TEST 1 - UNIT E.1 - CH 32 - COMMUNICATION (Fundamentals Book) Flashcards
1
Q
Communication is a complex process of
A
sending, receiving, and comprehending messages between two or more people
2
Q
Communication is a
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dynamic and ongoing process that creates a unique experience for the participants.
3
Q
When communication breaks down, the result can be
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workplace errors and the loss of professional credibility.
4
Q
Nurses use communication when providing care to demonstrate
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caring, establish therapeutic relationships, obtain and deliver information, and assist with changing behavior.
5
Q
Therapeutic communication is foundational to the
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nurse‑client relationship.
6
Q
Effective communication is key to ensuring
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clients’ safety.
7
Q
LEVELS OF BASIC COMM UNICATION
A
intrapersonal
interpersonal
public
small group
8
Q
Intrapersonal communication:
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Communication within an individual. It is each person’s “self‑talk,” the internal discussion when thinking but not outwardly verbalizing thoughts. It helps nurses assess clients and situations and think critically about them before communicating verbally.
9
Q
Interpersonal communication:
A
Communication between two people. This form of communication is the most common in nursing and requires an exchange of information with another individual. However, messages the receiver perceives can differ from what the sender intended.
10
Q
Public communication:
A
Communication to, within, or between large groups of people. Using this type of communication, many nurses teach, give community presentations, or write about nursing or health care topics and issues.
11
Q
Small group communication:
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Communication within a group of people, often working toward a mutual goal (in committees, research teams, and support groups).
12
Q
Functional components of communication
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Referent:
Sender:
Receiver:
Message:
Channel:
Environment:
Feedback:
Interpersonal variables:
13
Q
Referent
A
- The incentive or motivation for communication between two people
14
Q
Sender
A
- The person who initiates and transmits the message
15
Q
Receiver
A
The person to whom the sender aims the message and who interprets the sender’s message
16
Q
Message
A
The verbal and nonverbal information the sender expresses and intends for the receiver
17
Q
Channel
A
The method of transmitting and receiving a message (sight, hearing, touch, facial expression, body language)
18
Q
Environment
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The emotional and physical climate in which the communication takes place
19
Q
Feedback
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Can be verbal, nonverbal, positive, negative
● The message the receiver returns to the sender that indicates the receipt of the message
● An essential component of ongoing communication
20
Q
Interpersonal variables
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Factors that influence communication between the sender and the receiver (educational and developmental levels)
21
Q
methods of communication
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verbal
non-verbal
electronic
22
Q
componenets of verbal communication
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vocabulary
credibility
denotative and connotative meaning
clarity and brevity
timing and relevance
pacing
intonation
23
Q
Vocabulary
A
These are the words that communicate a message the sender writes or speaks.
24
Q
● Limited vocabulary or speaking a different language can
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make it difficult for nurses to communicate with clients.
25
Using medical or nursing jargon can
decrease clients’ understanding.
26
Children and adolescents tend to use words
differently than adults do.
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Credibility
Trustworthiness and reliability of the individual. Nurses must be knowledgeable, consistent, honest, confident, and dependable.
28
● Lack of credibility creates a sense of
uncertainty for clients.
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Denotative and connotative meaning
When communicating, participants must share meanings.
● Words that have multiple meanings can cause miscommunication if people interpret them differently.
30
Clarity and brevity
The shortest, simplest communication is usually most effective.
● Long and complex communication can be difficult to understand.
31
Timing and relevance
Knowing when to communicate makes the receiver more attentive to the message.
● When clients are uncomfortable or distracted, it can be difficult to convey the message.
32
Pacing
● The rate of speech can communicate a meaning the speaker did not intend.
● Speaking rapidly can suggest not having time for the clients.
33
Intonation
● The tone of voice can communicate a variety of feelings.
● Nurses communicate feelings (acceptance, judgment, and dislike) through their tone of voice.
34
Nonverbal communication can often have a
greater effect on a message than the words do.
35
Culture also affects i
nterpretation. Attention to the following in both the communicator and the receiver is necessary.
36
Appearance, posture, gait:
Physical characteristics can convey professionalism. Body language and posture can demonstrate comfort and ease in the situation. The first impression is very important.
37
Facial expressions, eye contact, gestures:
Facial expressions can reveal feelings that clients can easily misinterpret.
38
Eye contact typically conveys
interest and respect but varies with culture and the situation.
39
Gestures can
enhance verbal communication or create their own messages.
40
Sounds:
Crying or moaning can have multiple meanings, especially when other nonverbal communication accompanies it.
41
Territoriality, personal space:
Lack of awareness of territoriality (right to space) and personal space (the area
around an individual) can make clients perceive a threat and react defensively.
42
An email encryption system is essential for assuring
confidentiality.
43
for all clients, nurses must have their
permission to communicate electronically and must respect their preferences. Email communication becomes part of the clients’ medical record.
44
Therapeutic communication is the
purposeful use of communication to build and maintain helping relationships with clients, families, and significant others.
45
Nurses use interactive, purposeful communication skills to
◯ Elicit and attend to clients’ thoughts, feelings, concerns, and needs.
◯ Express empathy and genuine concern for clients’ and families’ issues.
◯ Obtain information and give feedback about clients’ status.
◯ Intervene to promote functional behavior and effective interpersonal relationships.
◯ Evaluate clients’ progress toward desired goals and outcomes.
46
Children and older adults often require
specific, age‑appropriate techniques to enhance communication.
47
Use of the nursing process depends on
therapeutic communication among the nurse, client, family, significant other, and the interprofessional health care team.
48
characteristics of therapeutic ocmmunication include
● Client‑centered: Not social or reciprocal
● Purposeful, planned, and goal‑directed
49
essential components of therapeutic ocmmunication include
time
attentive behaviour or active listening
caring attitude
honesty
trust
empathy
nonjudgemental attitude
50
Time
Plan for and allow adequate time to communicate with others.
51
Attentive behavior or active listening
Use this as a means of conveying interest, trust, and acceptance.
52
Caring attitude
Show concern and facilitate an emotional connection and support among nurses and clients, families, and significant others.
53
Honesty
Be open, direct, truthful, and sincere.
54
Trust
Demonstrate to clients, families, and significant others that they can rely on nurses without doubt, question, or judgment.
55
Empathy
Convey an objective awareness and understanding of the feelings, emotions, and behavior of clients, families, and significant others, including trying to envision what it must be like to be in their position.
56
Nonjudgmental attitude
A display of acceptance of clients, families, and significant others encourages open, honest communication
57
NURSING PROCESS
assessment / data collection
analysis
planning
implementation
evaluation
58
when communicating w/ children
Use simple, straightforward language.
■ Be aware of nonverbal messages because children are especially sensitive to nonverbal communication.
■ Enhance communication by being at the child’s eye level.
■ Incorporate play in interactions.
59
when communication w / clients
Determine verbal and nonverbal communication needs for client‑centered care.
◯ Clients who have hearing, vision, or cognitive losses, are unresponsive, are aphasic, or do not speak the same language as the staff.
● Consider physical status.
● Consider the developmental level, and alter communication accordingly.
60
when communication w / older adults
■ Recognize that many older adults require amplification of sound.
■ Make sure assistive devices (glasses and hearing aids) are available for clients who need them.
■ Minimize distractions, and face clients when speaking.
■ Speak in short and simple sentences.
■ Allow plenty of time for clients to respond.
■ Ask for input from caregivers or family to determine the extent of any communication deficits and how best to communicate.
● Identify any cultural considerations that affect communication.
◯ Provide an interpreter.
◯ Address the client directly when the interpreter is present.
◯ Provide educational materials and instructions in the client’s language.
61
Clients feel more at ease during the implementation phase when
nurses establish a helping relationship.
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Provide empathetic responses and explanations by using
observations, giving information, conveying hope, and using humor.
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Make sure verbal communication and nonverbal communication are
congruent.
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Demonstrate an empathic presence by appearing
relaxed and comfortable, facing the client, having an open posture, leaning toward the client, and maintaining good eye contact unless cultural norms discourage it.
65
effective therapeutic skills and techniques
silence
presenting reality
active listening
asking questions
open ended questions
clarifying techniques
offering general leads/ broad openeing statements
showing acceptance / recognition
focusing
giving information
summarizing
offering self
touch
sharing feeling
66
Clarifying techniques:
restating
reflecting
paraphrasing
exploring
67
Silence
This allows time for meaningful reflection.
68
Presenting reality
This helps the client distinguish what is real from what is not and to dispel delusions, hallucinations, and faulty beliefs.
69
Active listening
This helps the nurse hear, observe, and understand what the client communicates and provide feedback.
70
Asking questions
This is a way to seek additional information.
71
Open‑ended questions
This facilitates spontaneous responses and interactive discussion. It encourages the client to explore feelings and thoughts and avoids yes or no answers.
72
Clarifying techniques
This helps the nurse determine whether the message the client received was accurate
73
● Restating
Uses the client’s exact words
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● Reflecting
Directs the focus back to the client for them to examine their feelings
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● Paraphrasing
Restates the client’s feelings and thoughts for them to confirm what they have communicated
76
● Exploring
Allows the nurse to gather more information about important topics the client mentioned
77
Offering general leads, broad opening statements
This encourages the client to start and to continue talking.
78
Showing acceptance and recognition
This acknowledges the nurse’s interest and nonjudgmental attitude.
79
Focusing
This helps the client concentrate on what is important.
80
Giving information
This provides factual details that the client might need for decision‑making.
81
Summarizing
This emphasizes important points and reviews what the nurse and the client have discussed.
82
Offering self
This demonstrates a willingness to spend time with the client. The nurse can share limited personal information, but the focus should return to the client as soon as possible. Relevant self‑disclosure by the nurse helps the client see that others share their experience and understand.
83
Touch
If appropriate, touch can communicate caring and provide comfort.
84
Sharing feelings
Ask clients to express feelings and help them identify their feelings. Plan to discuss negative or angry feelings with peers or other support persons rather than the client. The nurse can also share feelings of caring and concern with the client, which can promote rapport with the client.
85
BARRIERS TO EFFECTIVE COMMUNICATION
Asking irrelevant personal questions
● Offering personal opinions
● Stereotyping
● Giving advice
● Giving false reassurance
● Minimizing feelings
● Changing the topic
● Asking “why” questions or asking for explanations
● Challenging
● Offering value judgments
● Asking questions excessively (probing)
● Responding approvingly or disapprovingly (refusing)
● Being defensive
● Testing
● Judging
● Offering sympathy
● Arguing
● Making automatic responses
● Reacting with passive or aggressive responses
86
Faulty communication among the members of the health care team can have a
negative effect on the work environment and on clients’ outcomes.
87
● Incivility
Rude dialogue or actions (sarcasm, eye rolling)
88
● Bullying
Repeated words or acts of intimidation
89
● Lateral violence
Abusive words or actions of peers (gossiping, exclusion of information, threats of harm, actual harm)
90
1. A nurse is caring for a client who states, “I have to check with my partner and see if they think I am ready to go home.” The nurse replies, “How do you feel about going home today?” Which clarifying technique is the nurse using to enhance communication with the client?
A. Pacing
B. Reflecting
C. Paraphrasing
D. Restating
1.
A. Pacing is a characteristic of verbal communication, not a clarifying technique.
B. CORRECT: Reflecting directs the focus of the conversation back to the client so that they can further explore their own feelings.
C. Paraphrasing restates the client’s feelings for them to confirm what they have communicated. In this scenario, the client did not verbalize their feelings to the nurse.
D. Restating uses the client’s exact words. In this scenario, the nurse did not restate what the client stated.
91
2. Which of the following actions should the nurse take when demonstrating an empathic presence to a client? (Select all that apply.)
A. Use an open posture.
B. Write down what the client says to avoid forgetting details.
C. Establish and maintain eye contact.
D. Nod in agreement with the client throughout the conversation.
E. Sit facing the client.
2.
A. CORRECT: Having an open posture, facing the client, and leaning forward are ways that can demonstrate an empathic presence.
B. Writing down everything the client says can interfere with the ability to convey full attention and interest.
C. CORRECT: Establishing and maintaining eye contact are ways that can demonstrate an empathic presence.
D. If the nurse nods in agreement throughout the conversation, the client could interpret that as agreement with what the client is saying when instead the nurse meant to convey attending to and understanding what they are saying.
E. CORRECT: Sitting while facing the client directly can demonstrate an empathic presence. It also helps clients who have a hearing loss understand verbal communication.
92
3. A nurse is caring for a client who is concerned about being discharged to home with a new colostomy because of being an avid swimmer. Which of the following statements should the nurse make? (Select all that apply.)
A. “You will do great! You just have to get used it.”
B. “Why are you worried about going home?”
C. “Your daily routines will be different when you get home.”
D. “Tell me about the support system you’ll have after you leave the hospital.”
E. “It sounds like you are not sure how having a colostomy will affect swimming.”
3.
A. Giving false reassurance and minimizing the client’s feelings are both barriers to effective communication.
B. Although this might appear to help the client discuss their feelings, asking a “why” question is a barrier to effective communication, because it could make the client react defensively.
C. CORRECT: Presenting reality is an effective communication technique that can help the client focus on what will really happen after the changes the surgery has made.
D. CORRECT: Asking open‑ended questions and offering general leads and broad opening statements are effective communication techniques that encourage the client to express feelings through dialogue and offer additional information.
E. CORRECT: Focusing is an effective communication technique that clearly directs the interaction to the relevant point.
93
4. Which of the following strategies should a nurse use to establish a helping relationship with a client?
A. Make sure the communication is equally distributed between the nurse’s and client’s desires.
B. Encourage the client to communicate their thoughts and feelings.
C. Give the nurse‑client communication no time limits.
D. Allow communication to occur spontaneously throughout the nurse‑client relationship.
4.
A. The communication should not be reciprocal but client‑focused.
B. CORRECT: Therapeutic communication facilitates a helping relationship that maximizes the client’s ability to express their thoughts and feelings openly.
C. Limit therapeutic communication to the boundaries of the therapeutic relationship, including time.
D. Plan therapeutic communication.
94
5. A nurse is caring for a school‑age child who is sitting in a chair. To facilitate effective communication, which
of the following actions should the nurse take?
A. Touch the child’s arm.
B. Sit at eye level with the child.
C. Stand facing the child.
D. Stand with a relaxed posture.
5.
A. Touching can intimidate the child and block communication.
B. CORRECT: Be at the same eye level as the child to facilitate communication.
C. Standing can appear domineering and intimidating.
D. Standing can appear domineering and intimidating, even with a relaxed posture.
95
RELATED CONTENT: List at least four examples of nonverbal communication.
● Appearance, posture, gait
● Facial expressions, eye contact, gestures
● Sounds
● Territoriality, personal space
96
Explain the effect on communication ● Appearance, posture, gait
Physical characteristics convey professionalism and can demonstrate comfort and ease in the situation.
97
Explain the effect on communication ● Facial expressions
Facial expressions can reveal feelings that clients could misinterpret.
98
Explain the effect on communication ● Eye contact
Eye contact conveys interest and respect but varies with culture and the situation.
99
Explain the effect on communication ● Gestures
Gestures can enhance verbal communication or create their own messages.
100
Explain the effect on communication ● Sounds
Crying or moaning can have multiple meanings when clients also convey other nonverbal communication.
101
Explain the effect on communication ● Territoriality, personal space
Lack of awareness of territoriality (right to space) and personal space (the area around an individual) can make clients perceive a threat and react defensively.
