Click to edit MasterG. UY, style MARK ADRIAN subtitle R.N.

Presenter

Communication in nursing
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Introduction

A process in which people affect one another through exchange of information, ideas and feelings.

HCWs

need to communicate info about clients accurately (precise/exact/truthful), timely, in an effective manner.

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 Documentation/recording

is a vital (fundamental/essential/crucial/critical) aspect of nursing practice. Serves as protection

Generally,

a health personnel communicate through discussion, reports, and records.

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 Reports

include both oral & written exchange of information between caregivers. the end of each work shift in the hospital & other agencies nurses give both verbal and written reports to the next shift. endorsement sheet, etc.

At

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Quality of client care

The

quality of client care greatly depends on the caregivers ability to communicate with one another. All health care providers require the same information about the clients so that they can plan an organized, comprehensive care plan.

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 Unless

this care plan is communicated to all members of the health care team, care becomes fragmented (patchy, uneven), repetition of task occurs and therapies may be delayed or even may affect client outcome, resulting in delayed recovery.

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 The

well-known adage ( wise saying). if you give a man a fish, you feed him for a day, but if you teach a man how to fish, you feed him for a lifetime, signifies the importance of client education. teaching learning process empowers clients & usually enables them to achieve a higher level of wellness or to manage specific healthcare needs.

The

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 This

chapter will help you gain knowledge, skills & appropriate attitude on communication in nursing and client education.

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MODES OF COMMUNICATION
Verbal

uses spoken or written words.

Non-verbal

uses gestures, facial expression, posture/gait (way of walking), body movements, physical appearance (also body language), eye contact, tone of voice.

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CHARACTERISTICS OF COMMUNICATION
1.

Simplicity includes use of commonly understood words, brevity(shortness/briefness) and completeness. Clarity involves saying exactly what is meant. The nurse also needs to speak slowly & enunciate words well. Repeat the message as needed. Reduce distractions.

1.

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3. Timing and Relevance require choice of appropriate time & consideration of the clients interests & concerns. Ask one question at a time. Wait for an answer before making another comment.

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4. Adaptability involves adjustment on what the nurse says & how it is said depending on moods & behavior of the client. The client is the reason we exist!

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5. Credibility means worthiness of belief. To become credible, the nurse requires adequate knowledge about the topic being discussed. The nurse should be able to provide accurate information, to convey confidence & certainly in what she says. Most importantly, she should be a good role model for what she teaches.

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COMPONENTS OF COMMUNICATION
Sender

is the person who encodes & delivers the message

Receiver

is the person who receives & decodes the message.

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 Message

is the content of the communication. It may contain verbal, nonverbal, & symbolic language.

Channels

are means of conveying & receiving messages through visual, auditory & tactile senses. Facial expressions send visual messages, spoken words are perceived through 4/14/12 auditory channels & touch uses tactile

 The

more channels the sender uses to convey a message, the more clearly it is usually understood.

Example: teaching a client on selfmonitoring of blood glucose levels, the nurse discusses & demonstrates the technique (pursed lip breathing/emphysema), gives client printed information & encourages return demonstration by the client.

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 Feedback

is the message returned by the receiver. It indicates whether the meaning of senders message was understood. is a basic component of human relationships & nurse-client relationships.

Communication

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 Non-verbal

communication is a more accurate expression of a persons thoughts & feelings than verbal communication. assessing non-verbal behaviors, consider cultural influences. Variety of feelings can be expressed by a single non-verbal expression.

When

Example: head nodding does not always mean agreement.

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 Effective

communication is reciprocal interaction (two-way process) based o trust & aimed at identifying client needs & developing mutual goals.

Trust

is the foundation of nurse-client relationship. It develops gradually as the client perceives an attitude of acceptance, understanding & empathy from the nurse. The client initially may test the nurses confidence such as sharing that he expects remain confidential. 4/14/12

 Therapeutic

Communication is a fundamental component in all phases of the nursing process, & for establishing effective-nurse client relationship. nurse-client relationship is a helping relationship which is growthfacilitating & provides support, comfort & hope.

Effective

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CRITERIA FOR EFFECTIVE VERBAL COMMUNICATION 1. Vocabulary

2. 3. 4. 5. 6.

Denotative & Connotative Meaning Pacing Intonation Clarity and Brevity Timing and Relevance

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Vocabulary
Medical

jargons are not understood by most clients who are unfamiliar with health care settings. sugar instead of blood glucose instead of CVA

Blood By

mouth instead of p.o.

Stroke

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Denotative & Connotative Meaning

Individuals

who use a common language share the denotation meaning basketball has the same meaning for everyone who speaks English, but code denotes cardiac arrest primarily to health care providers. should carefully use words that cannot be easily misinterpreted by clients and to their families.

Nurses

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Pacing
HCW

should speak slowly enough to clearly enunciate rapidly, long pauses, & rapid shifts to another subject may give the impression that the HCW is hiding the truth.

Talking

*call center
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Intonation
Tone

of voice dramatically affects a messages meaning.

*sarcastics

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Clarity and Brevity

Clarity

speaking slowly, enunciating clearly, and using examples to make explanations easier to understand. achieved by using short sentences & words that express an idea simply & directly. Ex: Do you have allergies? better than

Brevity

I would like you to tell me to which substances do you have allergic 4/14/12

Timing and Relevance

Ex:

when a patient is anxious or is in pain he may not be able to understand teachings.

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GUIDELINES OFOR USE OF TOUCH

Touch

is one of the nurses/HCWs most potent (effective) forms of communication. must learn to be sensitive to others reactions to touch & use it wisely. Consider cultural factors related to touch.

Nurses

*middle east
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 There

are times when touch should be withheld;

Psychiatric setting Example: suspicious or delusional or angry patients may respond negatively or even violently to the nurses touch.

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Documenting and Reporting

Documentation

serves as a permanent record of client information & care. takes place when 2 or more people share information about client care, either face to face or by telephone.

Reporting

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5 BASIC COMPONENTS OF TRADITIONAL CLIENT RECORDsheet 1. Admission

2. 3. 4. 5.

Physicians sheet Medical history Nurses notes Special records & reports (referrals, Xray reports, lab findings, report of surgery, anesthesia record, flow sheets, VS, I&O, and meds)

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Characteristics of Good Recording

Brevity

- Start each entry with a capital letter and end with a period even if the entry is a single word or phrase
Use

of ink / permanence

- avoid felt pen or pencil for permanence of data. Clients chart can be used as an evidence in a legal court.
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 Accuracy

- Chart objective facts, not your interpretations or opinions. E.g. correct: ate 50% of the food served incorrect : ate with poor appetite correct: refused medications incorrect: uncooperative correct: seen crying incorrect: depressed
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Appropriateness
Only

information that pertain to the clients health problems & care are recorded. other personal info that is conveyed to the nurse is inappropriate for the record.

Any

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Completeness and chronology/organization/sequence/ timing

Notes Only

should appear on each succeeding line alteration in from the normal, e.g. body temp, T=39.0 deg C the time the event occurred, not the time you entered the information.

Write

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The following info should be charted:

Physicians Times

visits

the patient leaves & returns to the unit, mode of transportation & destination and Treatments should be charted immediately after given

Medications

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Use standard terminology

Use

only those abbreviations & symbols approved by the institution; spell correctly; use proper grammar

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Signed
Affix

signature, place at the end of the charting, at the right hand margin of the nurses notes each entry with your full name and status, e.g. SN for student nurse, RN for registered nurse not printing is used for the signature

Sign

Script,

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In case of ERROR
Correct

errors by drawing a single (horizontal) line through the error. the word error above the line, and then sign your signature ink eradication, erasures or use of occlusive materials.

Write

No

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Confidentiality
Only

the health personnel who participate in the care of the client are allowed to read the chart.

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Legal Awareness
Chart

only what you personally have done, observed, heard, smelled, or felt. not discard any part of the client record.

Do

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Legible
Writing

others.

must be clear and easily read by

If

writing is not legible, then print.

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Do not use the word patient or pt in the chart belongs to the patient. All info The chart
in the char pertains to the patient.

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A horizontal line is drawn to fill up a partial line. To prevent other persons from adding
information in the nurses notes. e.g. _____________. Mark adrian uy, RN

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