COMMUNICATION SKILLS

F.MBURU
 Objectives

• Define communication
• State elements/components of communication
• Describe methods/forms of communication
• Describe techniques of therapeutic /effective
communication
• State styles of communication
• Discuss barriers to effective communication
Communication

Definition
• Communication is the process by which
information, feelings, ideas and facts are
transmitted from one person to another person
by means of words, gestures or signs
• The sending and receiving of a message.
Communication

• Human interaction
– Verbal and nonverbal
– Written and unwritten
– Planned and unplanned
• Conveys thoughts and ideas
• Transmits feelings
• Exchanges information
• Means various things
 The communication process
Elements/components of the communication process

• Sender (the one who conveys the message to

another person)
– Source-encoder
• Message (the thought, idea, or emotion conveyed)
-What is actually said/written, body language
• Channel - how the message is sent.
– How words are transmitted
• Receiver (the receiver’s response to the sender.)
– Listener  decoder  perception of intention
• Feedback  Response
 Sender
• Sender or source is the individual who generates
and sends the message
• They encode the information and send out through
a channel
• Encode is selecting specific symbols and signs in
transmitting the message
 Message

• Message consist of stimuli both verbal (words

spoken or written) and non verbal (signs or
gestures) that are generated by the source
• Complete product of communication process
Channel

• This is the medium through which the message

is transmitted-
• Communication medium relies on primary sense
of seeing, hearing, feeling /tactile sense
 Receiver/ Decoder

• It the the individual receiving the message

• He/she receives then interprets
• Factors that can influence
i)Social system in which they live
ii)Emotions and psychological status
iii)Communication skills they posses
 Feedback

• Information the sender receives as a reaction to the

message
• In form of answers, questions or clarification of facts
• Feedback is effective when both the sender and
receiver are effective and sensitive to each others
message and modify behavior responsibly
Methods/forms of communication

• Verbal - Speaking(oral), Listening, Writing,

Reading.

• Nonverbal - Gestures, facial expressions,

posture and gait, tone of voice, touch, eye
contact, body position, physical appearance.
Nonverbal communication
• Body language
– Gestures, movements, use of touch
• Essential skills: observation, interpretation
– Personal appearance
– Posture and gait
– Facial expression of self, others; eye contact
• Gestures
– Cultural component
Factors that influence communication
process
• Developmental age
• Gender
• Sociocultural characteristics
• Values and perception
• Personal space and territoriality
• Roles and relationships
• Environment
• Attitudes
• Education
Styles of communication

Three types of style:

• Passive - apologetic, weak, makes little eye
contact, often fidgety.
• Aggressive - haughty, angry, demanding,
shows no concern for anyone else’s feelings
• Assertive - honest, direct, firm, makes eye
contact, confident, respectful of others.
Therapeutic communication

• Sometimes called effective communication, it

is purposeful and goal-oriented, creating a
beneficial outcome for the client.
• Interactive process between nurse and
client/patient
• Helps client overcome temporary stress
– To get along with other people
– Overcome psychological blocks
Therapeutic communication

• Established with purpose of helping client

• Nurse responds to content
– Verbal, nonverbal
Goals of Therapeutic Communication
• To obtain or provide information
• To develop trust
• To show caring
• To explore feelings
Relationship characteristics

• Characteristics of therapeutic relationship

– Intellectual and emotional bond
• Focused on client
– Respects client as individual
– Respects client confidentiality
– Focuses on client’s well-being
– Based on mutual trust, respect, acceptance
Therapeutic communication techniques
• Empathizing
• Active listening
• Clarifying/validating.
• Paraphrasing.
• Asking open questions.
• Reflecting.
• Attending.
• Summarizing.
• Feedback.
• Silence.
Therapeutic communication techniques
• Empathizing
– Empathy is process
• People feel with one another
• Embrace attitude of person who is speaking
• Grasp idea that what client has to say
important
– NOT synonymous with sympathy
– Interprets clients feelings without inserting
own
Active Listening

• The process of hearing spoken words and

noting nonverbal behavior.
• Active listening takes energy and concentration.
• Attentive listening
– Mindful listening
– Paying attention to verbal, nonverbal
– Noting congruence
– Absorbing content and feeling
– Listening for key themes
– Be aware of own biases
– Highly developed skill
Clarification
• Clarifying
– Attempt to understand client’s statement
– Ask client to give an example
• Paraphrasing
This is restating the patients problem to confirm
that you understand especially during counseling
section
– Nurse assimilates or restates in own words
– Gives nurse opportunity to test understanding
Open ended questioning

• Questioning
– Very direct way of speaking with clients
– Open-ended questions focuses the topic
– Close question limits choice of responses
– Careful not to ask questions that steer answer
Reflection
• Reflecting
– Repeating the client’s message
• Verbal or nonverbal
– Reflecting content repeats client’s statement
• May be misused, overused
• Use judiciously
– Reflecting feelings
• Verbalizing implied feelings in client’s
comment
– Encourages client to clarify
Attending

• Physical attending
– Face the person
– Adopt an open posture
– Lean toward the person
– Maintain good eye contact
– Try to be relatively relaxed
Summarizing
• Summarizing
– Highlighting the main ideas expressed
– Conveys understanding
– Reviews main themes of conversation
– Use at different times during interaction
– Don’t rush to summarize
Giving feedback

• Nurse share reaction to what client said

• Give in a way that does not threaten client
• Risk of client experiencing feedback
– Personal rejection
• Nurses should be open, receptive to cues
Silence

• Using silence
– Encouraging the client to communicate
– Allowing client time to ponder what has been
said
– Allow client time to collect thoughts
– Allow client time to consider alternatives
– Look interested
– Uncomfortable silence should be broken
Listening and observing

• Listening and observing are two of the most

valuable skills a nurse can have.
• These two skills are used to gather the
subjective and objective data for the nursing
assessment.
Determinant factors in communication

A nurse’s communication is affected by:

• Past experiences
• State of health
• Home situation
• Workload
• Staff relations
• Self-Awareness
Determinant factors in communication

A client’s communication is affected by:

• Social Factors
• Religion
• Family situation
• Level of consciousness
• Stage of Illness
• Visual, hearing and Speech ability
• Language Proficiency
Three phases of
Nurse-Client communication

• Introduction: Fairly short; expectations

clarified; mutual goals set
• Working: Major portion of the interaction;
used to accomplish goals outlined in
introduction; feedback from client essential.
• Termination: Nurse asks if client has
questions; summarizing the topic is another
way to indicate closure.
Enhancing communication

• Self-Disclosure.
• Caring.
• Genuineness.
• Warmth.
• Active Listening.
• Empathy (the capacity to understand
another’s feelings).
• Acceptance and respect.
Barriers to communication

Some barriers include:

• Closed questions.
• False reassurance.
• Judgmental responses.
• Defensive reflex.
• Agreeing/Disagreeing or Approving/
Disapproving.
• Giving advice.
• Requesting an explanation.
• Changing the subject.
The Nurse’s communication

• Nurses are always in communication during

care delivery. They use various ways to
communicate to include; oral, written, non
verbal, self-reflection.
Oral communication

Nurses communicate within many

different relationships, each with their
own rules.
• Nurse-Nurse
• Nurse-Nursing assistant
• Nurse-Student Nurse
• Nurse-Physician/Doctor
• Nurse-Other Health Professionals
• Group Communication (I.e. client-care
conferences)
Written communication

Nurses’ communications are often

written:
• On charts
• Requisitions for x-rays and other tests and
services
• Electronic communications, via computer
• Telemedicine: the use of communications
technology to transmit health information
from one location to another.
 Facts about effective communication

• Effective communication is critical to the successful

delivery of health care services
• Recommends an approach to communicating health
information that encompasses language needs,
individual understanding, and cultural and other
communication issues
Facts about effective communication

• Most of clients chief complain in the hospital are

due to poor communication
• The best person to deal with patients complain is
the nurse hence the nurse should have
therapeutic communication
Application of communication in Nursing

• Used in nurse patient interaction in history

taking-interviewing
• When performing nursing procedure e.g. giving
injection, wound dressing
• Nurse-nurse or team member interaction
• Reporting
• Client teaching
• Conflict management
 Principles of Report Writing

• Report is exchange of information shared between

care givers in a number of ways
• Report is either oral or written

Oral report
• Given when information is in immediate use e.g.
handing over by nurses
-Nurses to the in charge
-Nurses to doctors
-Doctors to nurses
-Nurses to nurses
 Principles of report writing
Written report
• Used when information is for use for several
people
• Acts as a permanent record (incident report,
change of shift report, legal report

Purposes of report writing

• Shows the kind and amount of services rendered
for specified period of time
• Illustrate progress
• Study health condition (research)
• They can also substantiate legal claims
 Types of reports

Change of shift
• Given orally and provides objectives information
• Gives only essential background information e.g.
name, sex, diagnosis medical history and current
treatment
• During the report, identify clients needs without going
through all biographical sheets
• Stress on recent changes, clarifying on priority
• Shares significant information about family members
Types of report cont..

Transfer report
• Transferring a patient from one unit to another or
one hospital to another includes information of
patients bio-data or person
information ,summary of discharge progress
• Copy of current nursing care plan. Needs for any
special equipment and any other intervention
 Types of report cont..

Incident report
• Written by a nurse who witnessed the incident e.g. a
patient falling out of bed
• Write objectively, describing the client position when
the incident was discovered
• Indicate measures taken
• Do not attempt to interpret or explain the course
• No nurse is blamed in incident cause
 Types of reports cont..

Legal reports
• When writing this report, state the content briefly and
objectively
• Give all relevant information
• Incident reports are legal in nature
• A person writing the report as required by legal stature
is immune for being sued e.g. criminal act attained
during patient care
END

QUESTIONS