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Chapter 6
Communication Skills: Medium for All
Nursing Practice
Therapeutic Communication
-Essential in all settings of nursing care
Communication Process
-Process of receiving and sending messages
-Stimulus: one person has need to communicate with another
-Sender: person sending message initiates contact
-Message: information expressed or sent
-Media: how message is sent-hearing, visual, tactile, smell or
-Receiver: person receiving the message, interprets and responds
to sender by providing feedback
Nurse-patient interview
Peplau principles guiding communication
-Clarity: ensures the meaning of message is accurately
understood by both parties
-Continuity: promotes connections among ideas and
feelings, events, or themes conveyed in those ideas
Factors that affect communication
-Personal factors
-Environmental factors
-Relationship factors
Levels of communications
2 Levels
-Verbal Communication
 Consists of words a person speaks
 Conveys beliefs, values, perceptions, meanings
 Words are culturally perceived
-Nonverbal Communication
 Cues (physical appearance, facial expression,
body posture, amt eye contact, eye cast, hand
gestures, signs, fidgets and yawning
Communication is 10% verbal and 90%
Communication process
Content congruent with process is healthy
 When verbal message is not reinforced by
communicators actions , message is
ambiguous, or double (mixed) message
 Double-bind message
-Message sent to create meaning but also used
to defensively to hide what is going on ,
create confusion and attack relatedness
Effective communication for nurses
-Feel understood and comfortable
-Identify and explore problems relating to others
-Healthy ways of meeting emotional needs
-Experience satisfying interpersonal relationships
Tools to communicate with pts
-Active Listening
-Clarifying Techniques
Nontherapeutic techniques
Asking excessive questions
-Closed ended questions
-Lack of respect and sensitivity
Giving approval or disapproval
-Rarely helpful
Asking “why” questions
-Imply criticism
Communication and cultures
-To formulate a therapeutic alliance
Problematic areas for nurse interpretation
of verbal and nonverbal messages of pt
-Communication Styles
-Eye Contact
-Cultural Filters
Effective communication
Effective Communication
-Nurses knowing what to convey,
communicating what is meant to pt and
comprehending the meaning
-Most effective when they use nonthreatening
and open-ended communication techniques
-Skill that develops over time and integral to
establishment and maintenance of a
therapeutic alliance