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Communication Skills Unit 7 Communication Skills • How Communication and Observation are used: • Observations and care of patient • Interaction with patients and visitors • To convey patient’s feelings • Communication Skills • Three things needed for effective communication: • Sender • Clear message • Receiver Communication Skills • Verbal communication: • Uses words to communicate • Nonverbal communication: • Message sent through the use of one’s body, rather than through speech or writing • Posture • Hand & body movements • Activity level • Facial expressions • Overall appearance • Body position Communication Skills • Report: • Method of communicating with other shifts and conveys the following information: • Changes in patient’s condition • Information about new patient • Names of patients who were discharged or died • Patient incidents • New Physician’s orders • Special events for patients that are scheduled during your shift • This is Jane Doe, student nurse reporting on Mr. Smith in Room 101. He is a 60 year old patient of Dr. Jones admitted with CHF. He has a history of CAD, CVA, MI. He is alert, and oriented to person, place, and time. His lung fields are clear bilaterally. His 02 sat this shift was 94% on room air. His abdomen is nontender and nondistended. His last BM was on March 1. He has an IV of NS to his right forearm #20 Jelco dated 3/02 running at a KVO rate. His foley is patent draining clear yellow urine-1000cc this shift. His potassium was 4.0 this morning. He is scheduled for a BNP today. You are to call Dr. Jones with the results. Communication Skills • The Nursing Assistant uses the chain of command for reporting: • LPN • RN • Nursing Supervisor • Director of Nursing • Facility Administrator Communication Skills • Answering the telephone: • Identify the unit • Identify yourself and give your title • Ask the caller’s name; ask the caller to wait while to get the person asked for; or take a message, noting the date, time, caller’s name and telephone number • Sign the message with your name Communication Skills • Written communication: • Can take many forms • Memos • Policy & procedure manuals • Employee handbooks • Staff development: • Educating staff to new changes • Very important means of communication • CEU’s Communication Skills • Care Plan: • Each patient/resident has their own specific plan of care • Individualized for them • Medical Record: • Physician’s orders • Patient history and physical exam results • Results of diagnostic tests • Progress notes • Ongoing assessments • Nursing notes Communication Skills • Other methods of communication: • Fax (HIPAA) • Computers • Communicating with patients: • Gain patient’s full attention • Use nonthreatening words (easy to understand) • Speak clearly and courteously • Avoid covering mouth when speaking • NEVER – EVER chew gum • Use pleasant tone • Be mindful of your body language Communication Skills • Communicating with patients: • Be alert of the patients’ needs that they communicate to you • Avoid speaking about one patient in front of other patients (HIPAA) • Avoid interrupting patient • Paraphrase patient’s thoughts and feelings to validate that message was received • Ask for clarification if you do not understand • Give only factual information that you are allowed to give (let physician or nurse give other info) • Avoid arguing with patients about information Communication Skills • Communicating with patients with Special Needs: • Hearing impaired: • Get patient’s attention and ensure that you have a clear line of sight • If patient wears hearing aid, make sure they are wearing it • If patient has better hearing on one side, stand on that side • NEVER – EVER chew gum • Limit distractions • Use familiar words; speak slowly; pronounce carefully; avoid shouting Communication Skills • Communicating with patients with Special Needs: • Hearing impaired: • Use facial expressions; gestures and body language to get point across • Use low voice pitch (easier to hear) • Short sentences/avoid exaggerating movements • Rephrase sentences as needed • Avoid “mouthing” words • No abrupt subject changes (confusing) • Have notepad available, incase it is needed • Consider basic sign language for understaning Communication Skills • Communicating with patients with Special Needs: • Visually impaired: • Get patient’s attention using touch if needed • Introduce self and explain everything you are going to do • Be specific in your directions • Ensure patient knows when you are leaving area • Offer to read patients mail or dial phone • Tactfully inform patient of their clothing selection • Encourage patient to listen to TV/Radio/Books • Describe environment to patient Communication Skills • Communicating with patients with Special Needs: • Visually impaired: • NEVER rearrange patient’s room, or allow others (family) to do so without specific permission from patient • Avoid “surprising” patient when you approach them Communication Skills • Communicating with patients with Special Needs: • Patient’s with aphasia: • Face the patient and make eye contact • Greet the patient by name; “Mr., Mrs., Miss, Dr.” • Speak slowly and clearly, using short, simple sentences • Pause between sentences to allow for comprehension • Use nonverbal clues to convey your message • Ask questions requiring only short response • Repeat what patient says – helps focus patient Communication Skills • Communicating with patients with Special Needs: • Patient’s with aphasia: • Use alternative methods of communication – if available • Do not maintain silence, nor shout during patient care • Patient may show signs of frustration; acknowledge their frustration • Refocus patient (may require change of subject) Communication Skills • Communicating with patients with Special Needs: • Disoriented patients: • Identify yourself and greet patient by name • Speak in lower tone of voice • Maintain eye contact • Pleasant facial expression • Use touch, if not perceived as threatening • Avoid interruptions/distractions • Use short, simple phrases; allow time for response • Use pictures, pointing, gestures Communication Skills • Communicating with patients with Special Needs: • Disoriented patients: • Use word substitutes that are known to the patient • Present clear message • Repeat patient’s phrases to ensure focus • Avoid lengthy conversations/explanations • Use nonverbal praise Communication Skills • Communicating with patients with Special Needs: • Patients from different cultures: • Learn guidelines for communicating with specific culture • Communication with other cultures may greatly differ from your own guidelines for communication • Be respectful of differences