Communication
Life span - Chapter 4
Communication
• “Exchange of
information, ideas,
feelings or emotions
between two or more
people”.
• Do you buy it?
Communication Process
1.
2.
3.
4.
5.
Message
Sender
Method
Receiver
Feedback
Message
• Expression of your
thoughts
Sender
• Sends our the
message
Method
Receiver
• Person to whom
the message was
sent
Feedback!
• Response to the
message
Who’s communicating?
What are the 5 steps of the
communication process?
Types of Communication
Verbal
• Spoken word
• Written word
Non-verbal
• AKA: body language
8 modes of nonverbal communication
1.
2.
3.
4.
5.
6.
7.
8.
Physical appearance
Body movement & Posture
Facial expression
Gestures
Eye contact
Tone & volume or voice
Touch
Silence
Thought questions
• What are the 8 modes of non-verbal
communication?
• Give an example of each
Personality types
1. Passive
2. Aggressive
3. Assertive
Style of Communication
Intrapersonal
• Thinking to your self
Interpersonal
• Communication
between others
Style of Communication
Social
Therapeutic
• Family
• Friends
• Purposeful
• Goal oriented
6 components of therapeutic
communication
1.
2.
3.
4.
5.
6.
Listening & observing
Warmth
Genuineness
Attentiveness
Empathy
Positive reward
1. Listening & observing
• Cognitive & affective
domains
• Words & feeling
Stages of Listening
1. Sensation
– Ears pick up sound waves
2. Interpretation
– Attaches meaning
3. Evaluation
– Judge message
4. Reaction
– Feedback
Which is a more complex process?
A. Hearing
B. Listening
Active Listening
•
•
•
•
•
•
Face them
Open posture
Lean forward
Eye contact
Relaxed
Respond
Rules of listening
1. Don’t talk & listen at the same
time!
Rules of Listening
2. Open posture
Rules of Listening
3. Focus
Rules of Listening
4. Listen to understand
Rules of Listening
5. Environment control
– Quiet
– Limit distractions
Rules of Listening
6. Show that you care
Rules of Listening
7. Validate
Rules of Listening
8. Do not criticize
Rules of Listening
9. Be non judgmental and accepting
Rules of Listening
10. Ask questions
3. Genuineness
• Open
• Truthful
4. Attentiveness
Attentiveness
5. Empathy
• Understand feelings
• Stay in control
6. Positive Regard
• Accepting
• Non-judgmental
Functions of
Therapeutic Communication
1.
2.
3.
4.
Create understanding
Decrease anxiety
Provide information
Develop trust
Phases of
Therapeutic Communication
1. Orientation
2. Working
3. Termination
Factors Affecting Communication
Congruence
• Match
– Verbal
– Non-verbal
Time & Setting
• “I’ll be right there”
A.
B.
C.
D.
Be there within 5 minutes
Be there within an hour
Be there within a day
Be there within a week
Proxemics
• Personal space
Biases
• Prejudice
• Negative beliefs
Physical Handicaps
• Deaf
• Blind
Blocks to Communication
Belittling
• Dismissing or mocking
• 3 yrs old says he is afraid
of monsters.
• Mom - “You’re acting
like a baby, there are no
monsters.”
Belittling
• Dismissing or mocking
• Pt “I won’t leave here
alive.”
• Nrs “That’s ridiculous.
You shouldn’t even think
that way.”
Giving literal responses
• Pt: “They’re looking in
my head with a TV”.
• Nrs: “What channel?”
• Patient: “That doctor is
a pain in the neck.”
• Nurse: “Would you like
your pain medication?”
Challenging
• “If you’re dead, why is
your heart beating?”
Disagreeing
• Response that indicates
you believe the person
is incorrect
• Teenage girl “My
boyfriend is terrific”
• Mom – “I think he is a
loser. You can do
better.”
Disagreeing
• Response that indicates
you believe the person
is incorrect
• Pt “Why am I here?
Nothing is being done
for me and I’m not
getting any better.”
• Nrs – “You are getting
better.”
Disagreeing
• Expressing disapproval
• ‘You should stop
worrying like this.”
Agreeing
• Statements that show
you believe the person
is correct.
• To neighbor “I’m
thinking of divorcing my
husband.”
• “I’d get rid of him too.”
Agreeing
• Statements that show
you believe the person
is correct.
• Pt – “I don’t think the
doctor will send me
home tomorrow.”
• Nrs – “I am sure you are
correct. I doubt he will
let you go home so
soon.”
Defending
• Justification
• Counter reply to a
verbal attack
• Teenage to day “I don’t
get as much of an
allowance as Paul
does.”
• Dad – “I’m doing the
best I can.”
Defending
• Justification
• Counter reply to a
verbal attack
• Pt – “I’ve had my call
light on for 15 minutes.”
• Nrs – “I am doing the
best I can. You are not
the only patient here.”
Stereotyping
• Clichés
• Superficial
• “I know what is
happening to you.”
• “All 2 year olds are
terrible.”
Stereotyping
• Clichés
• Superficial
• Pt - “I am really worried
about my children. I came
to the hospital so quickly
and didn’t get to see them.
They just wont understand.
I wish I could talk to them”
• Nrs - “I know exactly how
you feel.”
Giving false reassurance
• Reassurance without
sincerity
• “Don’t worry.
Everything will be all
right. You will feel
better soon.”
Giving false reassurance
• Reassurance without
sincerity
• Pt – “What will I do if
this is malignant?”
• Nrs – “Don’t you worry.
Everything will work out
just fine.”
Giving advice
• “If I were you…”
• “Why don’t you…”
Giving Advice
• “What you should do
is…:
Changing the subject
• Introducing a new topic
• Pt – “They are doing a
biospy tomorrow. I
hope it isn’t cancer.”
• Nrs – “Are these
pictures of your
children? They are such
a nice looking family.”
Asking closed-ending questions
• Questions with oneword answers
Asking “why” questions
• Why?
• “Why did you fall?”
Probing
• Seeks information
beyond what is
necessary.
Techniques used to enhance
communication
Giving information
• “Susie is getting an
echocardiogram right now
which is a test that uses
painless sound waves to create
a moving picture of her heart
structures and valves and
should tell us what is causing
her murmur”.
Validating
• A statement or question
to verify your
perception
• “Has the diarrhea
stopped?”
Clarifying
• Seeking information to
understand
• “Could you explain?
• I’m not sure I
understand?
Clarifying
• Seeking information to
understand
• Pt - “There is no point in
asking for pain medication”
• “Are you saying no one give
you medication when you
have pain or do you mean
the medication doesn’t help
your pain?”
Reflecting
• Stating you
perception of the
message in the
affective (feeling)
domain
• Flashback
• Pt – “My sister won’t
help with our mother’s
care.”
• Nrs – “You feel angry.
Have you discussed this
with her?”
• Nrs – “I sense that you
feel angry”
Paraphrasing
• Restating
• Pt – “I was awake
most of the night.”
• Nrs – “You have
trouble sleeping.”
Paraphrasing
• Restating
• Pt – “I couldn’t eat
supper last night.”
• Nrs – “You had
difficulty eating.”
Asking broad questions
• Open-ended questions
• “Would you like to tell
me about it?”
• “Is there something you
would like to talk
about?”
Using general leads
• 1-2 works to encourage
the person to continue
• “Go on.”
• “And then…”
• “You were saying”
Stating observations
• “You seem tense.”
• “You are trembling”
Offering self
Silence
Touch
Time
• “I'd like to
understand.”
• “I’ll stay awhile if
you’d like.”
Focusing
• Directing the
conversation to a
specific topic
• "This point seems
worth looking at more
closely."
Using humor
• Laughter is the best
medicine
A = Therapeutic B = Block
• Patient: “I don’t know. I hate to have my boyfriend see
me looking like this. Just thinking about him coming to
visit makes me nervous.”
• Nurse: “You really should stop worrying. That may be
what’s keeping you from getting the rest you need. And
after all, no one expects you to look your best when
you’re in the hospital.”
A = Therapeutic B = Block
• Patient: “You’d think my doctor would have
prevented me from getting phlebitis, but he’s
too busy to care about what’s happening to
me.”
• Nurse: “You’re wrong, Mr. Iverson. Of course
he cares.”
A = Therapeutic B = Block
• Nurse: “You seem to be kind of restless
tonight.”
Patient: “Nobody cares. My doctor wants me
to go—just go on home. He doesn’t care?”
Nurse: “Go home?”
A = Therapeutic B = Block
• Patient: “Maybe I should find a hobby or something.
I try not to get discouraged; I know I shouldn’t let it
get me down.”
• Nurse: “That’s the right attitude. It really doesn’t
help to worry about it.”
A = Therapeutic B = Block
• Nurse: “How are you feeling this morning, Mr.
Patterson?”
• Patient: “Oh, fine, thanks.” (unenthusiastic)
• Nurse: That’s good.
A = Therapeutic B = Block
• Patient: “I can’t go home with this…AIDS. If they
want me out of here so bad, why don’t they just let
me die?”
• Nurse: “You can’t go home because you have AIDS?”
A = Therapeutic B = Block
• Patient: “Well, I haven’t been able to work for quite a
while now, and the doctor says I might not ever work
as a carpenter again.”
• Nurse: “It must be difficult for you right now, but I’m
sure everything will be all right.”
A = Therapeutic B = Block
• Patient: "I'm just jumpy-I get like this
sometimes. I guess it's because I didn't get too
much sleep last night."
• Nurse: "Yes, when you don't get a good night's
sleep it does make you edgy."
A = Therapeutic B = Block
• Patient: "What's there to talk about? First they
say they have to operate, and then when I'm
beginning to feel better, I get this infection. I
don't think I'm ever going to get out of here!"
• Nurse: "I know just how you feel. You know,
everyone gets frustrated when things aren't
going right."