COMMUNICATION AND NURSE PATIENT RELATIONSHIP

By :
SAYANTANI MONDAL
College Faculty
Govt College of Nursing, District Hospital,
Howrah

DEFINITION
COMMUNICATION IS AN ACT (BEHAVIOUR) AND
A PROCESS IN WHICH A MESSAGE IS
TRANSFERRED FROM ONE PERSON TO ANOTHER
PERSON THROUGH A SUITABLE MEDIA AND THE
INTENDED MESSAGE IS RECIVED AND
UNDERSTOOD BY THE RECIEVER.

LEVELS OF COMMUNICATION
Intrapersonal communication

ELEMENTS AND PROCESS OF
COMMUNICATION
THERE ARE SEVERAL ELEMENTS OF
COMMUNICATION:
THE REFERENT, SENDER AND RECEIVER,
MESSAGE, CHANNELS, CONTEXT OR
ENVIRONMENT IN WHICH THE
COMMUNICATION PROCESS OCCURS,
FEEDBACK, AND INTERPERSONAL VARIABLES.

Each person in the communication interaction, is both a
speaker and a listener.
They can be simultaneously sending and receiving messages.
Both parties view the perceptions, attitudes, and potential
reactions to a sent message. Communication becomes a
continuous and interactive activity.
Feedback from the receiver of environment enables the
communications to correct or validate the communication.

The role relationship of the communicators are
complementary and symmetrical.
Complementary role
relationships function with
one person holding an
elevated position over the
other person.
Symmetrical relationships
are more equal

TYPES AND MODES OF
COMMUNICATION
1. VERBAL COMMUNICATION
VERBAL COMMUNICATION USES SPOKEN OR
WRITTEN WORDS.

THE MOST IMPORTANT ASPECTS OF VERBAL
COMMUNICATION ARE THE FOLLOWINGS:
VOCABULARY: COMMUNICATION IS
UNSUCCESSFUL IF SENDERS AND RECEIVERS
CANNOT UNDERSTAND ONE ANOTHER'S WORDS
AND PHRASES. WHEN YOU CARE FOR A PATIENT
WHO SPEAKS ANOTHER LANGUAGE, A
PROFESSIONAL INTERPRETER IS NECESSARY.

DENOTATIVE AND CONNOTATIVE MEANING: SOME
WORDS HAVE SEVERAL MEANINGS. INDIVIDUALS
WHO USE A COMMON LANGUAGE SHARE THE
DENOTATIVE MEANING.
THE CONNOTATIVE MEANING IS THE SHADE OR
INTERPRETATION OF THE MEANING OF A WORD
INFLUENCED BY THE THOUGHTS, FEELINGS, OR IDEAS
THAT PEOPLE HAVE ABOUT THE WORD.

PACING:
CONVERSATION IS MORE SUCCESSFUL AT AN
APPROPRIATE SPEED OR PACE. SPEAK CLEARLY.
TALKING RAPIDLY, USING AWKWARD PAUSES, OR
SPEAKING SLOWLY AND DELIBERATELY CONVEYS
AN UNINTENDED MESSAGE.

INTONATION:
TONE OF VOICE DRAMATICALLY AFFECTS THE
MEANING OF A MESSAGE. DEPENDING ON
INTONATION, EVEN A SIMPLE QUESTION OR
STATEMENT EXPRESSES ENTHUSIASM, ANGER,
CONCERN OR INDIFFERENCE.

CLARITY AND BREVITY:
EFFECTIVE COMMUNICATION IS SIMPLE, BRIEF
AND DIRECT.

TIMING AND RELEVANCE:
TIMING IS CRITICAL IN COMMUNICATION. EVEN
THOUGH A MESSAGE IS CLEAR, POOR TIMING
PREVENTS IT FROM BEING EFFECTIVE.

2. NON-VERBAL COMMUNICATION
NON VERBAL COMMUNICATION INCLUDES THE
FIVE SENSES AND EVERYTHING THAT DOES NOT
INVOLVE THE SPOKEN OR WRITTEN WORD.
NONVERBAL ASPECTS OF COMMUNICATION SUCH
AS VOICE TONE, EYE CONTACT, AND BODY
POSITIONING ARE OFTEN AS IMPORTANT AS
VERBAL MESSAGES.

PERSONAL APPEARANCE:
PERSONAL APPEARANCE INCLUDES PHYSICAL
CHARACTERISTICS, FACIAL EXPRESSION, AND
MANNER OF DRESS AND GROOMING. THESE
FACTORS COMMUNICATE PHYSICAL WELL-BEING,
PERSONALITY, SOCIAL STATUS, OCCUPATION,
RELIGION, CULTURE, AND SELF-CONCEPT.

POSTURE AND GAIT:
POSTURE AND GAIT (MANNER OR PATTERN OF
WALKING) ARE FORMS OF SELF-EXPRESSION. THE
WAY PEOPLE SIT, STAND, AND MOVE REFLECTS
ATTITUDES, EMOTIONS, SELF-CONCEPT, AND
HEALTH STATUS.

FACIAL EXPRESSION:
FACIAL EXPRESSIONS CONVEY EMOTIONS SUCH
AS SURPRISE, FEAR, ANGER, HAPPINESS AND
SADNESS. SOME PEOPLE HAVE AN EXPRESSIONLESS
FACE, OR FLAT AFFECT, WHICH REVEALS LITTLE
ABOUT WHAT THEY ARE THINKING OR FEELING.

EYE CONTACT:
PEOPLE SIGNAL READINESS TO COMMUNICATE
THROUGH EYE CONTACT. MAINTAINING EYE
CONTACT DURING CONVERSATION SHOWS
RESPECT AND WILLINGNESS TO LISTEN.

GESTURES:
GESTURES EMPHASISE, PUNCTUATE, AND CLARIFY
THE SPOKEN WORD. GESTURES ALONE CARRY
SPECIFIC MEANINGS, OR THEY CREATE MESSAGES
WITH OTHER COMMUNICATION CUES.

SOUNDS:
SOUNDS SUCH AS SIGHS OR SOBS ALSO
COMMUNICATE FEELINGS AND THOUGHTS.
COMBINED WITH OTHER NONVERBAL
COMMUNICATION, SOUNDS HELP TO SEND CLEAR
MESSAGES.

TERRITORIALITY AND PERSONAL SPACE:
TERRITORIALITY IS THE NEED TO GAIN, MAINTAIN,
AND DEFEND ONE'S RIGHT TO SPACE. TERRITORY
PROVIDES A SENSE OF PRIVACY, IDENTITY AND
SECURITY.

FACTORS INFLUENCING
COMMUNICATION
Developmental level :
It is helpful to understand the process of language
development and intellectual and psychosocial
development.

Gender :
Men and women communicate differently and may
interpret the same conversation differently.

Sociocultural Differences :
As a nurse, you need to recognize ways in which culture,
economic condition, and overall lifestyle influence a
patient's preferred mode of communicating.

Roles and Responsibilities :
A person's occupation might give the nurse a general
idea of that person's abilities, talents, interests, and
economic status. Stereotyping a person according to
occupation, however, can be misleading and should be
avoided.

Physical, mental and emotional state :
Be sensitive to patient’s physical, mental and emotional
state to ensure effective communication. A full bladder,
headache, chest pain, anxiety can negatively influence
communication.

Values :
Communication is influenced by the way people value
them. When a nurse herself strongly value her words
while delivering a health teaching, the patients also
starts to value her words more effectively.

Environment :
Communication happens best when environment
facilitates easy exchange of needed information.

METHODS OF EFFECTIVE
COMMUNICATION
Rapport Building

BARRIERS OF EFFECTIVE
COMMUNICATION
Linguistic barriers

TECHNIQUES OF EFFECTIVE
COMMUNICATION
Observing

NONTHERAPEUTIC
COMMUNICATION TECHNIQUES
Overloading

PROFESSIONAL COMMUNICATION
THE NURSE DIRECTS COMMUNICATION TOWARDS
THE PATIENT TO IDENTIFY HIS CURRENT HEALTH
PROBLEMS, PLAN, IMPLEMENTS AND EVALUATES
ACTION TAKEN.
- BIMLA KAPOOR
IT IS A PROCESS IN WHICH UTILIZES A PLANNED
APPROACH TO LEARN ABOUT THE CLIENT.
- POTTER A.

HELPING RELATIONSHIP (NURSE
PATIENT RELATIONSHIP)
 The helping relationship is characterised by an
unequal sharing information. The patient shares
information about personal health problems, whereas
nurse shares information in terms of professional role.
 It is dynamic. Both the person proving the assistance
and the person being helped are active participants to
the extent each is able.
 It is purposeful and time limited. There are specific
goals that are intended to meet within a specific time
period.

PURPOSES OF HELPING RELATIONSHIP
 To assist the client with problem solving.
 To help the client examine self defeating behaviours
and test alternatives.
 To facilitate communication of distressing thoughts
and feelings.
 To promote self care and independence.

PHASES OF HELPING RELATIONSHIP
There are four phases in “Helping Relationship” or
“Nurse Patient Relationship”.
 Preorientation Phase
 Orientation Phase
 Working Phase
 Termination Phase

PREORIENTATION OR PREINTERACTION PHASE

COMMUNICATING EFFECTIVELY WITH
PATIENT, FAMILIES AND TEAM
MEMBERS

Qualities and skills necessary for
helping relationship
Genuineness

Therapeutic Impasses
Resistance

MAINTAINING EFFECTIVE HUMAN
RELATION AND COMMUNICATION
WITH VULNERABLE GROUP
VULNERABLE GROUPS ARE THOSE WHO NEED
SPECIAL ATTENTION SUCH AS CHILDREN, WOMEN,
PHYSICALLY AND MENTALLY CHALLENGED AND
ELDERLY. FAILURE OF HEALTH CARE PROVIDERS
TO COMMUNICATE WITH VULNERABLE GROUP IS
A MAJOR BARRIER IN COMMUNICATION AND
DELIVERING PROPER CARE.

Communication with Old age people

Communication with People with visual
impairment

Communication with People with hearing
impairment

Communication with People with speech
impairment

Communication with People with cognitive
impairment

Communication with People with intellectual
disability

COMMUNICATION AND NURSE PATIENT RELATIONSHIP

COMMUNICATION AND NURSE PATIENT RELATIONSHIP

COMMUNICATION AND NURSE PATIENT RELATIONSHIP

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