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Online Companion: Fundamentals of Nursing Standards and Practice 2E
The chapter provides a comprehensive summary of the communication process and how communication skills are used by nurses. Communication is fundamental to nursing activities and the process of communication is the vehicle for establishing the nurse-client relationship. The communication process can be broken down into five components: sender, message, channel, receiver and feedback. A variety of factors such as perception, culture, time, space and distance influence communication. For example, three types of personal space are identified based on the distance between sender and receiver. In the personal distance, a zone between 1.5 to 4 feet around a person's body, nonverbal communication is best read because vision is clear. The chapter discusses three levels of communication: messages one send to oneself (intrapersonal), messages between two people (interpersonal) and messages occurring among three or more people (group). Communication occurs in a variety of modalities: through words, actions or a combination of these. Nonverbal messages are communicated through body movements , such as posture, gestures, facial expression. Therapeutic communication is the use of communication for the purpose of creating a beneficial outcome for the client. Its purpose is to improve the client's ability to function. Therapeutic communication is different from social communication, the way we interact with friends. Therapeutic communication is purposeful and goal-directed, has defined boundaries, is client-focused, non-judgmental and uses well-planned techniques. These techniques are described and examples of their use is offered. Open-ended comments encourage the client to express thoughts and feelings. The comment "Tell me about your pain" elicits the client's description better than the question "Are you in pain?" There are barriers to effective communication that the nurse must be aware of: language differences, gender, developmental level, use of jargon, knowledge differences may lead to miscommunication between the nurse and the client. Some responses in communication actually block communication and leave the client feeling confused or intimidated. You may be surprised to learn that giving advice on how to solve a problem can block effective communication. The client is helped by a nurse who listens attentively and assists the client to find his own solutions. Nurses encounter clients who have
difficulty with the communication process. This may be due to hearing impairment,
vision impairment, confusion, anger. The client may be aphasic or unconscious.
These situations require the nurse to carefully and deliberately select communication
methods to establish and maintain the nurse-client relationship.
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