The Communication Process

1
The Communication Process

• By
• Cynthia Scriven, RN, MSN

2
Lets Talk!

• I know you believe you understand what you
  think I saidbut Im not sure you realize that
  what you heard is not what I meant.
• DUH?

3
Effective Communication Processes

• Effective communication is the foundation for
  therapeutic nurse-client relationships
• The communication process is always reciprocal in
  nature and is most effective when the message
  sent is the same as the message received-thereby,
  validating feedback is imperative

4
Effective Communication Model

• There are many models that illustrate effective
  communication patterns-
• The similarity among the models is that the
  senders and the receivers of any communicative
  medium truly understand what is being
  communicated(See Model A

5
Recognizing Barriers/Distortions to
Effective Communication

• Personal factors such as
• emotion, anger, anxiety
• physical pain, illness
• intellectual levels
• social factors, different cultures
  ethnicity,language

• Environmental factors such as
• too much background noise
• lack of privacy
• uncomfortable accomodations
• the presence of others

6
Verbal Communication

• Verbal communication is defined as the actual
  words that are spoken
• Consider the incongruities of the English
  language
• multiple contextual definitions of the same
  wordsex.dopean idiot or drug
• the vast use of slang and humorValley Girl
  Jive, Rap
• Our passing remarks that we dont expect a real
  response to..Whats happening? HOW CONFUSING!

7
Nonverbal Communication

• In 1988, Shea proposed that communication exists
  as 10 words and 90 nonverbal cuesthereby,
  nonverbal communication is more reliable and
  valid than verbal.
• Nonverbal communication is defined as the
  behaviors that are displayed, ex tone of voice,
  pace of speech, facial expressions, bodily
  movements or postures, hand gestures, sighs,
  yawns
• ACTIONS SPEAK LOUDER THAN WORDS??!!

8
Summary of Points re Verbal Nonverbal
Communication

• Both verbal and nonverbal processes are at work
  simultaneously.
• Usually, people are more conscious of what they
  say, rather than what their behaviors are
  communicating.
• According to Carl Rogers, when the content(verbal
  message) is congruent with the process(nonverbal
  cue), the communication is more clearly
  understood is considered healthy.

9
Summary of Points continued

• On the other hand, if the verbal message is not
  reinforced by the process, or in fact, is
  contradicted by the nonverbal behavior, then the
  message is CONFUSING and not clear. This is
  referred to as sending a double or mixed message.
• The nurse utilizes direct observation to enhance
  her/his awareness of the clients communication
  patterns.

10
Techniques that Enhance Effective
Communication

• The nurse must request feedback on the accuracy
  of the message received from both verbal
  nonverbal cues.
• The use of clarifying techniques assists the
  nurse to accomplish this feat. Examples of these
  techniques include
• paraphrasing, restating, reflecting, exploring,
  the use of silence, and active listening. (See
  Varcarolis text-Chapter 7)

11
Techniques that Enhance Effective
Communication

• Summarizing
• Accepting
• Giving recognition
• Offering self
• Offering general leads
• Giving broad openings
• Making observations
• Placing events in time or sequence

• Encouraging comparison
• Focusing
• Giving information
• Presenting reality
• Verbalizing the Implied
• Voicing doubt
• Suggesting collaboration

12
Techniques that Hinder Effective
Communication

• Reassuring
• Giving approval
• Rejecting
• Disapproving
• Agreeing
• Disagreeing
• Advising
• Probing

• Testing
• Defending
• Minimizing Feelings
• Using denial
• Changing the subject
• Requesting an explanation
• Making stereotypical comments

13
Therapeutic Encounter with your Client

• Before engaging in a nurse-client dialogue,
  establish a planned outcome/ goal for the
  conversation. This will assist you to remain
  focused during the actual conversation.
• Consider nurse-client boundaries-the discussion
  should be focused on the client, not on you.
  Redirect the con-versation back to the client.
• Practice congruency between your verbal/nonverbal
  cues.

14
Therapeutic Encounter cond.

• Do be empathic to your clients situation and
  needs
• Do be genuine and honest in your nurse-client
  interactions
• Do be respectful to your client
• Do recognize that spending time interacting with
  your client privately conveys a non-verbal
  message that he/she is important to you and that
  you are available to support them.

15
The Clinical Interview

• The clinical interview is not a random meeting
  between the nurse and client.
• It is a systematic attempt to understand those
  problems in clients lives that interfere with
  meeting their goals, and to help them improve
  their skills or learn alternative ways of dealing
  effectively with their problems.
• The content direction of the clinical interview
  are decided by the client. The client leads the
  discussion.

16
The Process Recording

• The process recording is a verbatim account of
  the actual dialogue that ensued between the nurse
  and the client both verbal nonverbal during
  the clinical interview. The process recording is
  writ ten ASAP after the interview is concluded. A
  third column is added so the nurse may an-alyze
  the effectiveness of her/his commun-ication
  techniques and reflect on what was truly
  communicated.