Basic Nursing:

Foundations of
Skills & Concepts
Communication

 The sending and receiving of a message.

Aspects of Communication (i)

 Sender - the one who conveys the message to another person.

 Message - the thought, idea, or emotion conveyed.
 Channel - how the message is sent.
Aspects of Communication (ii)

 Receiver - physiological/ psychological components.

 Feedback - the receiver’s response to the sender.
 Influences - Culture, education, emotions and other factors involved.
Methods of Communication

 Verbal - Speaking, Listening, Writing, Reading.

 Nonverbal - Gestures, Facial Expressions, Posture and Gait, Tone of

Voice, Touch, Eye Contact, Body Position, Physical Appearance.
Influences on Communication

 Age  Language
 Education  Attention
 Emotions  Surroundings
 Culture
Listening and Observing

 Listening and observing are two of the most valuable skills a nurse
can have.

 These two skills are used to gather the subjective and objective data
for the nursing assessment.
Active Listening

 The process of hearing spoken words and noting nonverbal behavior.

 Active listening takes energy and concentration.

Therapeutic Communication

 Sometimes called effective communication, it is purposeful and goal-

oriented, creating a beneficial outcome for the client.
Goals of
Therapeutic Communication

 To obtain or provide information

 To develop trust
 To show caring
 To explore feelings
Enhancing Communication

 Self-Disclosure.
 Caring.
 Warmth.
 Active Listening.
 Empathy (the capacity to understand another’s
feelings).
 Acceptance and respect.
Communication Techniques

 Clarifying/validating.
 Asking open questions.
 Using indirect statements.
 Reflecting.
 Paraphrasing.
 Summarizing.
 Silence.
Barriers Communication

Some barriers include:

 Closed questions.
 False reassurance.
 Judgmental responses.
 Defensive reflex.
 Agreeing/Disagreeing or Approving/ Disapproving.
 Giving advice.
 Requesting an explanation.
 Changing the subject.
Psychosocial Aspects
of Communication

 Style.
 Gestures.
 Meaning of time.
 Meaning of space.
 Cultural values.
 Political correctness.
Style

Three types of style:

 Passive - apologetic, weak, makes little eye

contact, often fidgety.

 Aggressive - haughty, angry, demanding, shows

no concern for anyone else’s feelings

 Assertive - honest, direct, firm, makes

eye contact, confident,
Gestures

 Movements of the hands and arms.

 Nurses must be sensitive to cultural variances with regard to

gestures.
Meaning of
Time

 In the U.S., great emphasis is placed on time and schedules. Being on

time is very important.

 In other cultures, such emphasis is not placed on time.

Meaning of Space

 Human beings all observe rules around comfort zones—the distance

observed between two people. Such comfort zones include:

 Intimate: touch to 18 inches

 Personal: 18 inches to 4 feet
 Social: 4 feet to 12 feet
 Public: 12 feet or more
Cultural Values

 A nurse should be familiar with the cultural values of the people in

the nurse’s region of employment.

 A nurse needs to be aware of those times when her values differ from
the values of the dominant culture.
The Nurse’s Ways of
Communication

 Oral


Written
Oral Communication

Nurses communicate within many different relationships, each with their

own rules.

 Nurse-Nurse
 Nurse-Nursing Assistant
 Nurse-Student Nurse
 Nurse-Physician
 Nurse-Other Health Professionals
 Group Communication (I.e. client-care conferences)
Written Communication

Nurses’ communications are often

written:
 On charts
 Requisitions for x-rays and other tests and
services
 Electronic communications, via computer
 Telemedicine: the use of communications
technology to transmit health information from one
location to another.
Communicating With Yourself

 Positive self-talk: Saying positive thoughts aloud; thinking, saying and

hearing positive statements about yourself

 Negative self-talk: Self-destructive. Your self-image is lowered by your

own criticism.
NursingEthical
….. Principles
Universal.
 Autonomy  Justice
Working for
 Beneficence
a noble cause.
 Paternalism
Non malfeasance
Dealing
  Respect
with human life.
 Confidentiality for Persons
Respect for human rights, including
Doublerights.
cultural
 Effect  Sanctity of

 Fidelity
Life
Right to life.  Veracity

Treating client with  Informed

consent
dignity. Care to
Nursing …..Autonomy
Definition: “autos” = self, “nomos” = rule
Universal.
– It is person’s independence and self reliance
Working
– Peoplefor a noble
should cause.on their own lives
have control
– Individual
Dealing rights oflife.
with human self determination for
making decisions.
Respect
– Freedomforofhuman
choice rights, including
cultural rights.
– Informed consent. right to know procedure,
complications, other options.
Right to life.
– Nurse should respect client’s decision
and choices….
Treating client with
dignity. Care to
 Beneficence
Nursing …..
 Duty to do good, goodness, kindness,
 Positive actions to help others
Universal.
Client interest
Working is more
for a noble important than
cause.
personal
Dealing with human
 Care should life.
be beneficial to all
Respect forclient
 Treating humanwithrights,
dignity.including
cultural
 Care torights.
humanity.
Right to life.
 NursingNon
….. malfeasance
Universal.
Commitment ……. Balance risk and benefits
Working for a noble cause.
 Not to cause harm
Dealingwith human life.
Prevent harm
Respect Remove harmrights, including
for human
cultural rights.

Right to life.
Treating client with
dignity. Care to
NURSING CONFIDENTIALITY

 Maintain Confidentiality
Personal and medical
information of the client
will not disclosed to other
unless the the client gives
informed consent.
Share information
selectively
Nursing …..
Confidentiality

Universal.
• Share or discuss patient
Working for a noble cause.
information only if it is necessary .
Dealing
• Neverwithshare
human life.
patient’s
identification
Respect number
for human or password
rights, includingwith
anyone.rights.
cultural
• Follow the hospital’s or
Right to life. provider’s policies.
healthcare
• Log off your computer when you are not
Treating client with
by your workstation/ nurses station
dignity. Care to
 Nursing ….. Justice
Universal.nursing care equally
• Providing
to all as per
Working for needs
a noble cause.
• Fairness/ unbiased
Dealing with human life.
• Giving equal treatment
Respect
• Equal for human
distribution rights, including
of benefits,
cultural rights.
costs and even risk.
• Some
Right time equality
to life.
distribution is not possible
Treating
during client with
emergency , the
services are based
dignity. Care to on priority.
Nursing …..Respect
Universal.
Call by name
Working for a noble cause.
Respect as an individual
Dealing with
Respect theirhuman life.
opinion
Respect relatives
Respect for human rights, including
Especially respect
cultural rights. the women
in labour/delivery room
Right to life.
Treating client with
dignity. Care to
 Nursing Responsibility
…..
Universal.
 Remember you are
taking responsibility
Working for a noble of human
cause.life
 Willing to take responsibilities
Dealing with
 Having to behuman life. for
answerable
the action
Respect for human rights, including
 Be accountable
cultural rights.
 Need to remain competent-
 Knowledge
Right
 Attitude
to life.
 Practice
Treating client with
 Take those responsibility which are
dignity.
in your jobCare to
descriptions
 Accountability

Be answerable to oneself and others for
one’s own actions.

Nurses are accountable for judgments
made and actions taken in the course of
nursing practice.

It is all about justifying actions, explaining
why something was (or was not) done
 Account for their actions is therefore to
establish whether they had good enough
reasons for acting in the way they did.
 Advocacy

 Support for a cause

 As a nurse you support for the

health
,safety, and rights of the clients.
 Follow institutional policy and procedure
 Report any unethical occurrence
that may cause harm to the clients