COMMUNICATING AND NURSING PRACTICE
COMMUNICATING AND INTERPERSONAL RELATIONSHIP
MODULE 5
DEVELOPING COMMUNICATION SKILL
COMMUNICATION THROUGHT THE NURSING PROCESSS
CLALLENGING COMMUNICATION SITUATION
NURSING AS AN ART: COMMUNITCATING LEVEL OF COMMUNICATION
ELEMENTS OF THE COMMUNICATION PROCESS
CIRCULAR TRANSACTIONAL MODEL
COMPONENTS OF THE CIRCULAR TRANSACTIONAL MODEL
FORMS OF COMMUNICATION
ZONE OF PERSONAL SPACE
SPECIAL ZONES OF TOUCH
PROFESSIONAL NURSING RELATIONSHIP
NURSE-PATIENT CARING RELATIONSHIP
ELEMENTS OF PROFESSIONAL COMMUNICATION
COMMUNICATING AND NURSING PRACTICE
Lifelong Learning Process: Effective communication is integral to nursing practice, requiring continuous learning.
Therapeutic Communication: Promotes personal growth and health-related goals, forming the foundation for nurse-
patient relationships.
Key to Nurse-Patient Relationships: Effective communication ensures patient safety, improves outcomes, and enhances
patient satisfaction.
COMMUNICATING AND INTERPERSONAL RELATIONSHIPS
Influence of Behavior: All behavior communicates something, and communication influences behavior.
Nurses' Role in Communication:
o Sensitivity to self and others
o Promoting the expression of both positive and negative emotions
o Building caring relationships
o Instilling hope and faith
o Providing a supportive environment and promoting spiritual expression
The Joint Commission (TJC) Standards: Focus on promoting communication for patient-centered care, cultural
competence, and safety.
DEVELOPING COMMUNICATION SKILLS
Critical Thinking and Reasoning: Essential for assessing and addressing patients' needs.
Key Skills:
o Perseverance and Creativity help nurses innovate.
o Self-Confidence leads to improved patient responses.
o Humility ensures responsiveness to patient needs, especially culturally.
o Integrity helps balance personal opinions with patient needs.
Emotional Intelligence (EI): Crucial for understanding and managing both personal and others' emotions, fostering
therapeutic relationships.
COMMUNICATION THROUGH THE NURSING PROCESS
1. Assessment:
o Involves verbal interviews, visual and tactile observations, and gathering data from multiple sources.
2. Nursing Diagnosis:
o Includes intrapersonal analysis and validation of health priorities.
3. Planning:
o Includes team collaboration, patient and family involvement, and documenting expected outcomes.
4. Implementation:
o Involves delegating tasks, verbal communication, health teaching, and patient progress documentation.
5. Evaluation:
o Includes feedback acquisition, comparison of outcomes, and modification of care plans.
CHALLENGING COMMUNICATION SITUATIONS
Includes patients who may be silent, withdrawn, angry, anxious, or have disabilities. Nurses need to adjust their
communication approaches to meet these challenges effectively.
LEVELS OF COMMUNICATION
Intrapersonal Communication (Self-talk): Crucial for self-awareness and professional growth.
Interpersonal Communication (One-on-one): Frequently used in nursing, essential for patient care.
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Small-Group Communication: Goal-directed communication within healthcare teams.
Public Communication: Presentations or discussions, often used by nurses in educational settings.
Electronic Communication: Uses technology (e.g., secure messaging) to connect with patients and healthcare teams.
ELEMENTS OF THE COMMUNICATION PROCESS
Dynamic Process: Communication is continuously changing.
Referent: Cues that initiate communication.
Sender/Receiver: Involves encoding and decoding messages.
Message: The content of communication, both verbal and nonverbal.
Channels: Visual, auditory, and tactile methods of communication.
Feedback: A response to confirm or correct messages.
Interpersonal Variables: Cultural, personal, and situational factors that influence communication.
Environment: Physical and emotional factors that shape the setting for communication.
CIRCULAR TRANSACTIONAL MODEL
Transactional Nature: Both sender and receiver are active in sending and receiving messages.
Feedback and Role Relationships: Feedback allows for corrections, and relationships can be complementary (one person
dominant) or symmetrical (equal).
COMPONENTS OF THE CIRCULAR TRANSACTIONAL MODEL
Referent: Cues that trigger communication.
Sender/Receiver: Encodes and decodes messages.
Message: Content conveyed in verbal and nonverbal forms.
Channels: Visual, auditory, and tactile means.
Feedback: Acknowledgment or clarification of the message.
Interpersonal Variables: Influenced by personal experiences and perceptions.
Environment: The setting for communication, which influences its effectiveness.
FORMS OF COMMUNICATION
Verbal Communication: Includes vocabulary, pacing, intonation, clarity, and timing.
o Denotative vs. Connotative meaning.
o Nonverbal Communication:
Appearance, posture, gait, facial expressions, gestures, and eye contact all play crucial roles.
Territoriality & Personal Space: Each individual has varying comfort with physical proximity.
Metacommunication: Refers to the non-verbal cues, tone, and context that influence the message’s interpretation.
ZONES OF PERSONAL SPACE
Intimate Zone (0-8 inches): Used in intimate or care-giving activities.
Personal Zone (18 inches-4 feet): Used for patient interactions such as history-taking.
Socio-Consultative Zone (9-12 feet): Used for giving directions or interacting with groups.
Public Zone (12 feet+): Public speaking and larger interactions.
SPECIAL ZONES OF TOUCH
Social Zone: Non-sensitive areas (e.g., shoulders, arms).
Consent Zone: Requires permission (e.g., mouth, wrists).
Vulnerable Zone: Requires care (e.g., face, neck).
Intimate Zone: Requires permission and sensitivity (e.g., genitalia, rectum).
PROFESSIONAL NURSING RELATIONSHIP
Caring as Foundation: Building trust, professionalism, and a caring approach is vital.
Nurse-Patient Caring Relationship:
o Pre-interaction Phase: Gathering information before meeting the patient.
o Orientation Phase: Initial meeting, setting the tone for the relationship.
o Working Phase: Nurse and patient work together to meet goals.
o Termination Phase: Ending the relationship, ensuring a smooth transition.
Motivational Interviewing
Purpose: Encourages patients to express concerns and motivates behavior change in a non-judgmental way
NURSE-PATIENT CARING RELATIONSHIP
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Nurse-Family Relationships
Requires understanding family dynamics to provide holistic care in settings like home care.
Nurse-Health Care Team Relationships
SBAR Technique: Standardized communication tool (Situation, Background, Assessment, Recommendation) for
transferring information.
Lateral Violence: Bullying behaviors among colleagues. It’s important to address and report such incidents for a better
work environment.
Nurse-Community Relationships
Nurses build relationships with community groups, often through service, outreach, or leadership roles.
ELEMENTS OF PROFESSIONAL COMMUNICATION
Appearance, Demeanor, and Behavior: A professional nurse is expected to maintain a polished and respectful appearance.
Courtesy: Saying “please,” “thank you,” and knocking before entering rooms.
Trustworthiness: Demonstrating consistency, reliability, and honesty to foster trust.
Autonomy and Responsibility: Taking responsibility for actions and advocating for others.
Assertiveness: Expressing oneself openly and confidently without disrespecting others.
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