Week 1 & 2 communication

What is interpersonal communication?

communication that connects people and ideas via verbal and nonverbal behaviors. Can impact quality of care n development of collaborative partnership, understanding of pt's condition.

What is a linear model of communication?

A simple model focusing on sender, message, and receiver, useful in emergency situations. Places focus on transmitting the information, not on the response.

what is the transactional communication model?

the sender and receiver influence each other's messages as they converse. Each person has a different perception + interpretation of the other's message. The communication in this model is reciprocal.

describe input, thoughput and output

A person gets new info from the environment (input), the info is processed and meaning is interpreted (thoughput), this leads to new information or behavior (output)

what is the systems theory?

idea that communication in healthcare happens within interconnected systems, not in isolation. Every person, role, and environment involved affects how messages are sent, received, and understood.

what is self-awareness?

the ability to understand one's strengths and weakenesses and it's influence on others/ Understanding helps us to build stronger relationships and communicate effectivel=y

what is countertransference?

a nurse's unconscious personal response to a person. Ex: a person reminds the nurse of a negative person in their life, the nurse may have a negative subconscious response towards the client

what are environmental factors that can impact communication?

privacy, personal space, timing, noise

what is semantic noise?

barriers derived from differences in perceived meaning or understanding of words, symbols, language between sender and receiver. Ex: language/accent differences, use of medical terminology

what is psychological noise?

internal mental/emotional barriers impacting one's ability to send, receive or understand a message. Ex: stereotypes, bias, emotions, fear, grief, stress, anxiety, pain, mental distractions

How to apply effective communication?

1). Engage the person - active listening, posture 2). Build rapport - routine questions, pt share concerns 3). Find a common ground - what is important to the pt? fully informed pt. 4). Observe nonverbal cues

What does it mean to develop a shared partnership btwn pt and nurse?

each person is an equal stakeholder in ensuring quality care, understand differing goals and alt. ways to meet them, respect social/cultural dif.

What are examples of physical behavior cues?

1). Emblems - gestures/motions 2). Illustrators -actions that emphasize the meaning of a verbal message (smile) 3). Affect - facial expressions 4). Regulators - nodding, gestures to stop convo/reinforce message 5). Adaptors - repetitive, nonverbal actions due to emotional response (blushing, hair twirling) 6). Physical characteristics - info derived from appearance

SOLER stands for what?

S- sit facing the person O- open posture L -lean towards the person E -eye contact maintained + initiated R -relax

What are open-ended questions?

questions open to interpretation, broad and yield complete info, elicit one's thoughts and experiences. Ex: what brought you in today?

what are focused questions?

quick and concise, targeted, less broad, emergency situations, clarify timing and sequence, helpful for those with limited verbal skills, less interpretation required. Ex: when did symptoms begin? What symptoms are you experiencing?

What are close-ended questions?

have narrow focus, single answer, yes/no is a valid response, quick gathering of info, emergency use is good. Ex: when was your last meal? Are you in pain?

What does it mean to mirror communication patterns?

to accept the other person's communication style, intentionally reflect someone's way of communicating to build trust, rapport. Ex: changing the way you speak to a child

How can figurative language be used to enhance understanding?

Compare medical terms/conditions with common images from every day life to promote understanding. Ex: describing a diseased lung as a piece of swiss cheese

What is active listening?

The provider shows signs that they hear and understand what the person is saying. Asks questions, responds, body language to show they are listening

For example: When a client is talking to you, straightening your posture, nodding when appropriate to show understanding, and asking questions to show genuine interest, giving full attention to the client who is talking to you.

What does it mean to provide information?

Providing clients with accurate, relevant and understandable information. With respect to the patient's age and cognitive ability

For example: When talking to a child, simplifying explanations of a procedure into age-appropriate terms that they can easily understand.

What does it mean to provide clarification?

Showing active listening, understanding and genuine interest by asking someone to clarify in simpler terms or repeat phrases for better understanding.

For example: A patient is explaining the onset of a couple symptoms, and the nurse asks the patient to re-sequence the events so the nurse can gain a better understanding of the timeline of the patient's experience

What does it mean to share observations>

Summarizing what the nurse is observing of the client's state/feelings for clarification, understanding and affirmation

For example: A nurse telling a patient who is distressed that "I can see why this is difficult for you".

What is reflection?

Mirroring what the person is feeling by emphasizing the emotional undertones of a message

For example: A nurse telling a patient, you seem so relaxed when your family comes to visit, I can tell they make you very happy.

What does it mean to share empathy?

Objectively putting yourself in the feelings and situations of others to really understand what they are feeling and experiencing.

For example: Sympathizing with a patient who is upset when having difficulty walking after a surgery. Understanding how it might feel to lose abilities that one used to have.

What does it mean to use summarization to enhance understanding?

Repeating/restating previously discussed topics to ensure understanding of the patient

For example: A nurse restates the treatment plan to the client to ensure their full understanding and agreement.

What does it mean to share hope with a patient?

The nurse celebrating in the client's wins and improvements.

For example: Cheering a patient on who is making great progress to being able to walk again.

What does the use of minimal cues + leads in a conversation look like?

Small actions during a conversation, verbal/non-verbal that can show interest and understanding.

Ex: The nurse nods to show understanding when the client responds to a question

what does it look like to share humor with a pt?

Humor can be used to lighten spirits and provide comfort and bonding between nurses and patients, depending on the context.

For example: a lighthearted joke could be used to break the ice between patient and nurse, and to make the client more comfortable

What does using paraphrasing for understanding look like?

Repeating, but in different words, what a client is telling you. To gain understanding and to reflect to them the message and themes of their situation, and to summarize the message.

Ex: The nurse is consoling a patient who is overwhelmed by a surgery they will soon undergo. The nurse listens to the patient's concerns and paraphrases from the client that it sounds like the client is stressed about complications during the surgery.

what does using restatement for understanding look like?

Showing understanding and listening by restating what someone has said for understanding and clarification

For example: A nurse restates the client's aforementioned treatment preferences to ensure understanding.

What does self-disclosure look like?

Disclosing information about oneself to a client. Should mainly be avoided, but can be used for therapeutic reasons

For example: A client is having a mental health struggle, such as with anxiety. A nurse could offer up breathing exercises that have helped them personally when facing similar struggles

What is metacommunication?

the message--can be subtle, indirect--explaining how a message should be interpreted, not just what is being said.

ex: saying "i'm fine" in a sarcastic tone

What is an example of non-verbal communication via facial expressions?

People's facial expressions can indicate mood and feeling

Ex: giving a warm smile to a patient to help them feel welcome when greeting them

what is an example of proxemics?

The personal space awarded to a person during interactions. Too close = invasive, threatening. Too far = cold, disengaged Eye level = reduce perceived power imbalance. Ask permission before intimate space = respect

Ex: reading the client's body language before moving closer to them in a distressing situation, to determine whether more or less closeness may be beneficial to the client.

Eye contact and non verbal comm.

An important part of active listening, looking at the person while you are talking to them, and while they are talking to you

Ex: looking up from a computer screen or a notepad, and directly at the client when they are talking to you.

Time and nonverbal comm.

Knowing when best to step in and offer help and support to a client, and knowing when space might be beneficial

Ex: When delivering news to a client's family about their condition, giving the family space for them to process alone

Touch and nonverbal comm.

The way that we touch people can offer comfort, offer harm etc.

Ex: Holding a client's hand when they may be going through a painful or scary procedure to offer comfort

Appearance and nonverbal communication

The way that we appear to be feeling ex: facial expressions, body language -- portrays messages about ourselves

Ex: the nurse keeps a warm, welcoming appearance, by ensuring open body language and giving a warm smile to her patients.

Gestures and nonverbal comm

Our conscious or subconscious gestures during speech can inflect meaning on the message we wish to convey.

For example: A nurse who is aggressively pointing, or has very forceful gestures, might come across as upset or stressed to a patient.

Clothing and nonverbal comm.

The way that we present ourselves to others, can have an impact on their instant perceptions and thoughts of us.

Example: The nurse comes to work looking groomed and professional in uniform. This assures the patient that the nurse is professional and competent.

Use of voice and nonverbal comm.

The tone of voice in which one uses can inflict meaning on the words used, whether intended or not. When possible, tone of voice used should match the meaning of the words/message being conveyed.

Ex: When offering comfort to a patient, the nurse uses a soft, quiet voice, rather than a loud, abrasive voice that might be read as stressful rather than comforting

Environment and nonverbal comm

Environmental stress, such as distracting noise or lack of privacy can impact one's communication with another.

For example: Pulling a client into a private, quiet room to talk to them, rather than talking to them in a noisy waiting room with other people present

Gender and nonverbal comm.

It must be recognized that individuals should not be generalized or assumed upon based on gender.

For example: The nurse does not assume gender, rather asks the client what pronouns they wish to use. Not simply assuming gender based on outward appearance.

Posture and nonverbal comm.

The way one holds themselves during a conversation can confer interest/disinterest in the conversation

Ex: when talking to a client, sitting with a straight posture, with the upper body slightly inclined towards the client to show genuine interest in what they have to say

Silence and nonverabal comm.

Silence can be offered therpeutically and compassionately to give the client space and time to process, and can press for deeper reflection.

For example: In an emotional moment for a client, the nurse pauses conversation to allow the client to gather their thoughts.

Congruence/incongruence and nonverbal comm

Whether the words and message being conveyed matches the non verbal cues of the speaker. When the message and the non-verbal cues are at odds with each other, often messages can be misinterpreted.

For example: If a client grimaces, as if in pain, when telling the nurse that they are not in pain, the nurse should recognize the incongruence in the client's physical presentation and the seemingly contrary words they are saying.