(29) Intro Lecture 2 - Communication

Objectives of the Lecture

  • Understand verbal and non-verbal communication

  • Discuss various communication techniques

  • Identify potential barriers to communication

Importance of Communication

  • About 93% of effective communication is nonverbal; spoken words only account for 7%

  • Nonverbal communication encompasses:

    • Eye contact

    • Facial expressions

    • Posture

  • Key in nursing care; the intended message may differ from what is received.

Characteristics of Communication

  • Involves the exchange of information via verbal and nonverbal forms

  • Influenced by various factors

  • Requires a sender and a receiver:

    • Sender: conveys the message

    • Receiver: interprets the message

Types of Communication

One-way Communication

  • Highly structured

  • Sender controls interaction

  • Little to no feedback from the receiver

  • Example: Lecture presentation

Two-way Communication

  • Involves active participation from both parties

  • Essential in establishing trust between the nurse and the patient

Verbal Communication

  • Involves the use of spoken or written words

  • Connotative Meaning: Subjective interpretation of a word; can lead to miscommunication

  • Denotative Meaning: Commonly accepted definition of a word

  • Jargon: Technical language specific to a context (e.g., nursing)

Nonverbal Communication

  • Highly powerful; can occur with or without words

  • Includes:

    • Tone and rate of voice

    • Volume of speech

    • Eye contact

    • Physical appearance

    • Use of touch

  • Eye Contact: Can imply aggression or lack of confidence; cultural differences affect its interpretation.

  • Posture: Conveys acceptance (open posture) or disinterest (closed posture). Always meet the patient at their level emotionally and physically.

Styles of Communication

Assertive Communication

  • Confident and respects both self and others

  • Aims to consider patient needs without undermining nurse's rights

Aggressive Communication

  • Forceful and overpowering

  • Often perceived as non-therapeutic

Unassertive Communication

  • Individual feels overwhelmed; struggles to set boundaries

  • Avoids taking responsibility

Building a Therapeutic Relationship

  • Focus on the patient

  • Be genuine and trustworthy

  • Follow through with commitments

Communication Techniques

Therapeutic Communication

  • Facilitates positive nurse-patient relationships

  • Requires sensitivity to patient emotions

  • Examples include:

    • Listening: Active engagement in hearing both verbal and nonverbal cues

    • Silence: Provides time for the receiver to think and respond

    • Touch: Used to convey warmth and understanding

Verbal Techniques

  • Closed Questions: Elicit specific responses (e.g., Yes/No)

  • Open-ended Questions: Encourage elaboration (e.g., feelings about discharge)

  • Restating: Repeats main points for clarity

  • Paraphrasing: Restates in the nurse's words for understanding

  • Clarifying: Ensures accurate message interpretation

  • Focusing: Gathers detailed information

  • Reflecting: Involves feelings to aid patient exploration

  • Summarizing: Reviews key points from the conversation

Factors Affecting Communication

  • Physical positioning relative to the patient (power dynamics)

  • Personal space considerations (18 inches to 4 feet)

  • Ensure a calm, relaxed atmosphere for communication

  • Display confidence and competence to build trust

  • Language barriers can hinder effective communication; avoid jargon

  • Consider cultural differences in communication

  • Challenges with specific populations:

    • Teens may use unique language.

    • Older adults may experience hearing or cognitive barriers.

    • Pain and stress impact communication capabilities.

Special Communication Situations

Ventilator-dependent Patients

  • Require alternative communication methods (e.g., communication boards)

Patients with Aphasia

  • Expressive Aphasia: Inability to send verbal messages

  • Receptive Aphasia: Inability to interpret received messages

Unresponsive Patients

  • May still hear verbal stimuli; communicate as though they are awake.