Communication

Communication is the process of sending and receiving information between two or more people, through verbal or nonverbal communication.

Verbal communication uses spoken or written words, whereas nonverbal communication uses body language to convey information, like gestures and facial expressions.

Nurses use communication to collaborate with members of the health care team and to foster trusting relationships with patients and their families.

Alright, now there are a variety of factors that can affect communication. When there are differences in language between you and your patient, you can promote communication by following your facility’s policy for providing an interpreter.

You’ll also need to be mindful of cultural influences that may affect how information is exchanged. For example, in some cultures direct eye contact is considered confrontational and rude, while in others, family members prefer to receive information as a group so they can participate in shared decision-making.

Also keep in mind that when your patient is stressed, tired, or in pain, these emotions can make it difficult for them to effectively receive information; likewise, a depressed patient might be reluctant to communicate with their caregivers.

Other factors that can affect communication include individual factors like age, developmental level, and underlying medical conditions.

For instance, a patient with hearing impairment may require nonverbal or written cues; or a pediatric patient may receive information best when toys, play, and simple language are used.

Lastly, environmental factors, such as an uncomfortable temperature or a noisy room can negatively impact communication, whereas a comfortable, quiet, and private setting can enhance it.

Now, to promote patient-centered care, you’ll use therapeutic communication techniques, including active listening, silence, restating, and clarification.

Starting with active listening, this is when you attend to what your patient is saying verbally and nonverbally. As you actively listen to your patient, you can demonstrate interest by sitting in a relaxed position, and facing them while maintaining eye contact, as appropriate.

Indicate understanding by nodding as they speak and waiting for them to finish their thoughts before responding to let them know you have grasped the meaning of their words and their feelings.

Next, using silence is especially beneficial for patients who are reluctant to share because it provides them with extra time to gather their thoughts before they respond.

During silence, you’ll also observe your patient’s nonverbal cues, like their posture, facial expressions, and signs of distress like restlessness or eye contact avoidance, and you’ll communicate interest by using attentive body language.

Then, restating involves rephrasing what your patient has said and summarizing the feelings they conveyed. For instance, if your patient says, “I’m so tired of lying in bed all day,” you could respond by saying, “It sounds like you are frustrated."

Likewise, with reflection, you can repeat what your patient says to you. For example, if your patient says, “I’m afraid of pain,” you could say, “You’re worried about being in pain.” Lastly, with clarification, you’ll ask questions to verify what your patient said.

So, if your patient tells you, “I’ve tried everything to manage my pain,” you can clarify by asking, “Can you tell me more about the strategies you’ve used?” Now, non-therapeutic communication can impair communication and negatively impact the nurse-patient relationship.

These include false reassurances, judgmental responses, asking probing questions, giving advice, and inattentive listening.

False reassurances can minimize your patient’s feelings or give false hope, like saying “Don’t worry about that” in response to their health concern.

Instead, you can use phrases like “I understand that can be scary. Let's talk more about your concerns.” Judgmental responses can cause your patient to feel guilty about their behavior, like saying, “You shouldn’t be smoking after your heart attack.” A more therapeutic response is, “It can be difficult to quit smoking, but I’d like to review some strategies to help you.” Also, asking probing questions that are unrelated to your patient’s health care and can invade their privacy, like asking, "Is this your husband at the bedside?” Instead, you can ask, “Tell me about who is with you today at your appointment.” You should also avoid giving advice, because it places the focus on you, rather than your patient.

So, instead of saying, “You should go ahead with the chemotherapy,” guide your patient to make their own decision by saying, “Let’s discuss some treatment options.” Lastly, inattentive listening occurs when you’re distracted while your patient is speaking, like charting during conversation, interrupting while they’re speaking, or changing the subject.

Instead, use active listening techniques to help your patient feel heard and supported. Alright, as a quick recap.

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Communication is the process of sending and receiving information between two or more people and includes verbal or nonverbal communication.

Communication is influenced by language, culture, emotions, environment, and individual factors. Techniques that aid in therapeutic communication are active listening, silence, restating, and clarification, whereas non-therapeutic communication techniques include providing false reassurances, judgmental responses, asking probing questions, giving advice, and inattentive listening.