H.A exam 4 study grid
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Exam 4 Study Grid Culture/Diversity
Types of culture orientation
Enculturation: Process by which a person learns norms, values, and behaviors of another culture
o
Example: A high school student from the United States spends a summer abroad with a family in Switzerland
Acculturation: Process of acquiring new attitudes, role, customs, or behaviors
o
Example: An immigrant from China develops a preference for Western foods and music
Assimilation: Process by which a person gives up his or her original identify and develops a new cultural identity by becoming absorbed into the dominant cultural group
o
Example: A Native American loses his Native identity after living in Chicago for 10 years
Biculturalism: Dual pattern of identification
o
Example: A woman of Christian faith married to a Muslim adopts some Muslim practices and also maintains some traditional Christian
practices
Process of cultural competence
The process of cultural competence in delivering health care services is “a culturally conscious model of care in which a healthcare professional continually strives to achieve the ability and availability to effectively work within the cultural context of a client”
(family, individual, or community) (
Transcultural C.A.R.E. Associates, 2015
). It is a process of becoming culturally competent, not being culturally competent (
Transcultural C.A.R.E. Associates, 2015
). The goal of delivering cultural care is to utilize research findings to provide culturally specific care that is safe and beneficial to the well-being of the diverse population
Global impact on culture
Historical and social realities shape an individual’s or group’s world view, which determines how people perceive others, how they interact and relate to reality, and how they process information. World view is a set of assumptions that begins to develop during childhood and guides how one sees, thinks about, experiences, and interprets the world
. Our world view evolves during a lifetime process of interacting with family, peers, communities, organizations, media, and institutions
(Fig. 9.1).
Enculturation: Process by which a person learns norms, values, and behaviors of another culture
o
Example: A high school student from the United States spends a summer abroad with a family in Switzerland
Acculturation: Process of acquiring new attitudes, role, customs, or behaviors
o
Example: An immigrant from China develops a preference for Western foods and music
Assimilation: Process by which a person gives up his or her original identify and develops a new cultural identity by becoming absorbed into the dominant cultural group
o
Example: A Native American loses his Native identity after living in Chicago for 10 years
Biculturalism: Dual pattern of identification
o
Example: A woman of Christian faith married to a Muslim adopts some Muslim practices and also maintains some traditional Christian practices
Stereotypes, prejudice, bias, etc.
Steps of cultural competence
Cultural awareness
is the process of conducting a self-examination of one’s own biases toward other cultures. understanding oneself, acknowledging your biases
Cultural knowledge
is the process in which a health care professional seeks and obtains a sound educational base about culturally diverse groups. reading, visiting ethnic neighborhoods, sampling different foods, learning a language, attending community events, talking with someone from another culture
Cultural skill
is the ability to conduct a cultural assessment of a patient to collect relevant cultural data about a patient’s presenting problem, as well as accurately conducting a culturally based physical assessment.
paying close attention to nurse patient relationship. Communication, engagement, collaboration
Cultural encounter
is a process that encourages health care professionals to directly engage in face-to-face cultural interactions
and other types of encounters with patients from culturally diverse backgrounds. Cultural desire
is the motivation of a health care professional to “want to” (and not “have to”) engage in the process of becoming culturally aware, culturally knowledgeable, and culturally skillful in seeking cultural encounters. learning to become more attuned to cultural differences
Culturally congruent care pg. 107
Culturally congruent care or transcultural care emphasizes the need to provide care based on an individual’s cultural beliefs, practices, and values
; therefore, effective
communication is a critical skill in culturally competent care and helps you engage a
patient and family in respectful, patient-centered dialogue
Treating the patient in way that is congruent or agreed upon for them and their family as well as the health care professional
Goal of culturally competent care
Understanding of others and their diverse cultures and still being able to treat them
The goal of cultural competence in health care settings is to reduce racial, economic, ethnic, and social disparities when meeting a community's health care needs.
Health care disparities and social determinants pg.108
A persons social detriments play a role in the outcome of their health. A persons social status (where they’re born, work, live) will effect their health status
Ex: a person who has always been isolated (living in mts. May then get health care and find out they have had uncontrolled diabetes, HTN, etc.) Health disparity
A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage (ODPHP, 2016)
Social determinants of health
The conditions in which people are born, grow, live, work, and age (WHO, 2019)
Marginalized groups
Gay, lesbian, bisexual, or transgender; people of color; people who are physically and/or mentally challenged; and people who are not college educated
Equity/inequity, attributes, roles (use box 24.8)
Use other grid and look over ppts
Care for patients with limited English
Required to provide language access services for their patients. For hospitals unable to provide on-site interpreters, telephone interpretation services must be available (Marcus, 2014). Use of family members, friends, or bilingual staff members to interpret for patients is strongly discouraged
Communication
Ch. 24 P&P
Levels of communication- pg.324
Pg. 333-337
Clarification questions- #22 ch.24 comms (box 24.1)
To check if pt. actually understood you, restate, repeat, teach back Use open ended questions
Ask who, what, where, when, why, how
Look for non-verbal and verbal cues (non-verbal tell you more(better))
Touch, gestures, etc.
Clarifying–
To check whether understanding is accurate, or to better understand, the nurse restates an unclear or ambiguous message to clarify the sender’s meaning. “I’m not sure I understand what you mean by ‘sicker than usual’, what is different now?”
Types of therapeutic communication- #22&23 ch.24 comms
Therapeutic communication techniques POSITIVE/GOOD
•
Providing information- Providing relevant information
•
Clarifying Questions
- Check for understanding, restate an unclear message Focusing- centering a conversation
•
Paraphrasing- restating what you heard ( I heard you say this)
•
Validation
•
Asking relevant questions
•
Summarizing- concise
•
Self-disclosure
•
Confrontation- don’t be confrontational- only after trust, must be done using therapeutic technique
o
You help the other person become more aware of inconsistencies in his or her feelings, attitudes, beliefs, and behaviors
Active listening- attentive to what pt is saying verbally and nonverbally SURETY model^
-
Sit at angle facing pt -
Uncross legs and arms
-
Relax & comfortable w pt
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Eye contact conveying willingness to listen to what pt is saying -
Touch- communicate empathy & understanding to pt
-
Your intuition- Trust as you grow in confidence to individualize, adapt &
apply communication •
Therapeutic communication techniques •
Sharing observations
•
Sharing empathy
•
Sharing hope- do not give false hope
•
Sharing humor
•
Sharing feelings
•
Using touch
•
Using silence
Nontherapeutic communication techniques NEGATIVE/BAD
•
Asking personal questions- Asking personal questions that are not relevant to a situation simply to satisfy your curiosity is inappropriate professional communication.
•
Giving personal opinions- takes decision making away
•
Changing the subject
•
Automatic responses -Stereotypes are generalized beliefs held about people
•
False reassurance
•
Sympathy- A nurse’s own emotional issues sometimes prevent effective problem solving and impair good judgment.
Nontherapeutic communication techniques •
Asking for explanations- don’t use Why question ( perceived as accusations)
•
Approval or disapproval
•
Defensive responses
•
Passive or aggressive responses
•
Arguing
Adapting communication techniques for the patient with special needs •
Use thought and sensitivity •
Adapt to unique circumstances, developmental level, or cognitive and sensory deficits
•
Communication types/techniques- start#22 ch.24 comms
Non-verbal vs. Verbal •
Verbal communication
o
Vocabulary – Communication is unsuccessful if senders and receivers cannot translate one another’s words and phrases.
o
Denotative and connotative meaning – Some words have several meanings.
LOOK AT OTHER GRID FOR FURTHER EXPLINATION
Look at Box 24.9 (comm. w/ pts. w/ special needs)
Box 24.7 (can be select
all ques.)
o
Pacing – Conversation is more successful at an appropriate speed or pace.
o
Intonation – Tone of voice dramatically affects the meaning of a message.
o
Clarity and brevity
– Effective communication is simple, brief, and direct.
o
Timing and relevance – Timing is critical in communication.
•
Nonverbal
o
Personal appearance
– Includes physical characteristics, facial expressions, and manner of dress and grooming.
o
Posture and gait
– Can be forms of self-expression.
o
Facial expressions
– The face is the most expressive part of the body.
o
Eye contact – People signal readiness to communicate through eye contact.
o
Gestures – Emphasize, punctuate, and clarify spoken word.
o
Sounds – Sounds such as sighs, moans, groans, or sobs also communicate feelings and thoughts.
o
Territoriality and personal space – Territoriality is the need to gain, maintain, and defend one’s right to space.
•
Metacommunication
– A broad term that refers to all factors that influence communication.
•
Intrapersonal- self talk
•
Interpersonal- one on one
•
Small group
•
Public
•
electronic
Transactional communication process- #9&10 ch.24 comms
•
Components:
o
Referent – Motivates one person to communicate with another.
o
Sender and receiver
– Sender is the person who encodes and delivers a message. The receiver is the person who receives and decodes the message.
o
Message – Is the content of the communication.
o
Channels – Use communication channels to send and receive messages through visual, auditory, and tactile senses.
o
Feedback – Is the message a sender receives from the receiver.
o
Interpersonal variables
– Are factors within both the sender and receiver that influence communication.
o
Environment – Is the setting for sender-receiver interactions.
Interaction types
•
Nurse-patient caring relationships
o
Caring relationships are the foundation of clinical nursing practice; they are created with skill and trust
•
Phases of the helping relationship
o
Pre-interaction phase
o
Orientation phase
o
Working phase
o
Termination phase
•
Motivational interviewing
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o
Encourages patients to share their thoughts, beliefs, fears, and concerns with the aim of changing their behavior
•
Nurse-family relationships
o
Use the same principles as one-on-one helping relationships
•
Nurse-health care team relationships
o
Affects patient safety and the work environment
Hand-off reports
SACCIA/SBAR
•
Lateral violence
o
Calmly address the behavior when it occurs.
o
Describe how the behavior affects your functioning.
o
Ask for the abuse to stop.
o
Notify the manager to get support for the situation.
o
Plan for taking action in the future.
o
Document the incidents in detail.
•
Nurse-community relationships
o
Formed by participating in local organizations, volunteering, or becoming politically active
Phases of helping relationships-#13 ch.24 comms (box 24.4)
•
Pre-interaction phase- Assessment (collect data)
•
Orientation phase- get to know stage
•
Working phase- collaboration with the patient (developing the plan of care and interventions)
•
Termination phase- evaluation stage, transition to the next nurse
Pre-interaction phase
•
Review available data, including medical and nursing history.
•
Talk to other caregivers who have information about the patient.
•
Anticipate health concerns or issues that arise.
•
Identify a location and setting that fosters comfortable, private interaction.
•
Plan enough time for the initial interaction.
Orientation phase
•
Set the tone for the relationship.
•
Recognize that the initial relationship is often superficial, uncertain, and tentative.
•
Expect the patient to test your competence and commitment.
•
Closely observe the patient and expect to be closely observed by the patient.
•
Begin to make inferences and form judgements about patient messages and behaviors.
•
Assess the patient’s health status.
•
Prioritize the patient’s problems and identify his or her goals.
•
Clarify the patient’s and your roles.
•
Form contracts with the patient that specify who will do what.
•
Let the patient know when to expect the relationship to be terminated.
Working phase
•
Encourage and help the patient express feelings about his or her health.
•
Encourage and help the patient with self-exploration
•
Provide information needed to understand and change behavior.
•
Encourage and help the patient set goals.
•
Take action to meet the goals set with the patient.
•
Use therapeutic communication skills to facilitate successful interactions.
•
Use appropriate self-disclosure and confrontation.
Termination phase
•
Remind the patient that termination is near.
•
Evaluate goal achievement with the patient.
•
Reminisce about the relationship with the patient.
•
Separate from the patient by relinquishing responsibility for his or her care.
•
Achieve a smooth transition for the patient to other caregivers as needed
SBAR
Situation, background, assessment, recommendation
This is a form of communication between healthcare professionals that allows for the important information to be passed and in a timely manner without any error or confusion
Situation question, will highlight a certain part and ask us to identify which part of SBAR it is
Nutrition
BMI >30= obesity
25-30= overweight
18.5-24.9= normal <18.5= underweight Causative factors for obesity
o
Sedentary lifestyle
o
Junk food/eating bad
o
Genetics
o
BMI > 25
Fiber rich food
o
Green leafy vegetables
o
Apples/ pears
o
Beans
o
Barley
o
Oats
o
Cereal grains
Risk for nutritional deficits
Anorexia
Bulimia
Cancer
Chrons disease
Scurvy- vit.c deficiency
Burns Factors influencing nutrition
Environmental factors
o
Developmental needs
Infants through school age
Breastfeeding, formula, introduction to solid foods
Adolescents
Energy needs increase to meet greater metabolic demands of growth.
Daily requirement for protein also increases.
Many other factors other than nutritional needs influence the adolescent’s diet, including concern about body image and appearance, desire for independence, eating at fast-food restaurants, peer pressure, and fad diets.
Young and middle adults
Pregnancy
Lactation
Older adults
Age-related changes in appetite, taste, smell, and the digestive system.
Decrease in taste cells that alter food flavor.
Income
Lack of Transportation
Health status
Oral health can result in difficulty chewing food.
Alternative food patterns
o
Many people followed special patterns of food intake on the basis of
religion, cultural background, health beliefs, personal preference, or concern for the efficient use of land to produce food.
o
Vegetarian diet
Consumption of a diet consisting predominantly of plant foods.
Insufficient nutrition
o
Insufficient calorie intake
o
Insufficient intake of one or more nutrients
o
Starvation-related malnutrition
o
Acute disease-related malnutrition
o
Chronic disease-related malnutrition
Excess nutrition
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o
Excess calorie intake
o
Excess micronutrient intake
2020-2025 Dietary Guidelines for Americans
1.
Follow a healthy dietary pattern at every life stage
2.
Customize and enjoy nutrient-dense food and beverage choices to reflect personal
preferences, cultural traditions, and budgetary considerations.
3.
Focus on meeting food group needs with nutrient-dense foods and beverages, and
stay within calorie limits
4.
Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.
Negative nitrogen balance
May occur during starvation- lacking essential amino acids
A negative nitrogen balance may occur during physical or emotional stress, starvation, when an individual is on a very low calorie diet, or when the quality of protein is poor (e.g. when the diet is lacking essential amino acids).
Nitrogen is the building block of amino acids
amino acids are building blocks for protein
When your body runs out of carbs and fats for energy, it turns to your protein when your protein levels drop to negative levels it results in muscle wasting because your muscles need protein and when proti2n is used from the muscles so is nitrogen leading to negative nitrogen levels/balance
Lab Tests to assess nutritional status
Electrolyte panel- shows potassium, magnesium, sodium, calcium, phosphorous levels, etc.
Albumin test shows amount of protein circulating in the blood- Low albumin can reflect protein calorie malnutrition
BUN & creatinine reflect how well your body is absorbing and getting rid of everything
Nutritional requirements throughout the life span-
• Age-related gastrointestinal changes that affect digestion of food and maintenance of nutrition include changes in the teeth and gums, reduced saliva production, atrophy of oral mucosal epithelial cells, increased taste threshold, decreased thirst sensation, reduced gag reflex, and decreased esophageal and colonic peristalsis
• The presence of chronic illnesses (e.g., diabetes mellitus, end-stage renal disease, cancer) often affects nutrition intake.
• Adequate nutrition in older adults is affected by multiple causes, such as
lifelong eating habits, culture, socialization, income, educational level, physical functional level to meet activities of daily living (ADLs), loss, dentition, and transportation • Adverse effects of medications cause problems such as anorexia, gastrointestinal bleeding, xerostomia, early satiety, and impaired smell and taste perception • Cognitive impairments such as delirium, dementia, and depression affect ability to
obtain, prepare, and eat healthy foods.
Choose MyPlate program
ChooseMyPlate includes guidelines for balancing calories; decreasing portion size; increasing healthy foods; increasing water consumption; and decreasing fats, sodium, and sugars.
Composed of half veggies and fruits. ½ protein, ¼ grains milk on side
Legal/Ethical
Professionalism/ Ethics
Code of ethics – is a set of guiding principles that all members of a profession accept.
Code of nursing ethics principles:
o
Includes advocacy, responsibility, accountability, and confidentiality
Advocacy - Refers to the application of one’s skills and knowledge for the benefit of another person.- advocating for your pt.
Responsibility - Refers to a willingness to respect one’s professional obligations and to follow through.- responsible to do what you were heired to do
Accountability - Refers to answering for your own actions.
Confidentiality - Refers to the health care team’s obligation to respect patient privacy.
Ethical Practice (2)
Benficience:
Nonmalifiance:
Justice:
Fidelity:
Identifying Code of Ethics
Following your scope of practice
Health information disclosure
Nurses are legally and ethically obligated to keep all patient information confidential.
Only discuss the patient’s status with members of the health care team.
Protected health information.
Can use data for research or continuing education, but need permission.
Determining which ethical principle (2)
Will be given a situation and asked to identify which ethical principle is being met or neglected
1)
Ask if this is an ethical problem.
2)
Gather all relevant information.
3)
Identify the ethical elements in the problem and examine your values.
4)
Name the problem.
5)
Consider possible courses of action.
6)
Create an action plan and carry it out.
7)
Evaluate the action plan.
Futile Care (no point/useless)
Futile care was defined as useless and inconclusive care, leading to the squandering of financial resources and patient/nurse discomfort, with both nursing and medical aspects.
Best Legal Action for patient safety
Always practice within your scope of practice
Good Samaritan laws protect whatever you do if it is under your scope of practice
Scope and standards of nursing
o
Defines nursing and reflects the values of the nursing profession
o
Standards of nursing care reflect the knowledge and skill ordinarily possessed and used by nurses
o
American Nurses Association (ANA)
Nurse Practice Act:
o
State laws intended to protect citizens, make nurses accountable and assure that care is consistent with best practice within the scope and standards of nursing
o
Licensure
o
Enhanced nurse licensure compact
Legal Scope of Practice
Nurses must always practice ethically and always do what is best for the patient
The below are the ANA standards for nurses and they must be incorporated into the nursing profession
1. Ethics: The registered nurse practices ethically.
2. Culturally Congruent Care: The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles.
3. Communication: The registered nurse communicates effectively in all areas of practice.
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4. Collaboration: The registered nurse collaborates with health care consumer and other key stakeholders in the conduct of nursing practice.
5. Leadership: The registered nurse demonstrates leadership in the professional practice setting and the profession.
6. Education: The registered nurse seeks knowledge and competency that reflects current nursing practice and promotes futuristic thinking.
7. Evidence-Based Practice and Research: The registered nurse integrates evidence and research findings into practice.
8. Quality of Practice: The registered nurse contributes to quality nursing practice.
9. Professional Practice Evaluation: The registered nurse evaluates one’s own and others’ nursing practice.
10. Resources Utilization: The registered nurse uses appropriate resources to plan and provide and sustain evidence-based nursing services that are safe, effective, and fiscally responsible.
11. Environmental Health: The registered nurse practices in an environmentally safe
and healthy manner.
Professionalism/caring
Providing a presence
Family/patient-centered care Holistic care
Types of caring touch
Nurse Practice Act
Nursing student's professionalism
Professional nursing roles
HIPPA
Roles of Different Healthcare professionals
Patient Education
Types of Patient Education
Determining if teaching is Effective Patient Feedback on teaching
Domains of Learning
Cognitive
1. • Discussion (one-on-one or group)
2.
1. • Involves nurse and one patient or a nurse with several patients
2. • Promotes active participation and focuses on topics of interest to patient
3. • Allows peer support
4. • Enhances application and analysis of new information
3. • Lecture
4.
1. • Is more formal method of instruction because it is educator controlled
2. • Helps learner acquire new knowledge and gain comprehension
5. • Question-and-answer session
6.
1. • Addresses patient’s specific concerns
2. • Helps patient apply knowledge
7. • Role play, discovery
8.
1. • Allows patient to actively apply knowledge in controlled situation
2. • Promotes synthesis of information and problem solving
9. • Independent project (computer-assisted instruction), field experience
10.
1. • Allows patient to assume responsibility for completing learning activities at own pace
2. • Promotes analysis, synthesis, and evaluation of new information and skills
Affective
1. • Role play
2.
1. • Allows expression of values, feelings, and attitudes
3. • Discussion (group)
4.
1. • Allows patient to receive support from others in group
2. • Helps patient learn from others’ experiences
3. • Promotes responding, valuing, and organization
5. • Discussion (one-on-one)
6.
1. • Allows discussion of personal, sensitive topics of interest or concern
Psychomotor
1. • Demonstration
2.
1. • Provides presentation of procedures or skills by nurse
2. • Permits patient to incorporate modeling of nurse’s behavior
3. • Allows nurse to control questioning during demonstration
3. • Practice
4.
1. • Gives patient opportunity to perform skills using equipment in a controlled setting
2. • Provides repetition
5. • Return demonstration
6.
1. • Permits patient to perform skill as nurse observes
2. • Provides excellent source of feedback and reinforcement
3. • Assists in determining patient’s ability to correctly perform a skill or technique
7. • Independent projects, games
8.
1. • Requires teaching method that promotes adaptation and origination of psychomotor learning
2. • Permits learner to use new skills
Teaching Technique
Assessing patients is readiness to learn (2 questions)
Learning Assistance (Priority)
Teaching and Learning Principles
Priority teaching action
Math
5 questions
Medical Terminology
10 questions
Eight Questions associated with the RESPECT Model:
1.
What do you call the problem?
2.
What do you think has caused the problem?
3.
Why do you think it started when it did?
4.
What do you think the sickness does? How does it work?
5.
How severe is the sickness? Will it have a long or short course?
6.
What kind of treatment do you think the patient should receive?
7.
What are the chief problems the sickness has caused?
8.
What do you fear most about the sickness? Key Points
Ch. 9 • Cultural awareness self-examines the dynamics of personal biases, stereotypes, values, and beliefs related to others
different from one’s own heritage, while cultural encounter is directly interacting with patients of a diverse population other than one’s own.
• Cultural desire is the pivotal and key construct of cultural competence. It is your desire to engage with patients who have cultural differences that evokes the entire process of cultural competence.
• A person’s culture and life experiences shape his or her world view about health, illness, and health care.
• Poor health, disease risk factors, poor health outcomes, and limited access to health care are types of preventable health care disparities often interrelated and influenced by the conditions and social context in which people live.
• Disparities in access to quality health care, preventive health care, and health education contribute to poor population health.
• Social determinants of health are defined by conditions in which people are born, grow, live, work, and age.
• Health care systems and providers contribute to the problem of health disparities as a result of inadequate resources, poor patient-provider communication, a lack of culturally competent care, system fragmentation, and inadequate access to language services.
• People who are marginalized are more likely to have poor health outcomes and to die at an early age because of a complex interaction among individual behaviors, public and health policy, cultural factors, and access to and quality
of health care.
• Gaining cultural knowledge and conducting a self-examination allows a health care provider to understand the cultural factors that shape a patient’s life experiences, a patient’s health care problems, a patient’s behavior, and how
a patient might perceive those problems while building a positive nurse-patient relationship.
• Cultural respect is critical to reducing health disparities and improving access to high-quality health care that is respectful and responsive to the needs of a diverse patient.
• Avoid forming inappropriate biases or stereotypes when assessing a patient’s needs. Approach each person individually and ask questions to gain a better understanding of a patient’s perspective and needs.
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• Ongoing cultural competence and cultural skill are necessary for a nurse to complete a cultural assessment and provide culturally appropriate nursing care for each patient, regardless of the patient’s cultural background.
• Knowledge about your patient directs your physical assessment, and the health care provider must learn to anticipate physical findings based on the patient’s cultural health practices and the physical characteristics of an ethnic or racial group.
• Teach-back is an ongoing process of asking patients open-ended questions to gather feedback through explanation or demonstration until the health care provider feels confident in the patient’s ability to understand and safely apply the new educational content.
• Linguistic competence is the ability to communicate effectively and convey information in a manner that is easily understood by diverse audiences.
• Effective communication is a critical skill in culturally competent care and helps you engage a patient and family in a respectful, patient-centered dialogue. Qualified translators (written words), interpreters (verbal words), and/or the use of a cultural broker (mediator) are options to be utilized to assist with linguistic needs related to effective communication.
Key Points
Ch. 24
• Effective use of critical thinking promotes good communication.
• Nurses use the five levels of communication in their interactions: intrapersonal, interpersonal, small group, public, and electronic.
• The circular transactional communication process demonstrates the ever-changing nature of communication, and includes the sender, the receiver, and referents.
• Verbal communication involves spoken or written words, and the vocabulary, pacing, tone, clarity, and brevity of the message.
• Nonverbal communication occurs through the five senses and includes everything except the written or spoken word.
• Nurse-patient caring relationships are the foundation of the nursing process.
• The four phases of a nurse-patient helping relationship are: pre-interaction, orientation, working, and termination.
• Effective nurse–health care team relationships promote safe and effective care and contribute to satisfying professional working relationships.
• Use of both professional and therapeutic communication techniques contributes to achievement of patient outcomes. Practicing these techniques is essential in your development as a nurse.
• Nontherapeutic communication techniques damage professional and caring relationships; therefore pay attention to
your own communication to remove these blocking techniques from your responses.
• Adapting your communication with older adults to meet their unique needs ensures an effective nurse-patient relationship.
• Patients with impaired communication benefit from the use of devices that overcome barriers to understanding and communicating.
• Patients with special communication needs such as an inability to speak, cognitive impairment, and hearing or vision loss require the nurse to employ specific techniques to facilitate mutual understanding
Ot?- ADLs
ACCESS model
Role play
Equity/gender norms