Communication Communication Giving receiving and interpreting of information through any of the five senses by two or more interacting people Therapeutic communication An interaction that is helpful and healing for one or more of the participants ID: 779487
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Slide1
Chapter 44:
Therapeutic Communication Skills
Slide2Communication
Communication
Giving, receiving, and interpreting of information through any of the five senses by two or more interacting people
Therapeutic communication
An interaction that is helpful and healing for one or more of the participants
Slide3Components of Communication
Sender: Originator or source of the idea
Message: Idea that may be verbal or nonverbal
Medium or channel: A means of transmitting the idea
Receiver: The person who receives and interprets the message
Interaction: The receiver
’
s response to the message
Slide4Communication and the Nursing Process
Problem-solving
The nurse needs to collect client data
accurately
Nursing diagnosis must be clear and
concise
Planning
Implementation of the nursing care plan
Ongoing evaluation of the effectiveness of nursing interventions
Client teaching and preparation for discharge
Slide5Rapport
Rapport
Feeling of harmony
Genuineness, caring, trust, empathy, and respect
The nurse conveys a nonjudgmental
attitude
Clients must experience a feeling of rapport with the nurse in order to share personal, and sometimes
embarrassing, information
The client and nurse are working toward a common goal
Slide6Verbal Communication
Definition
Sharing information through the written or spoken word
Types
Conversing with clients
Writing care plans
Documenting information and impressions
Imputing data into electronic record
Giving oral or written change-of-shift reports
Slide7Nonverbal Communication (NVC)
Proxemics
and personal space
Eye
contact and facial
expressions
Body
movements and
posture
Gestures
and rituals, influence of
culture
Personal
appearance and
grooming
Gender
differences
Therapeutic use of touch
Slide8Question
Is the following statement true or false?
Nonverbal communication generally conveys feelings and attitudes.
Slide9Answer
True
Verbal communication is used to communicate information.
Nonverbal communication conveys feelings and attitudes.
Slide10Characteristics of Speech
Volume
Loud: may be culturally based or may indicate conditions such as hearing impairment, mania, or difficulty with language
Soft: may be culturally based or may imply nervousness, paranoia, shyness, or lack of self-confidence
Slide11Characteristics of Speech (cont.)
Rate and rhythm
Fast: anxiety, mania, flight of ideas, impatience
Slow: brain disorder, mental illness, fear, minimal knowledge of English
Hesitation, thought-blocking, difficulty finding words or total aphasia
C
lient does not speak English well, has a brain disorder, or is hallucinating
Slide12Question
Is the following statement true or false?
Nursing care often involves the invasion of a client
’
s traditional personal space.
Slide13Answer
True
Nurses are often forced to invade a client
’
s personal space. The nurse should alert the client before touching him or her.
Slide14Therapeutic Use of Touch
Definition
Haptic communication or affective touch
Involves movements such as holding hands, a “high five”, or pat on the shoulder
Can say “I care”
Some clients may feel it invades their personal space
Slide15Factors Influencing Communication
Attention
Age; Gender
Culture and subculture
Aggressive client and need for assertive behavior
Social factors; religion
History of illness
Body image; physical disabilities
Slide16Question
Is the following statement true or false?
A client who insists that he does not need medication because he is not ill but has been cursed and is the victim of black magic should be diagnosed as being delusional.
Slide17Answer
False
Many people consider folk medicine or mystical beliefs to be a normal part of life. The documentation of the actual statement by the client is appropriate and objective. This client is not
“
delusional.
”
Slide18Aggressive versus Assertive Behavior
Client may be anxious or angry, aggressive or hostile
Nurse must remain objective and practice
assertiveness
Characteristics: Passivity, aggressiveness, passive-aggressive
Suggested approach
Involve the client and family in decisions about
care
Remain
calm
Document having given instructions to the client, along with the client
’
s actions or exact words (in quotes
)
Slide19Therapeutic Communication Skills
Interviewing
Closed-ended or open-ended questions
Nonverbal therapeutic techniques
Avoid crossing the arms over the chest, pointing fingers, or holding the hands on the hips.
Listen carefully.
Clarification
Necessary if not understood or if additional information is needed
Slide20Interviewing and Communication
Skills
Reflection
The nurse may echo the client
’
s words or point out behavior.
Paraphrasing
Helps to clarify the interpretation of the message
Summarizing
Helps to make sure it was what the client mean.
Using unfinished statements
Slide21Communicating With Different Age Levels
The young child
Keep normal developmental stages in
mind
Play is often the most effective means of
communication
The older adult
Communicate
with older adults at an appropriate
level
Be considerate of personal
dignity
Slide22Communicating With the Client Who Has
Sensory Problems
The visually impaired or hearing-impaired person
Do not frighten the
person
The person with a sensory impairment is
normal
Utilize the services of a sign language
interpreter
Slide23Communicating With the Client Who Has
Sensory Problems (
cont.)
The unconscious client
Always assume the client can
hear
Introduce self and explain
procedure
Talk to
the client but not about the
client
The person with aphasia
Develop a method of communication to help prevent withdrawal and social
isolation
Slide24The Client Who Is Not Able or
Who Refuses to Speak
Use
“
magic slate
”
or pencil and paper.
Establish hand signals or eye signals.
Most clients can hear and can often understand.
Treat each person with respect.
Talk to the client.
Allow the client time to formulate words.
Encourage the client to read.
Slide25The Client Who Speaks a Different Language
Provide a client
’
s language-to-English language dictionary.
Make sure to schedule a qualified interpreter.
Try to learn a few words of the client
’
s language.
Ask the client to repeat back and explain what was said.
Use translation devices.
Try to assign staff who can speak some of the client
’
s language.
Encourage family members and friends to visit.
Slide26Facilitating Communication
Skillfully interview clients and listen attentively.
Teach clients and their families.
Document information and maintain the confidentiality of information.
Report the condition of the client.
Participate in conferences.
Treat each client as a unique individual.
Use verbal, nonverbal, haptic communication.
Slide27Question
Is the following statement true or false?
If the client avoids direct eye contact, the client is probably not telling the truth or has something to hide.
Slide28Answer
False
Hesitation before speaking or avoiding direct eye contact may be a sign of respect in your client
’
s culture.
Slide29End of Presentation