COMMUNICATION AND NURSE PATIENT RELATIONSHIP

COMMUNICATION AND NURSE PATIENT RELATIONSHIP

1. COMMUNICATION AND NURSE PATIENT RELATIONSHIP By : SAYANTANI MONDAL College Faculty Govt College of Nursing, District Hospital, Howrah

2. DEFINITION COMMUNICATION IS AN ACT (BEHAVIOUR) AND A PROCESS IN WHICH A MESSAGE IS TRANSFERRED FROM ONE PERSON TO ANOTHER PERSON THROUGH A SUITABLE MEDIA AND THE INTENDED MESSAGE IS RECIVED AND UNDERSTOOD BY THE RECIEVER.

3. LEVELS OF COMMUNICATION Intrapersonal communication

4. Interpersonal communication

5. Small group communication

6. Public communication

7. Electric communication

8. ELEMENTS AND PROCESS OF COMMUNICATION THERE ARE SEVERAL ELEMENTS OF COMMUNICATION: THE REFERENT, SENDER AND RECEIVER, MESSAGE, CHANNELS, CONTEXT OR ENVIRONMENT IN WHICH THE COMMUNICATION PROCESS OCCURS, FEEDBACK, AND INTERPERSONAL VARIABLES.

9. Each person in the communication interaction, is both a speaker and a listener. They can be simultaneously sending and receiving messages. Both parties view the perceptions, attitudes, and potential reactions to a sent message. Communication becomes a continuous and interactive activity. Feedback from the receiver of environment enables the communications to correct or validate the communication.

10. The role relationship of the communicators are complementary and symmetrical. Complementary role relationships function with one person holding an elevated position over the other person. Symmetrical relationships are more equal

11. TYPES AND MODES OF COMMUNICATION 1. VERBAL COMMUNICATION VERBAL COMMUNICATION USES SPOKEN OR WRITTEN WORDS.

12. THE MOST IMPORTANT ASPECTS OF VERBAL COMMUNICATION ARE THE FOLLOWINGS: VOCABULARY: COMMUNICATION IS UNSUCCESSFUL IF SENDERS AND RECEIVERS CANNOT UNDERSTAND ONE ANOTHER'S WORDS AND PHRASES. WHEN YOU CARE FOR A PATIENT WHO SPEAKS ANOTHER LANGUAGE, A PROFESSIONAL INTERPRETER IS NECESSARY.

13. DENOTATIVE AND CONNOTATIVE MEANING: SOME WORDS HAVE SEVERAL MEANINGS. INDIVIDUALS WHO USE A COMMON LANGUAGE SHARE THE DENOTATIVE MEANING. THE CONNOTATIVE MEANING IS THE SHADE OR INTERPRETATION OF THE MEANING OF A WORD INFLUENCED BY THE THOUGHTS, FEELINGS, OR IDEAS THAT PEOPLE HAVE ABOUT THE WORD.

14. PACING: CONVERSATION IS MORE SUCCESSFUL AT AN APPROPRIATE SPEED OR PACE. SPEAK CLEARLY. TALKING RAPIDLY, USING AWKWARD PAUSES, OR SPEAKING SLOWLY AND DELIBERATELY CONVEYS AN UNINTENDED MESSAGE.

15. INTONATION: TONE OF VOICE DRAMATICALLY AFFECTS THE MEANING OF A MESSAGE. DEPENDING ON INTONATION, EVEN A SIMPLE QUESTION OR STATEMENT EXPRESSES ENTHUSIASM, ANGER, CONCERN OR INDIFFERENCE.

16. CLARITY AND BREVITY: EFFECTIVE COMMUNICATION IS SIMPLE, BRIEF AND DIRECT.

17. TIMING AND RELEVANCE: TIMING IS CRITICAL IN COMMUNICATION. EVEN THOUGH A MESSAGE IS CLEAR, POOR TIMING PREVENTS IT FROM BEING EFFECTIVE.

18. 2. NON-VERBAL COMMUNICATION NON VERBAL COMMUNICATION INCLUDES THE FIVE SENSES AND EVERYTHING THAT DOES NOT INVOLVE THE SPOKEN OR WRITTEN WORD. NONVERBAL ASPECTS OF COMMUNICATION SUCH AS VOICE TONE, EYE CONTACT, AND BODY POSITIONING ARE OFTEN AS IMPORTANT AS VERBAL MESSAGES.

19. PERSONAL APPEARANCE: PERSONAL APPEARANCE INCLUDES PHYSICAL CHARACTERISTICS, FACIAL EXPRESSION, AND MANNER OF DRESS AND GROOMING. THESE FACTORS COMMUNICATE PHYSICAL WELL-BEING, PERSONALITY, SOCIAL STATUS, OCCUPATION, RELIGION, CULTURE, AND SELF-CONCEPT.

20. POSTURE AND GAIT: POSTURE AND GAIT (MANNER OR PATTERN OF WALKING) ARE FORMS OF SELF-EXPRESSION. THE WAY PEOPLE SIT, STAND, AND MOVE REFLECTS ATTITUDES, EMOTIONS, SELF-CONCEPT, AND HEALTH STATUS.

21. FACIAL EXPRESSION: FACIAL EXPRESSIONS CONVEY EMOTIONS SUCH AS SURPRISE, FEAR, ANGER, HAPPINESS AND SADNESS. SOME PEOPLE HAVE AN EXPRESSIONLESS FACE, OR FLAT AFFECT, WHICH REVEALS LITTLE ABOUT WHAT THEY ARE THINKING OR FEELING.

22. EYE CONTACT: PEOPLE SIGNAL READINESS TO COMMUNICATE THROUGH EYE CONTACT. MAINTAINING EYE CONTACT DURING CONVERSATION SHOWS RESPECT AND WILLINGNESS TO LISTEN.

23. GESTURES: GESTURES EMPHASISE, PUNCTUATE, AND CLARIFY THE SPOKEN WORD. GESTURES ALONE CARRY SPECIFIC MEANINGS, OR THEY CREATE MESSAGES WITH OTHER COMMUNICATION CUES.

24. SOUNDS: SOUNDS SUCH AS SIGHS OR SOBS ALSO COMMUNICATE FEELINGS AND THOUGHTS. COMBINED WITH OTHER NONVERBAL COMMUNICATION, SOUNDS HELP TO SEND CLEAR MESSAGES.

25. TERRITORIALITY AND PERSONAL SPACE: TERRITORIALITY IS THE NEED TO GAIN, MAINTAIN, AND DEFEND ONE'S RIGHT TO SPACE. TERRITORY PROVIDES A SENSE OF PRIVACY, IDENTITY AND SECURITY.

26. FACTORS INFLUENCING COMMUNICATION Developmental level : It is helpful to understand the process of language development and intellectual and psychosocial development.

27. Gender : Men and women communicate differently and may interpret the same conversation differently.

28. Sociocultural Differences : As a nurse, you need to recognize ways in which culture, economic condition, and overall lifestyle influence a patient's preferred mode of communicating.

29. Roles and Responsibilities : A person's occupation might give the nurse a general idea of that person's abilities, talents, interests, and economic status. Stereotyping a person according to occupation, however, can be misleading and should be avoided.

30. Physical, mental and emotional state : Be sensitive to patient’s physical, mental and emotional state to ensure effective communication. A full bladder, headache, chest pain, anxiety can negatively influence communication.

31. Values : Communication is influenced by the way people value them. When a nurse herself strongly value her words while delivering a health teaching, the patients also starts to value her words more effectively.

32. Environment : Communication happens best when environment facilitates easy exchange of needed information.

33. METHODS OF EFFECTIVE COMMUNICATION Rapport Building

34. Specific Objective

35. Comfortable Environment

36. Privacy

37. Confidentiality

38. Empathy

39. Openness and Respect

40. Competence

41. BARRIERS OF EFFECTIVE COMMUNICATION Linguistic barriers

42. Psychological barriers

43. Emotional Barriers

44. Physical Barriers

45. Cultural Barriers

46. Attitude Barriers

47. Perception Barriers

48. Physiological Barriers

49. Technological Barriers

50. Socio-religious Barriers

51. TECHNIQUES OF EFFECTIVE COMMUNICATION Observing

52. Listening

53. Restating

54. Validating

55. Clarifying

56. Questioning

57. Summarizing

58. NONTHERAPEUTIC COMMUNICATION TECHNIQUES Overloading

59. Value judgement

60. Incongruence

61. Underloading

62. False assurance

63. Invalidation

64. Focusing on self

65. Changing subject

66. Disruptive behaviour

67. PROFESSIONAL COMMUNICATION THE NURSE DIRECTS COMMUNICATION TOWARDS THE PATIENT TO IDENTIFY HIS CURRENT HEALTH PROBLEMS, PLAN, IMPLEMENTS AND EVALUATES ACTION TAKEN. - BIMLA KAPOOR IT IS A PROCESS IN WHICH UTILIZES A PLANNED APPROACH TO LEARN ABOUT THE CLIENT. - POTTER A.

68. HELPING RELATIONSHIP (NURSE PATIENT RELATIONSHIP) The helping relationship is characterised by an unequal sharing information. The patient shares information about personal health problems, whereas nurse shares information in terms of professional role. It is dynamic. Both the person proving the assistance and the person being helped are active participants to the extent each is able. It is purposeful and time limited. There are specific goals that are intended to meet within a specific time period.

69. PURPOSES OF HELPING RELATIONSHIP To assist the client with problem solving. To help the client examine self defeating behaviours and test alternatives. To facilitate communication of distressing thoughts and feelings. To promote self care and independence.

70. PHASES OF HELPING RELATIONSHIP There are four phases in “Helping Relationship” or “Nurse Patient Relationship ”. Preorientation Phase Orientation Phase Working Phase Termination Phase

71. PREORIENTATION OR PREINTERACTION PHASE

72. ORIENTATION PHASE

73. WORKING PHASE

74. TERMINATION PHASE

75. COMMUNICATING EFFECTIVELY WITH PATIENT, FAMILIES AND TEAM MEMBERS

76. Qualities and skills necessary for helping relationship Genuineness

77. Respect

78. Empathetic understanding

79. Concreteness

80. Immediacy

81. Emotional Catharsis

82. Role Playing

83. Therapeutic Impasses Resistance

84. Transference

85. Counter-transference

86. Boundary Violation

87. MAINTAINING EFFECTIVE HUMAN RELATION AND COMMUNICATION WITH VULNERABLE GROUP VULNERABLE GROUPS ARE THOSE WHO NEED SPECIAL ATTENTION SUCH AS CHILDREN, WOMEN, PHYSICALLY AND MENTALLY CHALLENGED AND ELDERLY. FAILURE OF HEALTH CARE PROVIDERS TO COMMUNICATE WITH VULNERABLE GROUP IS A MAJOR BARRIER IN COMMUNICATION AND DELIVERING PROPER CARE.

88. Communication with Children

89. Communication with Old age people

90. Communication with Women

91. Communication with People with visual impairment

92. Communication with People with hearing impairment

93. Communication with People with speech impairment

94. Communication with People with cognitive impairment

95. Communication with People with intellectual disability