Its all about what you say and how you say it

1. Its all about what you say and how you say it Sharon Conner MSN, RN, CMSRN INTEGRIS Health Nursing Education and Research

2. Communication Communication is defined as: Exchange of Information: the exchange of information between people. Methods of Communication: Speaking Written Sign language Non-Verbal

3. It what you say, how you say, and how you act when you say it 60% 10% 30%

4. Stages of Communication

5. Barriers to Communication • The message: • Too long, too fast • Unorganized • Errors • Poor verbal and body language • Other barriers • Cultural • Environmental • Situation • Language

6. Overcoming the Barriers • Shorten the message and slow down your delivery • Organize your thoughts before you have that conversation • Make sure the information is accurate • Pay attention to your tone, body language and words that you use • Be sensitive to other cultures. • Give time for the person receiving the message to convert it into their language and then back into English • Make sure the environment is conducive. Meaning that it is not too noisy or filled with distractions • If it is an emotionally charged conversation allow time for the expression of feelings and that the conversation can not be heard by others

7. Listening is the key to good communication! • Become an active listener: • Pay attention to the speaker • Look at them directly • Put aside distracting thoughts. Do not mentally prepare a rebuttal • Avoid outside distractions • “Listen” to the speakers body language

8. Listening is the key to good communication! • Show that you are listening • Nod occasionally • Smile and use other facial expressions • Have an open and inviting posture • Use comments like “yes”, “uh huh”, “go on” to encourage the speaker to continue

9. Listening is the key to good communication! • Provide feedback • Take a few moments to reflect what is being said • Paraphrase what is being said. “What I am hearing…” “Sounds like you are saying..” • Ask questions to clarify certain points.

10. Listening is the key to good communication! • Defer Judgment • Interrupting is a waste of time • It frustrates the speaker • Limits full understanding of the message • Instead • Allow the speaker to finish • Don’t interrupt with counter arguments

11. Listening is the key to good communication! • Respond appropriately • Be candid, open and honest with your response • Assert your opinions respectfully • Treat the other person like you want to be treated

12. Communicating with the Hearing Impaired • When talking to someone who is hearing impaired make sure you do the following: • Make sure they can see your face when you are talking with them. • They often rely on interpretation of your facial expressions. • Minimize background noise. • Do not have gum or candy in your mouth. This distorts your enunciation of the words.

13. Communicating with the Hearing Impaired • If your patient is deaf: • Access the TTY phone (see handouts) • Sign Language interrupters • Use pen and paper

14. Susie Sunshine • Mrs. Ohno was admitted to your unit 3 days ago with a broken hip. She had fallen at home and laid in her kitchen for 4 hours before her daughter Lisa Imhere found her. Lisa has visited everyday and has spoken with the physician and social worker about her mother’s care. Susie Sunshine is her other daughter who lives in California. Lisa has realized for that a time would come when her mother would no longer be able to stay by herself. However Susie has not been home for the last 2 years. Susie calls today to check on her mothers condition.

15. The phone rings and you answer by saying “This is _____ on 12th floor how may I help you?” The caller says “I want to know how my mother is doing.” • How would you respond?

16. Susie states “What do you mean you can’t tell me what type of medication she is on?” • How would you respond? What would you do?

17. Susie Sunshine has flown in from California to see her mother. It is 9:30 and Susie wants to know why her mother has not had a bath for two days? • How do you respond/what would you do?

18. Susie stops you in the hallway and in a loud voice she tells you that she is not happy with her mother’s care. “What kind of place is this! I would not put my dog in here I don’t care how good my sister says you are” • What would you do immediately? • Why do you think Susie is acting this way?

19. Mr. A • Mr. A has been admitted to your unit for a cardiac work up. He is a partner in A to Z law office. He has a history of smoking 2 packs day and has a scotch and water every evening. You are helping to pass trays. When you enter Mr. A’s room with his tray he says in a loud gruff voice “Listen hon I am not wanting to be disturbed from 9:30 till 1:00 I have a conference call and my paralegal is coming up to work on some briefs. Could you deliver a pot of coffee around 10:00. Oh and I am going to need some note pads and ink pens” • How does his comments make you feel? • How would you respond?

20. This is day 3 of Mr. A’s stay. He has the reputation of being difficult, demanding and bossy. This is your first day to take care of him. You were told in report that treats everyone as if they are his personal maid and by the way he is a lawyer. • What do you think is causing his behavior • How do you plan on taking care of him for the next 12 hours? • What do you plan to say to him when you enter his room?