Communication Skills in Nursing: Forms, Process, and Enhancement Tactics

1. Textbook for Nursing Assistants Chapter 5: Communication Skills

2. What Is Communication?

3. What Is Communication? • Communication is the process of exchanging information that involves at least two persons A Sender A Receiver

4. Major Forms of Communication

5. Forms of Communication • Verbal Communication • Verbal communication tends to be deliberate—used to express a thought, with the intent of giving specific information to another person • Involves use of spoken and written language or sign language used by the deaf

6. Forms of Communication • Nonverbal Communication • Nonverbal communication tends to be more subtle • Involves giving information through the use of facial expressions, gestures, and body language • Tone of voice can be considered a form of nonverbal communication

7. Communicating Effectively

8. The Process of Communication • The sender creates a message • The sender delivers the message • The receiver receives the message • The receiver provides the feedback

9. The Process of Communication • The sender creates a message • Use language that the receiver understands • Use an interpreter wherever required • Use simple words • Speak clearly and loudly enough to be heard • Organize written matter legibly

10. The Process of Communication • The sender delivers a message • Speak face to face • Send letters, memos, and e-mails • Use telephone calls, intercom • Use legible hand writing and accurate language • Message should be delivered to the receiver in a mode that is understood (for example, written matter is not suitable for a blind person)

11. The Process of Communication • The receiver receives the message • Be an attentive listener

12. The Process of Communication • The receiver provides feedback • Feedback is an indication that the message sent by the sender was received and understood by the receiver • The sender looks for feedback from the receiver

13. Tactics That Enhance Communication • When you are the receiver, be a good listener • When you are the sender make sure that the message is clear • Rephrase or use open-ended questions to encourage the other person to talk • Provide and seek feedback • Use positive body language and pleasant tone of voice • Value silence and provide a comforting touch

14. Tactics That Enhance Communication • When you are the receiver, be a good listener • Active listening requires focusing your attention on the speaker • Avoid interrupting the speaker • Sit down or assume a relaxed posture so you do not appear rushed or in a hurry to move on • Make eye contact with the speaker

15. Tactics That Enhance Communication • When you are the sender make sure that the message is clear • Speak clearly and use words that the person you are speaking to understands • A person cannot give informed consent unless he understands what he is consenting to—encourage feedback • Consider a person’s language understanding skills as well as any physical disability that could impair receipt of your message

16. Tactics That Enhance Communication • Rephrase or use open-ended questions to encourage the other person to talk • Open-ended questions invite the person to say more • It also shows the person that you are, in fact, actively listening to what the other person is saying to you

17. Tactics That Enhance Communication • Provide and seek feedback • Use a gracious way to convey feedback so that it does not appear intimidating to the other person

18. Tactics That Enhance Communication • Be mindful of your body language • Negative body language • Crossing your arms across your chest • Tapping your feet or fingers • Constantly looking at your watch or toward the door • Positive body language • Facing the person • Nodding as he or she speaks • Smiling or looking serious as appropriate • Making vocal sounds to indicate your interest • Positioning yourself at eye level with the speaker • Provide a comforting touch

19. Tactics That Enhance Communication • Value of silence and a comforting touch • Touch is perhaps the most universal of all languages • Silence and a comforting touch will say more than words can • When words are not enough, touch is comforting and establishes a bond

20. Blocks to Effective Communication

21. Blocks to Effective Communication • Not listening carefully to what another person is saying • Interrupting the other person • Being judgmental • The assumption that other people know what you know, think the way you think, and feel the way you feel

22. Conflict Resolution

23. Conflict • Conflict, resulting from differences between people, occurs when • One person is unable to understand or accept another’s ideas or beliefs • One person’s expectations for another differ from that person’s expectations for himself • One person misunderstands another person’s words or intentions • One person’s needs or wants conflict with our own needs and wants • Conflict makes the people directly involved, as well as those around them, uncomfortable

24. Conflict Resolution • Ask to speak privately with the person • During your conversation, focus on the specific area of conflict • Focus on “I” rather than the more accusatory “you” • Be prepared to hear how the other person may feel toward you or the problem, even if it is not pleasant • Be gracious enough to apologize for misunderstanding the other person, or for being the one who was misunderstood • Ask the other person for insight into solutions for resolving the conflict • Sometimes it is necessary to “agree to disagree” • If you are unable to resolve a conflict on your own, seek the advice of your supervisor

25. Telephone Communication

26. Using Telephone Communication • Today, the telephone remains a primary tool of communication in the health care field • When using this mode of communication • Remember telephone etiquette • Respect patient and resident confidentiality • Know your facility’s policies

27. Reporting and Recording Information

28. Observation • Subjective data • Subjective data is information that cannot be objectively measured or assessed • Examples: Usually a person’s complaint, or symptom • Objective data • Objective data is information that you obtain directly, through measurements or by using one of your five senses • Examples: Temperature, pulse, respiratory rate, and blood pressure of a patient or resident

29. Recording • Recording or “charting,” is communicating information about a patient or resident to other health care team members in written form • Tools associated with recording include the • Medical record (chart) • Kardex

30. Reporting • Nursing assistants use reporting to communicate the following information to the nurse: • Observations that suggest a change in the patient’s or resident’s condition • Observations regarding the patient’s or resident’s response to a new treatment or therapy • A patient’s or resident’s complaints of pain or discomfort • A patient’s or resident’s refusal of treatment • A patient’s or resident’s request for clergy

31. Communication Among Members of the Health Care Team

32. Medical Record (Chart) • It is a legal document that contains • The person’s current condition • The measures that have been taken by the medical and nursing staff to diagnose and treat the condition • The person’s response to the treatment and care provided

33. A Typical Medical Record Contains… • Admission sheet • Medical history • Nursing history • Physician’s order sheet • Medication sheet • Physician’s progress notes • Narrative nurse’s notes • Graphic sheet • Miscellaneous documents

34. Kardex • The Kardex is a card file, containing condensed versions of each patient’s or resident’s medical record. It contains: • A summary of the person’s current diagnosis • The diagnostic tests and treatments ordered by the doctor • Information about routine care measures, such as the person’s diet, level of ambulation, and bathing schedule

35. Communication Technologies

36. Computer • A person’s medical record can be maintained by: • entering data into a computer in response to the computer’s prompts • this is preferable to filling out a paper form.

37. Vital Link in the Chain

38. The Nursing Assistant’s Role • A nursing assistant should be well aware of his or her job description and should work within the parameters defined by facility policy to ensure effective communication • Ensuring effective communication also helps avoid legal complications.

39. Nursing Process

40. The Nursing Process • In order to achieve its goals, the nursing team develops a specific plan of care, called the nursing care plan, for each patient or resident • The communication method that is used to develop the nursing care plan is called the nursing process • Nursing assistants play a key role in implementing and evaluating the nursing care plan

41. Steps of the Nursing Process • Assessment • Diagnosis • Planning • Implementation • Evaluation

42. Quality Health Care

43. Quality Health Care • Effective communication, both written and oral, allows all team members to stay informed about a patient’s or resident’s medical condition and response to treatment • When there are communication breakdowns among the health care team, this can adversely affect a patient’s or resident’s care and safety

44. End of Presentation