CommunicationCommunication
Unit I
Nursing 103
Nurses are HealersNurses are Healers
Communication: ObjectivesCommunication: Objectives
List key characteristics of a nurse/client helping relationship.
Define the terms caring and empathy.Describe the phases of a helping
relationship.Describe types of communication used
nursing care.Practice therapeutic communication skills.
The Helping RelationshipThe Helping Relationship
Nurse-Client Relationship referred to as interpersonal, therapeutic, and helping
Strives to achieve two major goals
1. Help clients manage their problems in living more effectively
2. Help clients become more effective at helping themselves
The Helping RelationshipThe Helping Relationship
CaringComforting Communicating
CaringCaring
Madeleine Leininger (1984): The essence of nursing and the dominant, distinctive, and unifying feature of nursing.
Jean Watson (1985): A set of universal human values;kindness, concern, love of self and others.
Miller (1995): “Intentional action that conveys physical and emotional security and genuine connectedness to another person…”
EmpathyEmpathy
Nurses develop attentive listeningRespond in ways that indicate
understanding of how client feelsEgan (1998), Empathy “can be seen as an
intellectual process that involves understanding correctly another person’s emotional state and point of view”
Communicate understanding to client.
ComfortingComforting
Morse (1996): A complex process that includes discrete, transitory actions, such as listening”
The comforting process is client-led It occurs in response to those cues presented
by a client.Clients themselves are attempting personal
comfort—the nurse supports these attempts.
Comfort Needs: Kolcaba Comfort Needs: Kolcaba (1991, 1995)(1991, 1995)
Physical Comfort
Relates to Body Sensations and medical Dx
Psycho spiritual Comfort
Self esteem, sexuality, and meaning in their life
Belief in a higher being
Social Comfort
Relates to interpersonal, family, and social relationships
Environmental Comfort
The external part of the human experience
Cultural Specific
Phases of HelpingPhases of Helping
Four sequential phasesProgress in successionBuild on the one beforeNurse needs to identify and understand
these phasesAble to identify the progress of the
relationship
Preinteraction PhasePreinteraction Phase
Similar to the planning stage before an interview
Nurses have information before the face to face
Nurse needs to recognize her own feelingsFocus on plan for information to be
discussed
Nursing Skills for Nursing Skills for Preinteractive PhasePreinteractive Phase
Organize Data
Recognize Limitations
Seek Assistance
Introductory PhaseIntroductory Phase
Sets the tone for the rest of the relationship.
Closely observe each other and form judgments about each others behavior.
Opening relationship, clarifying the problem, building trust.
Nursing Skills for Introductory Nursing Skills for Introductory PhasePhase
Put client at ease. Use relaxed , attentive
attitude. Not easy for clients to
accept help in many situations.
Resistive Behaviors Develop Trust
Respectful Culture Concerned Maintain
Confidentiality Mutual participant in
plan of care
Working PhaseWorking Phase
The client and nurse begin to see each other as unique individuals.
Begin to explore thoughts and feelingsBegin to take action to meet goalsNurse helps client form long and short term
goals Nurse reinforces successes and helps client
to deal realistically with failure.
Nursing Skills for Working Nursing Skills for Working Phase Phase
Empathetic Listening
Respect
Genuineness
Concreteness
Confrontation
Decision making and Goal setting
Termination PhaseTermination Phase
Nurse and client accept feelings of ending the relationship
The client has developed independence and and has no feelings of anxiety or dependence
Nursing Skills for Termination Nursing Skills for Termination PhasePhase
Summarize or review the hospitalization with a focus on accomplishments
Express feelings about termination
Allows time for client to adjust to independence
Follow up support may be needed
Follow up phone calls
Ease clients transition to independence
CommunicationCommunication
“Any means of exchanging information or
feelings between two or more people. It is
a basic component of human relationships,
including nursing.”
CommunicationCommunication
Collect data Initiate Interventions Evaluate Outcomes Initiate Change Prevent Legal
Problems
The communication process:
Intended to elicit a response
Sender Message Receiver Response
Modes of CommunicationModes of Communication
Verbal Mode Pace and Intonation Simplicity Clarity Timing and Relevance Adaptable Credible Humor
Nonverbal Mode Personal Appearance Posture/Gait Facial Expression Gestures
Therapeutic CommunicationTherapeutic Communication
Promotes understandingEstablishes a constructive relationship
between the nurse and the clientTherapeutic helping relationship is client
and goal directedRespond to words and feelingsStrong emotions require more time
Therapeutic CommunicationTherapeutic Communication
Attentive Listening:Uses all senses—note key themesMost important technique in nursingBasic to all other techniquesRequires energy and concentrationReceives total message—verbal and
nonverbal
Daily CommunicationDaily Communication
80% of working day is spent conversingTalking is not the same as communicatingBe clear and conciseLet the silence sitState your point up front, and back it upBe aware of body languageGood communication takes practice!
““Be a Bridge, Not a Wall”Be a Bridge, Not a Wall”