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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