This slide is for everyone

1. Communication
By : Ibne Amin
BSN , MSN
INS , Khyber Medical University
ibneamin.ins@kmu.edu.pk

2. Objectives
At the end of this unit students will be able to
1. Define communication, elements of the
communication process, ways of communication.
2. Identify the characteristics of the effective verbal
communication
3. Describe the factors that's facilitate and interfere with
the effective communication
4. Define ways to respond therapeutically
5. Identify non therapeutically respond
6. Discuss the legal aspects of documentation

3. Communication
Communication is regarded as a two- way process of
exchanging ideas, feelings, emotion and information so
as to
– To increase knowledge
– To change existing patterns of behavior & attitudes
– To acquire new skills.
It has two main purposes:
• To influence others
• To gain information

4. Components of Communication
It has the following main components
• Sender (source, communicator)
• Receiver (Audience)
• Message (content)
• Channels (medium or pathway)
• Feedback (effect)

5. Components of Communication
Sender:
• A sender is a person who encodes & 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.

6. Components of Communication
Message:
• The message is the content of communication & may
contain verbal, nonverbal or symbolic language.
• Perception & personal factors of the sender &
receiver may sometimes distort this element & the
intended outcome of communication may not be
achieved. For ex, the same message may be
communicated or perceived differently by two
individuals.

7. Components of Communication
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, &
tasting.
• While selecting channels of communication, several
factors must be considered: availability of channels ,
purpose, suitability, types of receivers, types of
message, preference of sender & receivers,
communication skills of the sender, cost, etc.

8. Components of Communication
Classification of channels of communication:
• Visual channel: Facial expression, body language,
posture, gestures, pictures & written words, electronic
mails, mass media, etc.
• Auditory channel: Spoken words, sounds, telephone or
mobile communications, delivering audio content (radio,
voicemail), etc.
• Tactile channel: Touch sensations, therapeutic touch, etc.
• Combined channel: Audiovisual media, consoling a person
with touch & spoken words.

9. Components of Communication
Receiver:
• A receiver is an individual or a group of individuals
intended to receive, decode & interpret the message
sent by the sender/source of message.
• A receiver also known as decoder.
• He is expected to have the ability & skills to receive,
decode & interpret the message

10. Components of Communication
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 & the
communication process is now consider complete.
• A successful communication must be a two-way process
where the sender sends the message & receives
feedback from the receiver.
• These feed back could be verbal & nonverbal.

12. Types of Communication
1. One way communication
2. Two way communication
3. Verbal communication
4. Non-verbal communication
5. Formal and informal communication
6. Visual communication
7. Telecommunication and internet

13. One Way Communication
• The flow of communication is “one-way” from the
communicator to the audience.
• Example - Lectures in classroom

14. Two Way Communication
• Two-way method of communication in which both
communicator and audience take part.
• Learning is active
• More likely to influence behavior.

15. Verbal Communication
• In Verbal communication, Spoken words are used. It
includes face-to-face conversations, speech.
• The words used vary among individuals according to
culture, socioeconomic background, age, and
education.

16. Characteristics of effective verbal
communication
• Simplicity Use of commonly understood words
• Clarity Say exactly what it means
• Timing and relevance
This involves being sensitive to the clients' needs and concerns
• Adaptability Spoken message needs to be altered in accordance with
behavioral cues from the receiver
• Credibility
the quality of being trusted & believed

17. Nonverbal communication
• Communication can occur even without words.
• It includes whole range of bodily movements, postures,
gestures and facial expression.
• Silence is non verbal communication, it can speak louder than
words.

18. Visual communication
The visual form of communication comprise ;
• Charts
• Graphs
• Pictograms
• Tables
• Maps
• posters

19. Telecommunication and internet
• Telecommunication is the process of communication
over distance using electromagnetic instruments
designed for the purpose.
• For example radio, TV, internet , telephones, satellite
etc

20. Levels of communication
• Intrapersonal communication
• Interpersonal communication
• Transpersonal communication
• Small group communication
• Public communication

21. Intrapersonal communication
• It occurs within an individual. This level of
communication is also called self talk, inner thought
and inner dialogue.

22. Interpersonal communication
• It is one to one interaction between the nurse and
another person that often occurs face to face.
• Meaningful interpersonal communication results in
exchange of ideas, problem solving, expression of
feelings, decision making and personal growth.

23. Transpersonal communication
• It occurs within a person’s spiritual domain. Many
persons use prayer, meditation religious rituals to
communicate with their higher power.

24. Small group communication
• It occurs when a small number of persons meet
together. It is usually goal directed and requires an
understanding of group dynamics.

25. Public communication
• It is the interaction with the audience. Nurses have
opportunities to speak with groups of consumers
about health related topics, present scholarly work
to colleagues at conferences or lead classroom
discussions

26. Therapeutic Communication
“In therapeutic communication the nurse directs the
communications towards the patient to identify his
current health problem, plan, implement & evaluation
the action taken.”

27. Therapeutic Communication
Techniques
• Offering self
• Giving broad opening
• Silence
• Exploring
• Focusing
• Providing general leads
• Giving information
• Restating

28. Technique purpose example
Using silence
Accepting pauses or silences that
may extend for several seconds or
minutes without
any verbal response.
Sitting quietly (or walking
with the client) and
waiting attentively until
the client is able to put
thoughts and feelings into
words.
Providing
general leads
Using statements or questions that
(a) encourage the client to verbalize,
(b) choose a topic of conversation,
and (c) facilitate continued
verbalization.
“Where would you like to
begin?”
“And then what?”
Broad
Opening
Initiates conversation;
Encourage the patient to select
Topics for discussion.
Tell me something
About your family?
What would you like to
discuss?
eg; “What are you
thinking about?”

29. Technique purpose example
Offeringself Making oneself
Available on an
Unconditional basis,
increasingclient‟s
Feelingof self-worth
I‟ll stay with you until
I‟ll be hear till 12.00
Clock.
“I’ll stay with you until your family
members arrives.”
Restating Repeating the main thought
expressed by the patient.
Eg; “You say that your mother left
you when you were five years old.”
Giving
information
Providing, in a simple and direct
manner, specific
factual information the client may or
may not
request. When information is not
known, the nurse
states this and indicates who has it
or when the
nurse will obtain it.
Your surgery is scheduled for 11
AM tomorrow.”
“You will feel a pulling sensation
when the tube is removed
from your abdomen.”
“I do not know the answer to that,
but I will find out from
Mrs. King, the nurse in charge.”

30. Technique purpose example
Exploring
delving further
into a subject or an idea
“Tell me more about
that.”
“Would you describe it
more
fully?”
“What kind of work?”
Focusing Concentrating on a single point. “This point seems worth
looking at more closely.”

31. Factors influencing communication
process
• Person Socio cultural background
• Language
• Age
• Education
• Ability of communication
• Time and setting
• Emotions and self esteem

32. Nontherapeutic response
• Not listening properly
• Rejection (refusing from discussion)
• False hopes
• Too much probing into personal matters
• Changing the subject
• Sharing personal or work related problems
• Reveal confidential information

33. Legal Aspects of Documentation

34. Legal Aspects of Recordkeeping
• Legally, the documentation of the care given to a
patient must be completed.
• If no documentation is recorded, no care was given
at all.
• Hospital accreditation agencies will carefully evaluate
the medical records of patients.

35. Legal Aspects of Recordkeeping
• If documentation is not done the hospital and the
practitioner could be accused of patient neglect.
• Proper documentation of care is valuable only in
reference to standards and criteria of care.

36. Legal Aspects of Recordkeeping
• For each standard, criteria must be outlined so that
adequacy of patient care be measured.
• Documentation will reflect the standards of the
department.

37. Practical Aspects of Recordkeeping
• Recordkeeping is one of the most important parts of
our duties.
• Documentation must be done for each medication,
treatment, and procedure.
• Accounts of patient’s condition and activities must
be charted correctly and be very clear.
• Briefness is important, although a complete account
of each patient encounter

38. General Rules for Recordkeeping
• Legible. Print or hand write entries in chart.
• Begin with date and time, then enter order and sign
the chart:
• Errors? Don’t erase, or use correction tape. If a
mistake, drawn a line through it, write date and write
the word error above it, with your initials
• Chart patient complaints and general behavior

39. General Rules of Recordkeeping
• Leave no blank or empty lines. Draw a line through
the center of the empty space in order to prevent
someone else from signing in your area.
• Use Standard abbreviations
• Spell Correctly
• Document conversations with patient and healthcare
providers that you feel are important

42. References
• Andrea Ackermann, Mount St. Mary College,
Critical-thinking-the-nursing-process 2001.
• http://www.umanitoba.ca/nursing/courses/12
8,(2005)
• Sara-jo Wiscombe, Nursing Process ,Wallace
Community College ,May 22,2001.
• Tucker C, MODULE A INTRODUCTION TO NURSING
Process, August 21, 2002 .