This document discusses various types and aspects of communication. It begins by defining communication and noting that it is a dynamic, reciprocal process of sending and receiving messages to share information and obtain a response. It then discusses different levels of communication including intrapersonal, interpersonal, group, public, and electronic communication. The document also covers factors that influence communication such as culture, emotions, misunderstandings, education levels, past experiences, and relationships between communicators. Barriers to communication and techniques for overcoming those barriers are also examined.

1. COMMUNICATION
PATIENT

2. Communication is a dynamic, reciprocal process of sending
and receiving messages.Communication is more than the act
of talking and listening. From the first cry of a newborn to the
whisper of a person who is dying, the primary purpose of a
communication is to share a information and obtain a
response. People use communication to meet their physical,
psychological, emotional and spiritual needs.

3. Communication is ‘any act by which one person gives to or
receives from person information about that person’s needs,
desires, perception, knowledge, or affective state’.
Communication may be intentional or unintentional, may
involve conventional or unconventional signals, may take
linguistic or non-linguistic forms and may occur through
spoken or other modes.

4. Intrapersonal Communication
Interpersonal Communication
Group Communication
Public Communication
Electronic Communication

5. Intrapersonal communication is a powerful form of
communication that can use as a professional nurse. This level
of communication is also called self-talk. People’s thoughts
and inner communication strongly influence perceptions,
feelings, behaviour, and self-esteem. Always be aware of the
nature and content of your own thinking. Positive self-talk
provide a mental rehearsal for difficult task or situations so
individuals deal with them more effectively and with
increased confidence. Nurses use intrapersonal
communication to develop self-awarness and a positive self-
esteem that enhances appropriate self-expression. Negative
self-talk can help the nurse to diminish cognitive distortions
that lead to a decrease in self-esteem and impact the nurses
ability to work with patients.
➢ It is communication between two or more people.
➢ Face to face conversation between two people is the
most frequent form of interpersonal relationship.
➢ Nurse use interpersonal communication to gather
information during assessment, to teach about health

6. issues to explain care and to provide comfort and
support.
It is the interaction that occurs when a small number of people
meet. This type of communication is usually goal directed and
requires an understanding of group dynamics. When nurses
work on committees with nurses or other disciplines and
participate in patient care conferences, they use a small-group
communication process. Communication in these situations
should be organized, concise and complete. All participating
disciplines are encouraged to contribute and provide feedback.
Good communication skills help each participant better meet a
patient’s needs and promote a safe care environment.
Public communication is interaction with an audience.
Nurses often speak with groups of consumers about health
related topics, present scholarly work to colleagues, or lead
classroom discussions with peers or students. Public
communication requires special adaptations in eye contact,
gestures, voice inflection, and use of media materials to
communicate message effectively. Effective public
communication increases audience knowledge about health

7. related topics, health issues, and other issues important to
the nursing profession.
Electronic communication is the use of technology to create
ongoing relationship with patients and their health care
team. Secure messaging provides an opportunity for
frequent and timely communication with a patient’s
physician or nurse via a patient portal. An electronic portal
enables patients to stay engaged and informed and build a
therapeutic relationship with the health care team.

8. ➢ The communication requires a sender, a message, a
receiver and a response or feedback.
➢ Communication is two-way process involving the
sending and receiving of a message. Because the
internet of communication is to elicit a response the
process of ongoing, the receiver of the message then
becomes the sender of a response, and the original
sender then becomes the receiver.
• Message
• Source(sender)
• Channel
• Receiver
• Feedback(response)

9. VERBAL COMMUNICATION (a type of
communication where we use spoken and written words
to get our message and information across to the other
person)
NONVERBAL COMMUNICATION(is the transfer of
information through body language, facial expression,
gestures, created space and more)
❖ Sender- A sender is a person who encodes and sends the
message to the expected receiver through an appropriate
channel
A sender is the source of the message that is
generated to be delivered to the receiver after appropriate
stimulus from the referent.
❖ Message- The message is the content of communication
and may contain verbal, nonverbal or symbolic language.
Perception and personal factors of the sender
and receiver may sometimes distort this element and the
intended outcome of communication may not be
achieved.

10. ❖ Channel- A channel is a medium through which a
message is sent or received between two or more people.
Several channels can be used to send or receive
the message, i.e seeing, hearing, touching, smelling and
tasting.
While selecting channels of communication, several
factors must be considered: availability of channels,
purpose, suitability, types of receivers, communication
skill of sender, cost, etc.
CLASSIFICATION OF CHANNELS OF COMMUNICATIONS-
• VISUAL- Facial expression, body language, posture, gestures,
pictures and written words, electronic mails, mass media etc.
• AUDITORY- Spoken words, sounds, telephone or mobile
communications etc.
• TACTILE- Touch sensation, therapeutic touch etc.
• COMBINED- Audiovisual media, consoling a person with touch
and spoken words.
❖ Receiver- A receiver is an individual or group
individuals intended to receive, decode and interpret the
message sent by the sender/source of message.
A receiver also known as decoder.
He is expected to have the ability and skills to
receive, decode and interpret the message.
❖Feedback- It is a return message sent by the receiver to
the sender.
It is most essential element of the communication
process as it shows that the receiver has understood the
primary message sent by the sender and the
communication process is non consider complete.

11. A successful communication must be a two-way
process where the sender sends the message and receives
feedback from the receiver.
TYPES OF COMMUNICATION BASED ON
THE COMMUNICATION CHANNEL USED
ARE:-
1. Verbal:- Verbal communication refers to the form
of communication in which message is transmitted
verbally, communication is done by word of mouth
and a piece of writing.
Verbal communication is further divided
into:-
Oral:- In oral communication, spoken words are used. It
includes face to face conversation, speech, telephonic
conversation, video, radio, television, voice over internet. In
oral communication, communication is influenced by pitch,
volume, speed and clarity of speaking.
Written- In written communication, written signs or symbols
are used to communicate. A written message may be printed
or hand written message may be printed or hand written. In
written communication message can be transmitted via email,
letter, report, memo etc.
2. Non-Verbal:- Non-verbal communication is the
sending or receiving of wordless message. We can

12. say that communication other than oral and
written, such as gesture, body language, posture,
tone of voice or facial expression, is called non-
verbal communication.
Non-verbal communication has the
following elements:-
Speaker:- Appearance, clothing, hairstyle, neatness, use of
cosmetics
Surrounding:- Room size, lighting, decorations, furnishings
Body language:- Facial expression, gestures, postures.
Sounds:- Voice tone, volume, speech rate.
TYPES OF COMMUNICATION BASED ON PURPOSE
AND STYLE
Communication types based on style and purpose are:-
• Formal Communication
• Informal Communication
Formal Communication- In formal communication,
certain rules, conventions and principles are followed
while communicate:
Formal communication occurs in formal and
official style. Usually professional settings, corporate
meetings, conferences undergo in formal pattern.
Informal communication- Informal communication is
done using channels that are in contrast with formal
communication channels. It’s just a casual talk.

13. Informal communication channel, unlike
formal communication, doesn’t follow authority lines. In
an organization, it helps in finding out staff grievances
as people express more when talking informally.
Informal communication helps in building relationships.
OTHER TYPES COMMUNICATION
One-way Communication- Communication in which
information is only transmitted from one point to
another or to many points simultaneously.
There is no reception of information at the
transmitting point and no transmission of information
from a receiving point.
One-way communication is used to transmit
current information and accurate time and frequency
signals, as well as for radio and television broadcasting.
Two-way Communication- Two-way communication
as processing can best be characterized as a style of
auditing. The process has everything to do with getting
the patient to it is about an area and keep him talking on
the subject. To do that, the auditor does not use set
commands, but listens with interest and uses light
questions and half acknowledgements.

14. FACTORS INFLUENCING
1. Cultural Diversity- The chance of
misunderstanding or misinterpretation of message
is higher in organizations with people from
different cultural background. This is due to
inability to relate and truly understand someone
with different background. This leads to
assumptions and speculation which feed bigger
problems in organizations if left unresolved. Being
aware of this is the first step to take measures to
address this issue.
2. Emotional Difference- Emotions and how people
feel when communicating affect the meaning of
communication. Again, being aware or conscious
that people often bring in personal issues into the
workplace no matter how hard they try to
compartmentalize them.
3. Misunderstanding or Misinterpretation of the
message- Communication can falter when people
assign different meanings to the same word. This
issue is very common in the communication
process but if left unchecked can lead to bigger
problems for organizations. Message must be
prepared properly, be specific, and have a feedback
system.

15. 4. Educational Difference- Different education level
between the sender and receiver also influence the
meaning of communication. If they have similar
educational qualifications, communication will be
effective.
5. Past Experiences- Previous communication with
the sender and receiver strongly determines the
effectiveness of further communication between
them. If either of the parties has a negative
experience, further communication between them is
likely ineffective.
6. Functional relationship between sender and
receiver- It is quite common that when a sender and
receiver belong to different functional departments
or areas, the receiver may not clearly understand
the sender’s message.
▪ Create an open communication
environment
▪ Implement an inclusive communication
strategy
▪ Communication must be two-way and
focused on results
▪ Use multiple channels to communicate
effectively
▪ Make sure that the massage is delivered.
▪ Feedback and be accountable with
communication process.

16. 1. Physiological barriers- Poor retention due to
memory problems, lac of attention, discomfort due
to illness, poor sensory perception, hearing
problems, poor listening skills, information
overload, gender physiological differences.
2. Environmental barriers- Loud background noise,
poor lighting, uncomfortable settings, unhygienic
surroundings and bad odour, very hot or cold room,
distance.
3. Psychological barriers- Misinterpretation and
misunderstanding, distrust and unhappy emotions,
emotional disturbance such as anger, jealousy, and
suspicion, psychotic or neurotic illness, worry and
emotional disturbance, fear, anxiety and confused
thinking.
4. Social barriers- Diffidence in social norms, values,
and behaviour, social strata(when we divided the
people based on the socioeconomic condition like
income, race, ethnicity, gender occupation etc.)
5. Semantic barriers- Language barriers, faulty
language translation, past experience of an
individual, failure to listen.
6. Cultural barriers- Religious, cultural differences,
cultural traditions, values and behaviour.
7. Organizational barriers- Organizational policy,
rules, and regulations, technical failure, time

17. pressure, complexity of organizational structure due
to hierarchy, size of the organization.
8. Communication process related barriers- Unclear
and conflicting message, inappropriate channels,
lack of poor feedback.
OVERCOME OF COMMUNICATION
1. Physiological barriers-
• Sender and recipient must keep in mind each
other’s retention and memory abilities.
• Sender and recipient must have each other’s
complete attention.
• Before initiating communication, the sender
and the recipient must ensure each other’s
comfort.
• Limitations of hearing ability must be kept in
mind.
• Information overload must be avoided.
• Gender differences must be kept in mind.
2. Environmental barriers-
• Background noise must be kept at the lowest
possible level.
• Good lighting must be ensured to facilitate
nonverbal communication.

18. • Comfortable seating arrangement must be for
effective communication.
3. Psychological barriers-
• Communication must be carried out in
happy and trustworthy manner.
• Sender and recipient must avoid negative
feelings such as anger, jealousy and
suspicion.
• Sender and recipient must be free from fear,
anxiety and confused thinking.
4. Social barriers-
• Social beliefs of the sender and recipient
must be kept in mind while
communicating.
5. Cultural barriers-
• Cultural traditions, values, and behaviour
must be kept in mind during
communication.
6. Semantic barriers ( barriers results in faulty
translation)-
• Technical jargons must be avoided during
communication.
• The language must be simple and clear and
individual differences of social-cultural
back ground must be kept in mind
7. Organizational barriers-

19. • There must be clear organizational policy
of promotion on better communication.
8. Communication process related barriers-
• There must be use of appropriate
channels of communication.
• Must be effective feedback to promote
better communication.
Therapeutic communication is a techniques that prioritize the
physical, mental, and emotional well-being of patients. Nurses
provide patients with support and information while
maintaining a level of professional distance and objectively.
With therapeutic communication, nurses often use open-ended
statements and questions, repeat information, or use silence to
prompt patients to work through problems on their own.
Techniques of Therapeutic Communication-
Using Silence- At times, it’s useful to not speak at all.
Deliberate silence can give both nurses and patients an
opportunity to think through and process what comes
next in conversation. It may give patients the time and
space they need to broach a new topic. Nurses should
always let patients break the silence.
Accepting- Sometimes it’s necessary to acknowledge
what patients say and affirm that they’ve been heard.

20. Acceptance isn’t necessarily the same thing as
agreement, it can be enough to simply make eye contact
and say “Yes, I understand.” Patients who feel their
nurses are listening to them and taking them seriously
are more likely to be receptive to care.
Giving Recognition- Recognition acknowledge a
patient’s behaviour and highlights it without giving an
overt compliment. A compliment can sometimes like “I
noticed you took all of your medications” draws
attention to the action and encourages it without
requiring a compliment.
Giving Broad Openings- Therapeutic communication
is often most effective when patients direct flow of
conversation and decide what to talk about. To that end,
giving patients a broad opening such as “What’s on
your mind today?” or “What would you like to talk
about?” can be a good way to allow patients an
opportunity to discuss what’s on their mind.
Offering Self- Hospital stays can be lonely, stressful
times when nurses offer their time, it shows they value
patients and that someone is willing to give them time
and attention. Offering to stay for lunch, watch a TV
show, or simply sit with patients for a while can help
boost their mood.
Active Listening- By using nonverbal and verbal cues
such as nodding and saying “I see,” nurses can.

21. Active listening involves showing interest in what
patient have to say, acknowledging that you are
listening and understanding, and engaging with them
throughout the conversation. Nurses can offer general
leads such as “What happened next?” to guide the
conversation or propel it forward.
Seeking Clarification- Similar to active listening,
asking patients for clarification when they say
something confusing or ambiguous is important. Saying
something like “I am not sure I understand. Can you
explain it to me?” helps nurses ensure they understand
what’s actually being said and can helps patients
process their ideas more thoroughly.
Summarizing- It is frequently useful for nurses to
summarize what patients have said after the fact. This
demonstrates to patients that the nurse was listening and
allows the nurse to document conversations. Ending a
summary with phrase like “Does that sound correct?”
gives patients permission to make corrections if they
are necessary.
Reflecting- Patients often ask nurses for advice about
what they should do about particular problems or in
specific situations. Nurses ask patients what they think
they should do, which encourages patients to be
accountable for their own action and helps them come
up with solutions themselves.
Focusing- Sometimes during a conversation, patients
mention something particularly important. When this

22. happens, nurses can focus on their statement, prompting
patients to discuss it further.
Confronting- Nurses should only apply this technique
after they have established trust. It can be vital to the
care of patients to disagree with them, present them
with reality, or challenge their assumptions.
Confrontation, when used correctly, can help patients
break destructive routines or understand the state of
their situation.
Voicing Doubt- Voicing doubt can be a gentler way to
call attention to the incorrect or delusional ideas and
perception of patients. By expressing doubt, nurses can
force patients to examine their assumption.
Offering Hope and Humors- Because hospitals can be
stressful places for patients, sharing hope that they can
persevere through their current situation and lightening
the mood with humors can help nurses establish rapport
quickly. This technique can keep patients in a more
positive state of mind.
Non-Therapeutic communication involves words,
phrases, actions, and tones that make patients feel

23. uncomfortable, increase their stress, and worsen
their mental and even physical wellbeing.
Overloading-
• Talking rapidly, changing subjects to often and ask
for more information that can be absorbed at one
time.
Value Judgements-
• Givings one’s own opinion, evaluating, normalizing,
or implying one’s values by using words such as
“nice”, “bad”, “right” “wrong”.
Underloading-
• Remaining silent and unresponsive, not picking up
cues and failing to give feedback.
Invalidation-
• Ignoring or denying another’s presence, thought’s or
feelings.
• Ex. Client: How are you?
Nurse responds: I can’t talk now. I am too busy.
Focusing on self-
• Responding in a way that focuses attention to the
nurse instead of the client.

24. Changing the subject-
• Introducing new topic.
Giving advice-
• Telling the client what to do, giving opinions or
making decision for the client cannot handle his or
her own life decisions and that the nurse is
accepting responsibility.
Internal validation-
• Making an assumption about the meaning of
someone else’s behaviour that is not validated by
the other person (jumping into conclusion)
Disagreeing-
• Another nontherapeutic communication techniques
is disagreeing, or opposing whatever idea the
patient has expressed. By saying something like,
‘That’s wrong, you are not just saying to the client
that their idea is wrong.
Probing-
• Non-therapeutic communication also includes
probing or continuous questioning of the client
about something.

25. Professional communication is defined as oral,
written, digital, or visual forms of information delivery in a
workplace. Professional communication also involves various
forms of speaking, writing, and responding within and beyond
the workplace environment. It is used in letters, business
proposals and press releases.
❖ Learn the importance of communication well in a
professional settings.
❖Discuss different types of communication for a
professional.
❖Review proper verbal and non-verbal communication
skills.
❖Discuss the importance of communicating in difficult
situations.
❖Discuss business e-mail communication
❖Identify several professional writing techniques and avoid
common mistakes when writing.

26. Definition- The nurse patient relationship is an
interaction between a nurse and patient aimed at
enhancing the well being of the client, who may be an
individual, a family, a group or a community.
Phases of Nurse Patient Relationship-
1. Pre-interaction phase
2. Engagement phase
3. Active intervention phase
4. Termination phase
1. Pre-interaction phase-
During this phase-
• Nurses assess the environment in which the nurse
meet with patient.
• Explain the professional goals and set priorities.
• Both parties enter to the relationship with
expectations.
• Patient and nurse become oriented to overall needs
and expectations from the relationship.
2. Engagement-
• Begin to develop the relationship.
• Nurse create a supportive environment.
• Establish a therapeutic contact with patients.
• Trust and empathy are basic qualities here.
• Developed strong bond and feel less anxiety.

27. • Nurse plays the key role with expertise on illness.
• Nurse act as a coordinator.
• Nurse observe and assess patients.
• Patients come to know their health issues and feel
fear, discomfort, or insecure feelings and expect
help.
• Nurses realize patients through their body
languages and help them.
• Therapeutic relationship is well established.
3. Active Intervention Phase-
• The sense of mutuality is developed between
nurse and patient.
• Discuss conflicting situation deeply.
• Nurse and patient work with commitment.
• Nurse sort out problem and solve them.
• Collaboration and equal participation is seen.
• Aware of the differences of rights, roles, and
responsibilities.
• Nurse acknowledge the patients’ feelings, show
the genuine interest, and honesty.
• Nurse convince the patient of equal rights to
make decision.
• Patients become independent decision maker.
4. Termination Phase-
• Start at the times of explaning plans and goals.
• Patient should be informed of this phase at the
beginning.

28. • Otherwise patients develops strong feelings of
separation at this phase.
• Nurse work on education, health advices
preparing discharge plan.

29. Many nursing situations, especially those in community
and home care setting, require the nurse to form helping
relationships with the patient’s entire family.
The same principles that guide one-to-one helping
relationships also also apply when the patient is family
unit, communication within familes requires additional
understanding of the complexities of family dynamics,
needs and relationship.
COMMUNICATION WITH
1. Identify and map your vulnerable groups-
Before crisis happens, you need to know who your
vulnerable groups are, where they are located, and what
their specific challenges and preferences are. You can use
various sources of data, such as surveys, reports or
community networks to identify and map your vulnerable
groups. You can also consult with representatives of these
groups, such as leaders, advocates, or service providers, to
understand their prospective and expectations.

30. 2. Tailor your messages and channels-
Once you have identified your vulnerable groups,
you need to tailor your message and channels to suit their
and preferences. You need to use clear, simple, and
consistent language that avoids jargon, acronyms or
technical terms. You need to use multiple formats and
media, such as text, audio, video or graphics, to convey
your messages. You need to use trusted and credible
sources, such as local leaders, influencers, or experts, to
deliver your messages.
3.Monitor and adjust your communication-
Communication is not one-way process. You need
to monitor and adjust your communication based on the
feedback and response of the vulnerable groups. You need to
use various methods and tools such as surveys, polls, focus
groups, or analytics, to measures the effectiveness and impact
of your communication. You need to use feedback and data to
improve your message and channels, as well as to address any
gaps, misinformation, concerns that may arise.
4.Collaborate and coordinate with partners-
Communication is not a solo effort. You need to
collaborate and coordinate with partners who can help you
reach and serve your vulnerable groups. You need to identify
and engage with partners who have relevant expertise,
resources or networks, such as NGOs, media outlet or
community organizations. You need to establish and maintain
regular communication and coordination mechanisms, such as

31. meetings, updates, or protocols, to ensure alignment and
consistency of your messages and actions.
5. Respect and empower your vulnerable groups-
Communication is not a top-down approach. You
need to respect and empower your vulnerable groups as
active and vulnerable participants in your communication
and emergency management.
COMMUNICATION WITH HEALTH
• Health team members communicate with each other
to give coordinated and effective care.
• Health team members share information about:-
o What was done for the person.
o What needs to be done for the person.
o The person’s response to treatment.
5 Best ways to improve communication in healthcare-
1. Assess your current method of communication.
2. Streamline communication channels.
3. Encourage mobile collaborative for effective
communication between healthcare professionals.
4. Give healthcare employees a voice.
5. Prioritize face-to-face communication.

32. NOTES:- The 7 Cs of Communication:-
1. Clear- When writing or speaking to someone, be
clear about your goal or message.
2. Concise- When you are concise in your
communication, you stick to the point and keep it
brief.
3. Concrete- Be clear, not fuzzy. Provide detail, but not
too much detail.
4. Correct- Make sure your message is accurate and
grammatically correct.
5. Coherent- Make sure your message flows well and
laid out logically.
6. Complete- Ensure the recipient has everything they
need to understand.
7. Courteous- Your message should be polite, friendly,
professional and open.