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Communication
NP 1, Unit 1 Communication Lecture
| Question | Answer |
|---|---|
| Why should you avoid questions beginning with "why"? | Because the person may become defensive. |
| What are some of the rights a patient has? | Skills, compassionate, and respectful care. Understandable information concerning his or her diagnosis, treatment, prognosis, the risks, benefits and alternatives to care, and financial implications of care. To make decisions about own care. |
| Communication (definition) | On-going dynamic series of events that involves transmission of information and/or feelings between participants. |
| Ways in which communication occurs, besides verbally or in writing? | Through: Movements Facial expressions Appearance Posture Behavior |
| T or F - You can choose not to communicate. | False. You are always communicating something in some way. |
| What is meant by effective communication? | The message received is the same as the message that was intended. |
| What should you do when a patient raises his or her voice? | Lower your voice. |
| What are the three levels of communication? | Intrapersonal Interpersonal Social/Public |
| What are the two modes of communication? | Verbal Non-verbal |
| Verbal Communication includes: | Written words, spoken words |
| Non-verbal communication includes | Gestures, facial expressions, nonword vocalizations, etc. |
| Ways to make verbal communication most effective? | Keep it simple and understandable Clear, well-enunciated and brief Timing is relevant Adaptable - occasional repetition, appropriate pace, intonation, use of humor. Credible delivery and credible deliverer. |
| Nonverbal expressions that influence verbal communication? | Physical appearance and dress Body posture and movement Touch Facial Expression Eye behavior |
| An expectation of a mutally pleasant exchange: therapeutic relationship or social relationship? | Social |
| An expectation that person will be helped: therapeutic relationship or social relationship? | Therapeutic |
| Goal directed, ends when goal is met - therapeutic relationship or social relationship? | Therapeutic |
| May be brief or long conversation with or without a goal - therapeutic relationship or social relationship? | Social |
| Structured around assisting the other person - therapeutic relationship or social relationship? | Therapeutic |
| Both parties share concerns equally - therapeutic relationship or social relationship? | Social |
| Mutual - therapeutic relationship or social relationship? | Social |
| Client-centered - therapeutic relationship or social relationship? | Therapeutic |
| Advice is given - therapeutic relationship or social? | Social |
| Other person accepted as he/she is - therapeutic or social? | Therapeutic |
| Other person expresses thoughts, feelings, actions as long as he or she isn't self-destructive or harmful to others - therapeutic or social? | Therapeutic |
| Socially accepted codes of conduct and expression guide conversation and behavior - therapeutic or social? | Social |
| Honesty and integrity maintained at all times - therapeutic or social? | Therapeutic |
| No obligation to be helpful - therapeutic or social? | Social |
| No obligation for honesty - therapeutic or social? | Social |
| Reassurance (i.e. "It's going to be OK") is offered - therapeutic or social? | Social |
| Reassurance (i.e. "it's going to be OK") is not offered - therapeutic or social? | Therapeutic |
| Conversation is confidential - therapeutic or social? | Therapeutic |
| No commitment to confidentiality - therapeutic or social? | Social |
| Dicussion of problems and important personal issues is optional - therapeutic or social? | Social |
| Self-awareness employed - therapeutic or social? | Therapeutic |
| No obligation of self-awareness - therapeutic or social? | Social |
| T or F - A nurse should never use social communication. | False. Social communication can be useful to put client at ease and develop rapport in the beginning of a conversation. However, once rapport is established the conversation quickly moves to areas of concern for the client. |
| What is the biggest inhibitor of effective communcation? | Failure to listen. |
| What causes a person to fail to listen? | Often the result of self-absorption, lack of presence, or anxiety. |
| Stressors that can impede effective communication | Environment, territoriality, proxemics. |
| Proxemics/Distance | How close you are to another person |
| Intimate Space | Up to 18 inches away. (Trust) |
| Personal Space | 18 inches to 4 feet (comfortable handshake) |
| Social Space | 4 to 12 feet (no touching possible) |
| Public Space | Beyond 12 feet (with no privacy) |
| Psychological Stressor to Effective Communication | Fear, Anxiety, Anger, Depression |
| What is the most obvious stressor when dealing with a client in a hospital? | The fact that they're in the hospital, which is not a normal environment. |
| Spiritual Stressors to effective communication | Loss of Hope Loss of Meaning Feelings of Helplessness Loss of Purpose in Life |
| Carl Rogers | Humanistic Theorist Believed people are capable of change. Individuals are "wired" to strive for self-actualization (Maslow), but sometimes need help along the way from professional "helpers". |
| What did Carl Rogers' theory have to say about the relationship between helper and client? | The quality of the relationship results in growth and healing. |
| Carl Rogers basic factors to forming a therapeutic relationship: | Genuineness Empathy Warmth Unconditional Positive Regard |
| Other factors to forming a therapeutic relationship: | Trust Respect |
| What is the relationship between thoughts, feelings, and actions? | Thoughts influence feelings, which influence actions. |
| T or F People are nearly always aware of their own thoughts. | False. People are often not aware or clear about their own thoughts. |
| T or F People are often not aware that their negative thoughts are making them feel poorly. | True. |
| T or F People are often aware of their patterns of behavior ("responses" to negative thoughts and feelings) | False. They are often unaware of these patterns. |
| Anxiety | Feeling described as uneasiness or tension that occurs in response to a perceived threat to one's self-concept or safety. |
| Goal of therapeutic communication | To recognize and reduce anxious feelings and increase effective coping skills. |
| T or F - The nurse should listen for use of vague references or responses and the use of cliches. These indicate possible anxious feelings. | True. Examples: They never think I have done enough. No one around here cares about me. Nice guys finish last. |
| If a client says, "They never..." the proper response from the nurse would be... | To ask who is meant by "they". |
| T or F - The use of absolutes (right or wrong, should or shouldn't) probably doesn't indicate anxiousness. | False. When a client says things like, "I shouldn't feel this way", the nurse should notice this statement and respond. |
| If a client says, "I know I shouldn't feel this way," the nurse should respond with... | "What makes you think you shouldn't feel that way?" |
| T or F - Ambiguity and uncertainty are cues that client may be feeling anxious. | True. Example - "I don't know, maybe it's for the best" |
| If a client says, "I don't know, maybe it's for the best," how should the nurse respond? | What do you think is best? |
| T or F - There is no need to respond to a client who says, "you" when he/she really means "me" or "him" or "her", etc. | False. This is called depersonalization, and the nurse should help the client recognize that these are their own thoughts and feelings. |
| If a client says, "When you go into the room and you are treat like you are not even there" the nurse should respond by saying... | "When you say, "you", who do you mean?" Or "Are you saying YOU felt ignored?" |
| The nurse should respond if the client confuses thoughts with feelings. | True. Example - Client says, "I feel like no one listens." This is a thought, not a feeling. |
| If a client says, "I feel like my sister doesn't love me," the nurse should respond with... | Sounds like you think your sister doesn't love you. How does that make you feel? |
| If a client answers a question and ends the response with, "You know?" how should the nurse respond? | "No, I don't know, tell me what you mean." |
| T or F - It's a good idea to be self-aware if you want to communicate effectively, but it's not necessary. | False. Self-awareness is a pre-requisite to effective communication. |
| What is the most important skill needed to communicate caring? | Listening. |
| What actions communicate caring? | Listening Lean slightly forward Open posture Appropriate eye contact Sit when able Acknowledge client (nod, hmm, etc.) |
| T or F - If you are anxious, the client probably won't notice as long as you try to hide it. | False. Anxiety is contagious. |
| Listen with ______ and ______. | Intention, presence. |
| Facilitative or Non-Facilitative? Summarizing | Facilitative |
| Facilitative or Non-Facilitative? Sharing Advice | Non |
| Facilitative or Non-Facilitative? Offering general leads | Facilitative |
| Facilitative or Non-Facilitative? Giving Approval or Disapproval | Non |
| Facilitative or Non-Facilitative? Asking "Why" Questions | Non |
| Facilitative or Non-Facilitative? Reassurance, saying, "It'll be OK". | Non |
| Facilitative or Non-Facilitative? Sharing Observations | Facilitative |
| Facilitative or Non-Facilitative? Changing the subject | Non |
| Facilitative or Non-Facilitative? Open Ended Questions | Facilitative |
| Facilitative or Non-Facilitative? Closed-ended questions | Non |
| Facilitative or Non-Facilitative? Reflecting Thoughts/Feelings | Facilitative |
| Facilitative or Non-Facilitative? Seeking clarification | Facilitative |
| Facilitative or Non-Facilitative? Defensiveness | Non |
| Facilitative or Non-Facilitative? Effective use of silence | Facilitative |
| Facilitative or Non-Facilitative? Placing event in time or sequence | Facilitative |
| What are the four phases of a facilitative communication relationship? | Preinteraction Introductory/Orientation Working Phase Termination Phase |
| Preinteraction Phase | Obtain patient information Examine own feelings and ability |
| Introductory/Orientation Phase | Open the relationship Structure and formulate the contract Help the client clarify the problem and set goals |
| Working Phase | Maintain trust and rapport and develop caring Help client explore thoughts and feelings associated with problem Support client as he/she takes action |
| Termination phase | Begins in the orientation phase when goals are identified. Feelings related to loss are explored Referrals for continuing assistance are initiated if needed. Let pts know how long you will be with them. Prepare them for end of therapeutic relationship |
| T or F - It's OK to ask a few closed-ended question as long as you follow those up with open-ended questions. | True. Example - "Are you feeling anxious?" "Yes" "Tell me what is making you feel that way." |
| T or F - The goal of therapeutic communication is to fix or cure the problem. | False. The goal is to guide the client in discussing the issue in enough depth to see patterns, or to get them to speak (and thereby recognize) their thoughts. |
| How can you begin an interview? | Start with a broad opening, encouraging client to share anxiety, the use of relief behaviors, or times when they took notice of a thought or feeling. |
| How can you dig deeper after the beginning of an interview? | Placing event in time or sequence. Getting specific information Making observations Clarifying important, relevant content. Restating Reflecting thoughts and feelings Focusing |
| How can you look at thoughts, feelings, and behaviors objectively? | Reviewing main points discussed Validating intuition: - Listen for underlying thoughts/feelings and help client identify them. -Observe for themes/patterns of behavior, validate these with client. - Explore effectiveness of the relief behavior. |
Created by:
christyness
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