Communication and Nursing Practice
 A lifelong learning process for nurses
 An essential attribute of professional nursing
practice
 Builds relationships with clients, families, and
multidisciplinary team members
Communication
and Interpersonal Relationships
 The means to establish helping and healing
relationships.
 The ability to relate to others is important for
interpersonal communication.
 Developing communication skills requires both
an understanding of the communication
process and of one’s own communication
experience.
 Box 24-1 presents communication throughout
the nursing process.
 Box 24-2 presents challenging communication
situations.
Levels of Communication
1. Intrapersonal
A. One-to-one interaction
between two people
2. Interpersonal
B. Occurs within an
individual
3. Transpersonal
C. Interaction with an
audience
4. Small Group
D. Interaction within a
person’s spiritual domain
5. Public
E. Interactions with a
small number of people
Basic Elements of the Communication
Process
1. Referent
A. One who encodes and one
who decodes the message
2. Sender and receiver
B. The setting for senderreceiver interactions
3. Message
C. Message the receiver
returns
4. Channels
D. Motivates one to
communicate with another
5. Feedback
E. Means of conveying and
receiving messages
6. Interpersonal variable
F. Factors that influence
communication
7. Environment
G. Content of the message
Forms of Communication
 Verbal
 Vocabulary
 Denotative and connotative meaning
 Pacing
 Intonation
 Clarity and brevity
 Timing and relevance
Nonverbal Communication
 Personal appearance
 Posture and gait
 Facial expressions
 Eye contact
 Gestures
 Sounds
 Territoriality and personal space
Other Forms of
Communication
 Symbolic
 The verbal and
nonverbal symbolism
used by others to convey
a meaning
 Metacommunication
 A broad term that refers
to all factors that
influence communication
Professional Nursing Relationships
 Nurse-client helping relationships
 Nurse-family relationships
 Nurse-health team relationships
 Nurse-community relationships
Elements of Professional
Communication
Appearance, demeanor,
and behavior
Courtesy
Use of names
Trustworthiness
Autonomy and
responsibility
Assertiveness
Therapeutic Communication
Techniques
 Attentive (active) listening – SOLER
 Sharing Observations, Empathy, Hope, Humor,
Feelings
 Using Touch
 Using Silence
 Providing Information
 Clarifying
Therapeutic Communication
Techniques
 Focusing
 Paraphrasing
 Asking Relevant Questions - Seeking validation
 Summarizing
 Self-Disclosure
 Confrontation
 Summarizing
Non-Therapeutic
Communication Techniques
 Asking personal questions
 Giving personal opinions
 Changing the subject
 Automatic response
 False Re-assurance
 Sympathy
 Asking for Explanation
 Approval or Disapproval
Non-Therapeutic
Communication Techniques
 Defensive Responses
 Passive or Aggressive Responses
 Arguing
Barriers to communication
 Agreeing or disagreeing
 Asking personal question
 Changing the subject
 Environment
 Giving advice
 Language and culture
 Passing judgment
 Physical limitation
 Stereotyping
 Testing
Adapting Communication Techniques
for Client with Special Needs
 Aging population and communication disability.
 Cultural Difference
 Impaired communication because requires special
thought and sensitivity.
 See Box – 24-10: Communicating With Clients Who
Have Special needs
 See Sample Communication Analysis.
 Critical Thinking Exercises – page 359
 NCLEX Style Questions – page 359.
Communication Within
the Nursing Process
 Assessment
 Physical and emotional factors
 Developmental factors
 Sociocultural factors
 Gender
Communication and Nursing Process
 Diagnosis
 Many clients experience difficulty with
communication




Lacking skills in attending, listening, responding, or
self- expression
Inability to articulate, inappropriate verbalization
Difficulty forming words
Difficulty with comprehension
Communication and Nursing Process
 Planning:
 Goals and outcomes:

Specific and measurable
 Setting of priorities
 Continuity of care:

Collaboration with other health care providers
Communication and Nursing Process
 Implementation:
 Therapeutic communication techniques
 Nontherapeutic communication techniques
 Adapting communication techniques
Communication and Nursing Process
 Evaluation:
 Nurses and clients need to determine whether
the plan of care has been successful.
 Nursing interventions are evaluated to determine
which strategies or interventions were effective.
 If expected outcomes are not met, the plan of
care needs to be modified.