COMMUNICATION SKILLS 8.
Trust
being as honest as possible with
Communication patients, willing to share information
Integral part of helping relationship and admitting mistakes or
Dynamic process used to gather data, to teach miscommunications
and persuade, and express care and comfort 9. Cultural Awareness
Interchanged of information or exchange of recognizing their own abilities and
ideas or thoughts paying close attention to patients,
Basic element of human interactions—establish, nurses can respond promptly to
maintain and improve contact with others challenges like language differences,
Meanings which are generated and transmitted, offer appropriate advice and
gave and received understand patient needs
Verbal and nonverbal behavior with a social 10. Compassion
context able to understand what information is
important to their patients, what kind of
10 Effective Communication Skills for Nurses tone can help them feel at ease and
better understand their concerns
1. Verbal communication
to accurately and clearly present Effective communication
information to patients, families and
doctors cornerstone of optimal patient care in
2. Nonverbal communication the healthcare landscape
communicate a powerful message reciprocal sharing of information and
without saying a word, be it positive or ideas of written, oral, and nonverbal
negative information regarding common set of
3. Active listening rules
you need to understand patient includes the use of active listening skills
concerns and interpret non-verbal cues and displaying an openness to other
fundamental for nurses to comprehend people’s ideas and thoughts
patients' concerns, fears, and questions when process of exchanging information between
4. Written communication sender and receiver is successful, it means they use a
uses when adding to patient records common set of symbols to which they both attach the
5. Presentation skills same meaning throughout the process of encoding,
ability to prioritize information, present transmitting and decoding intended message.
information in context and adjust their
presentation for an audience, timing Therapeutic communication
and developing information as it face-to-face process of interaction that focuses
becomes available on advancing the physical and emotional well-
brief other providers, like doctors and being
later nurses, on particular patient provide education and support to patients,
histories, shift updates or new protocols while maintaining objectivity and professional
6. Patient Education (Patient Teach-Back) distance
making sure patients understand their
treatment plan can help them be more Purposes of Therapeutic Communication
successful with taking medicine and
a. Collecting information to determine illnesses
completing their treatment
b. Assessing and modifying behavior
7. Making Personal Connections
c. Providing health education
easier for them to understand the
patient's needs and desires, provide Effective Communication Process
care and advocate for them with other
healthcare professionals The communication process
help patients trust the nurse and
cooperate more easily
4. Timing and Relevance- needs to be appropriate to
ensure words are heard and the message relates to the
person’s interest and concerns
Components of Communication 5. Adaptability- messages need to be altered in
1. Sender/Encoder- person or group to convey a accordance with behavior cues of the client
message to another, can be considered as the source- 6. Credibility- worthiness of belief, trustworthiness, and
encoder reliability
Encoding- selection of specific signs or symbols(codes) 7. Humor- must be used with care, used to help clients
to transmit the message such as which language and adjust to difficult and painful situations
words and what tone of voice and gestures to use
5 Steps of Attentive Listening
2. Message- what is actually said or written, body
language that accompanies the words, and how the Squarely face the person
message is transmitted
Open your posture
3. Channels- medium used to convey the message and it
targets any of the receivers senses, important to be Lean towards the sender
appropriate for the message, intent of message more Eye contact maintained
clear
Relax while attending
4. Receiver/Decoder- whom message is sent, receiver
must perceive or aware of the message; listener, must Paraphrasing
listen, observe and attend Restating the message with fewer words, where
Decoding- relate the message perceived to the receivers possibly try and get more to the point
storehouse of knowledge and experience and to sort Purpose:
out the meaning of the message
o To test your understanding of what you
5. Response/Feedback- message that the receiver
heard
returns to the sender, either verbal or nonverbal
o To communicate that you are trying to
response to the message, sender and receiver must be
understand what is being said
sensitive and open to each others message, clarify the
message and modify behavior accordingly. Active and Attentive Listening
6. Referent- motivates a person to communicate with Using all the senses as opposed to listening
another, may be an object, experience, emotions, ideas passively with just the ear
or act. Most important technique in nursing
Criteria for Effective Verbal Communication Guidelines for Active and Attentive Listening:
1. Pace and Intonation- modify feeling and impact of the 1. Requires energy and concentration
message 2. Involves paying attention to the total message,
verbal/nonverbal
Pace- indicate interest, anxiety, boredom or fear
Factors to be considered in communication
Intonation- express enthusiasm, sadness, anger or
amusement 1. Development- knowledge of client
developmental stage allow the nurse to modify
2. Simplicity- use of commonly known words/layman’s
the message accordingly
terms and not medical terms
2. Gender- females and male communicate
differently
Girls- use language to seek confirmations,
3. Clarity and Brevity- direct and simple minimize differences and establish intimacy
Clarity- saying precisely what is meant Boys- use language to establish independence
and negotiate status within the group
Brevity- using fewest words necessary
3. Values and Perceptions- each will perceive and a. Caring and warmth- conveys feeling of
interpret messages and experiences differently emotional closeness and in contact to an
Values- standard to influence behavior interpersonal approach, shown by acts of
Perceptions- personal view of events smiling and attention to physical comforts
4. Personal space- distance people prefer in b. Respect- an attitude that emphasizes the
interactions with others other person’s worth and individuality
Proxemics- study of distance between people in c. Acceptance- emphasizes neither approval or
their interactions disapproval
Four distance of Communications according to Therapeutic Communication Techniques
Tamparo and Lindh
Technique Description Examples
a. Intimate distance- characterized by body Using silence Accepting Sitting quietly or
contact heightened by sensations of body pauses and walking with the
heat and smell, and vocalizations that are silence that may client and
low extend for watching
Visions- intense, restricted to small body several minutes attentively until
part, and may be distorted(touching to 1 without the client is able
and ½ feet) interpreting any to put thoughts
b. Personal distance- less overwhelming that verbal response and feelings into
intimate distance. Voice tones are words
moderate, and body heat and smell are Providing Using “can you tell me
noticed less. Physical contacts such as general leads statements or how it is for
handshake or touching a shoulder if questions that you?”
possible. (1 and ½ to 4 feet) (a) encourage “perhaps you
c. Social distance- characterized by a clear the client to would like to
visual perception of the whole person, body verbalize (b) talk about?”
heat and odor are imperceptible, eye choose a topic “would it help to
contact is increased and vocalizations are of conversation describe your
loud enough overheard to others. (4 to 12 and (c) facilitate feelings?”
feet) continued “where would
d. Public distance- requires loud, clear verbalization you like to
vocalizations with careful enunciation, begin?”
although the faces and forms of people are Being specific Specific than “rate you pain in
seen in distance in public distance, and tentative general, a scale of 0-10”-
individuality is lost (12 to 15 feet) tentative than specific
5. Territoriality- concept of the space and things absolute statement
that are individual considers as belonging to the “are you in
self pain?”- general
6. Roles and Relationship- affect the statement
communication, choice of words, sentence “you seem
structure and tone of voice vary considerably concern with
from one to one role diabetes”-
7. Environment- extreme temperatures, excessive tentative
noise, and a poorly ventilated environment can statement
interfere with communication “you don’t care
8. Congruence- verbal and nonverbal aspects of about your
message match, this helps to prevent diabetes, and
miscommunication you never will”-
9. Interpersonal attitudes- conveys beliefs, absolute
thoughts and feelings about people and events. statement
They are communicated convincingly and Using open- Asking broad “I’d like to hear
rapidly to others ended questions that more about
questions lead the client that”
to explore, “Tell me about Client: well, “not
elaborate, it” even” he does
clarify, describe, “what brought get something
compare, you to the on my birthday
illustrate hospital?” and Christmas
thoughts or “ what is your but he never
feelings opinion?” think of giving
Using touch Providing “putting an arm me in any other
appropriate over the client, time
touch to shoulder, placing Offering self Understand the “I’ll stay with
reinforce caring your hand over client without you until your
feelings the client” making any daughter
Restating or Actively Client: I couldn’t demands arrives”
paraphrasing listening to the manage to eat “I’ll help you
client my dinner last dress to go
Repeating those night, not even home if you like”
message and the dessert Giving Providing a “your surgery is
thoughts, Nurse: you had information simple or scheduled at
feelings, will difficulty eating factual 11am
convey that the yesterday? information the tomorrow”
nurse has Client: yes, I was client may or
interest and upset when my may not request
understand the family left Acknowledging Giving “you trimmed
client Client: I have recognition in a your bears and
troubles talking non-judgmental mustache and
to strangers way of a change washed your
Nurse: you find in behavior hair”
difficult talking Clarifying time Helping the Client: I vomited
to people you do or sequence client clarify an this morning
Seeking Method of “I’m puzzled” event, situation Nurse: was that
clarification understanding “I am not sure I or happening in after the
the meaning of understand a relationship to breakfast?
the message that” time Client: I feel that
Used when “would you I have been
paraphrasing is please say that asleep for weeks
difficult or when again” Nurse: you had
communication “would you tell you operation
is rambling or me more” on Monday and
garbled today is Tuesday
Ask the client to Presenting Helping the “that telephone
repeat and reality client to ring came from
restate the differentiate the program of a
message real from unreal television
Perception Verifies the Client: my Focusing Helping the Client: my wife
checking or meaning of husband never client expand says she will
seeking specific words gives me and develop a look after me
consensual rather than presents topic of but I don’t think
validation overall meaning Nurse: you importance she can
of the message mean, he never Nurse: sounds
give you that you are
presents for worried about
your how can she
bday/Christmas? manage
Reflecting Directing ideas, Client: what can
feelings, I do?
questions or Nurse: what do
content back to you think that
client to enable can be helpful
them explore
their own ideas
and feelings
about the
situation
Summarizing Stating the main “During the past
and planning points of a hour we have
discussion to talk about”
clarify their own
ideas about the
situation
