Buy Caring and Communicating: The Interpersonal Relationship in Nursing 2nd edition by Paul Morrison, Philip Burnard (ISBN: ) from. Sep 19, The dyadic interpersonal communication model describes the this focus, nurses can help ensure optimal communication and patient care. Caring and Communicating: The Interpersonal Relationship in Nursing by Paul Morrison; Philip Burnard at posavski-obzor.info - ISBN - ISBN
Although she is forgetful, she is still able to live a relatively independent life. She experienced an episode of fainting that was witnessed by several people at church, and she was taken to her primary care physician.Nursing and Interpersonal Communications Part 1
It took a great deal of talking to her to help her understand that the fainting spell was, in fact, a major problem that needed to be investigated. In addition to restricting her driving privileges, Carolyn needed several tests to rule out different probable causes of her fainting spell. Each test needed to be carefully explained to Carolyn and the information repeated so that she could grasp what each one required.
She wrote down all the key information in a system that she had developed to keep herself from forgetting important points. It takes careful reminding to keep her from driving her car or performing other actions that may put her in danger. Include Family in the Conversation Finally, including family is a big part of communicating with older people.
You should always try to keep your older patient in the conversation, although not much of it may be understood. Often children, spouses and family friends can help the older person understand what is needed from them. Family and friends can help you to communicate with an older patient because they know how that person thinks. It may help to have a three-way conversation between the patient, their caregiver, and yourself.
When everyone works together to help the patient understand, you stand a much better chance of putting him or her at ease with all that is happening around them. Not only are you trying to explain a difficult situation to a child, but you are trying to include the parents in the conversation as well. It is natural for a child to be scared, unreasonable and resistant to medical treatment, and it takes a skilled nurse to work through these roadblocks to achieve understanding.
As with most communication, listening and allowing the patient to be heard will serve you well in talking to children. Communicating with Children When talking to children you want to avoid medical jargon. For very young children, you have to use words that are as simple as possible. Even then, you may not get them to understand because their fear response is overriding everything else. However, you have to use care when talking to older children. You have to make a mental note of the age of the patient and their level of understanding, and tailor your speech to meet their needs.
You need to moderate your language, get down on the level of the child, and use a soft tone of voice. Sometimes, though, you need to do something that will cause them discomfort, and you must explain this with honesty and using straightforward language. Talking to Parents Part of communicating with children is communicating with their parents.
Again, you are likely to be dealing with someone who is in a great deal of distress and fear. It is helpful to try to allay their fears, answering all their questions as honestly as possible. Some parents may get emotional and you need to be aware of possible outbursts of anger or sorrow.
Either of these can upset your patient and that can go against what you are trying to accomplish. Try talking to parents away from the child and use active listening techniques, as you would for any other patient, family and relatives. Case Study Daniel was a two-year-old heart patient who was preparing for his second open-heart surgery.
Already, starting the IV line had been a traumatic event. Then one of the nurses from the OR came into the room the night before the operation with a bag of items. She got down on her knees with Daniel and showed him the hairnet he would wear, the tubes that would come out of him, and the mask that would be placed over his face.
Instead of being afraid, Daniel was fascinated with the new toys in front of him and played with them all. During this time, the nurse took the time to talk to the parents about their concerns.
She helped them to understand what would happen, explaining the procedure, the heart-lung machine, and the estimated time of the surgery. When the nurse prepared to leave after half an hour of talking, both Daniel and his parents were much more at ease. Although all of them were still afraid of the surgery, it helped to know a little bit about what would happen so not everything would come as a shock.
Click To Tweet Including the Child Finally, it is important to include the child when talking about procedures or their health. It is so much easier to talk to the parents that you may have a tendency to ignore the child. Children are very sensitive to this, and they do not appreciate being ignored. You should address the child at the beginning of your explanation and try to focus your talk on them and their needs.
At the end, you should also ask the child if he or she has any questions. They may not, but it helps them to feel included if you treat them like more than just a parcel to be taken here and there. Talk to the child as much as possible, and then take the parents out of the room for more adult conversation, if needed. It is challenging and often awkward to face the person.
You might be too professional and distant, or you may go the other way, and be more emotional and connected than you should be. Remember, you have a roster of patients, and the wear and tear from becoming too emotionally involved can lead to burnout. How do you successfully balance all of the emotional roadblocks that can arise when dealing with a patient who has a poor prognosis? It is important for you to be mentally healthy when working as a nurse, but especially when working with a population of patients who are in the process of dying.
This means taking care of yourself and having ways to de-stress and unwind. When you go home you need to leave the sadness and emotion of the job at work. If you take it home you could end up becoming a victim of compassion fatigue—a syndrome that can lead to anger, depression, substance abuse, and other problems.
Communicating with dying patients is difficult and taking care of yourself emotionally should always come first. Most people who are dying are aware of what is happening. However, if you enter the room tongue tied and sad the patient could feel as if you pity them.
Neither of these approaches will make your patient feel supported through this difficult time. Instead, you should approach the patient with neutrality. You are an open, loving caregiver. You tend to their needs and answer their questions with honesty. It can be challenging to be open. When a patient asks a difficult question you may be tempted to pass the buck to other caregivers or to gloss over it.
However, your patients have the right to know what their condition is. That is part of ethical nursing. Your patient may also need to open up to someone and trusts you because you are their nurse. Although it may be difficult, always tell your patient the truth when they ask questions.
Being Present Sometimes, in this situation the best communication is not saying anything at all. This is not always easy; one part of you may want to draw the person out to explore their feelings while another part of you would just like the distraction of talking to avoid awkwardness. Neither of these approaches is helpful to a dying person. You just need to be present. In some cases, silence is more helpful than talking. Maybe your patient has been talked to so much that the quiet helps to finally give them a chance to talk.
They could also be tired of talking because everyone wants to know everything about what they are feeling. Helping Families Families of dying patients are also suffering, and it can be challenging to communicate with them as well.
Honesty is always the best course of action to take with families. They will know you are hiding the truth and may resent you for telling them something false. One of the best ways to talk to families is through active listening.
Since these people may be highly emotional they have the need to be heard as much as the patient.
Active listening means that you reflect back to the person what they are communicating to you. Can you tell me more about that? Is that what you are trying to say?
This can help with any emotional situation from anger to sorrow to apathy. Nurses teach and help patients communicate their needs, but something about silence is therapeutic too.
Once again, openness and the willingness to be with the patient will either help them to talk or give them a much-needed rest. That is the best therapeutic gift you can give your patient.
Chances are, this strategy of communicating with doctors is not going to get you far. You have a very busy, often impatient, person listening to you. You have to make the most of your time, and the best way to do that is with organisation. It stands for identify, situation, background, assessment, and recommendation. Merely having this structure in your head when picking up that phone to the doctor can make the call flow a bit more smoothly.
The doctor on the other end will get a clear picture, you will get all of your information out concisely, and the patient will get the treatment they need. Identification First, identify who you are, your role and who you are talking about your patient or client. Situation The situation part of ISBAR seems self-explanatory, but it can often throw you off when dealing with a patient you are not sure about or just have a bad feeling about.
It gets a little more difficult to state the situation when the patient is not presenting something black and white, so you should take some time to think about what is prompting your call to the doctor. What exactly is it that is bothering you? What do you think the doctor can do for you? In this section of the report, state concisely whom you are calling about and what prompted the call.
Background The background section of this approach has the most variability built into it.
However, if the patient has been going to this doctor for 30 years, you probably wont need to give as much background. The timeline leading up to the situation is important. What was the patient doing earlier in the day that may have an impact on the current situation?
Did they have some incident or event that has some bearing on how they are acting now? Assessment All doctors will ask for them, regardless of the reason you are calling. Pathology, recent test data and any other collected information from the history can also be given at this time.
Included in this section is other data that may not fit anywhere else. You can insert how the patient looks to you personally. Do not be afraid to let the doctor know where your concerns lie. If you do not express that your patient is worrying you, then the doctor will not know enough to be worried themselves. They are basing all of their decisions on what you are telling them.
Trust yourself and your assessment skills, and tell the doctor what you see. Recommendation Recommending a solution to a problem might feel a bit awkward to a nurse, especially newer ones, but doctors are often open to collaboration and do not mind working in tandem with a nurse. However, you do not want to be demanding. Often phrasing your thoughts as a question can be a great way of asking for something you think might help your patient.
This allows the doctor to understand your line of thinking and opens the lines of communication between the two of you. If they agree, you got what you wanted. If they disagree, they will likely explain why. After all, you know your patient best because you are with them see Communicating with Patients.
The doctor knows the medicine. With all of the difficult personalities that go into making up a working medical facility, nurses need to know how to navigate the waters of prickly relationships while remaining professional and retaining their sanity.
Communication Skills for Nurses - 10 Tips for Improvement| Ausmed
What should a nurse do when confronted with a difficult person? It is best to remain calm and cool while dealing with the person carefully. To use an apt metaphor, the skills required are akin to defusing a bomb. If you say the wrong thing, the situation with a difficult person can escalate very quickly.
You need to focus on staying professional and being assertiverather than aggressive.
Communication Skills for Nurses
This also means enduring personal attacks without losing your cool. Here are just a few strategies for dealing with difficult people as a nurse.
You may feel like the other person is walking all over you, but your calm, professional attitude may just show them how idiotic they are being. Professionalism is required in these situations, but what exactly does it mean? To be a professional means not to forget yourself.
You are a representative of your facility and nursing in general. They try to find ways of amicably solving the problem so that all parties are satisfied.
If there is no solution, a professional finds ways to make the difficult person see that there is no other course of action. Be AssertiveNot Aggressive Some nursing schools are now teaching students how to be assertive. Assertive means that you get your point across, no matter how difficult, in a calm yet direct way.
You can even tell the patient that non-compliance is only going to make their situation worse. Although you always remain professional, assertiveness allows you to say what needs to be said to a person who is being difficult.
The problem with assertiveness is that it can sometimes slip into aggression. It is a two way process. The patient conveys their fears and concerns to their nurse and helps them make a correct nursing diagnosis. The nurse takes the information and in turn transmits other information to the patient with discretion and delicacy as to the nature of the disease and advises with treatment and a rehabilitation plan for health promotion 4.
Effective communication requires an understanding of the patient and the experiences they express. It requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient. It is a reflection of the knowledge of the participants, the way they think and feel and their capabilities 5. In order for the nurses to be successful in their work they have to study communication and interpersonal relations in their education with special courses and internships.
They need to learn the various aspects and applications of communication in various fields of nursing 6. In this context it is understood that emphasis must be placed on the importance of communication between nurse and patient and nursing education must focus on communication skills of nurses. The entire process occurs in a context consisting of physical space, cultural and social values and psychological conditions 7. Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional.
When health professionals are not trained in communication skills, they face more difficulties separating work from their personal life, tending to transfer problems from one side to the other 8. Communication is an intrinsic characteristic of human nature. Communication has content and value. The contents regards to what was said, whilst the relationship regards as to how it was said. The nature of the relationship depends on how the two parties understand the communication sequence 9.
Communication is never unidirectional. It is an interaction in which each sender becomes receiver and vice versa. The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes Moreover, the message sent is not the same as the message received. The decoding of the messages is based on individual factors and subjective perceptions.
This fact, in conjunction with the process of feedback makes communication. We interpret something that we heard not according to what the sender actually said but according to our own code Particular attention should be given by the caregivers to use technical terms and medical terminology during their contact with the ill, because it is often found that the patient ascribes different interpretations to what he hears or even more cannot understand what is meant exactly, mainly by the therapist, thus increasing mental stress, a fact which makes it more difficult to communicate with the patient Communication happens without words.
It is an ongoing process. This non-verbal communication is expressed by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor It is important that there is an agreement between verbal and nonverbal communication.
Particularly under stressful conditions where it is difficult to see the changes in the non-verbal messages of the patients with whom we mostly communicate Moreover, each patient has his own specific characteristics that influence not only behavior in the process of communication, but also if and how to cooperate with nursing services and how they will undertake self-management of health Listening is important in communication.
It is responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and non-verbal messages emitted by each patient. Good personal relationships are described as the ability of the nurse to ask questions with kindness and provide information in a way that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society The therapeutic relationship is an important prerequisite to effective communication between health professionals and patients in order not only to transmit information, but also to effectively address mental processes which are activated by it.
The communication between health professionals and patients include the ability to express sincere concern for the care of the patient and the patient becomes a partaker of this interest 9. This will happen if the conversation is held in appropriate conditions. Even though it seems obvious, it should be noted that courtesy and kindness on part of the nurse is required 4 A key element is the need for a peaceful environment with no external distractions, which will ensure appropriate confidentiality of the dialogue.
Frequently we see the phenomenon of serious discussions taking place in the middle of the corridor of the outpatient department or the nursing department, clinic, or in some office of the hospital, in which third parties unrelated to the care of the individual patient are coming in and out In such an environment the patients are ashamed to express themselves freely Unfortunately, the concept of privacy is pretty much unknown to the Greek hospital system.
Skilled nursing operations for the patients are made in chambers without screens or in hallways, in front of others. Patients and visitors of hospitals move without restriction in all the areas of the nursing and clinical departments. However, it is up to us to teach our colleagues and especially the new nurses and their patients setting the right example, in order for things to slowly change for the better Even more than the comfort of space, communication with the patient requires ample time.
Each patient has his own way and pace to reveal his problem, but it takes some time to get to know the nurses and feel the confidence necessary to face them. The patient should have the feeling that the time-whether it is five minutes or an hour-is entirely his. The patient who has the undivided attention of the nurse reveals his problem sooner, with the satisfaction that the nurse has listened and observed him The language he uses for this purpose is very important.
Often the patient is bombarded with big words with little or no significance for him Once again the nurse may be directed to the ill in an incomprehensible way. Patients that are ashamed of their ignorance or are hesitant, avoid seeking an explanation, and as a result the consultation is inadequate and does not lead to the right outcome for the patient. The language of communication should therefore be at the level of the listener, who is not able to assess our scientific knowledge, but has to understand what we are telling him Another important requirement for proper and successful communication between nurses and patients is frankness and honesty.
The discussion with the patient should leave no suspicions, doubts and misunderstandings. Communication as already stated is bidirectional, but the nurse or other health professional is responsibility for its proper conduct. Moreover, depending on the psychosynthesis it can be more or less calm. Reactions such as anger, disbelief, moaning, aggression and denial of reality are known defence mechanisms, which are recruited to help him adjust to the new situation he is facing 8 ,