Chapter 21 Communicator

1. Chapter 21Communicator

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3. Five Parts of the Communication Process (Berlo) • The stimulus or referent • The sender or source of message (encoder) • The message itself • The medium or channel of communication • The receiver

4. Components in the Process of Communication

5. Four Levels of Communication • Intrapersonal • Interpersonal • Small-group • Organizational

6. Question A nurse who reassures herself that she is prepared to speak in front of a group of her peers is using which of the following types of communication? A. Intrapersonal B. Interpersonal C. Group D. Organizational

7. Answer Answer: A. Intrapersonal Rationale: Intrapersonal communication is self-talk that happens within the individual. Interpersonal communication occurs between two or more people to exchange messages. Group communication includes small-group and organizational group communication.

8. Roles of Group Members • Task-oriented—focus on work to be done • Group building or maintenance—focus on well-being of people doing work • Self-serving—advance the needs of individual members at group’s expense

9. Question An individual who dominates a group meeting to promote his own personal agenda is performing which of the following group-member roles? A. Task-oriented B. Group building C. Maintenance D. Self-serving

10. Question Answer: D. Self-serving Rationale: Self-serving roles advance the needs of individual members at the group’s expense. Task-oriented roles focus on the work to be done (e.g., information giver/seeker, coordinator, delegator) Group-building and maintenance roles focus on the well-being of the people doing the work (e.g., listener, trust builder, supporter).

11. Factors Influencing Communication • Developmental level • Gender • Sociocultural differences • Roles and responsibilities • Space and territoriality • Physical, mental, and emotional state • Environment

12. Forms of Communication • Verbal (language) • Nonverbal (body language) • Facial expressions, touch, eye contact • Posture, gait • Gestures • General physical appearance • Mode of dress and grooming • Sounds, silence

13. Question Tell whether the following statement is true or false. Touch is a personal behavior that means the same thing to all persons. A. True B. False

14. Answer Answer: B. False Touch is a personal behavior that means different things to different people.

15. The Helping Relationship • Does not occur spontaneously • Characterized by an unequal sharing of information • Built on the patient’s needs

16. Characteristics of the Helping Relationship • Dynamic • Purposeful and time limited • Person providing assistance is professionally accountable for the outcomes

17. Phases of the Helping Relationship • Orientation phase • Working phase • Termination phase

18. Question Which of the following activities generally occurs during the orientation phase of the helping relationship? A. An agreement or contract about the relationship is established. B. The nurse provides any assistance needed to achieve patient goals. C. The nurse provides patient counseling and teaching. D. The patient and nurse examine the goals of the helping relationship for indications of attainment.

19. Answer Answer: A. An agreement or contract about the relationship is established Rationale In the orientation phase a contract is made defining the goals of the relationship, frequency, location, length of contacts, and duration of the relationship. The nurse provides assistance needed to achieve patient goals, counseling and teaching in the working phase. The patient and nurse examine the goals of the helping relationship for indications of attainment in the terminations phase.

20. Goals of the Orientation Phase • Establish tone and guidelines for the relationship. • Identify each other by name. • Clarify roles of both people. • Establish an agreement about the relationship. • Provide the patient with orientation to the healthcare system.

21. Goals of the Working Phase • Work together to meet the patient’s needs. • Provide whatever assistance is needed to achieve each goal. • Provide teaching and counseling.

22. Goals of the Termination Phase • Examine goals of helping relationship for attainment. • Make suggestions for future efforts if necessary. • Encourage patient to express his or her emotions about the termination.

23. Factors that Promote Effective Communication • Dispositional traits • Rapport builders

24. Dispositional Traits • Warmth and friendliness • Openness and respect • Empathy • Honesty, authenticity, trust • Caring • Competence • Genuineness

25. Rapport Builders • Specific objectives • Comfortable environment • Privacy • Confidentiality • Patient vs. task focus • Utilization of nursing observations • Optimal pacing • Providing personal space

26. Question Tell whether the following statement is true or false. A nurse should respect a patient’s personal space by remaining outside an arm’s length of the patient and refraining from touching the patient unnecessarily. A. True B. False

27. Answer Answer: B. False A nurse should respect a patient’s personal space by assessing this space through careful observations of nonverbal communication.

28. Methods of SBAR Communication • Posters • Stickers on phones • Peer observation • Inclusion of SBAR in orientation and safety training

29. Developing Conversation Skills • Control the tone of your voice. • Be knowledgeable about the topic of conversation. • Be flexible. • Be clear and concise. • Avoid words that might have different interpretations. • Be truthful. • Keep an open mind. • Take advantage of available opportunities.

30. Developing Listening Skills • Sit when communicating with a patient. • Be alert and relaxed and take your time. • Keep the conversation as natural as possible. • Maintain eye contact if appropriate. • Use appropriate facial expressions and body gestures. • Think before responding to the patient. • Do not pretend to listen. • Listen for themes in the patient’s comments. • Use silence, therapeutic touch, and humor appropriately.

31. Using Therapeutic Touch to Convey a Message

32. Interviewing Techniques • Open-ended questions or comments • Closed questions or comments • Validating questions or comments • Clarifying questions or comments • Reflective questions or comments • Sequencing questions or comments • Directing questions or comments

33. Basic Components of Assertiveness • Having empathy • Describing one’s feelings or the situation • Clarifying one’s expectations • Anticipating consequences

34. Blocks to Communication • Failure to perceive the patient as a human being • Failure to listen • Inappropriate comments and questions • Using clichés • Using closed questions • Using questions containing the words “why” and “how” • Using questions that probe for information

35. Blocks to Communication (cont.) • Using leading questions • Using comments that give advice • Using judgmental comments • Changing the subject • Giving false assurance • Using gossip and rumors • Using aggressive interpersonal behavior

36. Question Tell whether the following statement is true or false. An open-ended question or comment serves to validate what the nurse believes is heard or observed. A. True B. False

37. Answer Answer: B. False A validating question or comment serves to validate what the nurse believes is heard or observed.