Communication

By : Miss shafaq zahra

Islamia university of Bahawalpure
Shah rokne alam nursing college Multan
 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
 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
 Components of Communication
It has the following main components
• Sender (source, communicator)
• Receiver (Audience)
• Message (content)
• Channels (medium or pathway)
• Feedback (effect)
 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.
 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.
 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.
 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.
 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
 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.
 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
 One Way Communication
• The flow of communication is “one-way” from the
communicator to the audience.

• Example - Lectures in classroom

 Two Way Communication
• Two-way method of communication in which both
communicator and audience take part.

• Learning is active
• More likely to influence behavior.
 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.
 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
 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.
 Visual communication
The visual form of communication comprise ;
• Charts
• Graphs
• Pictograms
• Tables
• Maps
• posters
 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
 Formal communication
• Formal communication refers to the flow of
official information through proper,
predefined channels and routes. The flow of
information is controlled and needs deliberate
effort to be properly communicated
 Informal communication
informal communication refers to communication
which is multi-dimensional. Informal communication
moves freely within the organization and is not bound
by pre-defined channels and communication routes.
Informal communication is particularly quick. Informal
communication is far more relational than formal
communication and is by nature, a very natural form
of communication as people interact with each other
freely and can talk about a diverse range of topics,
often extending outside of their work duties.
 Levels of communication

• Intrapersonal communication
• Interpersonal communication
• Transpersonal communication
• Small group communication
• Public communication
 Intrapersonal communication
• It occurs within an individual. This level of
communication is also called self talk, inner thought
and inner dialogue.
 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.
 Transpersonal communication
• It occurs within a person’s spiritual domain. Many
persons use prayer, meditation religious rituals to
communicate with their higher power.
• It is a communication between self and its beliefs,
something in which we believe in, which is higher
than us, beyond the body and the mind.
 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.
 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
 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.”
 Therapeutic Communication Techniques
• Offering self
• Giving broad opening
• Silence
• Exploring
• Focusing
• Providing general leads
• Giving information
• Restating
Technique purpose example

Using silence Sitting quietly (or walking

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

Offeringself Making oneself I‟ll stay with you until

Available on an I‟ll be hear till 12.00
Unconditional basis, Clock.
increasingclient‟s “I’ll stay with you until your family
Feelingof self-worth members arrives.”

Restating Repeating the main thought Eg; “You say that your mother left
expressed by the patient. you when you were five years old.”

Giving Providing, in a simple and direct

information manner, specific
factual information the client may or Your surgery is scheduled for 11
may not AM tomorrow.”
request. When information is not “You will feel a pulling sensation
known, the nurse when the tube is removed
states this and indicates who has it or from your abdomen.”
when the “I do not know the answer to that,
nurse will obtain it. but I will find out from
Mrs. King, the nurse in charge.”
Technique purpose example

Exploring “Tell me more about

that.”
delving further “Would you describe it
into a subject or an idea more
fully?”
“What kind of work?”
Focusing Concentrating on a single point. “This point seems worth
looking at more closely.”
 Factors influencing communication
process
• Person Socio cultural background
• Language
• Age
• Education
• Ability of communication
• Time and setting
• Emotions and self esteem
 Socio cultural background
• Cultural differences have many effects on
communication. People with different cultural
backgrounds communicate using different
styles. Their language, words, gestures, and
phrases may differ even in their application.
 Language
• Language allows us to express our feelings and
thoughts via sounds, symbols, written or
spoken words, posture, gestures or signs, etc.
 Age
• Children and teenagers may use more
informal language and rely on nonverbal cues,
such as facial expressions and body language,
to convey their emotions. Older adults, on the
other hand, may use more formal language
and be more direct in their communication.
Age can also affect the content of
communication.
 Education
• Different education levels between the sender
and receiver also influence the meaning of
communication. If they have similar
educational qualifications, communication will
be effective
 Time and setting
• Timing influences how a target audience
reacts to messages. People can get
overwhelmed with information coming from
many sources and channels. WHO
communicators must direct messages to
decision-makers when they are most
receptive.
 Emotions and self esteem
• Emotions also affect communication, with
anger being likely to increase it and fear being
likely to decrease it.
• There is a strong correlation between self-
esteem and having the ability to communicate
your needs and opinions. When your self-
esteem is low, you avoid speaking up for
yourself because the possibility of judgment
from others is much scarier than coping with
the situation on your own
 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
Legal Aspects of Documentation
 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.
 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.
• For each standard, criteria must be outlined so that
adequacy of patient care be measured.
• Documentation will reflect the standards of the
department.
 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
 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
 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
 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 .