ADDIS ABABA MEDICAL AND BUSINESS

COLLEGE

NURSING ASSISTANCE

Unit of Competence:- Work Effectively with Others in

Nursing proffesion

Set by Sisay Guta

2021
 Communication
• Communication is the art of developing and
attaining understanding between people.
• It is the process of exchanging information and
feeling between two or more people, and it is
essential to effective management.
• Most people think at a rate of 400 to 500
words a minute, but most people speak at only
about 120 words a minute.
• Communicating is one of the most important
facilitators of managerial activities.
• In general communication is the passing of
information.
• With out proper communication in the
organization, it would be difficult to be
successful.
• We communicate daily with our family,
friends, bosses etc.
 Definition of communication
• Communication is a process through which an
information, idea or opinion is transferred to more
number of persons.
• It is an exchange of facts, ideas, opinions or
emotions by two or more people.
• Communication is the process of sharing our
ideas, thoughts, and feelings with other people
and having those ideas, thoughts, and feelings
understood by the people we are communicating
with.
• When we communicate we speak, listen, and
observe.
• The way we communicate is a learned style.
• As children we learn from watching our
parents and other adults communicate.
• As an adult we can learn to improve the way
we communicate by observing others who
communicate effectively, learning new skills,
and practicing those skills.
 Barriers to communication or problems of communication

1. Noise (any thing that confuses, disturbs, diminishes or

interfere with communication e.g a machine operation etc.
2. Missing information
3. Overloading (when an increased in the number of
messages to be sent, or too much information by the
teacher in one day)
4. Lack of attention
5. Lack of confidence over the communicator(if students lack
confidence on one of their teacher, a nurse or kebele
leader)
6. Lack of time
7. Language
 THERAPEUTIC COMMUNICATION
• The nurses express their concerns for patents,
both through action & by manner of performing
it.
• It essentials includes
 Through orientation to physical facilities, listing
hours, date, etc to patient and their relations
Adequate explanation on various treatment and
procedures.
Good listening & comforting words to anxious
pts. & their relatives adequate health education.
Ingredients of therapeutic communication

1. Listen actively – involves being attentive

2. Help to identify what the person is feeling requires feed
back from the nurse about how the client appears.
3. Put yourself in the others person’s shop.
4. Be honest- In effective relationship nurse honestly
recognize that any lack of knowledge by saying “ 1 don’t
know the answer to that right now
5. Do not tell a person no to fed ____” Don’t worry about
it “Everything will be fine “or “please don’t cry “ such
as a hsponse inhibits the clients expression of feel.
6. Don’t tell a person what he/she should fed
Eg. You should not complain pain about pain
many other how gone through some
experience.
7. Don’t make excuses for the others person
8. Use your ingenuity => cleverness
9. Try to summarize to the person at the end of
the interview process of thing to get their
several through or feeling to one or two
statement.
10. Know your role & your limitation.
 Active listening
• Active listening is listening with a purpose. It is
more than just hearing which is the act of
perceiving sound.
• When you hear a sound or noise, you are
receiving aural stimuli.
• Listening goes beyond just registering that there
is a sound in the Environment.
• It involves receiving and interpreting the aural
stimuli, and creating meaning from the sound.
• Using active listening skills can help to minimize
or avoid unnecessary conflict.
• It can bring clarity and understanding to
conversations and interactions with other people.
• To work, the listener focuses on the words and
the feelings of the speaker for understanding.
• Active listening happens when the listener hears
the various messages being sent, understands
their meaning, and then verifies the meaning by
offering feedback.
 Characteristics of active listeners:-
• Spends more time listening than talking
• Let’s the speaker finish his or her own
sentences
• Let’s the other person finish speaking before
responding
• Allows the other person to speak and does not
dominate the conversation
• Aware of own biases
• Asks open-ended questions
• Focuses on what is being said and not what
one’s response will be to the Speaker
• To develop these skills and characteristics, it
helps to be aware of some verbal active
listening techniques, and nonverbal
techniques.
Active Listening Techniques
• When engaging in active listening, or in any
form of communication, it isimportant to
remember that there is more to it than just
the spoken part.
• There are many non-verbal behaviors to
listening and communicating.
 Asking questions
• Asking questions is an important and often
overlooked skill.
• The ability to apply effective questioning
techniques can elevate the thinking and
performance of your learners, which in turn
improves your performance and success as a
learning professional.
• This tool, designed to improve questioning
techniques in any learning setting, is based on
Bloom’s Taxonomy, Six Levels of Cognitive Ability.
Why use Questions?
• Engage listeners
• Assess knowledge
• Focus attention
• Facilitate discussion
• Review information
• Stimulate thinking
• Test knowledge
 What makes Questions Effective?

• You can use Bloom’s Taxonomy to guide question

development through the six levels to effectively
stimulate learners’ critical thinking.
• Utilize questions at the various levels to test for
understanding while challenging learners to
stretch their thinking.
• You can create a well-rounded, formal
assessment using questions from the various
levels. Ultimately, you can determine to what
degree learners actually acquire the desired
knowledge.
 Six Levels of Questions

1. Knowledge Observing or recalling facts (definitions, concepts,

principles, formulas).
2. Comprehension Describing and clarifying concepts, events or
relationships between ideas in one’s own words; citing examples.
3. Application Using information from prior situations in a new
context to solve problems, answer questions or perform other
tasks.
4. Analysis Identifying motives or causes, making inferences, finding
evidence to support generalizations, or making decisions.
5. Synthesis Solving problems, making predictions, producing
original representations, making decisions or organizing learned
information.
6. Evaluation Developing a judgment about the value of a concept,
idea, or method.
 Levels of Questions
1. Knowledge
• Key Verbs:
• Arrange, define, examine, list, tell
2. Comprehension
• Key Verbs: Classify, discuss, identify, illustrate, restate
3. Application
• Key Verbs: Apply, classify, illustrate,demonstrate, practice
4. Analysis
• Key Verbs: Analyze, categorize, compare, examine, sort
5. Synthesis
• Key Verbs: Apply, combine, formulate, interpret, predict
6. Evaluation
• Key Verbs: Assess, convince, evaluate, measure, rank
 Question Stems:
• What happened after...?
• How many...?
• Please tell why...
• Who do you think...?
• Provide an illustration of...
• What is the classification of...?
• Apply this idea to another time...
• How could this happen in...?
• What would you demonstrate if...?
• What can you conclude about...?
• What do you see as other possible outcomes
of...?
• How is this similar to...?
• Apply this concept to... ?
• What would happen if...?
• What is a possible solution to...?
• What do you think about...?
• Which did you like...? Why...?
• What is a better solution to...?
 How to ask a Question
1. Ask the question.
2. Pause.
3. Listen to the answer.
4. Emphasize the correct answer.
 Self-concept
• Self-concept is the way people think about
themselves.
• It is unique, dynamic, and always evolving.
• This mental image of oneself influences a
person’s identity, self-esteem, body image,
and role in society.
 COMPONENTS OF SELF-CONCEPT
• Self-concept is an individual’s perception of self,
including self-esteem, body image, and ideal self.
• A person’s self concept is often defined by self-
description such as “I am a mother, a nurse, and a
volunteer.”
• The nurse should be observant for self-descriptive
statements when assessing the client’s self-concept.
• A healthy self-concept is necessary for overall
physical and mental wellness.
• Three basic components of self-concept are the
ideal self, the public self, and the real self
• The ideal self is the person the client would like
to be, such as a good, moral, and well-respected
person.
• Sometimes, this ideal view of how a client
would like to be conflicts with the real self (how
the client really thinks about oneself, such as “I
try to be good and do what’s right, but I’m not
well respected”).
• This conflict can motivate a client to make
changes toward becoming the ideal self.
• Public self:- is what the client thinks others think
of him and influences the ideal and real self.
• Positive self-concept and good mental health
results when all three components are
compatible.
• A positive self-concept is an important part of a
client’s happiness and success.
• Individuals with a positive self-concept have self
confidence and set goals they can achieve.
• Achieving their goals reinforces their positive
self-concept.
• A person’s self-concept is composed of evolving
subjective conscious and unconscious self-
assessments.
• Physical attributes, occupation, knowledge, and
abilities of the person will change throughout
the life span, contributing to changes in one’s
self-concept.
 Characteristics of a Positive Self-Concept includes

• Self-confidence
• Ability to accept criticism and not become
defensive
• Setting obtainable goals
• Willingness to take risks and try new
experiences
 MEMORY TRICK
• The memory trick I LIKE ME lists nursing
interventions to promote a positive self-concept in
clients:
I = Identify client’s strengths.
L = Listen to the client’s self-description.
I = Involve the client in decision making.
K = Keep goals realistic.
E = Encourage client to think positively.
M = Maintain an environment conducive to client self-
expression.
E = Explain to the client how to use positive self talk
instead of negative self-talk.
 Self-Esteem
• Self-esteem is how we value ourselves; it is how
we perceive our value to the world and how
valuable we think we are to others.
• Self-esteem affects our trust in others, our
relationships, our work – nearly every part of our
lives.
• Positive self-esteem gives us the strength and
flexibility to take charge of our lives and grow
from our mistakes without the fear of rejection.
 Following are some outward signs of positive self-esteem:
• Confidence
• Self-direction
• Non-blaming behavior
• An awareness of personal strengths
• An ability to make mistakes and learn from them
• An ability to accept mistakes from others
• Optimism
• An ability to solve problems
• An independent and cooperative attitude
• Feeling comfortable with a wide range of emotions
• An ability to trust others
• A good sense of personal limitations
• Good self-care
• The ability to say no
 Low self-esteem
• Low self-esteem is a debilitating condition that
keeps individuals from realizing their full
potential.
• A person with low self-esteem feels unworthy,
incapable, and incompetent.
• In fact, because the person with low self-
esteem feels so poorly about him or herself,
these feelings may actually cause the person’s
continued low self-esteem
 Here are some signs of low self-esteem:
• Negative view of life
• Perfectionist attitude
• Mistrusting others – even those who show
signs of affection
• Blaming behavior
• Fear of taking risks
• Feelings of being unloved and unlovable
• Dependence – letting others make decisions
• Fear of being ridiculed
 How can you raise low self-esteem?
• positive thinking techniques that can be used to help
improve self-esteem are called affirmations.
• Using affirmations to stop negative self-talk is a
simple, positive way to help increase self-esteem.
• Affirmations are encouraging messages we can give
ourselves every day until they become part of our
feelings and beliefs.
• Affirmations work best when a person is relaxed. But
since people are often upset when they are giving
themselves negative self-messages, they may need
to counter negative messages with positive ones.
 Affirmations can help you to work toward a positive
self-image are
• I respect my self and others
• I am lovable and likable
• I am confident, and it shows
• I care about myself
• I am creating loving,healthy relationships
• I am a good friend to myself and others
• I accept myself just as I am
• I look great
• Life is good, and I like being a part of it
 Communication styles model
Model of communication process
I- Source ( encoder ) - The originator of the
message
• It may be an individual or several persons
working together
• Eg. T.V news teams
- May also be an institution organization
the sender initiates the communication action.
 II- Message: - is the idea that is communicated
- Is 2nd step in communication process?
- Transmitted through a channel or mass
media
III- The channel:- The means by which a
message travels from a source to a receiver.
A. Mass media Eg. News paper, films, radios &
TV etc…..
B. Interpersonal – face to face ( feedback more
facilitated
IV- Reciever (Decoder) – the person for whom the
message is intended(planned).
- The most single important in the communication
process.
V-Effect – the change in the receiver’s behavior
- The change in the receiver‘s knowledge
- The change in the receiver’s attitude
VI – feed back – response by the receiver to the sources
message, there are two types
A. Positive feedback – conform to the source that
intended effect of the message was achieves.
B. Negative feedback – the message was not achieved
leads to change or hostility among the element
 Types of communication

Types of communication can be classified on the

following basis:
1. On the basis of organizational Relationship
A. Formal communication (through proper
channel) in accordance with formalities
(referenced office letter)
B. Informal communication(information is passed
not in accordance with any formalities and rules
and regulations of an organization
2. On the basis of direction of flow of communication
A. Downward communication (a communication starts
from the top level executives and end with the lower
functionaries through middle management E.g.
Prime minister Meles to Minister of health)
B. Upward communication (just the opposite of
downward communication)
C. Horizontal communication( information passed to a
person who is at equal level, e.g. your friend)
3. On the basis of way of expression
A. Oral communication e.g. lecture, meeting, calling
etc.
B. Written communication (Circulars, this manual etc.)
 Conflict Resolution Skills
Managing and Resolving Conflict in a Positive Way
• Conflict is a normal, and even healthy, part of relationships.
• After all, two people can’t be expected to agree on
everything at all times.
• Since relationship conflicts are inevitable, learningto deal
with them in a healthy way is crucial.
• When conflict is mismanaged, it can harm the relationship.
• But when handled in a respectful and positive way, conflict
provides an opportunity for growth, ultimately
strengthening the bond between two people.
• By learning the skills you need for successful conflict
resolution, you can keep your personal and professional
relationships strong and growing.
 The fundamentals of conflict resolution
• Conflict arises from differences.
• It occurs whenever people disagree over their
values,motivations, perceptions, ideas, or
desires.
• Sometimes these differences look trivial, but
when a conflict triggers strong feelings, a deep
personal and relational need is at the core of
the problem—a need to feel safe and secure,
a need to feel respected and valued, or a need
for greater closeness and intimacy.
Recognizing and resolving conflicting needs

 In personal relationships, a lack of

understanding about differing needs can result
in distance,arguments, and breakups. In
workplace conflicts, differing needs are often at
the heart of bitter disputes.
When you can recognize the legitimacy of
conflicting needs and become willing to examine
them in an environment of compassionate
understanding, it opens pathways to creative
problem solving, team building, and improved
relationships.
Successful conflict resolution depends on your ability to:

– Manage stress while remaining alert and calm. By

staying calm, you can accurately read and interpret
verbal and nonverbal communication.
– Control your emotions and behavior. When you’re in
control of your emotions, you can communicate your
needs without threatening, frightening, or punishing
others.
– Pay attention to the feelings being expressed as well
as the spoken words of others.
– Be aware of and respectful of differences. By
avoiding disrespectful words and actions, you can
resolve the problem faster.
Unhealthy responses to conflict are characterized
by:-
• An inability to recognize and respond to matters
of great importance to the other person
• Explosive, angry, hurtful, and resentful reactions
• The withdrawal of love, resulting in rejection,
isolation, shaming, and fear of abandonment
• The expectation of bad outcomes
• The fear and avoidance of conflict
• Healthy responses to conflict are characterized
by:
– The capacity to recognize and respond to important
matters
– A readiness to forgive and forget
– The ability to seek compromise and avoid punishing
– A belief that resolution can support the interests
and needs of both parties
 Four key conflict resolution skills
1. Quickly relieve stress
2. Recognize and manage your emotions
3. Improve your nonverbal communication
skills
4. Use humor and play to deal with challenges
 Tips for managing and resolving conflict
Managing and resolving conflict requires
 emotional maturity,
 selfcontrol,and
 empathy.
 You can ensure that the process is as positive
as possible by sticking to the following conflict
resolution guidelines:-
1. Make the relationship your priority.
2. Focus on the present
3. Pick your battles
4. Be willing to forgive.
5. Be willing to forgive
6. Know when to let something go.
 Fair fighting: Ground rules are
• Remain calm.
• Express feelings in words, not actions.
• Be specific about what is bothering you.
• Deal with only one issue at a time
• No "hitting below the belt."
• Avoid accusations. Accusations will cause others to defend
themselves.
• Don't generalize. Avoid words like "never" or "always."
• Avoid "make believe."
• Don't stockpile.
• Avoid clamming up. When one person becomes silent and
stops responding to the other, frustration and anger can result
• Managing and resolving conflict by learning how to listen
 Tips for being a better listener:
• Listen to the reasons the other person gives for
being upset.
• Make sure you understand what the other person is
telling you—from his or her point of view.
• Repeat the other person’s words, and ask if you
have understood correctly.
• Ask if anything remains unspoken, giving the person
time to think before answering.
• Resist the temptation to interject your own point of
view until the other person has said everything he
or she wants to say and feels that you have listened
to and understood his or her message.
When listening to the other person's point of
view, the following responses are often
helpful:-
1. Encourage the other person to share his or
her issues as fully as possible.
2. Clarify the real issues, rather than making
assumptions.
3. Restate
4. Reflect feelings be as clear as possible.
5. Validate the concerns of the other person,
even if a solution is elusive at this time.
• Conflict resolution is one of the five key skills
of emotional intelligence
The Five Skills of Emotional Intelligence
Skill 1: Quick Stress Relief
Skill 2: Emotional Awareness
Skill 3: Nonverbal Communication
Skill 4: Playful Communication
Skill 5: Conflict Resolution
 Team building
• A method of improving organizational
effectiveness at the team level by diagnosing
barriers to team performance and improving
interteam relationships and task
accomplishments team management style
characterized by a high concern for both
production and employee moral and
satisfaction; also called democratic
management
 Team structures
• Definition
Team:-group of people (5-12) assigned to work
together
• Health team is a group of people working
together to give health care to individuals and
families in a community.
 who are Members of health team?
all technical staffs
all support staffs
village health workers
health extension workers
- N.B members of a health team includes all
those working together in any health
organization.
 Types of health team
• - it may vary depending on the type of work
and specialty.
• - a team is two or more people who interact
and influence each other towards a common
purpose.
mobile team
surgical team
MCH team etc
 Function of health team
• -Depending on the type team, it should respond to the
needs of the community mainly.
• Health team should have the following features:-
 usually team should have a based such as health center
 it works in a defined area with an agreed framework
 it must be able to enhance community participation or
involvement to achieve its purpose
 it must work closely with other partners such as teachers,
community, political people, religious leaders etc.
 it must work in the community for e.g. peoples home,
 it must understand and communicated with the
community
• Members or the leader of a health team
should have the following skills:-
- leadership,
– organizing,
– communicating,
– motivating,
- handling conflicts etc.
• There are five possible ways to achieve a good team
work. These are:-
1. setting and sharing objectives with team members
2. encourage good personal relationship by using
different supervision styles
3. distribute task/work (organizing)
4. co-coordinating the activities of the team
5. apply sound organizational principle
• Remember that there is no one person who can
acquire all the necessary skills or have enough time
to do all to satisfy the need of even a small
community.
How to lead health team?