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Communication:
Clients & Colleagues
Definition
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Dynamic social process involving the exchange of
ideas between two or more people
Behavior to express feelings
System of operations that include language, gestures,
or symbols to convey intended meanings
Method by which information is transmitted, received
and understood
Mutual transactional process to facilitate a
relationship with others
Essential element in the establishment of the nurseclient relationship
Therapeutic Nurse-Client
Relationship
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Special form of interacting that has a
health-related purpose and develops as
a continuous flow of interaction
between nurse and client, with input
from both contributing to its nature and
progression
Social
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vs.
Occurs at any time, not time-limited
Structure and conduct responsibility
of both parties
Spontaneous and not necessarily
goal-directed
Needs of both can receive equal
consideration
Purpose for both greater intimacy
Self-disclosure acceptable for both
parties
Social decorum and adherence to
rules of etiquette are expected
Therapeutic
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Occurs within designated time
frames and terminates when
therapeutic goals are achieved
Responsibility for structure and
conduct of the conversation is
ultimately the nurse’s.
Communication is purposeful and
directed toward mutually
established goals
Focus always on the patient only
NO self-disclosure by nurse other
than special circumstances
Not always follows rules of social
etiquette
Formally terminates with end of
session or purpose of relationship
Collegial Communication
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Among colleagues in the professional work
setting
Professional nursing groups
Purpose is professional collaboration
Effective collaboration has the advantage of
breaking through power issues and
competition that may arise when teams of
professionals are brought together
No member is more important than another
member or the group as a whole
Elements
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Stimulus
Sender
Message
Medium
Receiver
Feedback
Types
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Written
Verbal
Cultural
Nonverbal
Written - Documentation
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Facilitate care planning and delivery
Identify individual patterns or norms so
that deviation can be noted ASAP
Direction
Prove interventions were done, how,
response so care can be evaluated
Legal and accounting record
Evidence for outcomes
Cultural
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Different languages create and express
different personal realities
Culture expressed through language,
shapes the personalized meaning &
experience of illness and health
Some words do not have exact match in
another language
Culture: Paralanguage
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Dialect
Voice volume, Emphasis points and inflections
Eye contact
Facial expression
Space needs
Body posture
Diet
Behavior
Expectations
Gestures
Stereotypes
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Exercise
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American Indians
African Americans
Asians
Hispanics
Homosexual men
Homeless
AIDS victims
People on welfare
Elderly
Mentally Ill
Southerners
New Yorkers
Verbal
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Spoken language
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Dialect
Mannerisms
Inflection
Tone, volume, rate,
Inflections
Slang
Jargon
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Influences
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Age
Race
Socioeconomic
Group
Educational
background
Gender
Situation
Factors: Other
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Perception
Personal space and territoriality
Values
Roles & Relationships
Emotions
Environment
Physical Condition
Self-Awareness
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The thing I like best about myself is
The thing I like least about myself is
My favorite activity is
When I am in a group, I
It would surprise most people if they knew
The most important value to me is
I like
I most dislike
I feel most self-confident when I
Five years from now I see myself as
Healthy Self-Concept
Satisfaction with
Role Performance
Congruence between
Real and Ideal Self
Self
Spiritual well-being
High Self-Esteem
Distinct Sense of Identity
Emotional Stability
Realistic Life Goals
Satisfaction with Body Image
Cognitive distortions
and
Self-Concept
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“All or nothing”
Personalizing
Overgeneralizing
Mind-reading
“Should” / “Ought to”
“Awfulizing”
Anxiety and Communication
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Mild
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Moderate
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Decreased sensory
perceptions
Severe
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Heightened alertness,
Increase alertness
Greatly diminished
perceptions
Panic
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All internal: No external
perceptions
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Active listening
Honesty
Slow, calm
Clear, firm, NOT LOUD
Reasonable limits
Therapeutic touch ***
Breathing & relaxation
Nonverbal
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Actions speak louder than words
Context
Used to enhance, disguise, negate, or
modify verbal messages
90% of meaning of a message comes
from the NON-VERBAL
Proxemics
Appearance
Nonverbal
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Facial expression
Clothing
Posture
Movement
Vigorous
Slow
Caring
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Integral to nursing
Must be communicated!!
Can be a purposeful activity integrated
into each nurse experience with a
(client, patient, consumer, member,
colleague)
Respect
Polite decorum
Caring: Exercise
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What constitutes communication of
Caring?
Communication Techniques
Therapeutic
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Silence
Accepting
Recognition
Offering self
Broad openings
General leads
Making observations
Reflecting
Restating
Focusing
Giving information
Seeking clarification
Summarizing
Encouraging descriptions
Non-Therapeutic
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False reassurance
Approval/Disapproval
Advise giving
Defending
“WHY”???????????
Stereotyped Comments
Change of subject with NO explanation
“What”???????????? External source
Types of communication
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Assertive
Nonassertive
Aggressive
Nurse-Patient
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Trust
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Respect
Individualization
Appropriate eye-contact
Flexibility
Consistency
Honesty
Limits
Follow through on commitments
Control distractions
Attending posture
Time
Active listening
Nurse Patient
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Empathy
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Compassion
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What is it?
Sympathy
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What is it?
What is it?
Presence
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What is it?
Nurse-Patient Relationship
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Bridges
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Caring
Trust
Empathy
Mutuality
Confidentiality
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Barriers
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Anxiety
Stereotyping
Space Violation
Nurse Client Relationship
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Purpose
Focus
Boundaries
Phases
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Pre-orientation
Orientation
Working
Termination
Diagnoses
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Physical
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Breathing patterns, impaired
Communication, impaired verbal
Confusion, acute/chronic
Fatigue
Memory, impaired
Sensory/perecptual alterations
Diagnoses
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Mental/Emotional
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Anxiety
Denial
Family (Individual) coping, ineffective
Fear
Hopelessness
Knowledge deficit
Powerlessness
Spiritual distress
Social interaction, impaired
Thought processes, altered
Violence, risk for