Unit III - Communication, Collaboration, and Interprofessional Education (IPE) in Nursing (IPE

Identify factors that influence communication.

• Communication in nursing is heavily influenced by patient, nurse, and environmental factors, including emotional states, language, culture, and workload.

A) Who (patient-centered factors):

• Emotional/Physical state: pain, distress, anxiety, anger, fear can make patient disengage or defensive

• Cognitive/Physical ability: hearing/vision impairments, dementia, or unconsciousness hinder interaction

• Culture language: Different cultural norms, religious beliefs, and language barriers (requiring interpreters) impact comprehension.

• Age: Pediatric, adolescent, and elderly patients have distinct communication needs.

B) What (message or content):

• Complexity: Using jargon (complex medical terms) rather than simple, clear language creates barriers.

• Type of information: Prognosis, treatment options, and care instructions require clear, tailored communication.

• Nonverbal communication: Body language, eye contact, tone of voice, and facial expressions often convey more than words.

C) Where (Environment and Context):

• Physical Setting: High-noise environments, lack of privacy, poor lighting, or improper temperature inhibit open communication.

• Privacy: A private space ensures confidential, open, and honest dialogue.

D) When (Timing and Timing Factors):

• Urgency: High-pressure situations (codes, crises) require faster, more concise communication.

• Timing of Interaction: Pain management or administration of sedatives can hinder a patient's cognitive ability to process information.

E) Why (Purpose and Motivations):

• Need for Information: Patients need education on their condition to reduce anxiety.

• Building Rapport: Trust and empathy are necessary for honest disclosure and patient satisfaction.

F) What Else (Organizational and Nurse Factors):

• Workload: Time constraints, heavy workload, and burnout lead to shorter, less effective communication.

• Professionalism: A nurse's attitude, skill level, and ability to show empathy significantly impact the interaction.

• Technology: Electronic records or pagers may create distractions or provide a barrier to face-to-face interaction.

List and describe the 4 methods of communication

1. Verbal - active listening, expressing empathy, respect

2. Non-verbal - appearance, body posture, body language, nonjudgmental attitude, eye contact, power of silence

3. Written - i.e. SOAP

4. Electronic - EMR, EHR

Describe ways in which people communicate nonverbally.

• Non-Verbal communication - appearance and demeanor, nonjudgemental attitude, Body posture, Body language/nonverbals (eye contact, touch, facial expression, gestures, physical proximity), power of silence.

  • Silence - gives the client time to think and share more

  • Eye contact - shows attention and interest

  • Facial expression - nonjudgmental encourage openness

  • Body posture - uncrossed arms, leaning forward

→ Types of nonverbal communication:

1. Kinesics - body movement and gestures

2. Vocalics - quality of voice

3. Haptics - sense of touch

4. Proxemics - physical space and distance

5. Chronemics - impact of time

6. Physical appearance

7. Artifacts - objects or images

8. Digital nonverbal - cues

→ How can we improve nonverbal communication?

1. Hold your posture

2. Hold your eye contact

3. Maintain a positive tone

4. Have an open body language

5. Maintaining your stress levels

6. Enhance emotional awareness

Styles/Levels of Verbal and Written Communication (x4)

1. Informal - Casual, spontaneous, and unstructured interaction among staff, often occurring in hallways or during breaks.

   • Example: A nurse casually mentions to a colleague in the breakroom that a patient in Room 4 is having difficulty sleeping.

2. Intrapersonal (self-talk) - internal dialogue occurring within a nurse’s mind, self-reflection

   • Example: A nurse thinks, "I need to remain calm and focused while inserting this IV," to manage anxiety.

3. Interpersonal - direct, one-on-one interaction between the nurse and another person, such as a patient, family member, or colleague

   • Example: A nurse explains post-operative care instructions directly to a patient.

4. Formal - Structured, official communication methods designed to ensure accuracy and compliance with policy, such as documentation.

   • Example: A nurse provides a structure SBAR report during shift handover or documents vitals in the EHR.

Discuss professional responsibilities when using electronic communication and other communication technologies.

→ Communication Technologies:

• Computer

• EHR (electronic health record)

• Phone

• Email & Text

• Virtual visit

• Socia Media

→ Professional responsibilities when using electronic communication and other technologies

• HIPAA for all of these

• Guard passwords

• No screens left visible

• No conversations overheard

• Permission

• Is it in the chart? (if it isn’t charted, it wasn’t done)

• No identifying information

Describe how communication should happen with Older Adults, Toddlers, Grade School (6-11).

Talk about General Communication Tips

1) Older Adults

• No ‘Elder Speak’

• Don’t say ‘honey’ or ‘sweetie’

• R.E.S.P.E.C.T.!!

• Follow their cues

• Be aware of the need for glasses or hearing aids

• Be aware of physical limitations

2) Toddler (1-3)

• Talk to the adult first; ignore the toddler

• Don’t ask yes/no questions

• Make it a game (if possible)

• Watch speed & tone

3) Grade School (6-11)

• Don’t assume they are into sports

• Give control or options if possible

• Ages 6-8 (or so) eager to please

• Ages 9-11 may be ‘sassy’; treat them as a bit older than they are.

4) General Communication Tips

• Be kind, considerate

• Explain what you are about to do

• Ask if you don’t know!

• Reduce distractions/focus

• Ask one question at a time

• Observe for cues of pain or discomfort

• Be sensitive to/aware of gender/social/cultural differences

List and describe the four distance zones around the body that can be recognized as personal territories.

1. Zone 1: Intimate distance (0-18”) - parents and children, lovers, husband and wife

2. Zone 2: Personal distance zone (18”-4’) - close friends

3. Zone 3: Social distance zone (4’-12’) - co-workers, social gatherings, friends, work situations

4. Zone 4: Public distance zone (12’+) - Actors, total strangers, important officials

Identify patient goals for each phase of the therapeutic nurse–patient relationship.

1. The Orientation phase

• Introduce yourself/Identify your patient – Every patient/Every time!

• Roles & Goals

• Duration of the relationship

2. The working phase

• Patient needs, longest phase

• Nurse - assistance, direction, education, motivation

3. The termination phase

• Hand-off to another nurse, discharge, referrals, etc.

Utilize techniques of therapeutic communication. - talk about definition

→ Therapeutic Communication Definition:

• A process in which the nurse consciously influences a client or helps the client to a better understanding through verbal or nonverbal communication.

• Therapeutic communication involves the use of specific strategies that encourage the patient to express feelings and ideas and that convey acceptance and respect.

Identify barriers to therapeutic communication.

→ Barriers for Therapeutic Communication (what is not therapeutic communication):

• Challenging

• Probing/Leading

• Changing the subject

• Defensiveness

• False reassurances

• Disagreeing

• Judgment

Example of non-therapeutic communication:

• Nurse: You take all of your medications like you are supposed to, don’t you?

  Patient: Um, yeah, I guess…sure…

Describe effective interventions for patients with impaired communication.

→ Effective interventions for patients with impaired communication:

→ Communication tips for patients with visual impairment:

• Use large-print materials

• Use adequate lighting in all areas

• Use a normal speaking voice

• Talk directly and honestly

• Do not talk down to the patient

• Preserve the patient’s dignity

→ Communication Tips for people with hearing loss:

1. Be open: tell the person you’re speaking to that you have hearing loss

2. Ask people to get your attention before they start talking to you

3. Get a better view: stand a reasonable distance from the person so you can see their face and lips

4. If necessary, ask people to slow down and speak more clearly

5. If you don’t catch what someone says, just ask them to say it again or in a different way

6. Keep calm: if you get anxious, you might find it harder to follow what’s being said

7. Learn to lipread

8. Be kind to yourself

Collaboration Definition

Compare roles of collaborative members of the healthcare team.

Describe what is necessary for team collaborative work to happen

→ Collaboration definition: “when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, carers and communities to deliver the highest quality of care across settings”.

→ Who is on a Health Care Team:

• Healthcare provider

  • MDs, APRNs, and PAs

• RNs, LPNs

• PTs, OTs, UAPs

→ Describe what is necessary for team collaborative work to happen:

• Role clarity

• Trust and confidence

• Overcome adversity

• Overcome personal differences

• Collective leadership

Apply concepts of interprofessional practice (collaboration and communication).

→ Interprofessional Communication

• Shared goals

• Shared language

• Active listening

• SBAR

→ Benefits of Interprofessional Collaboration

• According to the WHO (2010), shown to improve access to and coordination of health services, health outcomes for patients with chronic diseases, patient care and safety.

• Can save money by decreasing hospital admissions, length of stay, mortality rates, total patient complications, and staff turnover.

• Research evidence and experience have demonstrated that a team-based approach to health-care delivery maximizes the strengths and skills of each contributing health worker.

→ Definition of interprofessional practice:

• Interprofessional practice in nursing involves collaborating with diverse healthcare professionals—physicians, pharmacists, social workers, and therapists—to provide comprehensive, patient-centered care. Key concepts include shared decision-making, effective communication, mutual trust, and role clarity to reduce errors, improve outcomes, and enhance team efficiency.

Describe collaborative practice.

Collaborative care in nursing is a patient-centered, interdisciplinary approach where nurses work with physicians, pharmacists, therapists, and other professionals to enhance patient outcomes. It emphasizes shared decision-making, open communication, and mutual respect among team members. Key elements include shared goals, clear roles, and efficient, coordinated care that reduces errors and lowers cost

Dosage calc:

• Reminder to look at posted Normandale Rounding Rule for Dosage Calc in D2L

• If volume is >1, round to tenth.

• If volume is <1, round to hundredth

• NO trailing zeros

• Always include a 0 before the decimal point is volume is <1

• Examples:

  • 0.8 is CORRECT

  • 0.80 is INCORRECT

  • 0.14 is CORRECT

  • .14 in INCORRECT