Basic Nursing: Foundations of

Skills & Concepts

COMMUNICATION
Are You Nervous about
this part of the course?
 Common Student Concerns
 What if I say the wrong thing?
 What will I be doing?
 What if no one will talk to me?
 Am I prying when I ask personal questions?
 How will I handle bizarre or inappropriate
behavior?
 Is my physical safety in jeopardy?
 What if I encounter someone I know?
Professional Communication
 CONSIDER…
How the nurse initially greets the client
and how his/her actions can have a
lasting impression on the client and the
family.
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
Congruency of Messages

 Verbal and nonverbal communication

must be congruent, or in agreement.
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.
 Genuineness.
 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.
 Focusing.
 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, respectful of others.
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.
Political Correctness

 To be politically correct in
communication means to use language
sensitive to those who are different from
oneself.
Nurse-Client Communication

 Almost every nurse-client interaction

should involve therapeutic
communication.

 Nurse-client communication is
influenced by both the nurse and the
client.
Three Phases of
Nurse-Client Communication

 Introduction: Fairly short; expectations clarified;

mutual goals set

 Working: Major portion of the interaction; used to

accomplish goals outlined in introduction; feedback
from client essential.

 Termination: Nurse asks if client has questions;

summarizing the topic is another way to indicate
closure.
Determinant Factors in
Communication

A nurse’s communication is affected by:

 Past Experience
 State of Health
 Home Situation
 Workload
 Staff Relations
 Self-Awareness
Determinant Factors in
Communication

A client’s communication is affected by:

 Social Factors
 Religion
 Family Situation
 Level of Consciousness
 Stage of Illness
 Visual, Hearing and Speech Ability
 Language Proficiency
Communication within the
Health Care Team

 Providing care is a team effort.

 To ensure efficiency and effectiveness,

effective communication is necessary.

 This communication may be oral or

written.
The Nurse’s Ways of
Communication

 Oral

 Written

 Self-Reflection
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.
Self-Reflection

Nurses often engage in internal

dialogue:
 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.
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.