Communication - is an interactive process that occurs when a person
(sender) sends a verbal or non- verbal message to another
person( receiver) and receives feedback. It is influenced by emotions,
needs, perceptions, values, education, culture, goals, literacy, cognitive
ability and the communication mode.
Modes of communication :
Verbal and non-verbal are exemplified in the nurse- patient scenario ,
because face to face encounters usually allow for verbal and non-verbal
exchange, they have been regarded as the most effective modes of
communication.
Verbal communication is a conscious process so the sender has the
ability to control what is said and it is generally accepted that the tone of
voice is more important than the words spoken.
When face to face encounters are not possible, or practical other
approaches can be used and the next most effective approaches is the
telephone followed by voice messages, electronic pages, e-mail
messages and written documents. – these electronic methods comprise
the third mode of communication and they will grow in importance as
nurses rely on technology particularly computers.
Levels of Communication :
Public communication – nurses rely primarily on interpersonal
communication however they may also used other levels.
Example: nurse educator presenting a workshop on s/s of menopause to
a room full middle-aged women engages in public communication..
Intrapersonal communication – ( self-talk) – is what the individual do
within themselves and can present as doubts and affirmation. A new
nurse may engage in intrapersonal communication as he simultaneously
doubts and affirms his ability to complete the procedure. Like inserting a
foley catheter ( I haven’t done it before)
Interpersonal communication- the last level involves communication
between individuals, person to person or in small groups. It allows for a
very effective level of communication to occur and incorporates all of
the elements, channels and modes previously discussed .Example: nurse
who observes patient grimace when he moves interprets the non verbal
cue as the patient is experiencing pain.
Communication goes back and forth until ideally both parties
understanding of message match.
Barriers to Communication : (obstacle)
Identify – avoid or to compensate
1. Gender – interferes with communication when men and
women lack the understanding that they may process
information differently. .
Men are more interested in using reason, to gender differences and
socializationthey are provided with more opportunities to develop
confidence and assertiveness than females
Women want to be heard and validated through communication,
The feminist movement and increased sexual equality in Western
society in general have lessened traditional sociological patterns of
competitiveness and deciveness in men and passitivity and
nurturing in women.
Culture: Diversity decreases and reduces that patient and nurse
will share a common cultural background . In turn the number of
safe assumptions about belief and practices decreases and the
probability for misunderstanding increases.. Example: shortly after
delivering a baby women are often hungry and thirsty and some
culture believe that for women to restore their energies
appropriately, they must eat hot foods and beverages while for
others were not, well intientioned nurse who does vnot consult
with the patient preferences may arrange culturally inappropriate
nourishment.
General differences : can create tensions among workers because
of the divergent outlooks on life. Different generations can have
different values about work and motivation., lifestyle and
communication.
Illiteracy: nurses need to be mindful that many individuals lack
the literacy skills o navigate health care systems and function
successfully as health care consumers.
Health literacy represent the cognitive and social skills which
determine the motivation and ability of individuals to gain access,
to understand and used information in ways to promote and
maintain good health.
Anger : is a universal, strong feeling of displeasure that is often
precipitated by a situation that frustrates or prevents a person from
attaining a goal or getting what is wanted in life. Ellis (1997)
describes anger as an irrational response that arise from one of four
irrational ideas:
1. that treatment one received was awful
2. feeling that one can not understand having been treated so
irresponsibly and unfairly
3. believing that one should not , must not behave as he
did( shoulding and musting)
4. because one acted in a terrible manner , he is a terrible
person( undeservingness and damnation)
Workplace Communication: ( diverse roles and relationship of nurses
in the workplace that calls for different communication patterns with
supervisors, co-worker, subordinates, practitioners and other health care
professionals
Delegation : defines by the ANA (1996) is the “ transfer of
responsibility for the performance of an activity from one individual to
an another while retaining accountability of the outcome” RN can
transfer the responsibility and authority for the performance of an
activity, they remain accountable for over all nursing care.
Under Delegation : Personnel in a new job role, such as nurse manager,
RN or nursing graduate often under delegate. Believing the older more
experienced staff may recent having someone new delegate to them, a
new nurse may simply avoid delegation or new nurses may seek
approval from other staff members by demonstrating their abilities to
complete all assigned duties without assistance. In addition, new nurses
maybe reluctant to delegate because they do not know trust individual on
their team or are not clear on the scope of their duties or what they are
allowed to do. New nurses can become frustrated and overwhelmed if
they failed to delegate appropriately.
Over Delegation: over delegation of duties can also place the patient at
risk. The reasons for overdelegations are numerous. Personnel may feel
uncomfortable performing duties that are unfamiliar to them, and they
may depend too much on others. They maybe an organized or inclined to
either avoid responsibility or immerse themselves in trivia. It leads to
delegating duties to personnel who are not educated for the task such as
LPN’s and UAP.
Delegation of Nursing Process : ultimately, some professional
activities involving the specialized knowledge , judgment, or skill of the
nursing process can never be delegated. This include patient assessment,
triage, nursing dx, nsg. plans of care, extensive teaching or counseling,
telephone advise, outcome evaluation, and px. discharges. Delegated
task are typically those task that occur frequently, are considered
technical by nature, are considered standard and unchanging have
predictable result and have minimal potential for risk because it usually
fall within the implementation phase of nsg. process
Assignment: is the process of designating nursing activities to be
perform by an individual consistent with the persons licensed scope of
practice.
- also defined by ANA as “ downward or lateral transfer of both the
responsibility and accountability of an activity from one
individual to another. An assignment designate those activities
that a staff member is responsible for performing as a condition of
employment and is consistent with a staff member job.
Decision Making : define as considering and selecting interventions
from a repertoire of action that facilitate the achievement of a desired
outcome.