Communication

Levels of Communication

3 levels: Social,Therapeutic, Collegial• Therapeutic: the nurse listens to patient

problems and focuses on patient needs

• Collegial – skills that result in enhanced relationships with colleagues, improved patient care, and better documentation.• [focus of this chapter/lecture]

Levels of Communication

Collegial Communication (cont.)• Verbal

• Written

*Note: Nonverbal communication takes place in all 3 levels of communication – i.e. body language, personal space, eye contact, etc.

The nurse needs to be an astute observant of nonverbal communication.

Levels of Communication

Verbal Communication• The sender must give clear messages

• The sender must verify that these messages are being accurately interpreted by the receiver.• Cultural factor: Effective communication may be

particularly difficult when the participants are from different cultures. In such situation, the nurse must accept different communication norms, seek to understand others, and verify that communication was successful

Collaboration

Definition: “two or more people workng together to a common end”

Nurses collaborate with nursing peronnel and other health care workers to improve patient care. Failure to communicate effectively can have serious consequences.

Collaboration

Nursing Personnel• Communication is the basis for effective team

building

• Nurses frequently communicate pt. needs, outcomes, and goals. Best accomplished in an atmosphere of openness and honesty.

• Team must embrace the diversity and creativity of its members

Collaboration

Nursing Personnel (cont.)• Delegating – assignment of individual duties

• When delegating a task the nurse is responsible for ensuring that the right direction or communication is given. [Ref. the Five Rights of delegation].

• Report Skills – “giving report”: at the end of each shift, nurses report essential information about the assigned patients to nurses working the next shift• Purpose of this report is continuity of care

• Format: usually oral, or audiotape, or walking rounds

• Information should be organized

Collaboration

Interdisciplinary Communication• Occurs among practitioners from different

disciplines

• Develop good rapport with individuals from other disciplines

• Informal and formal exchange of information Conflict Resolution

• Conflict is not always a negative thing; it can result in growth

Collaboration

• Conflict Resolution (cont.)

• New knowledge and better interpersonal skills can be obtained through the process

• Result of problems – need a problem-solving or nursing process format

• Assessment of facts - Listen!

• Identify /Analyze the problem – Use “I” messages

• Outcome Identification –”Where do I want to end up with this?” Is compromise a viable option?

• Generate solutions – look toward mutually beneficial decisions

Collaboration

• Conflict Resolution (cont.)• Implementation of conflict resolution – seek clarity

and to understand

• Evaluating Conflict resolution – Was rapport established? Did we focus on the needs of others? Were our communication skills effective?

Physician Notification• Physician – important participant in the

interdisciplinary team and interdisciplinary communication

Collaboration

• Physician Notification (cont.)

• More likely to respond if he/she trusts the nurse’s judgment

• Calling a Physician – the procedure becomes easier with practice!

• Know who may call the physician in your institution – check P&P for guidance

• Assess the necessity of the call.

• Obtain all pertinent data before making the call – lab reports, current VS, diagnostic test results, client condition.

• Check with other staff to see if anyone else needs to talk to the same MD

Collaboration

• Physician Notification (cont.)• Identify your self, the unit, the patient, the purpose of the

call and the actual or potential patient problem. Be clear and concise!

• Listen carefully• Record any orders received.

• Note: Clarify any orders – restate to MD• Note: Clarify any orders that are not understood.

• Be prepared to answer questions and make any appropriate recommendations.

• Inappropriate orders should be questioned and not accepted. Consult with your supervisor when unsure.The nurse is responsible for any results if he/she carries out an inappropriate order.

Collaboration

• Physician Notification (cont.)• Receiving Phone calls – answer quickly and

courteously

• Represent your employer

• Greeting: your unit, your name and title

Written Communication

Documentation• Organize and determine the significance of your

thoughts before writing them down

• Patient Chart – the legal documentation of the quality of care.• Consulted first in the event of a malpractice suit

• Basis of reimbursement

• Chart must remain confidential –viewed only by individuals who have the right to the information.

• Charting should be accurate and objective

• Appropriate spelling and grammar

Written Communication

• Patient Chart (cont.)

• Numerous items that require charting:

• Patient assessments

• Changes in pt. condition

• Description of pt. behavior

• Nursing interventions, activities, diagnosis

• Expected outcomes of care/achievement of outcomes

• Physician Notification

• Procedures and consultations

• Use of safety devices or major equipment