Communication and communication management
- 2. Definitions o According to 'Aristotle’, Communication is a means of persuasion to influence the other so that the desired effect is achieved. o Communication is “a process by which two or more people exchange ideas, facts, feelings or impressions in ways that each gains a ‘common understanding’ of meaning, intent and use of a message.”- Paul Leagens
- 4. Communication Process o Communication is an ongoing dynamic and multidimensional process. o Nursing situations have many unique aspects that influence the nature of communication and interpersonal relationship. o In the professional role, you will use critical thinking to focus on each aspect of communication. So your interactions are purposeful and effective.
- 6. Principles of communication o Communication should have objective and purpose. o Should be appropriate to situation. o Systematic analysis of the message, i.e., the idea, the thought to be communicated, so that one is clear about it. o Selection and determination of appropriate language and medium of communication according to its purpose. o Organizational climate, including appropriate timing and physical setting to convey the desired meaning of the communication.
- 7. Principles of communication…. o Consultation with others for planning of communication; involves special preparation. o Message should convey something of value to the receiver in the light of his needs and interests. o The communication action following a communication is important in effective communication as this speaks more than his/her words.
- 8. Principles of communication… o The sender has to understand the receivers’ attitude and reaction by careful, alert and proper listening to ensure that the desired meaning of the message has been comprehended by the receiver. o Credibility is very important. o Communication programme should make use of existing facilities to the great extent possible and should avoid challenging them unnecessarily
- 9. Types of Communication o One-way Communication (didactic) the flow of communication is “one-way” from the communicator to the receiver. e.g., Lecture method. o Two-way Communication (Socratic) both sender and receiver take part. o The process of learning is active and democratic. oIt is more likely to influence behaviour than one-way communication.
- 11. Forms of communication (Modes) o Communication occurs in a variety of ways: through words, actions or combinations of words and actions. o When there is congruence (“a match”) between words and actions, communication is enhance.
- 12. Verbal Communication o Verbal message are message communicated through words and language, either spoken or written. The most important aspects of communications are presented below. ◦ Vocabulary- Communication is unsuccessful if senders and receivers cannot translate each other’s words and phrases. Medical jargons (technical terminologies used by health professionals) sound like foreign language to clients unfamiliar with the health care settings. Children have more limited vocabulary then adults and teenagers use the language differently in a unique way than adults.
- 13. Verbal Communication o Denotative and connotative meaning- Some words have several meaning. o The interpretation of a word’s meaning influenced by the thoughts, feelings, or ideas people have about the word. o For eg. health care provider tell a family that a loved one is in serious condition and they believe that death is near, but to nurses serious simply describes the nature of illness. o We need to carefully select words, avoiding easily misinterpreted words.
- 14. Verbal Communication Pacing- Conversation is more successful at an appropriate speed or pace. Talking rapidly, using awkward pauses, or speaking slowly and deliberately conveys an unintended message. Think before speaking and develop an awareness of rhythm of your speech to improve pacing. Intonation- Tone of voice dramatically affects a message’s meaning. Depending on intonation, even simple question or statement express enthusiasm, anger, concern, or indifference. While communicating with patient, the nurses’ tone of voice either encourages or inhibits communication.
- 15. Verbal Communication Clarity and Brevity- Effective communication is simple, brief, and direct. Speaking slowly, enunciating clearly and using examples to make explanations easier to understand improves clarity. Use short sentences and words that express an idea simply and directly. Timing and relevance- Timing is critical in communication. Even though, a message is clear, poor timing prevents it from being effective. Often the best time for interaction is when a client expresses an interest in communicating.
- 16. Nonverbal Communication o Nonverbal communication includes all of the five senses and everything that doesn’t involve the spoken or written word. Researchers have estimated that approximately 7% of meaning is transmitted by words, 38% transmitted by vocal cues, and 55%is transmitted by body cues. o All kinds of nonverbal communication are important, but interpreting them are problematic. Sociocultural background is a major influence on the meaning of nonverbal behavior. Assessing nonverbal message is an important nursing skill.
- 17. Nonverbal Communication o Expression, and manner of dress and grooming. These factors help communicate physical wellbeing, personality, social status, occupation, religion, culture and self-concept. o Posture and Gait- Posture and gait (a way of walking) are forms of self-expression. The way people sit, stand and move reflect attitudes, emotions, self-concept, and health status. A slumped posture and slow shuffling gait indicates depression, illness or fatigue.
- 18. Nonverbal Communication o Facial Expression- Face is the most expressive part of the body. Facial expression conveys emotion such as surprise, fear, anger, happiness, and sadness. An inappropriate affect is a facial expression that does not match the content of verbal message. For eg, smiling when describing a sad situation. o Eye Contact- People signal readiness to communicate through eye contact. Maintaining eye contact during conversation shows respect and willingness to listen. It also allows people to closely observe one another. Lack of eye contact may indicate anxiety, defensiveness, discomfort or lack of confidence in communication.
- 19. Nonverbal Communication o Gestures- Gestures emphasize, punctuate, and clarify the spoken word. Gesture alone carries specific meaning or they create message with other communication cues. For eg, a finger pointed toward a person communicates several meanings, like sometimes accusation or threat. Sometimes pointing to an area of pain is sometimes more accurate than describing the pain’s location. o Sounds- Sounds such as signs, moans, groans, or sobs also communicate feeling and thought. o Territory and personal space- Territory is important because it provides people with sense of identity, security, and control.
- 20. Elements of Professional Communication o Professional appearance and behavior are important in establishing the nurse’s trustworthiness and competence. o Nothing harms nursing’s professional image like an individual nurse’s inappropriate appearance and behavior. A professional is expected to be clean, neat, well groomed, conservatively dressed, and odor free. o Professional behavior should reflect warmth, friendliness, confidence, and competence. Professionals speak in a clear well modulated voice, use good grammar, listen to others and communicate effectively.
- 21. Elements of Professional Communication a. Courtesy:- Common courtesy is a part of professional communication. Eg, say hello and goodbye to clients, knock the door before entering, use self-introduction, address people by name, say please and thank you to team members etc. When a nurse is discourteous, others perceive the nurse as rude or insensitive. It sets up barriers between nurse and client and friction among team members. b. Use of Names:-Addressing others by name conveys respect for human dignity and uniqueness. Because using last name is respectful in many cultures. Using first name is appropriate for infants, young children, confused or unconscious clients and closed team members. Avoid referring to clients by diagnosis, room number, which is demeaning and sends the message that the nurse does not care enough to know the person as an individual.
- 22. Elements of Professional Communication c. Trustworthiness:- Trust is relying on someone without doubt or question. To foster trust, the nurse communicates warmly and demonstrates consistency, reliability, honesty, competence and respect. Sharing personal information or gossiping about others sends the message that you cannot be trusted and damages interpersonal relationship. d. Autonomy:- Autonomy is the ability to be self-directed and independent in accomplishing goals and advocating for others. The nurse takes initiative in problem solving and communicates in a manner that reflects the importance and purpose of therapeutic conversation. The nurse also recognize the client’s autonomy because people who seek health care are often concerned about losing control of decisions that influence how they live. e. Assertiveness:- assertive communication allows you to express feeling and ideas without judging or hurting others.
- 23. Levels of communication 1. Intrapersonal communication 2. Interpersonal communication 3. Transpersonal communication 4. Small group communication 5. Public communication
- 24. Intrapersonal Communication o It is a powerful form of communication that occurs within an individual. This level of communication is also called as self-talk, self verbalization and inner thought. Intrapersonal communication creates a set of conditions through which life is experienced. o Positive self-talk can be used as a tool to improve the nurse's or client's health and self-esteem. For example: guided imagery can be used to enhance coping and reducing stress.
- 25. Interpersonal Communication o It is one-to-one interaction between the nurse and another person that often occurs face to face. It is the level most frequently used in nursing situations. o Nurses work with people who have different opinions, experiences, values and belief systems, so meaning must be validated or mutually negotiated between participants. o Meaningful interpersonal communication results in exchange of ideas, problem solving, expression of feelings, decision making goal accomplishment, team building and personal growth.
- 26. Transpersonal Communication o It is an interaction that occurs within a person's spiritual domain. Many persons use prayer, meditation, religious rituals, or other means to communicate with their "higher power". o Nurses who value the importance of human spirituality often use this form of communication with clients and for themselves.
- 27. Small group communication o It is interaction that occurs when a small number of persons meet together. o This type of communication is usually goal directed and requires an understanding of group dynamics.
- 28. Public Communication o It is an interaction with an audience. o Nurses have opportunities to speak with groups of consumers about health related topics, present scholarly work to colleagues at conferences, or lead classroom discussions with peers or students.
- 30. Barriers of Communication o Physiological: difficulties in hearing, talking, seeing and expressing; ill health. o Psychological: emotional disturbances, neurosis. o Environmental: noise. o Cultural: level of knowledge and understanding, customs, beliefs, religions and attitudes.
- 31. Barriers of Communication: o Information overload: when a person receives too many information at the same time o Message complexity o Language and speech: Greater chance of misunderstanding message unless the words used have the same meaning for sender and the receiver.