This document provides information on interpersonal relationships and communication in nursing. It discusses the definition and elements of communication, modes of communication including verbal and nonverbal, and factors that influence the communication process. It describes different levels of communication including intrapersonal, interpersonal, social, and therapeutic. Characteristics of helping relationships and therapeutic communication are outlined. Techniques of therapeutic communication and principles of the nurse-patient relationship are explained. The document also discusses process recording as a tool to evaluate nurse-patient interactions and improve communication skills.

1. 2023/6/26
INTERPERSONAL RELATIONSHIP
Ms.Samba sukanya
Asso.Professor,
Sims College of Nursing,
Guntur.

2. 2023/6/26 2
INTRODUCTION
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 information and obtain a response. People use
communication to meet their physical, psychosocial,
emotional and spiritual needs.

3. COMMUNICATION
Communication is a process by which
messages are transmitted from one person to
another person or groups with a view to bring
changes in behaviour.

4. Elements of Communication
•Message
•Source (sender)
•Channel
•Receiver
•Feedback (response)

5. The Communication Process
SENDER
(encodes)
RECEIVER
(decodes)
Barrier
Barrier
Message
Feedback/Response

6. MODES OF COMMUNICATION
Verbal communication
Non verbal communication

7. Factors in verbal and nonverbal modes of
communication
VERBAL
•Pace and intonation
•Simplicity
•Clarity and brevity
•Timing and relevance
•Adaptability
•Credibility
•Humor
NONVERBAL
Facial expression
Posture and Gait
Personal Appearance
Gestures
Touch

8. FACTORS INFLUENCING THE COMMUNICATION
PROCESS
Development
Gender
Values And Perceptions
Personal Space
Territoriality
Roles And Relationships
Environment
Congruence
Interpersonal attitudes.

9. LEVELS OF COMMUNICATION
Intrapersonal communication
Interpersonal communication
Social communication
Collegial communication
Therapeutic communication
Group communication
Small group
Organizational
Public speaking

10. INTERPERSONAL COMMUNICATION
It is communication between two or more people.
Face to Face conversation between two people is the most
frequent form of interpersonal communication.
Nurses use interpersonal communication to gather
information during assessment, to teach about health issues
to explain care and to provide comfort and support.

11. INTERPERSONAL RELATIONSHIP
 IPR is an association or relation between
two or more individuals.
 Association may be short term/ long term.
 IPR is based on needs.
Nurse – patient relationship is termed as:
IPR/ therapeutic relationship/ helping
ralationship.

12. PURPOSES OF IPR
 Promotion of community living.
 Promotion of positive thinking.
 To build a healthy society.
 To promote social hormony.
 To achieve the aims of an organization.
 To fulfill the responsibilities of a profession.

13. THERAPEUTIC COMMUNICATION
It is the relationship between the nurse and
client, in which nurse develops communication
skills, understanding personal strengths inorder
to enhance the client growth.

14. OBJECTIVES OF THERAPEUTIC
COMMUNICATION
To encourage the client to express
thoughts, feelings, behaviours and life
experiences in a meaning ful way.
To understand significance of client's
problems and their goals.
To assist in identification and resolution
processes of the client's area.

15. CHARACTERSTICS OF
HELPING RELATIONSHIPS
• It is an intellectual and emotional bond between
nurse and client.
• Respects client as an individual.
• Respects client confidentiality.
• Focuses on the client's confidentiality and well
being.
• It is based on mutual trust, respect and
acceptance.
• It is purposeful and goal directed.
• Uses well planned, selected techniques.

16. CHARACTERSTICS OF
THERAPEUTIC COMMUNICATION
* Genuineness
* Positive regard
* Empathy
* Trustworthyness
* Clarity
* Responsibility
* Assertiveness

17. THERAPEUTIC COMMUNICATION
TECHNIQUES
Using Silence Being Specific
and Tentative
Using Open-Ended Questions
Using Touch
Restating or Paraphrasing
Seeking Clarification
Perception Checking or
Seeking Consensual
Validation
Offering Self
Acknowledging
Giving Information
Clarifying Time or
Sequence
Presenting Reality
Focusing
Reflecting
Summarizing and
Planning

18. PRINCIPLES OF
THERAPEUTIC COMMUNICATION
• Plan to interview at an appropriate time.
• Ensure privacy.
• Establish guidelines for the therapeutic interactions.
• Provide comfort during the interaction.
• Accept the client.
• Encourage spontanity.
• Focus on the client.
• Encourage the expression of feelings.
• Be aware of your own feelings during interaction.

19. PHASES OF IPR

20. BARRIERS TO IPR
 Mistrust
 Lack of awareness regarding needs.
 Lack of mutual respect
 Ineffective communication.
 Absence of conducive environment.
 Cultural intolerance.
 Lack of common goal/ purpose
 Professional incompetence.
 Low relationship quotient.

21. PROCESS RECORDING

22. DEFINITION
“A process recording is a method in which
students record all the communications,
both verbal and non verbal, spoken and
observed through an interview.
-CHRIS JORDAN
Process recording is a written account or
verbatim recording of all that transpired
during and immediately following the nurse-
patient interaction.

23. USES OF PROCESS RECORD
Used as
• A teaching - learning tool.
• An evaluation tool.
• A therapuetic tool.

24. PURPOSE
To improve IPRs.
To recognize verbal and nonverbal cues to the
patient's needs.
To evaluate Nurse- Patient interactions.
To increase observational skills of the students.
To identify thoughts and feelings related to self and
others.
To improve the ability to identify problems and gain
skills in solving them.

25. 1.Preparing the student for process
recording.
2.Recording nurse-patient interactions.
3.Evaluating the interactions by instructor
and the student.
PHASES OF PROCESS
RECORDING

26. PRE REQUICITES FOR PROCESS
RECORDING
 Physical setting.
 Getting consent of the patient for the possibility
of cassette recording.
 Confidentiality.

27. 1. Identification Data
Name: Marital status:
Age: Occupation:
Sex: Language:
Literacy: Date of admission:
Ward no: Address:
Bed No.:
Religion:
Income:
Reliability:
SAMPLE OUTLINE FOR
PROCESS RECORDING

28. SAMPLE OUTLINE FOR
PROCESS RECORDING
2. Present complaints
 According to the patient
 According to the relatives
3.History of presenting complaints
4. Aims and objectives of interview
Patients point of view
Students point of views

29. FIRST INTERVIEW
Date:
Time and duration:
specific objective:
summary:
Introspective observation:
Interview techniques used.
PARTICIPANTS CONVERSATION INFERENCE

30. Example
Patient/Client
Nurse Techniques/Analyses
"Hello, Mrs. B. How are you
and the family doing
today?" (Sitting in Mrs.B's
kitchen. "Open" posture.)
Use of an open-ended question
allowed the opportunity for Mrs.
B. to
tell me in her own words what
was upsetting her.
"Oh, I'm OK, I guess. R. and I
just got into one of our little
fights about his smoking."
(Voice shaky. Poor eye
contact.)
"You say you're OK but you
seem upset." (Lightly
touching her arm.)
Mrs. B's statement, "I'm OK," did
not match her nonverbal
behavior.I shared my observation
with Mrs. B to determine if I have
interpreted her nonverbal
message accurately. I also used
touch because I wanted to
convey empathy and depth of
feeling.

31. ADVANTAGES
 Process recording helps in
differentiating thoughts and feelings.
 Helps to clarify the purpose of the
interview or intervention.
 Helps to improve written expression.
 Helps in identifying strengths and
weakness.
 Helps to improve self awareness.

32. Helps to separate facts from
judgments.
Helps to explore the interplay of values
operating between the student and the
patient system through an analysis of the
filtering process used in recording the
session.
CONT...

33. DISADVANTAGES
It is more time consuming.
The process is laborious.
Highly complex and complicated for
average student.
student require good communication
skills.
Patient may not be cooperative.

34. CLINICAL
ASSIGNMENTS

35. ASSIGNMENTS
Assignment is the allocation of
someone or something as belonging
to a particular group or category.
Assignment is a task or piece of
work allocated to someone as part of
a job or course of the study.

36. OBJECTIVES
To provide best possible nursing care to the
client.
To consider educational needs of the trainee.
To plan assignments that are interesting and
stimulating to professional growth.
To achieve good ward management.

37. FACTORS TO CONSIDER WHILE
PLANNING ASSIGNMENTS
• Previous clinical experience of the
students.
• proximity of the students.
• Assignments should be varied frequently
enough to maintain the interest of
students.
• Sociological and psycholoogical aspects of
the patient should be considered.

38. TYPES
1. Patient assignment.
2. Work assignment.
3. Team assignment.
4. Special assignment.
5. Functional assignment.
6. Combination of assignments.
7. Case method assignment.
8. Student assignment.

39. 1. Patient assignment.
1.The clinical instructor allot the specific
client to a student to render complete care.
2.Care includes general nursing measures,
treatment, medication, taking vitals,
providing nutrition and health education.
USES:
• Individualized nursing care is possible.
• Student gets satisfaction.
• opportunity for nursing education is suprior.

40. 2. Work assignment.
The clinical instructor will list the
work to be carried out by the students in
general in order to carry out clinical
activities by total students posted in the
ward like setting up of TPR tray, Injection
trolly, Care of sponge bags etc.

41. 3. TEAM ASSIGNMENT
• Students will work in different shifts (like
Morning, Afternoon, Evening) under strict
clinical supervision in specific wards like
Medical, Surgical and Post Operative wards.
Each student will carrry out specific activities
under team leader and clinical instructor
supervision.

42. USES
• Team spirit is created.
• We can prepare nursing leaders.
• Attitude of cooperation and coordination is
learnt.
• Nursing care is given under the guidance
and supervision of head nurse.

43. 4. Special assignment.
• In clinical area each learner will be
assigned special assignment like
maintaining drug register in the ward ,
linen supply, CSSD supplies etc. by
the clinical supervisor.
• The student is responsible for
completion of specific assignments.

44. 5. Functional assignment.
The clinical supervisor allot specific
function to be carried out by specific
student in their clinical posting.
e.g. Taking temperature,
Giving medications to all patients etc.

45. 6. Combination of assignments.
To provide holistic care for the patient,
combination of clinical activities has to
be carried out by the students.

46. 7. Case method assignment.
In clinical experience teacher will
provide opportunity for each student
to provide care for the clients with
specific diagnosis.

47. 8. Student assignment.
It is clinical experience in Block,
assigning the tasks for specific
students in organizing field trip.

48. PRINCIPLES OF STUDENT'S
ASSIGNMENTS
•Rotate the students through departments as per curriculum
plan.
•Make assignment as per the ability of the student.
•Reassignments may need to be planned for students who
require them.
•Assignment should be individualized.
•Do not assign same duties for long term.
•Deligate all duties among students.
•Anticipate emmergencies in the ward and make provision
ready.
•First year students to be posted where there is maximum
supervision.
•Ward sister to be informed well in advance regarding student

49. THANK YOU