Communication

Question 1

What is the definition of communication?

Answer 1

Any means of exchange of information, feelings, between two or more individuals.

Question 2

What must nurses be proficient in to be efficient in their interactions?

Answer 2

Verbal and written communication skille, awareness of body language, computer and electronic communication skills.

Question 3

What is the intent of any communication?

Answer 3

To illicit a response.

Question 4

What are the two main purposes of communication?

Answer 4

1. To influence others to respond,

2. To obtain information.

Question 5

What is the difference between positive (effective) and negative (ineffective) comminication?

Answer 5

Positive communication encourages the sharing of thoughts and feelings between two or more individuals.
Negative communication hinders or blocks the transfer of information or feelings.

Question 6

What are the two modes of communication?

Answer 6

Verbal and Nonverbal

Question 7

What considerations need to be taken with the verbal mode of communication?

Answer 7

Pace and intonation: how fast you talk to someone, and your tone
Simplicity:
Clarity and brevity: saying precisely what is meant, don’t beat around the bush; say what you need to say
Timing and relevance: if timing is off message can be meaningless. Ask questions one at a time
Adaptability: see what’s going on with the patient before talking to them
Credibility: is it true and trustworthy? Say what you mean, mean what you say.
Humor: use with care, can be appropriate and can reduce stress.

Question 8

What considerations need to be taken with the nonverbal mode of communication?

Answer 8

Body Language: gestures, movements, use of touch. Communicates more of the message than verbal. Essential skills: observation, interpretation. Personal appearance, posture and gait, facial expression, gestures. How you carry yourself!
Cultural component: take into consideration that different cultures have different “norms”. Some cultures think eye contact is disrespectful
Nonverbal patients: can still communicate, happens often, avoid handouts, use communication devices.

Question 9

True or False:

Verbal communication can be spoken or written.

Answer 9

TRUE

Question 10

What is the order of the communication process?

Answer 10

Sender sends message using selection of specific signs or symbols to transmit the messages to receiver, who must listen, observe and attend to the message to interpret the meaning or intention to provide a response, or feedback.
This process is continuous, the receiver will become the sender to respond to the message.

Question 11

Define the term Sender, or Source Encoder

Answer 11

an individual or group who wishes to convey a message to another
*This term suggests that the person or group sending the message must have an idea or reason for communicating (source) and must put the idea or reason into a form that can be transmitted. Encoding involves the selection of specific signs or symbols to transmit the message (ex: if the receiver speaks English then the sender will usually select English words)

Question 12

Define the term Message

Answer 12

the words actually spoken or written, the body language that accompanies the words, and how the words are transmitted.
*The medium used to convey they message is the channel. Taking face to face with an individual may be more effective than telephoning or writing a message. Written communication is often appropriate for long explanations or for a communication that needs to be preserved.

Question 13

Define the term Receiver, or Decoder

Answer 13

is the listener, who must listen observe, and attend. This person is the decoder, who must perceive what the sender intended (interpretation).
*Perception entails using all the senses to receive verbal and nonverbal messages

Question 14

Define the term Response, or Feedback

Answer 14

is the message that the receiver returns to the sender. It is also called feedback. A response can either be verbal, nonverbal, or both.
*A nod of the head or a yawn is an example of a nonverbal response. feedback always the sender to validate that the intended message has been received and correctly understood, and if not, then it provides the sender an opportunity to correct or reward a message.

Question 15

What are developmental factors that influence communication?

Answer 15

language and communication skills develop through stages. Communication techniques vary with stage:
Infants and toddlers: use touch
Older children: pictures as adjunct to words
Adolescents and adults: verbal communication
Older adults: adjust methods to physical changes of aging (poor vision or hearing)

Question 16

What gender factors can influence communication?

Answer 16

Females and males communicate differently from early ages
Boys establish independence, negotiate status
Girls seek confirmation, intimacy

Question 17

What are the three sociocultural factors that can influence communication?

Answer 17

Culture beliefs
Education
Economic level

Question 18

How can Values and Perceptions affect communication?

Answer 18

Values: standards that influence behavior
Perceptions: personal views of an event
-unique personality traits, values, experiences affect perception
-validate or correct perceptions as needed

Question 19

Define the term Personal Space and the different levels

Answer 19

distance people prefer in interactions with others
intimate→ frequently used by nurses (touching to 1.5 feet)
Personal → less overwhelming (1.5 feet to 4 feet)
Social → increased eye contact. Out of reach for touch (4 feet to 12 feet)
Public → (12-15 feet)

Question 20

What level of personal space is most often used by nurses?

Answer 20

Intimate

Question 21

How does Territoriality factor into communication?

Answer 21

defined as space and things individual considers as belonging to self. May be marked off in a visible way; curtains around bed unit/ walls of private room. Removing chair to use at another bed may be seen as invading territory or touching a person’s wheelchair if they are chair bound.

Question 22

How do Roles and Relationships affect communication?

Answer 22

roles differ (student, instructor, patient, primary care provider, parent or child). Choice of words, sentence structure, message content, body language, and tone of voice vary from role to role. 
Relationships differ. A nurse communicating with a patient for the first time is different from the nurse that has a previous relationship with the patient.

Question 23

How can environmental factors interfere with effective communication?

Answer 23

individuals communicate most effectively in comfortable environments. Extreme hot/cold, excessive noises, and poor ventilation can cause distractions. Lack of privacy may interfere with patient’s communication.

Question 24

How does congruence affect communication?

Answer 24

verbal and nonverbal aspects must match!! Seen by nurse and clients. Incongruence: don’t match. Sender’s true meaning in expressed through body language. sending “mixed signals”

Question 25

The nurse says to the patient, "I am happy to sit down with you and discuss your concerns about your upcoming procedure", however he checks his watch every few minutes. What factor that can influence communication is this an example of? a. Congruence b. Territoriality c. Incongruence d. Personal Space

Answer 25

c. Incongruence

Question 26

What are the barriers to communication?

Answer 26

Stereotyping: offering generalized and oversimplified beliefs about groups of individuals based on experiences to limited to be valid. Agreeing and disagreeing: similar to judgmental responses, implying the patient is either right or wrong and that the nurse is in a position to decide this. Being defensive: attempting to protect and individual or healthcare service from negative comments. Challenging: giving a response that makes the patient prove their statement or point of view Probing: asking for information chiefly out of curiosity rather than with the intent to assist the patient. Testing: asking questions that make the patient admit to something Rejecting: refusing to discuss certain topics with the patient. Changing topics: directing the communication into areas of self-interest rather than considering the patient’s concerns Unwarranted (false) reassurance: using cliches or comforting statements of advice as means to reassure the patient Passing judgement: giving opinions and approving or disapproving responses, moralizing, or imposing one’s values Giving advice: telling the patient what to do

Question 27

Which of the following are consistent with an open posturing? a. Smile and direct eye contact b. Slight shift of body position towards individual c. Using the word "Sir" or "Mom" even when the patient tells you not to. d. Sitting down near the bedside

Answer 27

a. Smile and direct eye contact b. Slight shift of body position towards individual d. Sitting down near the bedside

Question 28

An ability to confidently and comfortably express thoughts and feelings while still respecting the legitimate rights of the patient is a. Non-aggressive communication b. Unassertive communication c. Assertive communication d. Aggressive communication

Answer 28

c. Assertive Communication

Question 29

It means providing a review of the main points covered in an interaction. a. Restating b. Reflecting c. Summarizing d. Paraphrasing

Answer 29

c. Summarizing

Question 30

While helping a patient for discharge, the patient says: "Thank you so much for everything you did for me. If ever I need anything, what should I do?" What would be the nurse's most appropriate response? a. "Don't worry. I see that you have your email address. I will send you some email b. "You can always call your doctor or call the hospital. I am sure someone can help you" c. "Here is my cell phone number. You can either call or text me" d. "I think you actually live two blocks away from my house. Why don't you drop by and we can chat?"

Answer 30

b. "You can always call your doctor or call the hospital. I | am sure someone can help you"

Question 31

"What time do you take your insulin?", is what kind of question? a. Minimal encouragement b. Closed ended c. Open ended d. Assertive

Answer 31

b. Closed ended

Question 32

Focused on own needs. Recipient may see as attack. Loud and may use blaming or be demanding.

Answer 32

Aggressive Communication

Question 33

Focus on needs of others. Deny own feelings, won’t usually argue

Answer 33

Passive Communication

Question 34

Declare and affirm opinions. Respect of others. MOST EFFECTIVE! Acknowledge emotions. Use a lot of “I” statements.

Answer 34

Assertive Communication

Question 35

What are some techniques of assertive communication?

Answer 35

“I”statements Fogging: trying to find common ground with the patient Negative assertion: agree with criticism without being upset Repetition: when being met with resistance to a request, repeating the request can be useful Confidence: talk like you know what you are talking about. Maintain an air of confidence in order to help others see their needs and wants as having merit Managing nonverbal communication: don’t point fingers, don’t have an angry tone, don’t get too close Thinking before speaking: consider both the choice of words and the tone of voice before speaking Avoiding apologizing whenever possible: don’t say “I’m sorry” when there is no call for an apology. Puts you in a submissive position. (I’m sorry I didn’t hear you, I’m sorry to bother you, but….) Performing a post conversation evaluation: think about how to improve communication skills. How might things have been handled differently?

Question 36

The nurse needs to do patient teaching with a 25 year old patient who is deaf . What is the best care plan for the nurse to communication the information to the patient? a. Give the patient a handout, smile and leave the room. b. Use hand gestures and body language to "act out" what the patient needs to do. c. Arrange for a sign language interpreter to be in the patient's room to assist with patient teaching. d. Request for the patient's girlfriend to explain it to patient.

Answer 36

c. Arrange for a sign language interpreter to be in the | patient's room to assist with patient teaching.

Question 37

What is the purpose of nursing informatics?

Answer 37

Integrates nursing science, computer science and information science Manages and communicates data, information, knowledge and wisdom Supports decision making in all settings

Question 38

``` Face the person squarely Sit if possible Adopt an open posture Lean toward the person Maintain good eye contact Try to be relatively relaxed ```

Answer 38

SOLER

Question 39

``` Identify yourself (phone order) Situation Background Assessment Recommendations Readback (phone order) ```

Answer 39

I-SBAR-R

Question 40

Emphathizing

Answer 40

putting yourself in someone’s situation, accepting and respecting what that person is saying, interpreting patient’s feelings. Can be used when patient is given a frightening diagnosis or poor prognosis or other situation where the patient is experiencing a difficult time. NOT SYNONYMOUS WITH SYMPATHY Sympathy is when you feel sorry for someone; pity

Question 41

Active/Attentive Listening

Answer 41

putting yourself in someone’s situation, accepting and respecting what that person is saying, interpreting patient’s feelings. Can be used when patient is given a frightening diagnosis or poor prognosis or other situation where the patient is experiencing a difficult time. NOT SYNONYMOUS WITH SYMPATHY Sympathy is when you feel sorry for someone; pity

Question 42

Physical Attending

Answer 42

``` SOLER Face the person squarely Sit if possible Adopt an open posture Lean toward the person Maintain good eye contact Try to be relatively relaxed Sit, Open, Lean, Eye contact, Relax Can be used an all communications ```

Question 43

Checking Perceptions

Answer 43

sharing how one person perceives another, fives client opportunity to correct inaccurate perceptions, allows nurse to avoid actions based on false assumptions about client Can be used for clarity, nurse tell patient what she believes patient is trying to communicate, allowing the patient to verify that the nurse understands

Question 44

Questioning

Answer 44

very direct way of speaking with patients - open-ended questions elicit more information, closed-questions limit choice of responses. Be careful not to ask questions that steer answer NEVER ASK PATIENT “WHY” QUESTIONS - can be viewed as confrontational and put patient on the defensive Can be used when information gathering

Question 45

Giving Feedback

Answer 45

nurse shares reaction to patient statement, behaviors, immediate, honest, supportive, non-threatening manner, risk of patient feeling rejected, nurse should be open, receptive to patient cues Can be used during patient teaching

Question 46

Using Silence

Answer 46

encourage the patient to communicate, allow patient time to ponder what has been said, collect thoughts and consider alternatives, Look interested. Uncomfortable silences should be broken Can be used when patient has an important decision to make (nursing home, elective surgery)

Question 47

Reflecting

Answer 47

repeating the patient’s message, verbal or non-verbal, reflecting content - repeating client’s statement, may be mis- or overused, use judiciously Use when need to convey understanding of what patient is communicating

Question 48

Imparting Information

Answer 48

not appropriate to withhold useful information when patient is asking for it, avoid crossing line between information and advice, avoid personal, social information, client participation in decision making = positive mental health outcomes Used when communicating lab results, introducing yourself, giving choices or resources

Question 49

Avoiding Self-Disclosure

Answer 49

using techniques for deflecting a request for personal information, and refocusing the communication around the patient’s needs, maintain patient focus

Question 50

Clarifying

Answer 50

attempt to understand patient’s statement by asking patient to provide an example Use when clarification is needed or when nurse is unsure of what patient is trying to communicate

Question 51

Paraphrasing

Answer 51

nurse restates in own words to test own understanding, reflective in nature, gives patient opportunity to confirm whether nurse is correctly understanding what patient is saying Can be used when discussing issues, fears, feelings, wants/wishes etc with patient

Question 52

Summarizing

Answer 52

Highlighting the main ideas expressed, conveys understanding | Used when wrapping up or ending communication with patient, at end of shift

Question 53

Confronting

Answer 53

deliberate invitation to examine some aspect of personal behavior; discrepancy between actions and words Can be used when patient is denying pain, but is hold wrist as if it hurts

Question 54

``` Subjective data Objective Data Assessment Plan of Care Interventions Evaluation Revision ```

Answer 54

SOAPIER- used in Problem Oriented Medical Record (POMR)

Question 55

What are the CUS words to use in SBAR breifing?

Answer 55

C - Concerned U - Uncomfortable S - Safety "I am concerned about my patient's condition" "I am uncomfortable with my patient's condition." " The safety of this patient is as risk."

Question 56

What are the advantages of electronic communication?

Answer 56

It's fast, efficient, legible and improves communication and continuity of care.

Question 57

What are the disadvantages of electronic communication?

Answer 57

``` Confidentiality risk (HIPAA), Socioeconomics - Not everyone has email ```

Question 58

When should email not be used?

Answer 58

Urgent Information Abnormal Lab Data Highly Confidential Information (mental health, HIV) *any information sent electronically to patient is considered part of the medical record

Question 59

Describe how communication techniques vary with stage.

Answer 59

Infants and toddlers - use touch Older children - pictures as adjunct to words Adolescents and adults - verbal communication Older adults 0 adjust methods to physical changes of aging

Question 60

Standards that influence behavior

Answer 60

Values

Question 61

Personal views of an event, affected by personality traits, values, experiences

Answer 61

Perception

Question 62

Describe, Express, Specify, Consequences

Answer 62

DESC

Question 63

Used to let peers, coworkers know you don't understand something.

Answer 63

"I need clarity."

Question 64

What is the nursing process

Answer 64

``` APPIE Assessment Problem Planning Implementation Evaluation ```

Question 65

What is the primary cause of sentinel events?

Answer 65

Ineffective communication

Question 66

the transfer of information during transitions in care across the continuum.

Answer 66

Handoff Report

Question 67

Given to all nurses on next shift

Answer 67

Change of Shift Report

Question 68

True or False | A student nurse can take verbal orders from a physician.

Answer 68

False

Question 69

Record data quickly and concisely, graphic record/vital signs, I & O, medication administration record, skin assessment record

Answer 69

Flow Sheets

Question 70

Clinical notes/progress notes

Answer 70

Written by health care provider, with progress, plan of treatment, interventions and assessment/reassessment data