Ch. 15 - Communication and Therapeutic Relationships

Basic human function, Sending messages back and forth between two or more people, Consists of verbal and nonverbal messages, Helps build working relationships, Helps meet physical, psychosocial, emotional, and spiritual needs

Self-talk; can be positive or negative

Between two or more people

With many people at the same time

Unique form of group communication

Subject matter, Words, Gestures, Substance of the message, Open in interpretation

Sender (initiates content delivery), Encoding (process of selecting the words, gestures, tone of voice, signs, and symbols used to transmit the message), Message (words; gesture; letter), Channel (face-to-face; written; audiovisual; telephone; e-mail, Receiver (interprets the message), Feedback (verbal, nonverbal, or both)

involves speaking or writing words to send a message

Vocab, Denotative vs. connotative meaning, Pacing of conversation, Intonation: tone, pitch, cadence, volume, Clarity and brevity, Timing, Relevance of information, Credibility of the sender, Humor

Communicates feelings behind a message

Clue to attitude, self-concept

Clue to socioeconomic status, culture, feelings

Emphasize and clarify spoken word; can have different meanings

Can be misinterpreted

Environment, Developmental variations, Gender, Personal space, Territoriality, Sociocultural factors, Roles and relationships

Passive, Passive aggressive, Aggressive, Assertive

Avoids conflict; want to avoid conflict, so individual says nothing or simply agrees

Communication appears passive on the surface but demonstrates anger in a subtle, indirect way

Verbally and sometimes physically abusive

Honest and clear communication, doesn’t violate the rights of others

Speak clearly and positively, Maintain professional composure, Use “I” statements, Focus on the issue, Use effective nonverbal communication, Don’t invite negative responses, Accept criticism, Use negative inquiry, Strive for a compromise, Used by collaborative professionals

SBARQ: situation, background, assessment, recommendation, questions, Patient rounds

Incivility, Bullying, Lateral violence

Focus on improving the health of the client, Provide necessary info about health, treatments, and care, Involve use of therapeutic communication

Client-centered, Goal-directed, Strengthens therapeutic relationship

Gathering info prior to meeting client, No direct contact with patient

Meeting the client, introductions, establishing rapport and trust, Use on verbal and non-verbal communication

Use of techniques appropriate to therapeutic communication, Client clarifies feelings through verbal and non-verbal communication

Termination

Empathy, Respect, Genuineness, Concreteness, Confrontation

Types of groups (task, ongoing, self-help, therapy, work-related, social)

Medications, Language, vocab, literacy (Forein language? Do you need an interpreter? Education level), Cognitive function, Hearing, Vision, Aphasia, Physiological barriers, Communication style

Minimize distractions, Provide privacy, Set priorities according to the client’s needs, Collaborate with other health professionals when necessary

Asking irrelevant personal questions, Stereotyping, Giving false reassurance, Minimizing feelings, Excessively probing, Being defensive

Establish a trusting nurse-client relationship, Provide empathetic responses and explanations, Barriers to therapeutic communication, Manipulate the environment to decrease distractions, Congruent verbal and non-verbal communication, Body gestures (relaxed, face the client, open posture, lean toward the client, maintain good eye contact unless cultural norms discourage it)

Address the patient, Establish trust, Restate, clarify, and validate message, Listen actively, Be assertive, Interpret body language and share observations, Explore issues, ask open-ended questions, Use clarifying techniques, summarize the conversation, Use silence, Use process recordings

Asking too many questions, Fire-hosing info, Asking why, Changing the subject inappropriately, Failing to probe, Expressing approval or disapproval, Offering advice, Providing false reassurance, Stereotyping, Using patronizing language

Cultural sensitivity: be certain the communication strategies you usually use are culturally appropriate for the individual, Language barrier issues

Hand gestures, Family assistance, Be positive and patient