Lecture 4 Communication, Nursing education
- 1. Communication By : Ibne Amin BSN , MSN INS , Khyber Medical University ibneamin.ins@kmu.edu.pk
- 2. Objectives At the end of this unit students will be able to 1. Define communication, elements of the communication process, ways of communication. 2. Identify the characteristics of the effective verbal communication 3. Describe the factors that's facilitate and interfere with the effective communication 4. Define ways to respond therapeutically 5. Identify non therapeutically respond 6. Discuss the legal aspects of documentation
- 3. Communication Communication is regarded as a two- way process of exchanging ideas, feelings, emotion and information so as to – To increase knowledge – To change existing patterns of behavior & attitudes – To acquire new skills. It has two main purposes: • To influence others • To gain information
- 4. Components of Communication It has the following main components • Sender (source, communicator) • Receiver (Audience) • Message (content) • Channels (medium or pathway) • Feedback (effect)
- 5. Components of Communication Sender: • A sender is a person who encodes & sends the message to the expected receiver through an appropriate channel. • A sender is the source of the message that is generated to be delivered to the receiver after appropriate stimulus from the referent.
- 6. Components of Communication Message: • The message is the content of communication & may contain verbal, nonverbal or symbolic language. • Perception & personal factors of the sender & receiver may sometimes distort this element & the intended outcome of communication may not be achieved. For ex, the same message may be communicated or perceived differently by two individuals.
- 7. Components of Communication Channel: • A channel is a medium through which a message is sent or received between two or more people. • Several channels can be used to send or receive the message, i.e seeing, hearing, touching, smelling, & tasting. • While selecting channels of communication, several factors must be considered: availability of channels , purpose, suitability, types of receivers, types of message, preference of sender & receivers, communication skills of the sender, cost, etc.
- 8. Components of Communication Classification of channels of communication: • Visual channel: Facial expression, body language, posture, gestures, pictures & written words, electronic mails, mass media, etc. • Auditory channel: Spoken words, sounds, telephone or mobile communications, delivering audio content (radio, voicemail), etc. • Tactile channel: Touch sensations, therapeutic touch, etc. • Combined channel: Audiovisual media, consoling a person with touch & spoken words.
- 9. Components of Communication Receiver: • A receiver is an individual or a group of individuals intended to receive, decode & interpret the message sent by the sender/source of message. • A receiver also known as decoder. • He is expected to have the ability & skills to receive, decode & interpret the message
- 10. Components of Communication Feedback: • It is a return message sent by the receiver to the sender. • It is most essential element of the communication process as it shows that the receiver has understood the primary message sent by the sender & the communication process is now consider complete. • A successful communication must be a two-way process where the sender sends the message & receives feedback from the receiver. • These feed back could be verbal & nonverbal.
- 12. Types of Communication 1. One way communication 2. Two way communication 3. Verbal communication 4. Non-verbal communication 5. Formal and informal communication 6. Visual communication 7. Telecommunication and internet
- 13. One Way Communication • The flow of communication is “one-way” from the communicator to the audience. • Example - Lectures in classroom
- 14. Two Way Communication • Two-way method of communication in which both communicator and audience take part. • Learning is active • More likely to influence behavior.
- 15. Verbal Communication • In Verbal communication, Spoken words are used. It includes face-to-face conversations, speech. • The words used vary among individuals according to culture, socioeconomic background, age, and education.
- 16. Characteristics of effective verbal communication • Simplicity Use of commonly understood words • Clarity Say exactly what it means • Timing and relevance This involves being sensitive to the clients' needs and concerns • Adaptability Spoken message needs to be altered in accordance with behavioral cues from the receiver • Credibility the quality of being trusted & believed
- 17. Nonverbal communication • Communication can occur even without words. • It includes whole range of bodily movements, postures, gestures and facial expression. • Silence is non verbal communication, it can speak louder than words.
- 18. Visual communication The visual form of communication comprise ; • Charts • Graphs • Pictograms • Tables • Maps • posters
- 19. Telecommunication and internet • Telecommunication is the process of communication over distance using electromagnetic instruments designed for the purpose. • For example radio, TV, internet , telephones, satellite etc
- 20. Levels of communication • Intrapersonal communication • Interpersonal communication • Transpersonal communication • Small group communication • Public communication
- 21. Intrapersonal communication • It occurs within an individual. This level of communication is also called self talk, inner thought and inner dialogue.
- 22. Interpersonal communication • It is one to one interaction between the nurse and another person that often occurs face to face. • Meaningful interpersonal communication results in exchange of ideas, problem solving, expression of feelings, decision making and personal growth.
- 23. Transpersonal communication • It occurs within a person’s spiritual domain. Many persons use prayer, meditation religious rituals to communicate with their higher power.
- 24. Small group communication • It occurs when a small number of persons meet together. It is usually goal directed and requires an understanding of group dynamics.
- 25. Public communication • It is the interaction with the audience. Nurses have opportunities to speak with groups of consumers about health related topics, present scholarly work to colleagues at conferences or lead classroom discussions
- 26. Therapeutic Communication “In therapeutic communication the nurse directs the communications towards the patient to identify his current health problem, plan, implement & evaluation the action taken.”
- 27. Therapeutic Communication Techniques • Offering self • Giving broad opening • Silence • Exploring • Focusing • Providing general leads • Giving information • Restating
- 28. Technique purpose example Using silence Accepting pauses or silences that may extend for several seconds or minutes without any verbal response. Sitting quietly (or walking with the client) and waiting attentively until the client is able to put thoughts and feelings into words. Providing general leads Using statements or questions that (a) encourage the client to verbalize, (b) choose a topic of conversation, and (c) facilitate continued verbalization. “Where would you like to begin?” “And then what?” Broad Opening Initiates conversation; Encourage the patient to select Topics for discussion. Tell me something About your family? What would you like to discuss? eg; “What are you thinking about?”
- 29. Technique purpose example Offeringself Making oneself Available on an Unconditional basis, increasingclient‟s Feelingof self-worth I‟ll stay with you until I‟ll be hear till 12.00 Clock. “I’ll stay with you until your family members arrives.” Restating Repeating the main thought expressed by the patient. Eg; “You say that your mother left you when you were five years old.” Giving information Providing, in a simple and direct manner, specific factual information the client may or may not request. When information is not known, the nurse states this and indicates who has it or when the nurse will obtain it. Your surgery is scheduled for 11 AM tomorrow.” “You will feel a pulling sensation when the tube is removed from your abdomen.” “I do not know the answer to that, but I will find out from Mrs. King, the nurse in charge.”
- 30. Technique purpose example Exploring delving further into a subject or an idea “Tell me more about that.” “Would you describe it more fully?” “What kind of work?” Focusing Concentrating on a single point. “This point seems worth looking at more closely.”
- 31. Factors influencing communication process • Person Socio cultural background • Language • Age • Education • Ability of communication • Time and setting • Emotions and self esteem
- 32. Nontherapeutic response • Not listening properly • Rejection (refusing from discussion) • False hopes • Too much probing into personal matters • Changing the subject • Sharing personal or work related problems • Reveal confidential information
- 33. Legal Aspects of Documentation
- 34. Legal Aspects of Recordkeeping • Legally, the documentation of the care given to a patient must be completed. • If no documentation is recorded, no care was given at all. • Hospital accreditation agencies will carefully evaluate the medical records of patients.
- 35. Legal Aspects of Recordkeeping • If documentation is not done the hospital and the practitioner could be accused of patient neglect. • Proper documentation of care is valuable only in reference to standards and criteria of care.
- 36. Legal Aspects of Recordkeeping • For each standard, criteria must be outlined so that adequacy of patient care be measured. • Documentation will reflect the standards of the department.
- 37. Practical Aspects of Recordkeeping • Recordkeeping is one of the most important parts of our duties. • Documentation must be done for each medication, treatment, and procedure. • Accounts of patient’s condition and activities must be charted correctly and be very clear. • Briefness is important, although a complete account of each patient encounter
- 38. General Rules for Recordkeeping • Legible. Print or hand write entries in chart. • Begin with date and time, then enter order and sign the chart: • Errors? Don’t erase, or use correction tape. If a mistake, drawn a line through it, write date and write the word error above it, with your initials • Chart patient complaints and general behavior
- 39. General Rules of Recordkeeping • Leave no blank or empty lines. Draw a line through the center of the empty space in order to prevent someone else from signing in your area. • Use Standard abbreviations • Spell Correctly • Document conversations with patient and healthcare providers that you feel are important
- 42. References • Andrea Ackermann, Mount St. Mary College, Critical-thinking-the-nursing-process 2001. • http://www.umanitoba.ca/nursing/courses/12 8,(2005 ) • Sara-jo Wiscombe, Nursing Process ,Wallace Community College ,May 22,2001. • Tucker C, MODULE A INTRODUCTION TO NURSING Process, August 21, 2002 .
Editor's Notes
- #28: Active listening means using all the senses (hearing, vision, touch, taste and smell) while being attentive to what a patient is saying both verbally and nonverbally.
- #32: Rejecting Refusing to discuss certain topics with the client. These responses often make clients feel that the nurse is rejecting not only their communication but also the clients themselves