Learning Objectives

Define the term communication

Explain the principles that guide oral and
NURS 152 written reporting

Explain the principles that guide
Communication Skills
communication with the each client including
the Special Need Client

Scenario Model of Communication

Margie an emergency department nurse has just arrived at work. As she finishes
receiving the reports, and her assignment to be the triage nurse, a middle-aged
man with severe chest pains and dyspnoea arrives with his family. Margie gets Generation Transmission Receipt of
immediate help for the man, who is rushed to the cardiac catherisation lab. of idea Encoding over a channel message

Margie notices that the family members seem very anxious and distressed. When
she asks them if they would like anything, they reply “no” but the wife tries to
hold back tears as she wrings her hands, the daughter’s hands shake , and the son
paces. Feedback

Margie notes that the non-verbal behaviour of the family is incongruent with the
verbal message and wonders what would be the best course of action to help this
distressed family ? Decoding
Action (interpretation)
(response)

(Lancaster, 1999)
Communication

The exchange of meanings
between and amongst
individuals through a shared
system of symbols that have
the same meaning for both the
sender and the receiver of the
message (Vestal, 1995)
Interpretation

Interpretation involves perception,
symbolization, memory and thinking

The most important is perception. Taylor
(1977) defines this as the selection and
organisation of sensations so that they are
meaningful.
Communication Components

Verbal communication uses words which may
be spoken or written
 Issues and influences?

Non-verbal communication is the message
sent through the use of body language such as
hand gestures, tone and pitch of voice, facial
movements and body posture and position.
 Issue and influences?
Body Language

People use their bodies to send messages, so
non-verbal communication is called body
language

Most do not think about it, they just
experience it.
Body language –areas to watch

Eyes

Face

Tone of voice

Body movement

Posture

Gestures of hands and arms
Body Language

Messages are communicated by :

Touch

How close people get to each other

Mirroring of postures and movements

Copying the posture of each other
Groups

In any group individuals adopt differing roles
of behaviour.

The same person behaves differently within
different groups.

As a group goes through its maturation
process individuals adapt their behaviour.
 Group Behaviour
STAGES
Proposing

Building

Forming- leader emerges

Supporting

Storming –leadership challenges
Disagreeing

Norming – culture is established, roles
Defending/attacking

Blocking/difficulty stating
defined, trust is created
Open

Performing - more flexibility , the group
Summarising
shares a common system of norms and values
Seeking information /testing information

Giving information

Bringing in

Shutting out

Groupwork Communication – Types of Written

Survivors
Care plan

Medical chart

Observation chart

Drug chart

Consent forms

Diagnostic requests and results

Nursing notes

Policies and procedures
Communication - Written

Date and time each entry

Use indelible ink
preferably black

Chart entries in
chronological order

Print or write clearly

Entries should be brief,
objective and accurate

Correct spelling with
avoidance of abbreviations
Shift Report Components
 Shift report

Name and age

Date of admission and medical diagnosis

Changes in patient condition during shift
 Observations
 Input/output
 Wound & drains

New physician orders

Any events to occur for patient over next
shift

Leave no blank spaces

Make corrections by
drawing one line through
the incorrect entry, printing
the word “error” on the line
and initials next to the
entry

Sign each entry with last
name, initials and job title

Patient information is
confidential
Oral Communications

Culture of nursing

Our own culture

Events
 Telephone
 Oral reports to nurse
during shift
 Multidisciplinary team
 During teamwork eg
moving patient
 Shift report
Telephone

Identify the nursing unit
If you need to take a

Identify yourself and your message or provide advice,
status include the following:
 Date and time of call

Offer assistance eg “How
 Caller’s name
can I help you?”
 Document clearly the

Following response, ask message left or advice given
the caller’s name.  Whether person is to return

If you need to put them on call, be followed up by nurse
hold, please tell them!! or whether caller will
telephone later
 Your signature
Communication Communication – Special Needs
Special Needs Patients Hearing Impairment

Types of special needs
Get patient’s attention
 Hearing impairment
Face the patient
 Visual impairment
Hearing aid? Turned on? Which side is best?
 Aphasia
Speak clearly – do not eat etc whilst speaking
 Disorientation
Do not shout or speak very slowly
 Cognitive age
?sign language
 Different culture or language
Use non-verbal language

Keep sentences short and unambiguous

Communication – Special Needs Communication – Special Needs

Visual Impairment

Speak whilst approaching to reduce startling

Identify yourself

Explain why you are there

Be specific if giving directions

Tell patient when you are leaving them

Advocate – help with mail, telephone

Keep patient informed about their environment

?braille
Aphasia or Disorientation

Face patient, making eye contact before speaking

Greet the patient by name

Speak slowly, in short sentences.

Ensure you are aware of level of cognition

Allow time for patient to assimilate information

Consider repeating back to the patient what they have said to
you

Use nonverbal cues to augment the message

?speech and language therapist

Do not shout to help with understanding

Look for signs of frustration
Communication – Special Needs
Culture or Language References

Lancaster, J. (1999). Nursing issues in leading and managing change. St.
Louis: Mosby.

Need for a linguist?

Ascertain specific culture or language
Vestal, K. (1995). Nursing management: concepts and issues 2nd ed.

Identify your own deficits of knowledge Philadelphia:J.B. Lippincott.

Provide written guidelines if possible

Be respectful of cultural norms
Hegner, B., Caldwell, E. & Needham, J. (1999). Nursing assistant. 8th ed.
New York, USA: Delmar Publishers.

Facilitate the presence of support person especially
Hood, L,. Leddy S.K. (2008)Conceptual bases of Professional Nursing
during communication

Do not increase pitch of voice in attempt to facilitate
understanding,