Complex Communication 2 Flashcards
What are the usual complex topics that are discussed with clients and/or their families during a health challenge:
- Diagnosis
- Prognosis (how we predict the recovery from surgery will be)
- Treatments
- Palliation & end of life
- Loss
- Purpose and meaning
What are Crucial Conversations?
- Dialogue under stress
- To be successful, requires effective communication skills
- Controlling emotions is vital
- Emotions (such as frustration and anxiety) can alter one’s thought process and listening abilities
What are the 3 characteristics of Crucial Conversations?
1) Opinion differentiation
○ The conversation starts when there is a difference in opinion
2) High stakes
○ Can cause stress and tension, which leads to strong emotions
3) Emotions
○ Emotions can take over and result in individuals becoming silent, withdrawn, aggressive, distressed out of control
How to Identify a Crucial Conversation
3 Main Reactions
1. Emotional- Scared, angry, hurt, anxious
- Physical - Stomach aches, sweaty palms., fidgeting, restlessness
- Behavioural - Raising their voice, slamming objects, pointing theory fingers
- As a conversations moves from routine to crucial, nurses can recognize cues and try to prevent them from getting out of control
What is the result of failed crucial conversations?
- Bad communication impacts the quality and safety of client care
- 20% of HCPs have seen harm occur to their clients because of failed crucial conversations
- Nurses play a role as advocates and leaders to facilitate dialogue between individuals even when strong emotions are involved
Preparing for Crucial
- Nurses are responsible for fostering a safe and calm environment that enhance clients’ physical and emotional comfort
- The environment can hinder effective communication and distract the sender/receiver, distorting the message
Steps to Respond to Crucial Conversations
1) Identify goal
○ What is the mutual goal to reach?
2) Determine issue
○ What is the problem?
○ Avoid triggers that break down the conversation
3) Explore options
○ Brainstorm options by actively listening
4) Discuss pros/cons of the options
○ Share facts and perspectives without letting emotions take over
5) Mutually plan next steps
○ Make decisions, determine follow-up, document
Challenges Nurses face during Crucial Conversations
- discussing spirituality, grief and loss, and caring for crying clients and/or families
- Based on the nurse’s comfort level, conversations may be avoided if they lack the necessary skills to engage in the dialogue
Health Challenges Include:
- A time of spiritual renewal – the discovery of inner strengths and resources
- A time of spiritual disconnectedness – feelings of distress and powerlessness
- A time when people begin to question the meaning and purpose of their life
Definitions of Spirituality?
- An inner knowing and source of strength reflected in one’s being, one’s knowing, and one’s doing
- An energy that gives a person a reason to exist
- A sense of harmonious interconnectedness between self and others, nature and an ultimate being
- A power greater than yourself
Ones definition of spirituality changes through their life
What is Spirituality?
- A coping mechanism
- Frequently identified as a key element in hope
- Important in maintaining health and well-being
- Has evolved beyond religious considerations to include multidimensional and existential perspectives that are integral to maintaining well being and coping with illness.
Define Spiritual Distress
- When life circumstances overwhelm our resources and ability to cope
Spirituality & Nursing Practice
- Nurses struggle to conceptualize spirituality even though they recognize it as being important to their clients
- 93% of nurses believed spiritual care should be addressed with clients
- Only 5.3% felt able to meet spiritual needs of clients all the time
- The nurse’s intentional, caring presence with clients makes possible the speaking and hearing of spiritual concerns
- Nurses can assess for signs of hope or hopelessness, and promote resources (chaplain, minister)
- Give clients the opportunity to discuss what their illness means to them: (“How has this illness affected you…your relationship, family, work, your activities?”
Importance of Having Hope
- Hope gives clients the strength and determination to continue and alleviates despair
- Hope changes along the illness trajectory
- Can shift from hoping to be cured to hoping for symptom relief or having more time
How to Foster Hope
- Encourage involvement in positive experiences
- Help clients find meaning and explore their spirituality
- Promote connections with others
- Develop goals with clients
(May need to focus on the short-term future close to the end of life)
