Lesson Plan on Communication and confidentiality by Kajal Thakur, student of M.Sc. Nursing 2nd Year.

1. NETAJI SUBHASH COLLEGE OF NURSING, PALAMPUR
PRESENTATION
ON
COMMUNICATION, CONFIDENTIALITY
SUBJECT : NURSING MANAGEMENT
SUBMITTED TO: SUBMITTED BY:
Mrs. Ritika Kajal Thakur
Assist. Professor MSc. Nursing 2nd Year
(OBG Nursing) Roll No. – 04
NSCN, Palampur NSCN, Palampur
SUBMITTED ON: 21-06-22

2. BackgroundInformation:
 Title of course : M.Sc. (N) 2nd Year
 Unit : 02
 Name of student teacher : Kajal Thakur
 Topic : Communication and Confidentiality
 Duration : 45-60 min
 Date and time : 21-06-22 , 3.15 - 4pm
 Place : M.Sc. (N) 2nd year class
 Method of teaching : Lecture cum discussion
 Total students : 16
 AV Aids : PPT, Blackboard
 Name of evaluator : Mrs. Ritika (Asst. Professor, OBG)
 Previous background of trainees : Students have little knowledge about the topic.

3. GeneralObjective :
 By the end of this lecture students will gain knowledge, attitude, skills and practice about the definition of co-ordination, its characteristics,
principles, types, techniques, importance and difficulties; delegation, its features, characteristics, need, principles, types, importance,
advantages, pre-requisites and problems.
Specific Objective :
At the end of the lecture students will be able to :
 to introduce and define communication
 to describe the importance and elements of communication
 to explain the process of communication
 to explain the types and strategies of communication
 to describe interpersonal communication
 to explain the levels and theories of communication
 to explain the barriers of communication
 to introduce and define confidentiality
 to describe the purpose and importance of confidentiality
 to explain patient confidentiality for health care professionals
 to explain breach of confidentiality

4. S.
NO.
TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
METHOD
OF
TEACHING
EVALUATION
1. 20sec To introduce
self
Good morning everyone. Myself Kajal Thakur, student of MSc.
Nursing 2nd year in Netaji Subash College of Nursing, Palampur.
- - -
2. 20sec To announce
the topic
Announcement of the topic – Today I’m here to teach you about the
topic Communication and confidentiality. Do you have any knowledge
about this topic?
- - -
3. 20sec To introduce
the topic
COMMUNICATION
- Communication is the basic element of human interaction that
allows people to establish, maintain and improve contact with
others.
- Nurse managers are required to be aware of the techniques that
can help them ensure effective management of educational/
service unit.
- Communication is one of the most important activities in
nursing management. It is the foundation upon which the
manager achieves organizational objectives.
PPT Lecture cum
discussion
-
4. 2min To define
communication
DEFINITION OF COMMUNICATION
 Communication is a process in which a message is transferred
from one person to other person through a suitable media and
the intended message is received and understood by the
receiver.
 According to Paul Leagens, it is “ a process by which two or
more people exchange ideas, facts, feelings or impressions in
ways that each gain a 'common understanding’ of meaning,
intended and use of a message”.
PPT Lecture cum
discussion
Define
communication.

5.  According to Aristotle, communication is a means of
persuasion to influence the other so that the desired effect is
achieved.
5. 4min To describe the
importance of
communication
IMPORTANCE OF COMMUNICATION
1. Promotes motivation : Communication promotes motivation
by informing and clarifying the employees about the task to be
done, the manner they are performing the task, and how to
improve their performance.
2. Source of information : communication is a source of
information to the organizational members for decision making
process as it helps identifying and assessing alternative course
of actions.
3. Altering individual’s attitudes : a well informed individual
will have better attitude than a less informed individual.
Various forms of oral and written communication help in
moulding employee’s attitudes.
4. Helps in socializing : communication also helps in socializing.
In today’s life the only presence of another individual fosters
communication. It is also said that one cannot survive without
communication.
5. Controlling process : it helps in controlling organizational
member’s behavior in various ways. There are various levels of
hierarchy and certain principles and guidelines that employees
must follow in an organization. They must comply with
organizational policies, perform their job role efficiently and
communicate any work problem and grievance to their
superiors. Thus communication helps in controlling function of
management.
PPT Lecture cum
discussion
What is the
importance of
communication

6. 6. 3min To describe the
elements of
communication
ELEMENTS OF COMMUNICATION
There are seven elements of communication :
1. Source idea
2. Message
3. Encoding
4. Channel
5. Receiver
6. Decoding
7. Feedback
1. Source idea : is the process by which one formulates an idea to
communicate to another party. It is the basis for communication.
2. Message : the message is what will be communicated to another
party. It is based on the source idea, but the message is crafted to
meet the needs of the audience.
3. Encoding : encoding is how the message is converted into a
suitable form (written or spoken form).
4. Channel : the channel is the medium of communication. The
channel must be able to transmit the message from one party to
another without changing the content of the message. The
channel can be a piece of paper, radio, or email, etc. the channel
is the path of communication from sender to receiver.
5. Receiver : the receiver is the party receiving the communication.
The party uses the channel to get the communication from the
transmitter. A receiver can be a television set, a computer, or a
piece of paper depending on the channel used for the
communication.
6. Decoding : is the process where the message is interpreted for its
content. It also means the receiver thinks about the message’s
content and internalizes the message.
PPT Lecture cum
discussion
What are the
elements of
communication?

7. 7. Feedback : feedback is the final step in the communication
process. This step conveys to the transmitter that the message is
understood by the receiver.
7. 3min To explain the
process of
communication
PROCESSOF COMMUNICATION
1. Ideation : The first step ideation begins when the sender
decides to share the content of her message with someone,
senses a need to communicate, develops an idea or selects
information to share. The purpose of communication may be
inform, persuade, command, inquire or entertain.
2. Encoding : it involves putting meaning into symbolic forms.
Speaking, writing or non verbal behavior. One’s personal,
cultural and professional biases affect the goals and encoding
process. Use of clearly understood symbols and communication
of all the receiver needs to know are important.
3. Transmission : transmission of the message must overcome
interference such as garbled speech, unintelligible use of words,
long complex sentences, and distortion from recording devices,
noise and illegible handwriting.
4. Receiving : the receiver’s senses of seeing and hearing are
activated as the transmitted message is received. People tend to
have selective attention and selective perception that cause
incomplete and distorted interpretation of the communication.
The receiver may be pre-occupied with other activities and
consequently not be ready to listen.
5. Decoding : decoding of the message by the receiver is the
critical fifth step. Written messages allow more time for
decoding, as the receiver assesses the explicit meaning and
implications of the messsage based on what the symbol means
to her. The communication depends on the receiver’s
understanding of the information.
PPT Lecture cum
discussion
What is the
process of
communication
?

8. 6. Response or feedback : it is the final step. It is important for
the manager or sender to know that the message has been
received and accurately interpreted.
8. 7min To explain the
types of
communication
TYPES OF COMMUNICATION
1. On the basis of relationship :
- Formal
- Informal
2. On the basis of flow :
- Vertical : downward and upward.
- Horizontal.
3. On the basis of expression :
- Verbal : oral, written
- Non-verbal
4. Other types :
- Physiological communication
- Psychic communication
- Serial communication
- Symbolic communication
- Visual communication
- Mechanical communication
I. ONE WAY V/S TWO WAY COMMUNICATION
1. One – way communication
The flow of communication is one way from the
communicator to the audience.
Drawbacks are :
- Knowledge is imposed.
- Learning is authoritative.
- Little audience participation.
- No feedback.
- Does not influence human behavior.
PPT Lecture cum
discussion
What are the
types of
communication
?

9. 2. Two – way communication
In this both the communicators and the audience take place.
The process of communication is active and democratic.it is
more likely to influence behavior than one way communication.
II. FORMAL V/S INFORMAL COMMUNICATION
1. Formal Communication
It is officially organized channels of communication and it is
delayed communication. It is generally used for all practices
purposes. This authoritative, specific, accurate and reaches
everybody. The medium of formal communication may be
department meeting, conferences, telephone calls, interviews,
circular etc.
2. Informal network
Gossip circles such as friend’s internet group, like minded
people and casual groups. Communication is very faster here.
The informal channels may be more active. It does not reach
everyone. Informal communications are quite fast and
spontaneous.
III. VERBAL V/S NON VERBAL COMMUNICATION
1. Verbal Communication
The traditional way of communication has been by word of
mouth language is the chief vehicle of communication. Direct
verbal communication by word of mouth may be loaded with
hidden meanings. The important aspects of verbal
communications are as follows :
- Vocabulary
- Denotative and connotative meaning
- Pacing
- Adoptability
- Intonation
- Clarity and brevity

10. - Credibility
- Time and relevance
- Oral communication and written communication.
2. Non – verbal Communication
Communication can occur even without word. Non – verbal
communication is message transmission through body language
without using words. It includes bodily movements, positive,
facial expression. Silence is non verbal communication. It can
speak louder than words.
- Personal appearance
- Posture and gait
- Facial expression
- Eye contact
- Hand movements and gestures
IV. OTHER TYPES
1. Physiological communication :
It is a stimulus received by the body, immediately the brain
receives the information and transmits to the respective organs
through the nerves.
2. Psychic communication :
Extra sensory perception occurs, i.e., something which will occur
in future. The person pertains and predicts that in advance is
called psychic communication.
3. Serial communication :
Person to person the message will be passed like a chain. Sender
passes the message to one person, then the receiver passes
information to other and so on.
4. Symbolic communication :
Good communication requires awareness of symbolic
communication, the verbal and non-verbal symbolism used by

11. others to convey meaning.
5. Visual communication :
The visual forms of communication compromise charts and
graphs, pictograms, tables, maps, posters, etc.
ADVANTAGES OF COMMUNICATION
1. Oral Communication :
- It is face to face system and hence can be clarified.
- There is an opportunity to ask questions, exchange ideas and
clarify meaning.
- It can develop a friendly and cooperative spirit.
- It is easy and quick.
- It is flexible and hence effective.
2. Written Communication :
- It has permanent record for future reference.
- It is less likely to be misunderstood.
- It will have adequate coverage and accuracy.
- Suitable for communicating lengthy messages.
- It is an authoritative communication.
DISADVANTAGES OF COMMUNICATION
1. Oral Communication :
- The spoken words may be misunderstood.
- The facial expression and tone of voice of the communicator
may mislead the receiver.
- Not suitable for lengthy communication.
- It requires the art of effective specificity.
- It has no record for future reference.
2. Written Communication :
- It requires skill and education for understanding.
- It is also one way communication and hence may not be

12. effective.
- There is no opportunity for the subordinates to ask questions
and exchange ideas.
- It may not communicate all aspects.
9. 4min To explain the
strategies of
communication
STRATEGIESFOR COMMUNICATION
1. Think before you speak :
Think about the purpose of your communication What do you
hope to accomplish with your words or actions ?
Before you speak, ask yourself : Is it kind ? Is it necessary? Is it
true? Does it improve on the silence? Also think about the
structure of your communication.
2. Listening :
The most effective leaders know when to stop talking and start
listening. This is especially important in 3 particular situations :
- When emotions are high
- In team situations
- When employees are sharing ideas.
Listening is crucial when emotions are high. Extreme emotions
such as anger, resentment and excitement, warrant attention from a
personal and a business standpoint.
Managers who ignore feelings can create distance between
themselves and their employees, eroding the relationship and
ultimately affecting the working environment.
3. Questioning :
Many leaders need information but aren’t sure how to get it.
Similarly, their employees may have information but may not
know how to impart it. Managers can open the lines of
communication by asking good questions.
Different kind of questions (closed questions, open questions,
personal questions) yield different kinds of results.
4. Using discretion :
PPT Lecture cum
discussion
What are the
strategies of
communication
?

13. Knowing when not to speak as a leader is just as important as
speaking. Managers must understand that the moment they don a
new title, they become a leader, one whom others look for
guidance, direction and even protection. Good leaders adopt a
policy of discretion. Only then can develop the trust that is so vital
to productivity.
5. Directing :
Many managers direct their employees because they believe it’s
the only way to get things done. It is not.
Directing means giving directions clearly and unequivocally, such
that people know exactly what to do and when. It is best used in
times of confusion.
10. 2min To describe
interpersonal
communication
INTERPERSONALCOMMUNICATION
- It is the interaction that occurs between two people or in a small
group. Healthy interpersonal communication allows problem
solving, sharing of ideas, decision making and personal growth.
- In administration, being a member of nursing committee in
hospital/ institutions challenges the nurse’s ability to express
ideas clearly and decisively.
Advantages :
1. There is an opportunity to ask questions, exchange ideas and
clarify meaning.
2. It can develop a friendly and co-operative spirit.
3. It is easy and quick.
4. It is flexible and hence effective.
5. Helps to understand each other.
6. Avoids duplication of work.
7. Shares ideas, knowledge and views on various prospective.
PPT Lecture cum
discussion
What is
interpersonal
communication?
11. 3min To describe the
levels/ channels
of
LEVELS / CHANNELS OF MANAGERIAL
COMMUNICATION
PPT Lecture cum
discussion
What are the
levels of
communication

14. communication
There are four levels of managerial communication :
- Downward communication
- Upward communication
- Lateral communication
- Diagonal communication
1. Downward communication :
This is the traditional and most used communication, where the
management gives orders to the subordinates at the bottom
level to carry out the orders as per the organizational hierarchy.
2. Upward communication :
Upward communication in the management levels from staff,
lower and middle management personnel and continues up to
the organizational hierarchy. It provides a means for motivating
satisfying personnel by encouraging employees input.
3. Lateral communication :
?
Management
Subordinates Subordinates
Management
Subordinates Subordinates

15. Lateral or horizontal communication is referred to the
communication which takes place between the departments or
personnel on the same level of the hierarchy.
4. Diagonal communication :
It occurs between two individuals or departments that are not o
the same level of the hierarchy. Eg : X-Ray department informs
appointments given to patients in a particular unit., etc.
12. 5min To describe the
theories of
communication
THEORIES OF COMMUNICATION
The theories of communication related to management are :
1. The Decibel theory
2. The Sell theory
3. The Minimet theory
1. The Decibel Theory :
It argues that the best way to get the message across is to state one’s
point loudly and frequently. Its effectiveness over a period of time is
nil, but many of us still need to be reminded that shouting only makes
poor communication louder.
2. The Sell theory :
It lays down that the total burden of communication is on the
communicator while the receiver is passive and pliable. One of the
problems created by this approach is that it tends to increase the
barriers between the individuals and thus reduces the chances of
hearing each other.
3. The Minimet Theory :
It assumes that the receiver probably is not much interested in what is
PPT Lecture cum
discussion
What are the
theories of
communication?
Management
Subordinates Subordinates

16. being communicated. By telling an individual what he needs to
know, he will have little to object and little to question.
13. 4min To explain the
barriers of
communication
BARRIERS OF COMMUNICATION
Following are the main barriers to overcome :
1. Due to organization structure :
- Several layers of management.
- Long lines of communication.
- Lack of instructions for passing information to the
subordinates.
- Heavy pressures of work at certain levels of authority.
2. Due to status and position :
- Attitude exhibited by the supervisor is sometimes a hurdle in
two way communication.
- Prejudice among the supervisors and subordinates may stand in
the way of a free flow of information and understanding.
- The supervisors particularly at the middle level may sometimes
like to be in good books of top management.
3. Semantic barriers :
- Words seldom mean same thing to two people. Symbols or
words usually have a variety of meaning arid the sender and the
receiver have to choose one meaning from among many. If both
of them choose the same meaning, communication will be
perfect.
- But this is not so always because of differences in formal
education and specific situations of the people.
4. Tendency to evaluate :
- A major barrier to the communication is the natural tendency to
judge the statement of the person or other group.
- Everyone tries to evaluate others from his own point of view or
experience.
- Communication requires an open mind and willingness to see
PPT Lecture cum
discussion
What are the
barriers of
communication?

17. things through the eyes of others.
5. Heightened emotions:
- Barriers may also arise but in specific situations, e.g., emotional
reactions, physical conditions like noise or insufficient light,
past experience, etc.
- When emotions are strong, it is most difficult to know the
frame of mind of the other person or group.
6. Lack of ability to communicate :
All persons do not have the skill to communicate. Skill in
communication may come naturally to some, but an average man
may need some sort of training and practice by way of
interviewing and public speaking, etc.
7. Inattention :
- The simple failure to read bulletins, notices and reports is a
common feature.
- With regard to failure to listen to oral communications, it has
been seen that non-listeners are often turned off while they are
pre-occupied with others affairs, like their family problems.
8. Resistance to change :
- Resistance to change is an important obstacle to effective
communication.
- Sometimes, organizations announce changes which seriously
affect the employees, e.g., shifts in timings, place and order of
work, installations of new plant, etc.
- Changes affect people in different ways and it may take some
time to think through the full meaning of the message.
- Hence it is important for the management not to force changes
before people are in a position to adjust to their implications.
9. Closed minds :
Certain people who think that they know everything about a
particular subject also create obstacles in the way of effective
communication.

18. 14. 7min To explain
confidentiality
CONFIDENTIALITY
- Confidentiality is mainly about privacy, meaning that any
information you write down or tell someone about will be kept
between you and that person.
- Confidentiality is practiced in many professions.
- It is both a legal duty as well as an ethical duty.
DEFINITION :
- Confidentiality in the work place can be defined as keeping the
employee customer and client information private.
- Confidentiality is a set of rules or a promise that limits access
or places restrictions on certain type of information.
- Confidentiality can be defined as the ethical principle or legal
right that a physician or a health professional will hold secret
all information relating to a patient, unless the patient gives
consent permitting disclosure.
PURPOSE :
- To allow the patient to feel free to make a full and frank
disclosure of information to the physician.
- To build a trusting environment between the patient and
physician.
- To protect the ideas or information which are unique and
sensitive in nature from being not disclosed to the public
- To enable the physician to diagnose conditions properly and to
treat the patient appropriately by full disclosure of information.
IMPORTANCE :
1. Natural human desire of privacy.
2. Fear of social embarrassment or disapproval.
PPT Lecture cum
discussion
What is
confidentiality?

19. 3. Fear of discrimination, stigmatization.
4. Information misused against patient.
5. Builds confidence and open communication.
6. Demonstrates doctor’s fidelity to the patient.
7. Respects patient’s privacy, dignity and individuality.
8. Encourages free exchange of information which is critical for :
-effective medical intervention.
-public health effort.
-preventing harm to others.
9. Medical confidentiality respects patient’s autonomy.
10. Right to determine with whom, when and how much of
personal medical information is shared.
DISCLOSURE OF INFORMATION :
Medical confidentiality is not absolute. Disclosure of the information
should be done :
- With patient’s consent.
- For benefit of patient.
- To prevent harm to others.
- When required by law.
- Medical research or audit.
Principles for disclosure :
- The disclosure of information should be done to proper
authorities.
- Information disclosed should not be beyond what is required or
relevant.
- Reason for disclosure should be documented in the medical
records.
15. 4min To describe
patient
confidentiality
for health care
professionals
PATIENT CONFIDENTIALITYFOR HEALTH CARE
PROFESSIONALS
- Patient confidentiality is the right of an individual to have
personal, identifiable medical information kept private.
- Such information should be available only to the physician of
PPT Lecture cum
discussion
What do you
understand by
patient
confidentiality
for health care
professionals ?

20. record and other health care and insurance personnel as
necessary.
- Permission must be received from the patient prior to any
disclosure.
Medical confidentiality is defined in many ways. In simple words, it
can be said as :
- Foundation of trust in doctor patient relationship.
- Privileged communication intended only for the knowledge of a
particular person.
- The act to keep private information secret.
It is both an ethical duty and legal duty. Respect for confidentiality
is firmly established in codes of medical ethics.
1. Hippocratic oath :
“ Whatever in connection with my professional practice, or not
in connection with it, I see or hear in the life of men, which
ought not to be spoken of abroad. I will not divulge as
reckoning that all such should be kept secret. While I continue
to keep this Oath unviolated, may it be granted to me to enjoy
life and the practice of the art, respected by all men, in all
times. But should I trespass and violate this Oath, may the
reverse be my lot.”
2. International Code of Ethics :
“Except when obligated by the law of the country concerned, a
doctor shall not disclose, without the consent of the patient,
information which he has obtained in the course of his
professional relationship with the patient.”
As a legal duty there is HIPAA Enforcement.
- In 1996 Congress enacted the HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT or
H.I.P.A.A.

21. - The primary purpose of this act was to ensure the continuity of
the health insurance when one changes the jobs.
- The Privacy Rule was published in April 2001 and has been
enforced since April 2003 by the office of Civil Rights.
- Thus HIPAA requires all professionals and organizations to
guard the privacy of their patients and customers.
- Individuals must provide written consent for any and all
releases of medical or health-related information. Employees at
all levels are required to maintain confidentiality.
- There civil penalties of 100 / violation up to $25,000 /
violation.
- Criminal penalties are also possible including $50,000/violation
and/or 1 year in prison for wrongful disclosure or $250,000 and
10 years in prison for the intent to sell information.
16. 5min To explain
breach of
confidentiality
BREACH OF CONFIDENTIALITY
- A breach of confidentiality is a disclosure to a third party,
without patient consent or court order, of private information
that the physician has learned within the patient-physician
relationship.
- Disclosure can be oral or written, by telephone or fax, or
electronically, e.g., via e-mail or health information networks.
- It is rare for medical records to remain completely sealed,
however. The most benign breach of confidentiality takes place
when clinicians share medical information as case studies.
- The greatest threat to medical privacy occurs because most of
the time the bills are paid by some form of health insurance,
either private or public. This makes it difficult to keep
PPT Lecture cum
discussion
What is breach
of
confidentiality ?

22. information truly confidential.
Health records are routinely viewed not only by physicians and
their staffs, but by the employees of insurance companies,
medical laboratories, public health departments, researchers
and many others.
- Confidentiality is breached when situations arise where the
harm in maintaining confidentiality is greater than the harm
brought about by disclosing confidential information.
- Medical conditions becomes critical in certain conditions like :
1. Sexual history & STD
2. Adolescent sexuality
3. Alcohol & drug dependence
4. Psychiatric conditions
EXCEPTIONS :
The medical records are to be kept secret except in certain conditions
like :
- Treatment of minors
- HIV + patients
- Abuse of a child or adult
- Transportation safety
- Duty to report harm/ injury
17. 1min To summarize
the topic
SUMMARIZATION
 Introduction of the topic
 Definition of communication
 Importance and elements of communication
 Process of communication
 Types and strategies of communication
 Interpersonal communication
 Levels and theories of communication
 Barriers of communication
- - -

23.  Introduction and definition of confidentiality
 Purpose and importance of confidentiality
 Patient confidentiality for health care professionals
 Breach of confidentiality
18. 1min To recapitulate
the topic
RECAPITULATION
 What is communication ?
 What are the strategies of communication ?
 What is confidentiality ?
 What is the importance of confidentiality ?
- - -

24. BIBLIOGRAPHY
 “K. Deepak, C. Chandran Sarath, B.P. Kumar Mithun”, “A Comprehensive Textbook on Nursing Management”, 2nd Edition,
Published by EMMESS Medical Publishers, pp. 216-228
 https://www.slideshare.net/shivakumarchawan9/comm-bsc
 https://www.nursingpath.in/2013/04/communication-in-nursingppt.html
 https://www.scribd.com/presentation/323933951/Confidentiality-Ppt