotion) - .REFERENT or stimulus which motivates the person to talk ( idea.

A person or group who wishes to convey a message to another. can be considered the SOURCE-ENCODER .SENDER .ELEMENTS OF COMMUNICATION 2.

ENCODING involves the selection of specific signs or symbols (codes) to transmit the message. such as which language and words to use. and what tone of voice and gestures to use. . how to arrange the words.

the body language that accompanies the words .MESSAGE -What is usually said or written.ELEMENTS OF COMMUNICATION 3.

CHANNEL the medium used to convey the message and it can target any of the receiver’s senses. .ELEMENTS OF COMMUNICATION 4.

TOUCH – nonverbal communication is often highly effective. .

observe. who must listen.RECEIVER --Is the listener.ELEMENTS OF COMMUNICATION 5. and attend .

.DECODER to decode means to relate the message perceived to the receiver’s storehouse of knowledge and experience and to sort out the meaning of the message.

INEFFECTIVE COMMUNICATION is misinterpreted by the receiver -when the message sent .

.ELEMENTS OF COMMUNICATION 6.RESPONSE/FEEDBACK --Is the message that the receiver returns to the sender.

age and education . VERBAL COMMUNICATION Uses spoken or written word  Words use vary depending on ones culture socioeconomic background.MODES OF COMMUNICATION A.

nurses need to consider: 1.PACE AND INTONATION 2. SIMPLICITY 3. CLARITY & BREVITY .When choosing words to say or write.

ADAPTABILITY 6. HUMOR .4. TIMING & RELEVANCE 5. CREDIBILITY 7.

effective verbal communication techniques… Vocabulary Communication is unsuccessful if the receiver is unable to translate the sender’s words and phrases A message in spoken in terms the receiver understands makes communication more effective - 27 .

-mnordinado- 28 .effective verbal communication techniques… Denotative and connotative meaning A denotative meaning is one shared by individuals who use a common language. A connotative meaning of a word reflects the shade or interpretation of a word’s meaning rather than the definition.

effective verbal communication techniques… Clarity and brevity Clarity is best achieved by speaking slowly and enunciating clearly Effective communication is simple. short and direct Vague phrases such as you know add a little clarity to the message Brevity is best achieved by using words that express an idea simply 29 .

Pauses should be used to accentuate or stress a particular point. 30 .effective verbal communication techniques… Pacing Verbal is more successful when expresses at an appropriate speed or pace. giving the listener to time to hear and the speaker to think what to say.

A person is more likely to communicate when a message is important or relevant. 31 .effective verbal communication techniques… Timing and relevance Timing is critical to reception of a message.

“laughter is the best medicine” applies when it helps to adjust to stress imposed by different kinds of stressor 32 .effective verbal communication techniques… Humor Can be a powerful tool in promoting well-being. The phrase.

facial expressions. touch.NONVERBAL COMMUNICATION BODY LANGUAGE It includes gestures. physical appearance.B. adornment .

 PERSONAL APPEARANCE  FACIAL EXPRESSION  POSTURE & GAIT  GESTURES .

Non verbal cues: Personal appearance The general impression formed of another person influences the response to that person Intonation The tone of the speaker’s voice can have a significant effect on a message’s meaning Voice tone can be a cue to a person’s emotional state and energy level 35 .

Facial expression The face has a rich communication potential A mutual glance or communication of eyes between two people can set the tone for an interpersonal encounter. - 36 ..non verbal cues..

self concept and physical wellness 37 . Posture and gait The way that people stand and move is visibly form of self expression..non verbal cues. emotions. Posture and gait reflects attitudes..

tenderness. Various messages such as affection. 38 . emotional support. encouragement. • Touch Is a personal form of non verbal communication.non verbal cues… • Gestures Are used to illustrate an idea that is difficult or inconvenient to describe in words. and personal attention conveyed by touch.

ELECTRONIC COMMUNICATION • E-MAIL – most common form of electronic communication • Advantage efficient way to communicate and legible -facilitate communication and continuity of care -better access .

E-MAIL Disadvantage • Risk to client confidentiality • Socioeconomics • Not every one has the necessary computer skills .

When not to use E-MAIL • When the information is urgent and clients health is in jeopardy • High confidential information ( HIV status , mental health , chemical dependency) • Abnormal lab data, confusing information , it is better to call the client

PHASES OF COMMUNICATION 1. ORIENTATION PHASE
Tone and guidelines for the relationship are established. Nurse and client meet and learn to identify each other by names.

– interaction this time are purposeful to achieve mutual goals and objective
2.WORKING PHASE

3. TERMINATION PHASE conclusion of the initial agreement is acknowledged. .

.BARRIERS TO COMMUNICATION 1.STEREOTYPING  generalized and oversimplified beliefs about groups of people that are based on experiences.

2. These responses prevent the client from expressing true concerns.AGREEING AND DISAGREEING 3. . BEING DEFENSIVE Attempting to protect a person or health care services from negative comments.

CHALLENGING Giving a response that makes clients prove their statement or point of view. .4.

 Asking “why” ? . PROBING  Asking for information’s chiefly out of curiosity rather than with the intent to assist the client.5.

REJECTING  Refusing to discuss certain topics with the client. 7.6. TESTING  Asking questions that make the client admit to something. .

.8. CHANGING TOPICS AND SUBJECTS Directing the communication into areas of self-interest rather than considering the client’s concerns.

.9. UNWARRANTED REASSURANCE Using clichés or comforting statements of advice as a means to reassure the client.

PASSING JUDGEMENT  Giving opinions and approving or disapproving responses.10. or implying one’s own values. moralizing. .

. GIVING COMMON ADVICE Telling the client what to do.11. These responses deny the client’s right to be an equal partner.

THERAPEUTIC COMMUNICATION .

ex. USING SILENCE  Accepting pauses or silences that may extend for several seconds or minutes without interjecting any verbal response.THERAPEUTIC COMMUNICATION TECHNIQUES 1. Sitting quietly and waiting attentively until the client is able to put thoughts and feelings into words .

.To be an attentive listener. the nurse uses the following skills: Face clients while they speak. Assume an attentive posture. Maintain natural eye contact to show willingness to listen. Avoid crossing legs and arms because this conveys a defensive posture.

Nod in acknowledgement when clients talk about important points of look for feedback. or fidgeting with an object in the hands. tapping feet. the nurse uses the following skills: Avoid distracting body movements.To be an attentive listener. such as wringing hands. . Lean toward speakers to communicate involvement.

PROVIDING GENERAL LEADS Using statements or questions that encourage the client to verbalize or choose a topic of conversation. Can you tell me how it is for you? . ex.2. and facilitated continued conversation.

” (specific statement) . ex.3. and tentative rather than absolute. BEING SPECIFIC AND TENTATIVE  Making statements that are specific rather than general. “Rate your pain on a scale of 0-10.

USING OPEN-ENDED QUESTION Asking broad question that lead or invite the client to explore ex.4. What is your opinion? .

Placing your hand over the client’s hand. USING TOUCH Providing appropriate form of touch to reinforce caring feelings. Putting an arm over the client’s shoulder. .5. ex.

6. RESTATING Repeating the main idea expressed by the client saying the same key words that he just had spoken. Client: “I couldn’t manage to sleep last night ” Nurse: “You were not able to sleep last night?” . ex.

PARAPHRASING  Stating in newer and fewer words the basic content of the client’s message.7. Client: “I couldn’t manage to eat any dinner last night not even the dessert. ex.” Nurse: “You have difficulty eating yesterday?” .

” . ex. SEEKING CLARIFICATION  Helping client clarify their own thoughts and maximize mutual understanding between the client and the health provider.8. “I’m puzzled.

.9. PERCEPTION CHECKING OR SEEKING CONSENSUAL VALIDATION a method similar to clarifying that verifies the meaning of specific words rather than the overall meaning of a message.

“ I’ll stay with you until your daughter arrives. interest or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse’s attention.” . ex. OFFERING SELF  suggesting one’s presence.10.

“Your surgery is scheduled for 11 AM tomorrow .11. specific factual information that the client may or may not request ex. GIVING INFORMATION providing in a simple and direct manner.

ACKNOWLEDGING giving recognition in a nonjudgmental way.12. or a contribution to a communication. of a change of behavior. . an effort the client has made. “You walked twice as far today with your walker.” ex .

Nurse: “Was that after breakfast?” . ex.13. or happening in relationship to time. situation. CLARIFYING TIME AND SEQUENCE  helping the client clarify an event.

client from .14. PRESENTING REALITY  helping the differentiate real unreal.

FOCUSING  helping the client expand on and develop a topic of importance.15. .

questions.16. feelings. Client: “What can I do?” Nurse: “What do you think would be helpful?” . ex. or content back to clients to enable them to explore their own ideas and feelings about a situation. REFLECTING  directing ideas.

. SUMMARIZING AND PLANNING ex.’ . Bringing together important points discussion to enhance understanding 17. “During the past half our we have talked about..

SUMMARY • COMMUNICATION • THERAPEUTIC COMMUNICATION • PROXEMICS • 2 PURPOSES OF COMMUNICATION • COMMUNICATION PROCESS • ELEMENTS OF COMMUNICATION • MODES OF COMMUNICATION • ELECTRONIC COMMUNICATION • PHASES OF COMMUNICATION • BARRIERS TO COMMUNICATION .

Thank you.. Are there any question?? 75 - .

.Review for 5 minutes. -mnordinado- 76 .

RN. LIM.Ph.D .MAN.DAISY R.

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