Obj 18- Communication Process Providing Information- Providing relevant information
tells other people what they need/want to know to make
Difference of Therapeutic, Non-
decisions, experience less anxiety, feel safe/secure, and
Therapeutic, Interviewing and Social an integral aspect of health teaching. Patients have right
Communication to know about their health status and what’s happening
Therapeutic Communication- Specific responses that in their environment.
encourage the depression of feelings/ideas and convey Clarifying- Restate an unclear message to clarify the
acceptance and respect. sender's message. Without clarification, there can be
Active Listening- Being attentive to what the patient is invalid assumptions and miss valuable information.
saying both verbally and nonverbally. Focusing- Centers a conversation on key elements.
S- Sit facing patient. Present and interested. Paraphrasing- Restating another's message using your
U- Uncross legs and arms. Open to what the patient says. own words. Send feedback to the sender that you are
R- Relax. Comfortable with patient. involved with their understanding.
E- Eye contact. Involved and willing to listen. Validation- Technique used to recognize/acknowledge a
T- Touch. Communicate empathy. patient’s thoughts, feelings, and needs. Patients and their
Y- Your intuition. Trust in your intuition as confidence families know that they have been heard when the
grows to individualize/apply communication techniques. caregiver addresses their issues.
Sharing Observations- Make observations on how a Asking Relevant Questions- Can seek information
patient looks/sounds/acts. Helps start a conversation with needed for decision making. Ask questions one at a time
quiet/withdrawn patients. Differs than assumptions. and fully explore one topic before moving onto another.
Sharing Empathy- The ability to understand and accept Summarizing- Review of key aspects of an interaction.
a person's reality, feelings and communicate this Can bring a sense of satisfaction/closure to conversation.
understanding to the other person. Enables nurses to Self-Disclosure- True personal experiences about
understand a patient's feelings/situation/concerns. yourself that are intentionally revealed to another person.
Sharing Hope- Hope is essential for healing. Use of Shows the patient that the nurse understands their
appropriate encouragement and positive feedback of a experiences and that they are not alone/unique.
patient's behavior, performance or response. Confrontation-Help the other person to become more
Sharing Humor- Coping strategy that can reduce aware of inconsistencies in their feelings/attitudes.
anxiety and promote positive feelings. Enhances Non-Therapeutic Communication- Damages
teamwork, relieves tension and helps nurses develop a professional relationships. Blocks and causes recipients
bond between people who laugh together. Be careful to activate defenses to avoid being hurt negatively.
when using humor with a patient of a different cultural Discourages further expression of feelings/ideas and
background. Humor is very culturally-based and can be leads to negative responses/behaviors.
misunderstood. Asking Personal Questions- Asking personal questions
Sharing Feelings- Feelings are not right/wrong or not relevant to the situation to satisfy your curiosity is
good/bad. Not expressing feelings can lead to stress and not appropriate. Can be nosey, invasive and unnecessary.
illness. Give patients permission to express negative Patients will share information if they want.
emotions. Do NOT take patient anger personally. Giving Personal Opinions- Takes decision-making
Using Touch- Touch is one of the most potent and away from patient/family, stalls problem solving and
personal forms of communication. Expresses concern or creates doubt. Different from professional advice and the
care that can establish a feeling of connection and problem/solution belongs to patient/family.
promote healing. Should be gentle or firm as needed and EX- giving suggestions with options/letting
delivered in a nonthreatening manner. Can promote a them make the decision.
bonding moment with the patient. Changing Subject- Rude and shows lack of empathy.
Using Silence- Allows time for patients to gather Blocks further communication and sender withholds
thoughts, sort out feelings and think about how to say important messages/fails to openly express feelings.
things. Allows patients to break silence and is useful Automatic Responses- Stereotype remarks about others
when people are confronted with decisions that require reflects poor judgment and threatens relationships. Can
thought. Therapeutic during times of sadness and grief.
,belittle others feelings and minimize the importance of a Timing/Relevance- Communication while performing
message. Can show that you're not taking it seriously. assessments, giving medications, and performing
EX- Saying older adults are always confused procedures are good opportunities to talk with patients.
and saying you can't win them all. NonVerbal Communication- Include 5 senses and
False Reassurance- Gives false assurances and everything that does NOT involve spoken/written words.
discourages open communication. Offering reassurance Usually unconsciously motivated and accurately
not supported by facts does more harm than good. indicates the meaning than the spoken words.
Sympathy- Pity for another person. Prevent effective Interpreting can be a challenge and sociocultural
problem solving and impair good judgment. background has major influences on the meanings.
Asking for Explanations- Patients interpret why EX- Tone, eye contact and body position
questions as accusations or think the nurse knows the Physical Appearance- Communicate physical
reason and is testing them. Causes resentment, insecurity well-being, personality, social status, occupation,
and mistrust. religion, culture and self-concept. First impressions
Aggressive- Provoke confrontation at people’s expense. largely based on physical appearance.
Approval/Disapproval- Sends a message that you have EX- Dress, grooming and facial expression
the right to make judgements about patient decisions. Do Posture/Gait- Form of self expression. Erect posture can
not use “should, ought, good, bad, right or wrong” communicate a sense of confidence, leaning forward
Defensive- Implies that the other person has no right to means attention, and slumped posture/shuffling can
their opinion and ignores the sender's concerns. mean depression, illness and fatigue.
Passive- Avoids conflict and sidestep issues. Can reflect Facial Expression- Face is the most expressive part of
feelings of sadness, fear, powerlessness and hopelessness the body. Some people have expressionless faces that
Arguing- Denies that their perceptions are real/valid. reveal little about what they feel/think. An inappropriate
Interviewing Communication- Guided technique facial expression does not match the verbal message
used to encourage patients to share their thoughts, (smiling when describing a sad event).
beliefs, fears and concerns with the aim of changing Eye Contact- People signal readiness to communicate
their health behavior. Delivered in non judgemental way. through eye contact. Maintaining eye contact means
Social Communication- Establishes a foundation for showing respect/willingness to listen. Allows people to
building trust with patients. Encompasses forms of observe. Lack of eye contact can mean anxiety,
communication that help delivery of effective healthcare. defensiveness, discomfort and lack of confidence.
Verbal and Nonverbal Behaviors Gestures- Emphasize and clarify the spoken word. Can
carry specific markings/create messages.
Verbal Communication- Medical terminology is
EX- Pointing finger with stern voice
unfamiliar to many patients. Children have more limited/
Sounds- Help send a message and communicate feelings
concrete vocabulary than adults and use slang unfamiliar
and thoughts.
to adults.
EX- Crying can be sadness or happiness
Vocabulary- Even those who speak same language use
Territoriality- The need to gain, maintain and defend
sub-cultural variations of certain words
one's right to space. Territory gives a person a sense of
EX- Supper=Dinner
privacy, identity, security and control.
Denotative Meaning- Words having several meanings
Space- Personal space is invisible, individual and travels
and understood by sharing common language.
like a bubble with a person wherever they go. Depends
Connotative Meaning- Interpretation of the meaning of
on culture, nature of relationship and situation. When
the word influenced by thought/feelings of ideas
invaded, people become defensive/communicate less.
Pacing- More successful conversation if at appropriate
Metacommunication- All factors that influence
speed/pace. Thinking before speaking.
communication. The sum of verbal and nonverbal
Intonation- Tone of voice changes the meaning of the
communication.
message. It’s not what you say, but how you say it.
Clarity- Speak simple and direct, enunciate clearly and
use examples to make explanations easier to understand.
, Communication Process Influences physical/emotional comfort and safety. Privacy level,
Each person is both the sender and receiver. noise level, comfort/safety level and distraction level.
Communication is continuous and both parties interpret EX- Noise/Distractions ≠ good environment.
messages based on their views. Feedback from receiver Physcophysicological- Internal factors affecting
enables communicators to validate the communication. communication. Physiological status (pain/hunger),
emotional status (anger), growth status (age), attitudes,
values/beliefs (meaning of illness), personality (introvert
vs extrovert), and self-esteem (positive vs negative).
Relational- Social, working, or helping relationship,
level of trust among participants, level of caring
expressed, level of self-disclosure among participants,
shared history, and balance of power/control.
Situational- The reason for communication. The
information exchange, goal achievement, problem
resolution and feelings expression.
Culture- Sociocultural elements that affect an
interaction. Can be education level, language, customs
Referent- Something that motivates one person to and expectations.
communicate Cues/Stimulants to communicate Gender- Men tend to be more direct/action-oriented,
EX- Sights, sounds, perceptions and ideas. while women tend to be more relationship-oriented. Men
Sender and Receiver- The person sending a message focus on getting to the point, while women prioritize
building to the point.
is the sender. The person who receives the message is the
receiver. The more the sender and receiver have in Developmental- Most language development happens
common/the closer the relationship, the more likely they in early childhood, and patterns that develop can impact
will accurately perceive one another’s message. how a person communicates throughout their entire life.
Communication with Patients with Hearing Loss-
Message- The content of the communication. It
Make sure patient knows you’re talking, face patient,
contains verbal/nonverbal expressions of thought and
speak clearly/slowly, and allow patient time to respond.
feelings. As a nurse, you send effective messages by
Communication with Non-English Speaking Patients-
expressing clearly, directly, and in a manner familiar to
Assess level of patients primary language and level of
the patient. Communication may be difficult for people
fluency in English, provide medical interpreters and
with a different level of education or experience.
incorporate patients communication methods/needs.
Channels- Sending and receiving messages through
Nursing Process to Communication Needs
visual, auditory, and tactile senses. Facial expressions
Assessment- Verbal interviewing, history taking,
send visual messages, spoken words travel through
observations through nonverbal communication, visual/
auditory channels. Individuals usually understand tactile during physical exam, written medical records,
messages better when several channels are used. tests and literature review.
Feedback- Message sender receives back from Diagnosis- Analysis of assessment findings. Validation
receiver. Indicates if receiver understood the intended of healthcare needs/priorities given from verbal
message. Continuously between sender and receiver. discussion with patients
Interpersonal Variables- Factors within both the Planning- Written/Verbal referral to healthcare
sender and receiver that influence communication. workers/documentation of expected outcomes.
EX- Education, developmental level, sociocultural Implementation- Delegation and verbal discussion
background, values/beliefs, gender, age, physical health with healthcare workers. Verbal, visual, auditory and
status, pain and anxiety. tactile health teaching activities. Support given from
Environment- Setting for sender/receiver interaction. therapeutic communication techniques
An effective communication setting gives participants Evaluation- Comparison of actual and expected
outcomes and factors influencing outcomes.
tells other people what they need/want to know to make
Difference of Therapeutic, Non-
decisions, experience less anxiety, feel safe/secure, and
Therapeutic, Interviewing and Social an integral aspect of health teaching. Patients have right
Communication to know about their health status and what’s happening
Therapeutic Communication- Specific responses that in their environment.
encourage the depression of feelings/ideas and convey Clarifying- Restate an unclear message to clarify the
acceptance and respect. sender's message. Without clarification, there can be
Active Listening- Being attentive to what the patient is invalid assumptions and miss valuable information.
saying both verbally and nonverbally. Focusing- Centers a conversation on key elements.
S- Sit facing patient. Present and interested. Paraphrasing- Restating another's message using your
U- Uncross legs and arms. Open to what the patient says. own words. Send feedback to the sender that you are
R- Relax. Comfortable with patient. involved with their understanding.
E- Eye contact. Involved and willing to listen. Validation- Technique used to recognize/acknowledge a
T- Touch. Communicate empathy. patient’s thoughts, feelings, and needs. Patients and their
Y- Your intuition. Trust in your intuition as confidence families know that they have been heard when the
grows to individualize/apply communication techniques. caregiver addresses their issues.
Sharing Observations- Make observations on how a Asking Relevant Questions- Can seek information
patient looks/sounds/acts. Helps start a conversation with needed for decision making. Ask questions one at a time
quiet/withdrawn patients. Differs than assumptions. and fully explore one topic before moving onto another.
Sharing Empathy- The ability to understand and accept Summarizing- Review of key aspects of an interaction.
a person's reality, feelings and communicate this Can bring a sense of satisfaction/closure to conversation.
understanding to the other person. Enables nurses to Self-Disclosure- True personal experiences about
understand a patient's feelings/situation/concerns. yourself that are intentionally revealed to another person.
Sharing Hope- Hope is essential for healing. Use of Shows the patient that the nurse understands their
appropriate encouragement and positive feedback of a experiences and that they are not alone/unique.
patient's behavior, performance or response. Confrontation-Help the other person to become more
Sharing Humor- Coping strategy that can reduce aware of inconsistencies in their feelings/attitudes.
anxiety and promote positive feelings. Enhances Non-Therapeutic Communication- Damages
teamwork, relieves tension and helps nurses develop a professional relationships. Blocks and causes recipients
bond between people who laugh together. Be careful to activate defenses to avoid being hurt negatively.
when using humor with a patient of a different cultural Discourages further expression of feelings/ideas and
background. Humor is very culturally-based and can be leads to negative responses/behaviors.
misunderstood. Asking Personal Questions- Asking personal questions
Sharing Feelings- Feelings are not right/wrong or not relevant to the situation to satisfy your curiosity is
good/bad. Not expressing feelings can lead to stress and not appropriate. Can be nosey, invasive and unnecessary.
illness. Give patients permission to express negative Patients will share information if they want.
emotions. Do NOT take patient anger personally. Giving Personal Opinions- Takes decision-making
Using Touch- Touch is one of the most potent and away from patient/family, stalls problem solving and
personal forms of communication. Expresses concern or creates doubt. Different from professional advice and the
care that can establish a feeling of connection and problem/solution belongs to patient/family.
promote healing. Should be gentle or firm as needed and EX- giving suggestions with options/letting
delivered in a nonthreatening manner. Can promote a them make the decision.
bonding moment with the patient. Changing Subject- Rude and shows lack of empathy.
Using Silence- Allows time for patients to gather Blocks further communication and sender withholds
thoughts, sort out feelings and think about how to say important messages/fails to openly express feelings.
things. Allows patients to break silence and is useful Automatic Responses- Stereotype remarks about others
when people are confronted with decisions that require reflects poor judgment and threatens relationships. Can
thought. Therapeutic during times of sadness and grief.
,belittle others feelings and minimize the importance of a Timing/Relevance- Communication while performing
message. Can show that you're not taking it seriously. assessments, giving medications, and performing
EX- Saying older adults are always confused procedures are good opportunities to talk with patients.
and saying you can't win them all. NonVerbal Communication- Include 5 senses and
False Reassurance- Gives false assurances and everything that does NOT involve spoken/written words.
discourages open communication. Offering reassurance Usually unconsciously motivated and accurately
not supported by facts does more harm than good. indicates the meaning than the spoken words.
Sympathy- Pity for another person. Prevent effective Interpreting can be a challenge and sociocultural
problem solving and impair good judgment. background has major influences on the meanings.
Asking for Explanations- Patients interpret why EX- Tone, eye contact and body position
questions as accusations or think the nurse knows the Physical Appearance- Communicate physical
reason and is testing them. Causes resentment, insecurity well-being, personality, social status, occupation,
and mistrust. religion, culture and self-concept. First impressions
Aggressive- Provoke confrontation at people’s expense. largely based on physical appearance.
Approval/Disapproval- Sends a message that you have EX- Dress, grooming and facial expression
the right to make judgements about patient decisions. Do Posture/Gait- Form of self expression. Erect posture can
not use “should, ought, good, bad, right or wrong” communicate a sense of confidence, leaning forward
Defensive- Implies that the other person has no right to means attention, and slumped posture/shuffling can
their opinion and ignores the sender's concerns. mean depression, illness and fatigue.
Passive- Avoids conflict and sidestep issues. Can reflect Facial Expression- Face is the most expressive part of
feelings of sadness, fear, powerlessness and hopelessness the body. Some people have expressionless faces that
Arguing- Denies that their perceptions are real/valid. reveal little about what they feel/think. An inappropriate
Interviewing Communication- Guided technique facial expression does not match the verbal message
used to encourage patients to share their thoughts, (smiling when describing a sad event).
beliefs, fears and concerns with the aim of changing Eye Contact- People signal readiness to communicate
their health behavior. Delivered in non judgemental way. through eye contact. Maintaining eye contact means
Social Communication- Establishes a foundation for showing respect/willingness to listen. Allows people to
building trust with patients. Encompasses forms of observe. Lack of eye contact can mean anxiety,
communication that help delivery of effective healthcare. defensiveness, discomfort and lack of confidence.
Verbal and Nonverbal Behaviors Gestures- Emphasize and clarify the spoken word. Can
carry specific markings/create messages.
Verbal Communication- Medical terminology is
EX- Pointing finger with stern voice
unfamiliar to many patients. Children have more limited/
Sounds- Help send a message and communicate feelings
concrete vocabulary than adults and use slang unfamiliar
and thoughts.
to adults.
EX- Crying can be sadness or happiness
Vocabulary- Even those who speak same language use
Territoriality- The need to gain, maintain and defend
sub-cultural variations of certain words
one's right to space. Territory gives a person a sense of
EX- Supper=Dinner
privacy, identity, security and control.
Denotative Meaning- Words having several meanings
Space- Personal space is invisible, individual and travels
and understood by sharing common language.
like a bubble with a person wherever they go. Depends
Connotative Meaning- Interpretation of the meaning of
on culture, nature of relationship and situation. When
the word influenced by thought/feelings of ideas
invaded, people become defensive/communicate less.
Pacing- More successful conversation if at appropriate
Metacommunication- All factors that influence
speed/pace. Thinking before speaking.
communication. The sum of verbal and nonverbal
Intonation- Tone of voice changes the meaning of the
communication.
message. It’s not what you say, but how you say it.
Clarity- Speak simple and direct, enunciate clearly and
use examples to make explanations easier to understand.
, Communication Process Influences physical/emotional comfort and safety. Privacy level,
Each person is both the sender and receiver. noise level, comfort/safety level and distraction level.
Communication is continuous and both parties interpret EX- Noise/Distractions ≠ good environment.
messages based on their views. Feedback from receiver Physcophysicological- Internal factors affecting
enables communicators to validate the communication. communication. Physiological status (pain/hunger),
emotional status (anger), growth status (age), attitudes,
values/beliefs (meaning of illness), personality (introvert
vs extrovert), and self-esteem (positive vs negative).
Relational- Social, working, or helping relationship,
level of trust among participants, level of caring
expressed, level of self-disclosure among participants,
shared history, and balance of power/control.
Situational- The reason for communication. The
information exchange, goal achievement, problem
resolution and feelings expression.
Culture- Sociocultural elements that affect an
interaction. Can be education level, language, customs
Referent- Something that motivates one person to and expectations.
communicate Cues/Stimulants to communicate Gender- Men tend to be more direct/action-oriented,
EX- Sights, sounds, perceptions and ideas. while women tend to be more relationship-oriented. Men
Sender and Receiver- The person sending a message focus on getting to the point, while women prioritize
building to the point.
is the sender. The person who receives the message is the
receiver. The more the sender and receiver have in Developmental- Most language development happens
common/the closer the relationship, the more likely they in early childhood, and patterns that develop can impact
will accurately perceive one another’s message. how a person communicates throughout their entire life.
Communication with Patients with Hearing Loss-
Message- The content of the communication. It
Make sure patient knows you’re talking, face patient,
contains verbal/nonverbal expressions of thought and
speak clearly/slowly, and allow patient time to respond.
feelings. As a nurse, you send effective messages by
Communication with Non-English Speaking Patients-
expressing clearly, directly, and in a manner familiar to
Assess level of patients primary language and level of
the patient. Communication may be difficult for people
fluency in English, provide medical interpreters and
with a different level of education or experience.
incorporate patients communication methods/needs.
Channels- Sending and receiving messages through
Nursing Process to Communication Needs
visual, auditory, and tactile senses. Facial expressions
Assessment- Verbal interviewing, history taking,
send visual messages, spoken words travel through
observations through nonverbal communication, visual/
auditory channels. Individuals usually understand tactile during physical exam, written medical records,
messages better when several channels are used. tests and literature review.
Feedback- Message sender receives back from Diagnosis- Analysis of assessment findings. Validation
receiver. Indicates if receiver understood the intended of healthcare needs/priorities given from verbal
message. Continuously between sender and receiver. discussion with patients
Interpersonal Variables- Factors within both the Planning- Written/Verbal referral to healthcare
sender and receiver that influence communication. workers/documentation of expected outcomes.
EX- Education, developmental level, sociocultural Implementation- Delegation and verbal discussion
background, values/beliefs, gender, age, physical health with healthcare workers. Verbal, visual, auditory and
status, pain and anxiety. tactile health teaching activities. Support given from
Environment- Setting for sender/receiver interaction. therapeutic communication techniques
An effective communication setting gives participants Evaluation- Comparison of actual and expected
outcomes and factors influencing outcomes.
