Types of Communication

Nurse's touch: Professional Communication -> Types of Communication

Types of Communication

• verbal

  • need validation of received message

• nonverbal

  • dress

  • posture

  • facial expression

  • eye movement

  • vocal tone

• written

  • demands clear, timely, & accurate info

  • more permanent

  • legal document of care

• computer-mediated

  • EX: Electronic Health Records (EHRs) & emails

Communication modes

• raised voice

• gentle smile

• abrupt email

Verbal Communication

• Verbal

  • vaules

  • perceptions

  • culture

  • age

  • education

  • socioeconomic

  • Word choice and word meaning

    • make sure to be clear when speaking to a client - EX: supper to them may mean a mid day meal but to you it may mean an evening meal

  • Pace

    • slow = soothing

    • shifts = avoidance

  • Intonation - (EX: sarcasm)

  • Clarity - say exactly what you mean and using examples to improve clarity

  • Brevity - using the fewest words necessary

  • Timing - if inappropriate, impedes communication

  • Relevance - we should be addressing the client’s immediate concerns

  • Adaptability - align message with nonverbal cues / ability to remain focused on the conversation and respond appropriately. EX: seeing someone cry and adapt your verbal ques to it and ask them whats wrong

  • Credibility - convey confidence and provide accurate info

  • Humor - can relieve tension but be sure to use caution

Nonverbal Communication

• may not match (EX: asking a patient what are their concerns but you turn your back to them)

• majority of a message’s meaning

• Physical cues can support or conflict with verbal message

  • EX: a patient is grimace but says she is fine. This gives a conflicting report

• Cultural differences impact communication

  • EX: in some cultures, a smile mask anger or fear

Written Communication

• usually takes the form of a nursing record

  • info must be timely and accurate

    • timely - include the date and time (in military time)

    • accurate - factual objective. No opinions. Use direct quotes from the client. Any changes in client status warrant documentation.

  • documents findings, supports actions

  • be sure it is clear and free of any spelling errors

    • clear - easy to read, legible. follows agency guidelines. signature and title

    • correct spelling - errors can lead to mistakes. avoid writing the word “error”, draw a line through it and place initials above the mistake

Computer-Mediated Communication

• Electronic health records

  • integrate client visits

  • capture data

  • assimilate data easily for clinical trials and research purposes

• email & text

  • most common

  • HIPAA requires safeguards

  • avoid email when client needs urgent information

  • avoid email, text with confidential information or abnormal results

• instant messaging

• social media

  • we must sort through information to provide valid data

  • avoid blurring personal & professional boundaries

• Web conferencing

  • share information simultaneously

  • communicate long distance

    • EX: a patient with a mental health disorder can web conference with is therapist

Protect your computer passwords, log off from the computer, keep client information secure

Components of Communication

• sender - transmits a message

  

• message - what is said and the body language that accompanies the words

  

• channels - means of sending and receiving various messages (visually, auditorily, or tactilely)

  

• receiver - translates and responds to a message

  

• response/feedback - the message that a receiver returns and the send assesses feedback and offers clarification (EX: “okay, I understand.”)

  

• Environment - such as noise, room temp. etc may affect the ability to communicate effectively.

  • here we should identify and control concerns

Vocal inflection

EX: of nonverbal communication cues that include vocal inflection:

• Volume

  • whisper indicates a need for secrecy & privacy

  • low volume - soothing, avoids disruption

  • shouting - frustration, anger

  • maintain normal volume, rate, tone with clients who have hearing loss

• Posture & gait (walking)

  • good posture and brisk walking exude a sense of well-being and confidence

  • poor posture, shuffling gives off depression, fatigue, & discomfort

  • tense posture, rapid walking give off anxiety and anger

• Eye contact

  • sign of respect, willingness to listen

  • get on client’s level

  • know that some cultures interpret eye contact differently

• Personal expression

  • facial expressions - avoid shock, disgust facial expressions

• Gestures

  • EX: holding your nose when something smells bad / this can create uncertainty in your patient and fear in some cases

• Personal appearance - effect first impressions and perceptions

• Personal space - provide you and your client a sense of identify, control, and security

  • varies by person, culture, relationship, situation

  • personal space is about an arms length between you and the client

    • ease the patient’s anxiety by building trust, displaying confidence, and the patient’s need for privacy

    • personal space provides you are you client a sense of control

    • personal space varies based on cultural needs

Vocal inflection occurs when there are pitch changes in your voice

• doubt

• suspense

• confusion

• inquiry

Telephone communication

• Record date, time

• Name of the Person reporting

• Information you receive

• Repeat information for accurately

Case Study Q1:

The nursing staff continues to communicate about the correct policy for e-mailing and text messaging. Which of the following should the nurse consider as a barrier to communication?

Changing the subject of conversation

• Changing the subject projects a lack of empathy and gives the sender the feeling that her issue is unimportant. This is a barrier to communication. When the sender and receiver are facing each other, communication is enhanced. Intermittent eye contact is appropriate and conveys willingness to listen. Avoiding eye contact sends a message of disinterest.

Case Study Q2:

When Chandra warns Helen about her use of personal e-mail at work, she realizes nonverbal communication will affect how her message is received. Which of the following uses of personal space zones will strengthen Chandra’s communication?

Position self within arm’s distance

• Placing self within arm’s distance is considered personal distance and will allow Chandra’s message to be received in a constructive manner. Standing or sitting behind a counter is considered social distance and is perceived as a more formal, remote style of communication typically used for general interaction. Distancing oneself with minimal eye contact is considered public distance and would detract from the message Chandra is trying to convey.

Case Study Q3:

Helen discusses with Allison the advantages and risks of electronic communication sent to the client per
the institution’s policy. Which of the following types of information should the nurse avoid sending to the
client?

Confidential information

• The nurse should avoid sending confidential information that may jeopardize the client’s right to privacy. The nurse may send normal lab information to a client, but the nurse should avoid sending abnormal lab information due to questions the client may have for the provider. The nurse may send nonurgent information. 

Case Study Q4:

Allison and Helen discuss the situation of a coworker who was fired for sending client information in an
e-mail. Which of the following methods of communication would be appropriate when sharing client
information with another nurse?

Locate the nurse manager and ask to speak to her in private.

• The nurse manager and the nurse should arrange for a private place to share client information to maintain privacy and confidentiality. Calling the nurse at the nursing desk to discuss the client and sending e-mail to another nurse concerning a client are not appropriate methods of communication and may breach confidentiality.

Case Study Q5:

Helen is checking e-mail on her phone when Chandra approaches her. Which of the following is the
most appropriate statement from Chandra?

“Please follow the computer use policy of the hospital.”

• "Please follow the computer use policy of the hospital" assertively conveys a congruent and straightforward message, which is that staff must follow hospital policy when using electronic messaging. “You know you shouldn’t be doing that” sends a passive mixed message with no concrete direction, and it avoids conflict. “Please complete your work assignment” sends a confusing message that may contradict the nonverbal message to avoid conflict.

Which of the following should not be included when discussing modes of computer-mediated communication?

Voice mail

• Voice mail is not a mode of computer-mediated communication and should not be included in the discussion.

A nurse is planning to document a conversation with a client who is preparing for a surgical procedure. Which of the following client information is an accurate and factual form of written communication? (Select all that apply.)

• "Client states, 'I have a throbbing pain on my left foot'" is correct. It is accurate and factual information about what the client said.

• "Client states, 'I feel nervous about having my foot removed'" is correct. It is accurate and factual information about what the client said.

Which of the following should not be included when discussing components of the communication process?

Tone of voice

• Tone of voice is not a component of the communication process.

A nurse manager is discussing the topic of personal space as it relates to nonverbal behavior with a staff nurse. Which of the following statements by the staff nurse indicates a need for further teaching?

"Use of personal space will increase the client's self-esteem."

• Personal space does not increase the client’s self-esteem.

Electronic health records capture data for which of the following? (Select all that apply.)

• Continuous quality improvement is correct. Electronic health records capture data for continuous quality improvement.

• Utilization review is correct. Electronic health records capture data for utilization review.
  

• Resource planning is correct. Electronic health records capture data for resource planning.
  

• Risk management is correct. Electronic health records capture data for risk management.

A charge nurse is discussing with a staff nurse the establishment of credibility when providing nursing care. Which of the following statements made by the staff nurse indicates a need for further teaching?

"Using sympathy will help to build credibility."

• Showing sympathy involves displaying personal emotions and does not improve the trusting relationship with the client, and it does not build the nurse’s credibility.

A nurse engages in verbal communication with a client. Which of the following is reflective of the nurse's word selection?

Personal values

• Personal values, perceptions, culture, age, education, and socioeconomic background are reflective of  word selection while engaging in verbal communication.

A nurse is counseling a client who recently received a diagnosis of type 1 diabetes mellitus. Which of the following is a component of nonverbal communication the nurse may display? (Select all that apply.)

• Vocal inflection is correct. Vocal inflection is a component of nonverbal communication.
  

• Volume is correct. Volume is a component of nonverbal communication.
  

• Posture is correct. Posture is a component of nonverbal communication.
  

• Gestures are correct. Gestures are a component of nonverbal communication.

A nurse is using a health-related Internet blog. Which of the following is an acceptable use of this form of communication?

Access information

• A nurse should use blogs to access information and discover the most up-to-date evidence-based practice information available to health professionals.

Which of the following are characteristics of effective written communication? (Select all that apply.)

• Factual is correct. Effective written communication is factual.
  

• Objective is correct. Effective written communication is objective.
  

• Accurate is correct. Effective written communication is accurate.
  

• Concise is correct. Effective written communication is concise.