Week Two

Question 1

What is active listening?

Answer 1

A communication technique requiring the nurse to be present physically and emotionally by listening attentively to the client

Question 2

What is authenticity?

Answer 2

The ability to be genuine and true to yourself in word, deed, and action

Question 3

What is a close ended question?

Answer 3

Constrained question requiring a limited response

Question 4

What is Confidentiality?

Answer 4

The assurance given to an individual that his or her personal and private information will not be shared indiscriminately and without consent

Question 5

What is Interpersonal Communication?

Answer 5

The simultaneous exchange of information between two individuals, whereby they mutually influence one another with the goal of creating shared meaning and understanding

Question 6

What is Intrapersonal Communication?

Answer 6

Occurs within each individual and comprises our thought and internal voice

Question 7

What is Therapeutic Communication?

Answer 7

Intentional and purposeful interpersonal techniques used by healthcare workers, with the goal of enhancing the physical, emotional, and spiritual needs of a client

Question 8

What are the 5 levels of communication?

Answer 8

1) Intrapersonal Communication (otherwise referred to as self talk)

2) Transpersonal Communication (Discussions about spirituality means to the client. How his/her spirituality helps them in difficult circumstances)

3) Interpersonal Communication

4) Small Group
Communication (occurring among 2-15 individuals)

5) Public Communication

Question 9

What is a therapeutic relationship?

Answer 9

Constructive relationship between a nurse and a client, consisting of four progressive phases

Question 10

What are the 4 phases of therapeutic communication?

Answer 10

1) Pre-Orientation Phase

2) Orientation Phase

3) Working Phase

4) Termination Phase

Question 11

What is the Pre-Orientation Phase in therapeutic relationships?

Answer 11

• Before meeting a client, nurses attend a shift report and review the Kardex and client chart
• The data needs to be completely objective
• Examine your thoughts and feelings about working with the patient

Question 12

What is the Orientation Phase in therapeutic relationships?

Answer 12

Self-knowledge on the part of the nurse is one of the greatest influences when communicating within the orientation phase

During this brief phase, trust is established, and rapport begins to develop between the client and the nurse.

Keeping this in mind, the nurse employs specific communication skills to initiate a relationship with the client

nurses introduce themselves and begin to obtain essential information about clients as individuals with unique needs, values, beliefs, and priorities

Question 13

What is the working phase of a therapeutic relationship?

Answer 13

• The nurse acknowledges that collaboration is the key to client success
• When engaged in the third phase of the therapeutic relationship, the nurse uses effective communication strategies such as silence, touch, open-ended questions, paraphrasing, shared observation, self-disclosure, and listening
• During the working phase, clients begin to accept nurses as health educators, counselors, and care providers.
• Nurses use therapeutic communication techniques to facilitate clients’ awareness of their thoughts and feelings and mutually develop goals and an individualized plan of care.

Question 14

What is the termination phase of a therapeutic relationship?

Answer 14

Terminating the nurse-client relationship may occur at the end of each shift, upon client transfer to another unit ot facility, upon discharge, or end of shift, nurses summarize for the client the client’s care requirements, care plan, and goals met or unmet

Effective communication and active involvement of the client during the termination phase enhances patient knowledge and health outcomes, whereas nurses feel empowered and experience an increase in job satisfaction

Question 15

What are the 3 models of Patient Centred Communication?

Answer 15

1) Linear

2) Transactional

3) Therapeutic

Question 16

What is the linear model in Patient Centred communication?

Answer 16

Traditional form of communication only focuses on sending and receiving information

Question 17

When is the best situation to use the linear model? (Patient Centred Communication)

Answer 17

Emergency Situations

Question 18

What are the 5 components of the linear model?

Answer 18

1) Sender

2) Message

3) Receiver

4) Channel of Communication

5) Context

Question 19

What is the transactional model in patient centred communication?

Answer 19

Requires more time, it is complex, it is reciprocal (I get something out of the interaction and so does my client)

We can influence each other simultaneously

I can look for perceptions and reactions

The transactional model of communication is based on the belief that communication is a two-way process in which both sender and receiver simultaneously send and receive messages.

Receive the information, Interpret the information

Question 20

Which model of patient centred communication has feedback loops and output?

Answer 20

TRANSACTIONAL

Feedback loops built back into it so we can validate, reflect and correct

The client has a role with this type of communication

Question 21

What is the therapeutic model in patient centred communication?

Answer 21

Dynamic

Interactive

Requires active engagement from all parties

Question 22

What are the 3 main components of patient centred communication?

Answer 22

1) Active Listening

2) Shared Partnership

3) Self Awareness

Question 23

What is the functions of patient centred communication?

Answer 23

It has goals and its health centered we use it to inform, we use this type of communication to support, educate, inform, and to empower

Combination of relationship building, information sharing and decision making

Question 24

What are some characteristics to patient centred communication?

Answer 24

Honesty

Clarity

Empathy

Boundaries (professional boundaries)

Looking at the verbal and non-verbal responses

Question 25

What are some components of active listening?

Answer 25

Ask questions to seek clarification Requires your full attention Using open ended type questions Looking at the persons body language Observing the room (silence and watching)

Question 26

What is the goal of active listening in patient centred communication?

Answer 26

to understand (Not to be heard but to understand)

Question 27

What are the components of a shared partnership in patient centred communications?

Answer 27

Broad range of collaborative communication skills Fosters healing relationships Gives us an opportunity to share information and respond to emotions Manage uncertainty Allows the opportunity to make decisions Enables our patient to self manage

Question 28

What are the components of self-awareness in patient centred communication?

Answer 28

Reflets to you as the nurse Your have an ethical and professional responsibility Be aware of your own vulnerabilities Be aware of prejudices or biases We have to be aware of our own non-verbal body language

Question 29

What is countertransference?

Answer 29

Countertransference is the unconscious redirection of a clinician's feelings, attitudes, and desires about a close, personal relationship onto the patient. This is a direct response to the transference exhibited by a patient.

Question 30

What are verbal styles that influence communication? (6)

Answer 30

1) Moderate pitch and tone 2) Vary your vocalizations (louder, shorter, crisper) 3) Encourage involvement (when you are having these conversations you are having them with the patients and their supports) 4) Validate Worth 5) Advocate with/for that patient 6) Appropriately provide information (maybe even repeat it if necessary)

Question 31

What are non-verbal styles that influence communication? (6)

Answer 31

1) Allow Silences 2) Use congruent non-verbal behaviours 3) Use facilitative body language 4) Touch (use touch appropriately) 5) Proxemics (personal space) 6) Seek clarification in regard to non-verbals

Question 32

What is accommodation theory? (variations in communication styles)

Answer 32

This tells us that when we are communicating with other people we will adjust or adapt our speech (ex. HOH patient and adjusting speech for what my patient needs)

Question 33

What is competence in variations in communication styles? (3)

Answer 33

1) Interpersonal: your competence level and will develop as you understand the communication process, meaning the complex cognitive, behavior and cultural factors that you need to be aware of 2) Social: Interpret communication from the other persons point of view 3) Message: know your audience, do you use medical terminology or not?

Question 34

What are the 2 different types of meaning? (variations in communication styles)

Answer 34

1) Denotation: A word has a generalized meaning 2) Connotation: A personal meaning for that individual

Question 35

What is metacommunication? (variations in communication styles)

Answer 35

Looking at the verbal and the non-verbal What are the factors that can influence how that message is being received? → what is the pitch, tone or frequency of my voice Seek for clarification in your conversations Meta-communication is a secondary communication about how a piece of information is meant to be interpreted. It is based on the idea that the same message accompanied by different meta-communication can mean something entirely different

Question 36

What are some style factors in communication that affect it?

Answer 36

slang, Jargon, where did we grow up, where did we live, LOC of patient, is the patient participatory, what is their role?

Question 37

How to apply patient centred communication? (9)

Answer 37

- Find a common ground - Develop a shared partnership - Build rapport - Engage the Patient - Observe non-verbal cues - Use respectful tone - Maintain appropriate eye contact - Face the patient - Center on the patient

Question 38

How do you build rapport when applying patient centred communication?

Answer 38

- Start off with routine questions first not the heavy questions (we want our patient to feel, safe, accepted, and validated) - We need to be sincere and genuine

Question 39

What non-verbal cues should we be aware of in patient centred communication?

Answer 39

- Movement - Physical Space - Tones

Question 40

What are some organizational system barriers in therapeutic communication?

Answer 40

- Heavy workloads - Production expectations - Inconsistent caregivers

Question 41

What are some bridges & barriers in therapeutic relationships?

Answer 41

Cultural barriers Proxemics Confidence Anxiety Acceptance Veracity (truthfulness) Mutuality Empathy Empowerment Caring Respect

Question 42

What are some components of "Active Listening"? (ON EXAM: given examples and have to know what they are categorized under)

Answer 42

- Minimal Cues & Leads - Silence - Summarizing - Reflection - Paraphrasing - Restatement - Clarification

Question 43

What are the different types of questions you can ask in therapeutic communication?

Answer 43

Listen for themes Closed Ended Open Ended Focused

Question 44

What are some other forms of communication in therapeutic communication?

Answer 44

Touch Metaphors Humour

Question 45

What are some verbal communication and responses?

Answer 45

- Matching - Use plain language - Focusing - Give feedback - Validation

Question 46

What are some components when giving feedback?

Answer 46

Focus on the content Focus on relationship Focus on feelings Be specific Be clear, honest and reflective Ask before you provide feedback… is this going to advance the situation?

Question 47

What are 7 therapeutic communication techniques?

Answer 47

1) Open Ended Questions 2) Clarification 3) Probing 4) Paraphrasing 5) Sharing Observations 6) Silence 7) Summarizing