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Communication: Clients & Colleagues Definition       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  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        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        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      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       Stimulus Sender Message Medium Receiver Feedback Types     Written Verbal Cultural Nonverbal Written - Documentation       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    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           Dialect Voice volume, Emphasis points and inflections Eye contact Facial expression Space needs Body posture Diet Behavior Expectations Gestures Stereotypes  Exercise             American Indians African Americans Asians Hispanics Homosexual men Homeless AIDS victims People on welfare Elderly Mentally Ill Southerners New Yorkers Verbal  Spoken language        Dialect Mannerisms Inflection Tone, volume, rate, Inflections Slang Jargon  Influences       Age Race Socioeconomic Group Educational background Gender Situation Factors: Other        Perception Personal space and territoriality Values Roles & Relationships Emotions Environment Physical Condition Self-Awareness           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       “All or nothing” Personalizing Overgeneralizing Mind-reading “Should” / “Ought to” “Awfulizing” Anxiety and Communication  Mild   Moderate   Decreased sensory perceptions Severe   Heightened alertness, Increase alertness Greatly diminished perceptions Panic  All internal: No external perceptions        Active listening Honesty Slow, calm Clear, firm, NOT LOUD Reasonable limits Therapeutic touch *** Breathing & relaxation Nonverbal       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       Facial expression Clothing Posture Movement Vigorous Slow Caring      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  What constitutes communication of Caring? Communication Techniques Therapeutic               Silence Accepting Recognition Offering self Broad openings General leads Making observations Reflecting Restating Focusing Giving information Seeking clarification Summarizing Encouraging descriptions Non-Therapeutic         False reassurance Approval/Disapproval Advise giving Defending “WHY”??????????? Stereotyped Comments Change of subject with NO explanation “What”???????????? External source Types of communication    Assertive Nonassertive Aggressive Nurse-Patient  Trust             Respect Individualization Appropriate eye-contact Flexibility Consistency Honesty Limits Follow through on commitments Control distractions Attending posture Time Active listening Nurse Patient  Empathy   Compassion   What is it? Sympathy   What is it? What is it? Presence  What is it? Nurse-Patient Relationship  Bridges      Caring Trust Empathy Mutuality Confidentiality  Barriers    Anxiety Stereotyping Space Violation Nurse Client Relationship     Purpose Focus Boundaries Phases     Pre-orientation Orientation Working Termination Diagnoses  Physical       Breathing patterns, impaired Communication, impaired verbal Confusion, acute/chronic Fatigue Memory, impaired Sensory/perecptual alterations Diagnoses  Mental/Emotional            Anxiety Denial Family (Individual) coping, ineffective Fear Hopelessness Knowledge deficit Powerlessness Spiritual distress Social interaction, impaired Thought processes, altered Violence, risk for