Module 3 : Communication/Interpersonal Skills

Addressing the person

Use their titles; do not call them by their first names or any other names unless they ask you to

Abraham Maslow theory

Basic needs must be met for a person to survive and function; needs are arranged in order of importance; lower level needs must be met before higher level needs

Basic needs hierarchy

From lowest level to highest level:

• Physical needs

• Safety & security needs

• Love & belonging needs

• Self-esteem needs

• Self-actualization need

Culture

The characteristics of a group of people passed from one generation to the next; a person’s culture influences health beliefs, practices, and thinking/behavior during illness and when in a hospital setting

Religion

Relates to spiritual beliefs, needs, and practices; a person’s religion influences health and illness practices; the nursing process reflects the person’s culture and religion—do not judge the person by your standards

Communicating w/ the person

• Use words that have the same meaning for you and the person

• Avoid medical terms/words not familiar to the person

• Communicate in a logical and orderly manner

• Give facts, be specific, be brief, and be concise

• Understand and respect the patient/resident as a person

• View the person as a physical, psychological, social, and spiritual human being

Persons with Disabilities — comatose

Being unable to respond to stimuli

• The person who is comatose cannot respond to others, although they can often hear and feel touch and pain

• Assume that the person hears and understands you

• Use touch and give care gently

Common psychological defense mechanisms

1. Denial

2. Projection

3. Anger

4. Rationalization

5. Regression

6. Displacement

7. Conversion

8. Repression

9. Sublimation

10. Substitution/compensation

11. Identification

Family Interaction

Show respect for all family members and listen to them

• Allow uninterrupted time

• Provide privacy as indicated

• Avoid involvement in family matters

• Maintain resident confidentiality

• Encourage family to participate in care planning and care as allowed by facility policy

• Provide information about the facility

• Encourage family to provide information about resident preferences

Delegation

To authorize another person to perform a nursing task in a certain situation; the person must be competent to perform a task in a given situation

• RNs can delegate nursing tasks to LPNs/LVNs and nursing assistants

• Nursing assistants cannot delegate

• Delegation must protect health and safety

Delegation — Step-by-Step process

1. Assessment and planning are done by the nurse

2. Communication involves the nurse and you

3. Surveillance and supervision; the nurse observes the care you give

4. Evaluation and feedback are done by the nurse

Delegation — refusing a task

• The task is beyond the legal limits of your role/job description

• You were not prepared to performed the task

• The task could harm the person

• Directions are not ethical or legal; are against agency policies; are unclear/incomplete

• A nurse is not available for supervision

Communicating w/ the health team

Health team members share information about

• What was done for the person

• What needs to be done for the person

• The person’s response to treatment

The Medical Record

A written or electronic account of a person’s condition and response to treatment and care:

• The health team uses it to share information about the person

• It is a permanent, legal document

• It can be used in court as legal evidence of the person’s problems, treatment, and care

Parts of the medical record

• The admission record is completed when the person is admitted to the center

• The health history (nursing history) is completed when the person is admitted

• The graphic sheet is used to record measurements and observations made daily

• Progress notes describe the care given and person’s response and progress

• Flow sheets are used to record frequent measurements/observations

Reporting to the nurse

Report to the nurse:

• Whenever there’s a change from normal or a change in the person’s condition

• When the nurses asks you to do so

• When the leave the unit for meals, breaks, or for other reasons

• Before the end-of-shift report

Reporting on the medical record

When recording on a person’s chart, you must communicate clearly and thoroughly:

• Anyone who reads your charting should know what you observed, what you did, and the person’s response

Medical Terms/Abbreviations — Direction

Give the direction of the body part when a person is standing and facing forward:

• Anterior (ventral) - at or toward the front of the body/body part

• Posterior (dorsal) - at or toward the back of the body/body part

• Proximal - the part nearest to the center or to the point of origin

• Distal - the part farthest from the center or from the point of attachment

• Lateral - away from the midline; at the side of the body/body part

• Medial - at or near the middle or midline of the body/body part