COMMUNICATION SKILLS IN NURSING FON.ppt
- 1. COMMUNICATION SKILLS IN NURSING DR.C. B. BELLO
- 2. COMMUNICATION • Communication is the exchange of information between individuals. • It is a means of exchanging information or feelings between two or more people. • It is a basic component of human relationship, including nursing. • Communication is a process and it has two main purposes; • To influence others and to obtain information • The intent of any communication is to obtain a response
- 3. Communication Process • During the communication process • An individual, sometimes called the sender • develop an idea & transmit it in the form of a message to another person or receiver. • The receiver perceives the message, {the sender’s transmitted idea and interprets it} • Once the receiver interprets the meaning, • the receiver formulates a response & transmits it back to the sender as feedback
- 4. Encoding & Decoding • Encoding is the process of formulating a message for transmission to another person. • To encode an idea, the sender has to choose the word, body languages, signs or symbols that would be used to convey the message. • Decoding is the process of recording through one’s memory, experience, & knowledge based to determine the meaning of intended message.
- 5. Encoding & Decoding • To communicate successfully, the client must be able to accurately decode the message the nurse sent. • Communication may break down, if the nurse uses the words the client does not understand or present a behavior that is frightening. • Communication may also break down, • if the nurse fails to decode the client’s message, accurately by not listening actively and attentively.
- 6. PROCESS OF COMMUNICATION • FACE-TO-FACE- • Involves a sender, message, a receiver and a response or feedback. • Communication is a two way process, involving the sender and the receiver of the message.
- 7. SENDER • it is a person or group who wish to convey a message to another, • Can be considered as the source encoder. • The person sending the message has an idea or reason for communicating & must put the idea or feeling into a form that can be transmitted. • When transmitting a message, the nurse must not only deal with the dialect& foreign languages • but also differentiate between communication with a lay person & the health professionals.
- 8. MESSAGE • It is what is actually said or written, • the body language that accompanies the word & how the message is transmitted • {the medium used to convey the message is the channel, & • it can target any of the receiver sense. • The intent of the message should be clearer. • Talking face to face with a person may be more effective in some instances than • telephoning or writing message
- 9. MESSAGE Cont’d • Recording messages on tape or communicating by radio or television may be more appropriate for large audience. • Written communication often appropriate for long explanation are for a communication that needs to be preserved. • Non-verbal channel or touch is often highly effective.
- 10. RECEIVER • it is the listener who must listen, observe and attend. • This individual or person is the decoder, • who must perceive what the sender interned {interpretation}. • Perception uses all of the senses to receive verbal and non-verbal messages. • Ineffective communication occurs when the message sent is misinterpreted by the receiver.
- 11. RESPONSE • This is the message that the receiver returns to the sender, • it is also called feedback. • Feedback can be either verbal, • nonverbal or both. • Non verbal examples are a nod of the head or a yawn.
- 12. LEVELS OF COMMUNICATION • Communication occurs at • the intra personal, • interpersonal and • public levels.
- 13. INTRAPERSONAL • Communication occurs within an individual, • it is the way people consider their thoughts internally, • so they can express themselves appropriately to others. Also called self-talk. • The goals of intrapersonal communication is self awareness which is influenced by self concept & feeling of self worth.
- 14. Interpersonal • This is an interaction between two people only or a small group. • Problem solving, sharing of ideas, decision making and personal growth are outcomes of effective interpersonal communication. • Through interpersonal communication, • nurse interacts with client, family members, physicians, fellow nurses and other health care provider • to develop strategies that brings about positive changes in a client’s health status
- 15. PUBLIC • It is the interaction with large group of people. • The nurse often has opportunity to speak with group of client or consumers in health related topics. • It requires special aids such as posters and voice inflections to communication.
- 16. BASIC CHARACTERISTIC OF COMMUNICATION • 1. More than one person must be involved. • 2. The sender & the receiver must participate simultaneously through verbal & non-verbal communication. • 3. Communication must be continuous and reciprocal.
- 17. BASIC CHARACTERISTIC Cont’d • 4. Exchange messages require knowledge. • 5. Communication is influenced by the way people feel about themselves, the subject matter etc. • 6. The person’s position within a social cultural system may influence the process of communication
- 18. INTERACTIONAL SKILLS • These are actions that are used during the encoding process to obtain and disseminate information, • develop relationship and promote understanding of self and others. • Nurses use a variety of interactional skills, during the communication process
- 19. INTERACTIONAL SKILLS cont’d • to gather assessment data from clients, family, • significant others and health care personnel’s • The nurse uses this interactional technique • to help the client communicate information thoroughly &also • to confirm that the nurse has understood the client’s communication correctly
- 20. 1. LISTENING SKILL • Paying individual attention to what the client say and successful listening, • involve taking in the client’s whole message • by hearing the words as well as interpreting body language. • Not only the words that the client speaks that the nurse should take note of, • but also the tone of voice and even what the client does not say.
- 21. 2. ATTENTION • It is giving full attention to verbal and non verbal messages. • Body languages or non verbal messages • provide significant information that the nurse might otherwise overlook and • signals information that the client may have omitted intentionally or unintentionally. • Body language can send messages such as hostility, defensiveness or confusion,
- 22. ATTENTION cont’d • The nurse must tune into the client’s non- verbal as well as verbal messages. • Non-verbal communication of client, such as • postures, eye contact, make up, dress, accessories and items in the clients environment {books, rosary, photograph etc.} • tells a significant story and add more depth to the intended messages.
- 23. 3. PARAPHRASING • It means that the nurse restate the client’s basic message. • Communication skills include • checking to make sure that the nurse has understood the client accurately by paraphrasing.
- 24. 4. LEADING • Nurses use leading skills to encourage open communication. • These skills are most effective when starting an interaction or • when trying to get the client to discuss health concerns. • Leading skills are especially helpful in getting clients to explore their feelings and • to elaborate on areas already introduced in the discussion.
- 25. LEADING cont’d • Leading techniques that nurses commonly use when interviewing a client includes • direct leading, • focusing and • questioning
- 26. a. Direct leading • This means that the nurse decides the areas she wants to ask questions. • The nurse asks directly what the client’s complaints are • so as to get accurate information from the client. • It is also good to ask about what happened & • the degree of complaints e.g. Severe pains
- 27. Focusing & Questioning • 5. Focusing:- Total focusing is essential, the nurse should note detail from the original/real point that client is complaining of. • 6. Questioning:- it is a very direct way of speaking with client to obtain subjective data for decision making and planning care. Questioning technique include closed and open ended question.
- 28. Questioning cont’d • Closed questions limits the client’s response to Yes, No or one word answer • e.g. “were you feeling angry when your mother said that?” • open ended questions are purposely general and encourage the client to provide additional information • e.g. “what brought you here today”.
- 29. REFLECTING • 7. REFLECTING:- repeating the client verbal or non-verbal message for the client benefit. • It is a way of showing the client that the nurse empathizes or • is in tune with the client’s thought, feelings and experiences.
- 30. 8. SUMMARIZING • It is the process of gathering the ideals, feelings that clients have discussed throughout the interview and restating them in several general statements. • It is a useful tool because it shows client that the nurse had listened and understood their concern. • It allows client to know that progress is being made in resolving their health concerns and signals closure of the interview
- 31. MODES OF COMMUNICATION • This is generally carried out in two different ways:- • Verbal communication. • Non-communication.
- 32. 1. VERBAL COMMUNICATION • It uses the spoken or reading aloud written words and it constitutes only about 7% of the communicated messages. • It is used extensively by nurses to share information with client and other health workers. • It is largely conscious, because people choose the words they use, • the words used varies among individual according to culture, socio-economic background, age and education
- 33. VERBAL COMMUNICATION Cont’d • The way ideals are exchanged depends on countless possibilities that exist. • When choosing words to say or write, • nurses need to consider simplicity, • timing, pace and intonation, clearly and • brevity, relevance, adaptability, credibility and humor.
- 34. 1. PACE AND INTONATION • manner of speech as in pace or rhythm and intonation, will modify the feeling and impact of the message. • The intonation can express enthusiasm, sadness, anger or amusement. • Pace of speech can indicate interest, anxiety, boredom or fear • e.g. speaking slowly or softly to an excited client may help calm the client.
- 35. 2. SIMPLICITY • It include the use of commonly understood words, brevity and completeness. • Nurse need to learn to select appropriate, • understandable terms based on the age, knowledge, • culture and education of the client • e.g. instead of saying
- 36. SIMPLICITY Cont’d • “the nurses will catheterize you tomorrow for a urine analysis” • it may be appropriate and understandable to say,” • tomorrow, we need to get a sample of your urine and • we will need to insert a small tube into your bladder in the process”.
- 37. CLEARITY AND BRIEFITY • Message that is direct and simple will be more effective • clarity is saying precisely what is meant and brevity is using the fewest words necessary. • To ensure clarity in communication, nurses needs to speak slowly and enunciate carefully.
- 38. TIMING AND RELEVANCE • No matter how clearly or simply words are stated or written, • the timing needs to be appropriate to ensure that words are heard. • It involves sensitivity to the client’s needs and concern.
- 39. ADAPTABILITY • Spoken messages need to be altered in accordance with behavior cues from the client. • What the nurse says and how it is said must be individualized and carefully considered. • It is important for the nurse to then modify his tone of speech and express concerns in his facial expression while moving towards the client.
- 40. CREDIBILITY • It means worthiness of belief, truth worthiness and reliability. • Nurses foster credibility by been consistent, dependable and honest. • He or she needs to be knowledgeable about what is being discussed and to have accurate information.
- 41. CREDIBILITY Cont’d • Nurses should convey confidence and certainty in what they are saying, • while been able to acknowledge their limitation • e.g. “I don’t know the answer to that, • but l will find someone who does.”
- 42. HUMOUR • Use of humor can be positive & powerful tool in the nurse-client relationship, • but must be used with care, it can be used to help client adjust to difficult and painful situations. • Physical act of laughter can be an emotional and physical release, • reducing tension by providing a different perspective and promoting a sense of well being.
- 43. NON-VERBAL COMMUNICATION • It uses other forms such as gestures or facial expression and touch. • It makes up the other 93% of communication. • Majority of communication is non-verbal. • Another form of communication has evolved with technology and that is electronic communication and • the most common form of electronic communication is E-Mail where an individual can send a message by computer.
- 44. NON-VERBAL COMMUNICATION • When the verbal and non-verbal messages are congruent, • then the messages is more easily encoded and clearly understood. • If the verbal and non-verbal messages are conflicting, the non-verbal message is the most reliable. • It is relatively easy for one to tell lies with verbal message {words} • but non-verbal communication tend to be unconscious and more difficult to control
- 45. NON-VERBAL COMMUNICATION Cont’d • It is sometimes called body language. • It is the exchange of information without the use of words. • There are various ways in which information is exchanged through non-verbal communication and • it is a general belief that it expresses more of the true meaning of the message than verbal communication.
- 46. NON-VERBAL COMMUNICATION Cont’d • Nurses must be aware of both verbal and non- verbal messages they send, and non-verbal messages they receive from client. • It includes gestures, body movement, use of touch, and physical appearance including adornment. • Non-verbal communication often tells others more about what a person is feeling than what is actually said, • because non-verbal behaviour is controlled less consciously than verbal behaviour.
- 47. NON-VERBAL COMMUNICATION Cont’d • Observing & interpreting the client non-verbal behaviour is an essential skill for nurses to develop. • To observe non-verbal behaviour efficiently requires a systematic assessment of the person’s overall physical appearance, • posture, • gait, • facial expressions and gesture
- 48. PERSONAL PHYSICAL APPERANCE • Choice of apparel is highly personal, • it may convey social and financial status, culture, religion, group, association and self concept. • Charms and amulets may be won for decorative or for health protection purposes.
- 49. POSTURE AND GAIT • the ways people walk and carry themselves are often reliable indicators of self concept, • current mood, and health, erect posture and active purposeful stride suggest a feeling of well-being. • Slouched posture and a slow, shuffling gait suggest depression or physical discomfort. • Tense posture and a rapid determined gait suggest anxiety or anger. • Posture of people when they are sitting or lying can also indicate feelings.
- 50. FACIAL EXPRESSION • Feelings of surprise, fear, anger, disgust, happiness and sadness can be conveyed by facial expression. • Face may express the person’s genuine emotion and facial expressions convey a universal meaning. • Nurses should be aware of their own expression and what they are communicating to others, • control expressions of feeling such as disgust or fear in some circumstances.
- 51. GESTURES • Hand and body gesture may emphasize and clarify the spoken word. • Or they may occur without words to indicate a particular feeling or to give a sign. • Gestures using various parts of the body are capable of carrying numerous messages • e.g. thumbs up, which means victory where as thumbs down means negative connotation.
- 52. Factors influencing communication process • Language, intellectual and psychosocial development • Gender • Values and perceptions • Personal space • Territoriality • Roles and relationships • Environment