Professional Documents
Culture Documents
NCM 103 - Communication
NCM 103 - Communication
COMMUNICATION
Communication
-any forms of exchanging information or feelings between two or more people.
-basic component of human relationships, including nursing
Our job mainly needs a consumer (Our patients or clients). Without talking to them, or
communicating with them, our relationship cannot be formed.
Communication Process:
- A two-way process involving the sending and the receiving of a message
- Has four components:
- Sender: A person or group who wishes to convey a message to another.
Considered as the source encoder.
- Source: idea or reason for communicating
- Encoding: involves the selection of specific signs/symbols
to transmit the message, such as which language or words
to use, how to arrange the words and what tone or
gestures to use
Modes of Communication
- Verbal: uses spoken/written words
- Nonverbal: Sometimes called “body language”
Includes gestures, body movements, use of touch and physical
appearance including adornment (actions that make more meaningful)
Often tells others about what a person is feeling that what is actually said;
either reinforces or contradicts what is said verbally
- Electronic Communication: a form of communication that has evolved with technology
● Simplicity
- Use of commonly understood words, brevity and completeness
- Nurses need to learn and select appropriate and understandable terms based on
the age , knowledge and culture, and education of the client
● Credibility
- Means worthiness of belief, trustworthiness and reliability
- Nurses foster credibility by being consistent, dependent honest
- Nurses need to be knowledgeable about what is being discussed and to have
accurate information.
● Humor
- Can be a positive and powerful tool in the nurse-client relationship, but it must be
used with care
- Can be used to help clients adjust to difficult and painful situations
- Consider the client’s perception of what is humorous.
- Timing should also be considered
- May be considered offensive or distracting at a peak crisis period.
● Facial Expression
- No part of the body is as expressive as the face.
- Although the face may express the person’s genuine emotions, it is also possible
to control these muscles, so the emotion expressed does not reflect the person's
feeling.
- When the message is not clear, it is important to get feedback to be sure of the
intent of expression.
- Nurses need to be aware of their own expressions and what they are
communicating to others; clients are quick to notice the nurse’s facial expression
- It is possible to control all facial expressions, but the nurse must learn to control
expressions of feelings
● Eye contact
- Acknowledges recognition of the other person and willingness to maintain
communication; a person who feels weak and defenseless often averts the eyes
or avoids eye contact
● Gestures
- Hand and body gestures may emphasize and clarify the spoken word, or they
may occur without words to indicate a particular feeling or sign.
- May be devised by the client and nurse to denote other meanings.
Electronic communication:
● Email
- Most common form of electronic information
- Advantages
- Fast, efficient and legible
- Provides a record of the date and time of the message that was sent or
received.
- Improves communication and continuity of client care
- Disadvantages
- Risk to client confidentiality
- Socioeconomics; not all have computers or computer skills
- When not to use
- When the information is urgent
- HIghly confidential information
In this case, it’s better to see or telephone the person
- Other guidelines
- Follow agency’s guidelines, like what could be emailed to clients
- Secure email consent form that the client signs
- Identify “confidential” in the subject line
- Include a disclaimer that the message is only to be read by the person
whose address appears and that no one else is to read it.
- The disclaimer should also state if the message is sent to anyone by
mistake, they should contact the sender.
- Considered to be part of the client’s medical record, a copy should be
placed in the client’s chart
- Not a substitute for effective verbal or non verbal communication
● Gender
- Girls tend to use language to seek confirmation, minimize difference and
establish intimacy
- Boys use language to establish independence and negotiate status within the
group.
● Personal Space
- The distance between people prefer interactions with others
- Proxemics: study of distance between people in their interactions
- Communication alters in accordance with four distances. Tamparo and Lindh
(2000) list the following examples:
- Intimate Distance
- Touching to 1 and ½ feet
- Characterized by body contact, heightened sensations of
body heat and smell and vocalizations that are low
- Vision is intense, is restricted to a small body part, and
maybe distorted.
- E.g. cuddling a baby, touching sightless clients and
positioning clients
- In their therapeutic roles, nurses often are required to
violate this personal space (to communicate warmth and
caring) therefore, it is important for the client to know when
this will occur and to be forewarned
- Personal Distance
- 1 ½ feet to 4 feet
- Much communication between the nurses and clients
occurs at this distance
- Voice tones are moderate
- Body heat and smell are less noticed
- Social Distance
- Characterized by clear visual perception of the whole
person, body heat is imperceptible, eye contact is
increased and vocalizations are loud enough to be
overheard by others
- More formal and limited to seeing and hearing
- Allows more activity and movement back and forth
- E.g. nurses make rounds or wave as a greeting to
someone
- Public distance
● Territoriality
- Concept of the space and things that an individual considers as a belonging to
the self
- Nurses need to obtain permission from clients to remove , rearrange or borrow
objects in the hospital area
● Environment
- People usually communicate most effectively in a comfortable environment
- Temperature extremes, Excessive noise and poorly ventilated environment can
interfere with communication
- Lack of privacy also interferes communication
● Congruence
- In congruent communication, the verbal and nonverbal aspects of the message
match
- If there is incongruence, the body language or the nonverbal communication is
usually the one with the true meaning
● Interpersonal Attitudes
- Attitudes convey beliefs, thoughts and feelings about people and events.
- Attitudes such as caring, warmth and respect and acceptance facilitate
communication
- Condescension, lack of interest and coldness inhibit communication
- Caring and warmth convey a feeling of emotional closeness, in contrast to an
impersonal approach
- Caring coveys deep and genuine conversation for the person; warmth conveys
friendliness and consideration, shown by acts of smiling and attention to physical
comforts
- Respect is an attitude that emphasizes the other person’s worth and individuality
- Acceptance emphasizes neither approval or disapproval; the nurse willingly
receives the client’s honest feelings
- An accepting attitude allows the clients to express personal feelings freely and to
be themselves
- The nurse may need to restrict acceptance in situations where clients’ behaviors
are harmful to themselves of others
● Boundaries
- Limits of individuals, objects, or relationships (Boyd, 2012)
- Professional boundaries are crucial in the context of the nurse-client relationships
- Nurses should avoid sharing personal information
- Decline invitation if client seeks friendship or relationship outside of work
environment
- Gift-giving, spending more time than necessary and believing that he/she
understands client should be addressed
- Diligent about not crossing nurse-client boundaries in an online setting
- Aylott (2011) encourages the:
- P - ause and process
- C - choices
- A - ct accountably