-Non violent communication:

• Non-Violent Communication is a way of communicating that leads us to give from the heart.
• It guides us to reframe how we express ourselves, how we hear others and resolve conflicts by
focusing our consciousness on what we are observing, feeling, needing, and requesting.
• It is a tool that leads us toward a quality of connection among people where everyone's needs are
valued and get met
• NVC teaches us to observe carefully, and to be able to specify behaviors and conditions that are
affecting us.
• four components of the NVC model:
1. Observation
2. Feeling
3. Needs
4. Request
✓First, we observe what happened,The trick is to be able to articulate this observation without
introducing any judgment or evaluation.
✓Next, we state how we feel when we observe this action: are we hurt, scared, joyful, amused,
irritated, etc.
✓And thirdly, we say what needs of ours are connected to the feelings we have identified.
✓This fourth component addresses what we are wanting from the other person that would enrich our
lives or make life more wonderful for us.

-Caring communication:
• The CARE Model is a communication technique that helps us to relate to others in a respectful,
understanding, and empathetic way.
• It encourages us to actively listen, respond without judgement, and use I-statements to express our
thoughts and feelings.
• It emphasizes the importance of being aware of how our words and actions impact others.
• Caring communication involves being open and honest, while also being respectful and
understanding of the other person's perspective.
• good communication is a two-way street of listening and responding.
• C.A.R.E. is an acronym that stands for Connect, Appreciate, Respond, and Empower.
• It is a philosophy of communication that encourages individuals to foster meaningful relationships
with one another.
✓Connect :
• C.A.R.E. encourages individuals to take the time to get to know one another
• It also encourages individuals to be open and honest with one another, to share their thoughts and
feelings.
✓Appreciate :
• C.A.R.E. encourages individuals to recognize and celebrate the unique gifts and talents that each
person brings to the group.
It also encourages individuals to express gratitude for one another.
✓Respond :
• C.A.R.E. encourages individuals to take the time to respond to one another's needs.
• It encourages individuals to listen to one another, to be understanding, empathetic and patient, and
to be willing to offer support and assistance when needed.
✓Empower:
• C.A.R.E. encourages individuals to be encouraging and supportive, to provide guidance and
assistance, and to help others reach their goals.
• It also encourages individuals to be inspiring and motivating, to be open to feedback and criticism,
and to be willing to take risks and try new things.
•Communication:
• Communication is a key element in any human activity.
• Communication is a learned skill.
• Communication takes place when we are
supposedly at the same level of understanding and comprehension.
✓Characteristics of Communication:
1. system and complex process.
2. dynamic.
3. Communication is a two-way process of reaching mutual understanding.
4. Communication is irreversible
5. Communication can be verbal/ non verbal or visual.
6. Communication can be accidental especially in non-verbal
✓There three elements account differently for the meaning of the message:
⇒ Words account for 7% Tone of voice accounts for 38% and Body language accounts for 55% of the
message.

•Effective Communication:
• Although we can all communicate, not all our communication acts are effective.
• This is that communication which produces results.
• this is communication that does not give room for misunderstanding.
• Ineffective communication is expensive to the participants because it blocks results.
• In other words its effectiveness is dependent on one's competency in communication.
✓Effective Communication skills:
1-Eye contact & visible mouth
2-Body language
3-Silence
4-Checking for understanding.
5-Smiling face.
6-Summarizing what has been said.
7-Encouragement to continue.
8-Asking some questions
✓ communication needs to be:(7Cs)
Clear,Concise,Concrete,Correct,Coherent
,complete and Courteous
✓Levels of communication:
1. Intrapersonal (Within a person)
2. Interpersonal (Face to face)
3. Group communication
4. Mass communication
5. Inter country/ Development

•Communication skills:
• Elements of communication process:
1-The sender.
2-The message.
3-The receiver.
4- Feedback.
5- Context.
✓Types of communication:
1-verbal (spoken or written).
2-non-verbal(without using words)
⇒non-verbal communication include:
1- Appearance
2- Kinesics include all body languages ( facial expression, eye contact, body movement)
3) Proxemics: distance
4) Touch
5) Paralanguage: it's include tone of voice, volume of speech,ect..
✓Relationship between verbal communication and non-verbal communication:
1- Repeating
2- Contradict
3- Complementing
4- Accenting
5- Relating and regulating
6-Substituting
✓Communication may be blocked by any of the following blocks:
1. Changing the subject of communication.
2. Destruction on environment such as loud voice.
3. Stating one's personal opinions, and ideas about the person and his situation.
4- Giving false or inappropriate (reassurance.)
5- Jumping to conclusions or offering solutions to problems.
6- Asking many questions.

✓Barriers to communication:
1- Physical Barriers
2- Cultural Barriers
3- Difference in Perception
4- Emotional barrier
5- listening barrier
6- language barrier
7- lack of subject knowledge.
✓Skills to facilities person's expression of needs and feelings:
1- Active listening:
✓Active listening is composed of six distinct components:
• Hearing: The physiological process of receiving sound and/or other stimuli.
• Attending: process of focusing attention
• Interpreting: The process of decoding the symbols.
• Evaluating: The process of deciding the value of the information to the receiver.
• Remembering: The process of placing the appropriate information into short-term or long-
term storage.
• Responding: The process of giving feedback to the source and/or other receivers.
2-General leads:These are broad openings which will encourage the person to talk.E.g:"go"
"and then".
3-Silence:
4-Empathy: Is the ability to see things home the other person's perception and
communication this understanding to other person.
✓Skills for understanding person expression:
1-Restatement: It is repeating what the person has said in nearly the same words he has
used.
• e.g. Sender: "I do not sleep. I stay awake all night".
• Receiver: "You stay awake all night:
2- Paraphrasing :This is repeating the idea that the person expressed in different words.
• e.g, Sender :- I can't sleep, I stay awake all night.
• Receiver:- "You have difficulty sleeping".
3-Validating: To achieve agreement of interpretation of an event, behavior or issue to make
sure the nurse understands.
4-Clarifying: Trying to clear up confusion about events or people,the nurse asks specif
questions until the information is completely understood.
• For example: I am not sure about what you mean?
✓Non therapeutic communication skills or techniques:
1- Advising
2- Challenging
3-Disagreeing
4- Reassuring
5-Rejecting

•Emotional intelligence:
•Definition of Emotional intelligence (EI):
It is the ability to recognize and control your emotions and behaviors in relationships with
others.
✓emotional intelligence is important and improve :
●Physical Health
● Mental well-being
● Relationships
●leadership
✓Emotional Intelligence domains:
1) Self awareness: is your ability to accurately perceive your own emotions
2) Self-management: is being aware of your emotions so you can direct your behavior in a
positive manner.
3) Social awareness: The ability to accurately pick up on the emotions of other people
4) Social/relationship management: is your ability to use your awareness of both your own
emotions and those of others to manage interactions successfully

• self awareness )‫)الوعى بقيمتى الذاتية برأيى أنا‬

- Definition of Self-awareness:
✓ is process by which the nurse gains recognition of his or her own feeling, beliefs and
attitudes.
✓ It is a consciousness of her personality.
-The importance of self-awareness in nursing :
• very important for skill development.
• knowing areas of strengths and weaknesses.
• stress management.
• work as motivation.
• change in your relationship.
- Johor window's model: It is a helpful model for understanding the nature of self
awareness.
• This model is formed of :
●The window's upper left quadrant: "open " quadrant represents a person's beliefs and
feeling that are known to the person and to others.
●The upper right quadrant, the "blind" quadrant represents those beliefs and feeling is
hidden from person's awareness, known among others
●The lower left quadrant of the josher windows: This quadrant is termed "private or
hidden". It is represents beliefs and feeling known to the person but unknown to others
●The lower right quadrant (The closed quadrant) It represents beliefs and feeling so deeply
buried in the person's unconscious mind that are unknown both to the person and to others
- Methods of increase self-awareness:
1-Introspection :(search in your self)
• is the process of observing one's own behavior in various situations and identify its themes
and patterns.
• is listening to one self
2-Self-sharing: process of disclosure of personal thought, feeling, perception and
interpretation by openly expressing that to others.
3- Enlarging one's experience: is the act of purposefully choosing to engage in unfamiliar
activities
4-Role play: exercise in which participants enact the parts of the persons involved in a real
or anticipated interaction

• Self-Concept
- Definition :
• is the mental image one has of oneself
• It is defined as one's perception of personal characteristics and abilities and interaction
with the other people and environment, values associated with experiences, objects, and
goals.
- Components of self concept:
1- identity : description of the self such as gender, names relationship, occupation physical,
attributes and personality traits.
2- Body image: It is the sum of attitude a person has toward one's own body.
3- self ideal : It is the sort of a person one would wish to be. It is the person's perception of
how to behave based on certain personal standard.
4-Self-esteem : is defined as the personal estimate of worth
- How to improve self esteem :
1. Face your fears
2. Forget your failures and learn from them.
3. Know what you want and ask for it.
4. Reward yourself when you succeed.
5. Don't be defeated
6- When you hear negative comments in your head, tell yourself you to stop.
8- Remember that there are things about yourself you can't change

• Helping relation
-Def : is an intensive interactive process characterized by a unique relationship between the
helper (The nurse) and client(patient )
- Content of Helping Relation:
1- Behavior
2- personal constructs
3- Cope
4- Decision making
-Characteristic of effective Helping Relation :
1- clarify the Purpose of helping
2- Flexibility
3- respect
4- trust
5- successful communication
6- Acceptance
7- positive regard
8- listen actively
9- Empathy
10- cultural sensitivity
- Characteristics of Effective Helper:
1- Personal warmth
2- Genuineness
3- Empathy
4- Patience
5- Unconditional positive regard
6- self awareness.
- Types of relationships :
(1) Social relation ship :
• It is primarily initiated for the purpose of friendship, socialization, companion ship, or
accomplishment of tasks.
• Communication, which may be superficial, usually focuses on sharing ideas, feelings, and
experiences and meets the basic need for people to interact.
(2) Intimate relation ship :
• A healthy intimate relation ship involves two people who are emotionally committed to
each other.
• The intimate relation ship has no place in the nurse-client interaction.
(3) Therapeutic relation ship :
Therapeutic relation ship differs from the social or intimate relation ship in many ways
because it focuses on the need, experiences, feeling and ideas of client only.
- Phases of Helping Relationship :
1-Initiating phase:-
A-pre orientation stage:-
• during this part of phase gather data about the client (his or her condition, and the present
situation).
B-Orientation Stage:
• Begins when the helper & client meet and ends when client begins to identify problems to
examine.
• During this phase the helper begin to build trust with the client.
- Characteristics of this phase :
1- Lack of Knowledge.
2- Lack of trust.
3- High level of anxiety.
4- High level of dependence.
- In this phase: Mutual expectation Testing behavior, Orientation , Contract occur.
2-Continuing or working) phase :
- this phase divided into sub phases :
A- Problem identification: patient identifies the issues or concerns causing problems.
B- Exploitation the nurse guide the client to examine feelings & responses and to develop
better coping skills and move positive
self-image
- This phase characterized by:
• There is lowering of anxiety.
• Owing to feeling of trust perceived by the client. However, some clients continue to test
the helper's trust.
• The helper and the client get to know each other.
• Both become an active participant, both are working with the client's problems and needs.
3-Clouding or resolution (Termination) phase :
• It is bringing the helping relation to a close it begin when problem resolved and end when
relationship is ended .
•Actually, the patient should have been prepared for final stage
during the beginning of the relation.

• Conflict management
- Def of conflict (disagreement-struggle): is opposing viewpoints, forces, issues, and
problems which confront individuals, groups, and institutions.
- Sources of conflict :
1. Incompatible goals.
2. Regulation
3. Personality traits, attitudes, and behaviors
4. Lack of communication
5. Values
6. Structural
7. Culture, race, and ethnicity
8. Gender and sexuality
9. Power struggle
10. Competing Work and Family Demands
11. internal struggles
- Negative impacts of conflict :
1. Stress
2. Reduced productivity
3. Negative feelings
4. Decreased satisfaction
5. Personal insult
- Negative impacts of conflict :
1. Stress
2. Reduced productivity
3. Negative feelings
4. Decreased satisfaction
5. Personal insults
- Types of conflict :
1. Inter sender conflict :Arises when an individual receives conflicting messages from two or
more sources.
2. Inter role conflict : Can occur when an individual belongs to more than one group
3. Inter person conflict: between individuals
4. Intrapersonal conflict (within individual)
As nurse struggle to balance her job requirements with her personal life and beliefs
5. Intergroup or inter-organizational conflict: Arises between two groups
6. Role overload
- Five conflict handling styles :
1. Competitive style. Win-lose (assertive but uncooperative) : This style is used when one
party pursue what is wants at the expense of others.
2. Accommodating style. Win-lose (cooperative but unassertive) : In this style one
individual or group scarifies his beliefs & wants to allow the other party to win. The actual
problem is usually not solved .
3. Avoiding style .lose-win (unassertive and uncooperative) : This approach is low on both
assertiveness and cooperativeness. It means walking away from a conflict situation.
4. Collaborating style. win-win (assertive and cooperative) : The collaborating style is high
on assertiveness and cooperativeness. It is useful when parties have significant differences,
but it is important to maintain working relations.
5. Compromising style. Lose-lose (assertive and cooperative) : The compromising style is
characterized by moderate levels of assertiveness and cooperativeness.
- Strategies to resolve conflict :
1-Recognize conflict early
2-Be proactive
3-Actively listen
4-Remain calm
5-Define the problem.
6-Seek a solution.
7-Empathy
8-Exploration
9-Cognitive Restructuring
10-Stroking
11-Patience
12-Assertiveness

Change management
- Def of change: is a dynamic process that can be external to us and coming from forces
around us(air and temperature)or it can be the intenal personnel change we experience as
we grow; mature and develop our own personality
- Change can be spontaneous or it can be planned
- Type of change:
1- developmental change :
• Have to do psychosocial change in the person experience and the normal life cycle stages
and can there for be apart of planned change
2- situational changes :
• that are external or accidental(un planed) to the client
- Theories of change :
• The developmental change process is complex, continuous, orderly and unique to the
person.
•Change can be spontaneous,or it can be planned.It has three steps :
(1) unfreezing ( motivation to change, disturbing the equilibrium, or breaking habit by
introducing new behaviors while retaining old patterns
(2) moving (Change is self creating new habits and modifying attitudes)
(3) Refreezing (Integrating of change into a steady state of behavior)
- Change process that is either spontaneous or planned includes the following responses:
(1) feelings of tension, anxiety, or even fear
(2)a sense of need
(3) feeling of hope
(4) a search
(5) decision and goal setting,
(6) commitment to goals and change
(7) creative behavior
(8) change in behavior or even fear
- Risks of change :
1- The greatest risk involved in change is the risk of losing the wholeness or identity
2- Second risk involved in the change process is the stress response
3- The third risk is loss: whether perceived as positive or negative change involves a sense of
loss of the familiar of the way.
4- Risk of change also brings up other unfamiliar and frightening feelings.
5- Psychological or physical illness
- Forces for Changes :
A- Driving force
B- Restraining Force
- Driving force:
• Facilitate change (Push the persons toward the change).
• Pressure from other.
• Desire to please.
• Perception that change will be improve one's self image.
• The belief that the change will improve the situation.
- Restraining Forces:
• Impede change (Pull the persons away from the change).
• These forces can be :
a-Conformity to normal.
b-Ethics.
c-Morals.
d-Perception of economic threats.
- Resistance to change : is any behavior that will oppose, obstruct, or block movement in the
change process.
- Ways to overcome resistance :
1- Know as much as possible about the client and the system.
2- Know the reasons for the resistance.
3-ncreas trust between client and the nurse
4- Active and open communication should be encouraged.
5- Answers to questions to alleviate fears.
6- Supportive persons may be helpful to the individual confronting change.
7- Encourage participation and decision makimg will encourage involvement in change

• Group dynamics
- Def of Group : defined as a number of individuals who join together to achieve a goal
required from them.
- Types of groups :
1-Formal groups :
• these groups are consciously created by the organization with the intent to accomplish its
objective.
• Formal groups can be further divided into different types :
A. Command group : It is a group determine by the connection between individual who are
a formal part of the organization. (e.g.),the nurse manager and other nursing staff.
B. Task group : A task group is created by the management to accomplish certain tasks.
C. Functional group : created by an organization to accomplish specific goals within an
unspecified time frame
2-Informal groups: Informal groups are groups that develop spontaneously, without any
direction from the organization
- Group Dynamics : refers to the study of human behaviors in a group.
- Stages of group formation :
1- Forming :
• the members try to know more about the tasks to be performed.
• Goals are not yet established, leadership not determined.
2-Storming: The members accept the existence of the group, but they are still resisting the
constraints the group poses for them.
3-Norming: relationship became close between the members and the group demonstrates
cohesiveness
4- Performing: During this stage, the group members work effectively and efficiently
towards achieving the group.
5- Adjourning: In this stage the group prepares for disbandment.
- All teams are groups but not all groups are teams.

• Comparison between group and team :

Basis for comparison Group Team

Meaning is a collection of individuals
who coordinate their
individual efforts.
No of leaders A group have only leader.
Members Are independent
Focuses on Accomplishing individual
goals
Responsibility Don't share responsibilities
Process The process of a group is to
discuss the problem, then
decide and finally delegate
the tasks to individual
members
Conflict Members of group are
bothered by the conflict.
Conflict resolution In group there is no process
for conflict resolution
is a group of peoplewho
share a common team
purpose and a number of
challenging goals.
More than one leader.
Are interdependent
Accomplishing team goals
Share responsibilities
Team discusses the
problem,then decide the
way of solving and finally do
it collectively.
Members of a team see
conflict as part of problem
solving.
in team there is provision
for conflict resolution.
 Freedom In groups members are very Open communication
cautious about what they
say and are afraid to ask
Diverse perspective Diverse Perspective may not Welcomed
be welcomed

- Eight Cs for Team Building:

1. Clear Expectations
2. Commitment
3. Competence
4. Control
5. Collaboration
6. Communication
7. creativity
8. Coordination

- Factors Affecting Group Performance :

1. Group Member Resources: The members' knowledge, abilities, skills; and personality
charact (sociability, self-reliance, and independence)
2. Group Structure:
A-Group Size
B-Group Roles
C- Group norms
D- cohesiveness
3- Group process : (taking decisions,..)