COMMUNICATION SKILLS ,NPR AND PATIENT TEACHING

COMMUNICATION SKILLS
PRESENTED BY
MS.C.KEERTHANA RN. RM., M.SC (N).,
TUTOR
SRM TRICHY COLLEGE OF NURSING
TRICHY
1

Specific objectives
6/1/2024 DGNM I ST YEAR SRMTCON 2
Define the term communication.
Interpret the process of communication.
List down purposes of communication.
Describe principles and types of communication
Determine the importance of communication in
nursing education.
Enlist the barriers of communication.
Explain the Establishment of successful
communication.
Enumerate Observing skill Listening skill in
communication

INTRODUCTION
3
6/1/2024 DGNM I ST YEAR SRMTCON

Cont..
• The word communication is derived from Latin word
“communicare” which means to participate, to inform or impact.
Communication refers to the various ways of keeping humans in
touch with one another.
• On this basis communication is the participation and exchange
of thinking, experiences, views and opinions, information's
and facts between individuals and groups.
• The term “Health communication” is often used with health
education. The developing countries are on the move to exploit
the current communication revolution to put today health
information at the disposal of families, to help people to achieve
health by their own actions and efforts.
4

DEFINITION
•Communication can also defined as social
interaction, where at least two or more
people interact and share ideas through
common language.
•Communication is the process of
exchanging information, thought, ideas,
and feeling from one individual to another.
5

PURPOSE OF COMMUNICATION
• To Transfer information between all class of
employees to have a common understanding among
them.
• To interpret and adopt policies in the organization
• To include motivation,cooperation and coodination in
the employees.
• To improve the employer-employe relationship.
• To encourage participation in decision making.
DGNM I ST YEAR SRMTCON 6
6/1/2024

Cont..
• To delegate or decentalize authority.
• To boost the group morale of the worker.
• To ensure job satisfaction
• To help in the grevance procedure and disciplinary actions.
• To inform the community of theservices in the organization.
• To prepare the personnel and public for a change process.
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COMMUNICATION
PROCESS
8

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sender
message
Encoding
channel
Receiver
Decoding
Feedback

CONT..
• SENDER: Individual /article which delivers information to
others.
• MESSAGE :This is the content (message subject
matter)of communication.
• ENCODING: To convert content into codes
(words,actions,pictures)is known as encoding.
• CHANNEL:Radio,telephone,speech,television,written
message gestures etc. can be the channels of
communication.
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Cont..
• RECEIVER: It is the person for whom the message sent.
• DECODING: The opening of codes is called as decoding. It
provides meaning to the received content.
• FEEDBACK: This is an answer from the receiver. Feedback is
necessary to ensure whether the message has reached in the
desired form.
• Communication process can also be taught through another
model,that is S-M-C-R
(SOURCE,MESSAGE,CHANNEL,RECEIVER)
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PRINCIPLES OF COMMUNICATION
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CLARITY
COMPLETENESS
COURTESY CONCISENESS
CORRECTNESS
CONCRETENESS

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LEVELS OF COMMUNICATION
• INTRAPERSONAL COMMUNICATION-Self talk,self
instruction
• INTERPERSONAL COMMUNICATION –Face to face
• GROUP COMMUNICATION-Interaction among several
people.(Small group,one to group,mass)
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TECHNIQUES OF
COMMUNICATION
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• Listening
• Broad opening
• Restating
• Clarification
• Reflection
• Informing
• Attentive
• Empathetically
• Focussing
• Sharing perception
• Theme identification
• Silence
• Humour
• Suggesting
• Rapport building skills
• Body language

TYPES OF
COMMUNICATION

TYPES OF
COMMUNICATION
• Based on flow
 One way communication
Two waycommunication
• Based on structure /organization of content /purpose
Formal
Informal
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Cont...
One-way communication
Two way communication
Verbal communication - oral and written communication
Nonverbal communication
Formal communication
Informal communication
DGNM I ST YEAR SRMTCON
6/1/2024 18

Cont...
Downward communication
Upward communication
Horizontal communication
Visual communication
Telecommunication and internet
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One-way
communication
Flow of communication is one way from the communicator to the
audience.
E. g Lecture method, mass media communication
Drawback:
Knowledge is imposed
Audience participation is littoe
Does not influence human behaviour
Nofeedback
Learning is authoritative
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One-way
communication
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Two-way communication
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Two way communication
In this method both the communicator and the audience take part.
The feedback is fast.
Audience may raise questions and add their own information's,
ideas and opinion to the subject.
Hearing process is active and democratic. It is more likely to
influence the behavior of the audience in desirable direction.
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Verbal communication
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Verbal communication
Cont..
In this, written or spoken words are used for communication.
Oral communication:Through conversation telephone,
interviews.lectures,conference and other means but unclear words
and absence of permanent records can lead to misunderstanding.
Written communication:Through newspaper, posters, handbook,
booklet, letters, magazines, bulletins and notice board etc. But the
readers and viewers should be able to understand or read the
language for effective communication.
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Nonverbal
communication...
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Cont..
• In this types, communication is done without words.
• Includes whiole range of movements, postures, gestures, facial
expressions.
• Smile, raised eyebrows, frown, staring gazing etc.
• Silence is nonverbal communication can speak louder than words.
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Formal communication
• The formal communication occurs In organization under
the organization Structure and follows the line of authority.
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Informal communication
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Cont..
• Conversation between peoples on non official matter.
• E. g interaction between 2 close friends.
• Informal (grape-wine) communication network exists in all organization
e. g. Gossip circle
• The inform channel may be most active, if the formal channel Donot
cater to the information needs.
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Downward communication
• Flow from Top to bottom and the main objective is to convey
orders directives,instructions,standing orders and protocols etc.
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Upward communication
• From the subordinate staff to the superior ,which flow in the form
of reports, complaints and suggestions.
• Message runs from lower level to the high level.
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Horizontal communication
• There is an exchange of information between individuals of the
same status or designation.
• Communication between two health workers regarding a service.
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Visual communication
• Through charts, graphs, photograph, tables, maps, posters etc.
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Tele communication and
internet
• Tele communication is the process of communicating over distance
using electrolytes magnetic instruments designed for the Purpose.
• Radio, TV, internet ect. are the mass communication media,
whereas telephone, telex or teletype and telegraph ate known as
point to point telecommunication system.
• Point to point telecommunication system are closer to interpersonal
communication.
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Tele communication
Cont..
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Importance of
communication
• Communication is one of the important invisible factor of
production.
• Communication helps in the process of organization important in
directing and motivating employees in the management in getting
things done by other personnel in the organization.
• Communication makes better understanding between labor and
management in industry as prerequisite of conductive climate to
necessary for overall Advancement and productivity.
• Communication is the lifeline of any organization to bring an
effective change to influence action.
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Cont...
• Serves as a lubricant fostering the smooth operation of the
management process.
• Good communication is important in healthcare industry for
smooth functioning of the hospital and health care setting.
• It is the basis of decentralization and delegation. Every person must
have clear understanding of their objective and responsibility and
must be aware of his/her job is related to the job of others.
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Importance of
communication
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Importance of planning and
coordination
• Planning depends on an efficient network of communication. If the
system of communication is good, useful suggestions will flow
from the subordinate to the superior and thus will considerably
help in formulation of plans.
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Basis to good
external
communication
Helps to mold
attitude
Basic for
democratic
management
Binds people
together
Orient people to
their
environment For avoiding
misunderstanding
and ignorance
For higher
priductivity

BARRIERS OF
COMMUNICATION

BARRIERS OF COMMUNICATION
• Communication barriers can be defined as obstacles that one may
face when attempting to effectively communicate with another
person.
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BARRIERS OF COMMUNICATION
CONT.
• Linguistic barrier
• Physiological barrier
• Psychological barrier
• Organizational barriers
• Personal barriers
• Environmental barriers
• Cultural barriers
• Barriers due to status or position
• sematic barriers
• Tendency to evaluate
• Lack of ability to communication
• Inattention
• Heighted emotions
• Resisitance to change

cont..
Linguistic barrier
• A language barrier is any
linguistic limitation that
creates confusion or
prevents comprehension.
• These include Incorrect
message,faulty translation
and use of technical
language etc.
PHYSIOLOGICAL BARRIERS
• Difficulties in hearing or
listening expresion.

cont..
• Emotional disturbances
• Immaturity
• Haste
• Carelessness
• Jealousy
• Lack of interest
• Prejustice
• Poor retention power,fear
• Phobia
• Superstitions and ooposite thinking
etc.
PERSONAL BARRIER
• Lack of interest in
communication,false promises
• Lack of
knowledge,confidence,time
• Fear of criticism
• Difference in formal eduction.

ORGANIZATIONAL BARRIERS
• Breakdown in communication sometimes may arise due to :
6/1/2024
several layer
of
managemnt
long lines of
communication
l
special
distance of
subordinates
from top
managementay
ers
Lack of means
of
communication
layers
Incorrect
policies
Long lin
oHeavy
pressure of
work at certain
levels of
authorityayers
Lack of
instructions
for passing
informations
to the
subordinates

BARRIERS cont..
ENVIRONMENTAL BARRIER
• Geographical distance
,mechanical and electrical failure
• Sound pollution and physical
obstacles can block
communication.
CULTURAL BARRIERS
• Customs ,beliefs,religion
attitudes ,economic and social
class differences language
variations
• Cultural difficulties between
foreigners and nationals
,between urban eduction and
rural education.

BARRIERS cont..
BARRIERS DUE TO STATUS AND
POSITION
• The attitude exhibited by the
superior sometimes causes
disturbance in two way
communication.
SEMANTIC BARRIER
• Sematic is the science of
meaning.
• The words may not have same
meaning to two persons.
• One cannot convey meaning
only one can convey words.
• But the same words may be
perceived differently by
different persons.

BARRIERS cont..
TENDENCY TO EVALUATE
• People may try to judge the
statement of other person.
• Everyperson tries to evaluate
others from his point of
experience.
• communication requires an open
mind and willingness to see
through the eyes of others.
LACK OF ABILITY TO
COMMUNICATE
• All persons do not have the skill
to communicate.
• Some people may have natural
inborn skill whereas an average
person may need some training
and practice by interviewing and
public speaking .

Barriers cont..
INATTENTION
• Failure in communication results
when the person does not listen to
the instructions properly or fail to
read the message
,bulletins,notices,minutes and reports
due to lack of attention and
preoccupied by family problems etc.
Heighted Emotions
• Barriers may arise due to
emotional reactions ,physical
attention like noise ,insufficient
light,past experience etc.It is
easy to communicate to people
with balanced emotions.

Barriers cont..
Resistance to change :There is a general tendency of human being to
maintain status and ego.When new ideas are communicated ,the listening
apparatus may act as a filter in rejecting new ideas.Thus resistance to
change is an important obstacle to effective communication.
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COMMUNICATION GAP
• Communication gap may occur when the message is conveyed
through various channels.
• It may arise duo to lack of coordination between the various
departments which lead to conflicts and interdependental vivalries.
• Strict demaracation between various fuctions of organization
restricts the interaction and resulting in tight compartments.
• lack of flexibility to accommodate the changing conditions and
emergencies.
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Communication gap can be overcome
by:
• Encouraging feedback
• Encoraging suggestions
• Issue clear cut instructions
• Encouraging personal communication and avoiding impersonal
communication
• Establishing rules and regulations for smooth functioning of the
organization.
• organizing various functional areas to avoid compartmentation.
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ESSENTIALS OF
COMMUNICATION
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Think before
communicating
Know your
objective well
know your
audience
Consult
Determine your
audience
Help the
receiver
Proper tone and
content
Timing and
timeliness
Check the result
Look for
tommorrow
Listen
Climate of trust
and confidence
Continous
process and
feedback.

ESTABLISHMENT OF SUCCESSFUL
COMMUNICATION
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simple ,clear and the
language in which the
audience understand.
Latest and relable information
Proper use of AV aids
,gestures,words and pictures.
Health message should be
useful
Effective feedback ,use the
two way communication
Cretibility and genuiness of
communication
Topic for health education
should be according to
requirement ,feelings,belefs and
experience of people.
Correct medium and mehod
for communication should be
used.
Appropriate attention to verbal
as well as nonverbal message.

cont..
• Increase communication skills by observing the under mentioned lines:
• CONFIDENCE:Be confident in your ability to relate to people.
• Honest: Always be honest with your feelings.
• Sensitive :Be sensitive to the needs of others.
• Consistent:Be consistent and know know yourself.
• Anxiety: Recognize symptoms of anxiety.
• Recognized differences,Use word carefully.
• Recognize and evaluate your own actions and response
• Be careful in your nonverbal
communication.eg.gestures,postion,touch,physical apperance ,facila expression
,distanceetc.
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COMMUNICATION
MODELS

CONTINOUS LOOP MODEL
• This is the EARLIEST model of communication that has been
presented and accepted by others who study the field.
• It is also the SIMPLEST model (though it might not look like it at
first).
• It includes all of the basic parts/players in the communication
process.
• This model is based on the fact that language is a system or machine.
• In this machine ,communication acts as the “gears”for the machine to
work properly,Any breakdown or interference hurts efficiency.
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cont..
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SHANNON AND WEAVER MODEL
6/1/2024

cont..
• Shannon and weaver created in 1949.This mosel was designed to be
practical.Just as loop model was more academic .the shannon and
weaver model is model down -to-earth.
• The basis for this model was a study of telephone conservation over
a very lengthy time for a period of 2yeras.
• The team studied only what they deemed to be important or
significant of some length.
• THe focus of the mechanisms of the message.
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OBSERVING AND LISTENING
COMMUNICATION

OBSERVATION
“SEE ,DONT JUST LOOK”-SWANSON
According to dictionary: Observation means to see the events on right
perspectives and to record them for knowledge the mutual relationship
between the cause and effect.
According to CA Major: The broad meaning of observation is to use
the eyes more as compared to the ears and tongue.Observation and
inspection is the collection of facts about realities and incidents.
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observation
includes more
than just seeing

CONT..
“OAR not OR”
• O-OBSERVE (SEE) what populates your environment.
• A- Assess what you need to do about it
• R-React by carrying out the required action.
• Observe -Assess-React
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6/1/2024

cont...
•Observation and inspection are qualities of a good
manager,supervisor and health eduactor.
•Observation is completely a scientific process.
•In health eduaction ,during communication,the
observation must be a goal oriented.
•The medium and method of observation should be
selected according to the level ,i.e personal ,group or
community.
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For effective communication the
following facts are to be observed:
• The health educator should adopt the method which is being received or welcomed by the
individula or the group.
• Subject chosen should be relevant to the individual ,group or the health problems of the
community.
• The results of the efforts ,made to solve health problems.
• Determining the topic for furture health eduaction.
• Use of specific audio-visual aids by community health nurse/workers/health educators.
• The advantages or gains to the individual or groups by health education.
• Observation should be close to reality and should be focussed on the present or immediate
problems.eg.if a person is suffering from jaundice or anemia,the color of eyes,skin,nails and the
dietary status should be observed.
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TYPES
• Paricipatory observation
• Nonparticipatory observation
• Semiparticipatory observation
• Controlled participatory
• Uncontrolled participatory
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OBSERVATION OF HEALTH
EDUCATION
• Observation should be limited only to the reference
subject.
• The objective of observation should be clear.
• The observer should be familiar with special
technique and methods used for observation.
• The observer should have previous experience and
knowledge of health eduaction.
• The observer should have interest and expertness of
communication skills.
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EXERCISES OBSERVATION
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LIMITATION
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• Reaction of individual /group toward health
education
• Bias or favoritism of the observer
• Limited area of study
• Inability to observe special events.

LISTENING

DEFINITION
6/1/2024
• To be a good speaker is easy but to be a good listener is difficult.
• Most people try to impress by speaking or giving a speech but donot
bother to hera anyone with patience.
• But in communication it should be kept in mind that apart from
speaking,one should have the art of listening.
• Just listening by keeping mum is not a sign of good listener.
• The listener should hear others with attention and patience.The
health problem should be well listened,understood and evaluated ,to
make health eduaction effective.
• The meaning of good listener is to be attentive and pay attention on
the “totalindividuals”.

cont..
• For effective communication ,one should be a discreet listener
,keeping concentration and patience. LADDER
• L-ook at others,keep good eye contact.
• A-Ask appropriate questions only
• D-Do not interrupt
• D-Do not change the subject
• E-Express emotions with control
• R-Responsively listen.
6/1/2024

• Good art of listening enhances improvement in personality ,save
stime,decides the focu sof the probelem,fulfills objectives and
facilitates feedback.
• PHYSICALLY: One should attain a forward looking posture and
should look at the person who is speaking.He should keep his ears
toward apeaker.
• PSYCHOLOGICALLY:It means that the listener should pay
attention to the speaker and show interest in him by
nodding,encouraging, with suitable small responses as “go on”etc.
• Facial expression avoided.
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GOLDEN RULES OF
COMMUNICATION
6/1/2024
• Communication skills
• Behaviour of the sender and receiver
• Socila and cultural system
• Knowledge of the subject and the receiver
• Purpose of communication
• Feedback

HEALTH COMMUNICATION
• Health communication is an important area of communication .It
links the domains of communication and health.
• Health communication includes the study and use of
communication strategies to inform and influence individuals and
community decisions that enhance haelth.
• Health communication can contribute to all aspects of disease
prevention and health promotion.
• Functions are
:Information,education,motivation,counseling,raising morals and
making people agree to do something about health concern.
6/1/2024

• Health communication is an important tool for health
health development and is the milestones of all health
organizations .
• For individuals:
create health awarness,health risks and solution.
can change attitude and result in health seeking behaviour.
provide motivation and skill needed from available resources.
Help them to find support from available resources
can motivate to protect and promote their health.
6/1/2024

cont..
• FOR THE COMUNITY:
Influence the public agenda
Advocate the policies and programs
Improve in delivering of public health and health care servicse.
Promote positive changes in the socioeconomic and physical
environment.
Encourage socila norms that benefit health and quality of life.
6/1/2024

6/1/2024

NURSE PATIENT
RELATIONSHIP

DEFINITION
• It is an interaction between two Persons in which the
nurse offers a series of purposeful activities and
practice that are useful to particular patient.
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TYPES
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Social
relationship
Therapeutic
relationship
Intimate
relationship
As a relationship that is
primarily initiated with the
purpose of friendship
socialization, enjoyment or
accomplishing a task.
Emotional commitment
between two people's.
Relationship between
nurse and the client.

PRINCIPLES OF THERAPEUTIC
COMMUNICATION
• Respect
• Genuiness
• Empathy
• Active listening
• Trust
• Confidentiality
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PURPOSE OF THERAPEUTIC
RELATIONSHIP
• Support the patient
• Promote healing
• Support or enhance functioning
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A CONTINUUM OG PROFESSIONAL
BEHAVIOUR
Patient Centered care
• Too little care provider ........ Too much care
provider Involvement
Involvement
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Therapeutic Nurse
patient
rellationship

PHASES OF NPR
• Peplau identified 5 phases
• Orientation
• Identification
• Exploitation
• Resolution
• Termination
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ORIENTATION
• Beginning the nurse patient relationship require unique
communication skills.
• Everyday people communicate with those around them by
listening, talking, sharing, laughing, reassuring and caring.
• Define the problem
• Data collection
• Defining problem and deciding the type of service Needed.
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IDENTIFICATION
• The work segment of the relationship starts with this phase.
The nurse and the patient work together to identify the problem
and set specific problem oriented goals.
• Selection of appropriate professional assistance.
• Patient begins to have a feeling of belonging and a capability
of dealing with the problem which decrease the feeling of
helplessness.
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EXPLOITATION
• The. Nurse assist the client in using the health
services.
• Active work of relationship happens during
exploitation.
• Interventions appropriate to the mutually planned
goals are carried out with the ongoing reassessment
and reevaluation.
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RESOLUTION
• Relationship ends phase.
• No longer periods.
• Closure for both parties
• Evaluate the intervention
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TERMINATION

PATIENT
TEACHING

DEFINITION
• Patient teaching is a process involves teaching the patient about
reducing health risk factors, increasing client level of wellness
and taking specific protective health measures.
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PROCESS
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6/1/2024
TYPES LISTEN
OBSERVE COMMUNICATION
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COMMUNICATION SKILLS ,NPR AND PATIENT TEACHING

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