Communication in Nursing

by Balzer Riley

• ISBN13: 9780323024013
• ISBN10: 0323024017
• Edition: 5th
• Format: Paperback
• Copyright: 2003-10-17
• Publisher: Mosby

Summary

From spiritual and artistic to practical and clinical, this outstanding resource takes a unique approach to presenting the basic concepts of therapeutic communication and their application in various clinical situations with both clients and colleagues. It covers a wide array of topics, including being assertive, electronic communication, respect, humor, group communication, confrontation, and requesting support. Chapters are organized into four parts, building from the ground up: Getting Started, Building Relationships, Meeting Challenges, and Building Confidence. Valuable nursing knowledge is presented with a personal touch through quotes, stories, and poetry excerpts. It goes beyond the clinical setting and introduces students to empathy and sensitivity and how they are the prerequisites of successful communication in this field. Wit & Wisdom boxes feature selected spiritual verses, bits of poetry, and quotations to add interest and humor to chapter content The Myers-Briggs Type Indicator is discussed as a tool to help the reader enhance his/her own communication style and recognize the different style of colleagues and clients Moments of Connection boxes are interspersed throughout each chapter to highlight the benefits and outcomes of successful communication Reflections On... boxes focus on what is learned from the chapter, how it will impact nursing practice, and how new knowledge and skills will be implemented Poetry excerpts can be found in every chapter to give a less clinical example of how best to achieve fruitful communication Includes communication strategies to manage professional issues such as burnout and verbal harassment Addresses the therapeutic use of humor and spirituality as part of a holistic approach to communication in nursing Offers insights on communicating with populations with special needs, such as family, children, the elderly, clients from different cultures, clients with HIV/AIDS, suicidal clients, and victims of abuse New Group Process chapter focuses on the importance of effective communication in group situations, and the techniques to achieve it The Electronic Communication and Communication and Culture chapters have been completely updated and revised to include the very latest developments in each area Nursing process content has been revised to include evaluation End-of-life content has been added to address the importance of proper communication at this difficult time A new two-column design makes the book more user-friendly

Author Biography

Julia Balzer Riley, RN, MN, HNC, in private practice as a consultant and professional speaker for over 25 years, is President of Constant Source Seminars and adjunct faculty in nursing at the University of Tampa

Table of Contents

PART 1 GETTING STARTED: BASIC COMMUNICATION COMPETENCE,	1	(90)
1 Responsible, Assertive, Caring Communication in Nursing,	5	(16)
The Meaning of Interpersonal Communication,	6	(2)
The Meaning of Assertive Communication,	8	(2)
Now Do You Get Started?,	10	(4)
The Meaning of Responsible Communication,	14	(1)
The Meaning of Caring,	15	(2)
How Can You Learn to Communicate Assertively and Responsibly?,	17	(2)
Cognitive Domain: Basic Communication Competencies,	17	(1)
Affective Domain: Belief in the Value and Impact of Positive Communication,	17	(1)
Psychomotor Domain: Putting It All Together,	17	(2)
Practicing Responsible, Assertive, Caring Communication,	19	(2)
2 The Client-Nurse Relationship: A Helping Relationship,	21	(14)
Nature of the Helping Relationship,	22	(4)
Cognitive, Affective, and Psychomotor Abilities in the Therapeutic Encounter,	22	(4)
Clients' Rights in the Helping Relationship,	26	(1)
Characteristics of Client-Nurse Helping Relationships,	26	(1)
Pointers to Guide You in Your Client-Nurse Helping Relationships,	27	(3)
True Presence,	30	(1)
Practicing the Client-Nurse Relationship,	31	(4)
3 Solving Problems Together,	35	(16)
Face Work and Politeness Theory,	36	(1)
Defining the Difference Between Problem Solving and Mutual Problem Solving in Nursing,	37	(8)
Problem Solving: The Nursing Process,	37	(1)
The Mutual Problem-Solving Process in Nursing,	37	(8)
Practicing Solving Problems Together,	45	(6)
4 Understanding Each Other: Communication and Culture,	51	(16)
Joyce Larson Presswalla, RN, PhD
Definition of Culture, Ethnicity, and Ethnocentrism,	52	(1)
Reasons Why Nurses Need to Be Informed About Culture,	52	(1)
Barriers That Interfere with Nurses' Recognition and Appreciation of Diverse Cultures,	53	(10)
Dominant Language and Dialects,	55	(2)
Cultural Communication Patterns,	57	(2)
Temporal Relationships,	59	(1)
Format for Names,	59	(1)
Age,	59	(2)
Gender,	61	(2)
A Closing Thought,	63	(1)
Practicing Understanding Each Other,	64	(3)
5 Working Together in Groups,	67	(12)
Three Conditions for Effective Group Development,	68	(1)
Four Stages of Group Development,	68	(1)
Effect of Personal Mental Processes on Behavior in Groups,	68	(2)
Task, Maintenance, and Individual Roles in Groups,	70	(2)
Emotional Intelligence in Groups,	72	(1)
Importance of Meetings,	72	(2)
To Meet or Not to Meet,	73	(1)
Tools to Promote Effectiveness of Meetings,	73	(1)
Characteristics of an Effective Group,	74	(1)
Strategies for Building Successful Committees,	74	(2)
Practicing Working Together in Groups,	76	(3)
6 Electronic Communication,	79	(12)
Janet K. Graves, PhD, RN
Why Nurses Need to Know About Electronic Communication,	80	(1)
What Electronic Communication Includes,	80	(1)
Advantages of Communicating by E-mail,	80	(1)
What Can Be Sent by E-mail,	80	(4)
Use of E-mail to Transfer files,	80	(1)
Methods of Opening Files Sent by Attachment (or Any Way),	81	(2)
Other Ways to Transfer Files,	83	(1)
Instant Messaging and Chat Rooms,	83	(1)
Differences Between Electronic Communication and Face-to-Face Communication,	83	(1)
Too Much and Unwanted E-mail,	84	(1)
Use of E-mail with Other Professionals,	84	(1)
Telenursing-Use of Electronic Communication with Clients,	84	(2)
Special Considerations for Using E-mail with Clients,	84	(1)
Use of the World Wide Web by Clients,	85	(1)
Electronic Communication About Clients,	86	(1)
Dangers of Electronic Communication,	86	(2)
Protecting Your Computer from Viruses, Worms, and Trojan Horses,	86	(1)
Protecting Your Privacy,	87	(1)
Protecting Yourself,	87	(1)
Practicing Electronic Communication,	88	(3)
PART 2 BUILDING RELATIONSHIPS,	91	(128)
7 Warmth,	93	(12)
Benefits of Warmth for Your Clients and Colleagues,	94	(1)
Ways to Display Warmth to Your Clients and Colleagues,	95	(5)
Stories of Warmth in the Actions of Nurses,	97	(1)
Extension and Withdrawal of Warmth,	97	(3)
Practicing Warmth,	100	(5)
8 Respect,	105	(10)
Recognizing the Benefits of Respect,	106	(1)
Showing Respect to Your Clients,	106	(4)
Acknowledging Clients,	107	(1)
Establishing the Nature of the Contact,	108	(1)
Establishing a Comfortable Climate,	109	(1)
Discussing Sensitive Subjects,	109	(1)
Terminating Contact,	110	(1)
Showing Respect to Your Colleagues,	110	(2)
Practicing Respect,	112	(3)
9 Genuineness,	115	(10)
Benefits of Genuineness in Interpersonal Relationships,	116	(1)
Incongruence,	117	(2)
Demonstration of Genuineness with Clients and Colleagues,	119	(1)
Factors Influencing Genuineness,	120	(1)
Palliative Care: A Call to Authenticity,	121	(1)
Evaluation of Your Genuineness,	121	(1)
Practicing Genuineness,	122	(3)
10 Empathy,	125	(22)
What Empathy Is,	126	(1)
Now to Communicate Empathically,	127	(3)
Preverbal Aspects of Empathy,	127	(1)
Verbal Aspects of Empathy,	128	(1)
Nonverbal Aspects of Empathy,	129	(1)
When to Communicate Empathically,	130	(2)
How Empathy Benefits Clients and Colleagues,	132	(3)
Now Empathy Benefits the Nurse,	135	(1)
Now to Overcome Blocks to Empathy,	136	(2)
What Steps Can help You Communicate More Empathically,	138	(1)
Now to Break Bad News,	139	(1)
Now to Center Yourself,	139	(1)
Practicing Empathy,	140	(7)
11 Self-Disclosure,	147	(12)
Self Disclosure in Personal and Professional Relationships,	148	(1)
Guidelines for Self Disclosing in the Helping Relationship,	148	(3)
Why Nurses Should Use Self-Disclosure with Clients,	149	(1)
What Nurses Should Reveal to Clients in Self Disclosures,	149	(1)
When Nurses Should Use Self Disclosure with Clients,	149	(1)
How to Self Disclose in the Helping Relationship,	150	(1)
Examples of Helpful and Nonhelpful Self Disclosures,	151	(5)
Situation 1: With a Client,	151	(2)
Situation 2: With a Colleague,	153	(3)
Practicing Self Disclosure,	156	(3)
12 Specificity,	159	(8)
Recognizing When Specificity Is Useful,	160	(1)
Being Specific When Explaining Your Thoughts and peelings,	160	(1)
Being Specific When Reflecting Others' Thoughts and feelings,	161	(1)
Being Specific When Asking Questions,	162	(1)
Being Specific When Giving Information or feedback,	162	(1)
Being Specific When Evaluating,	163	(1)
Providing Specific Documentation,	164	(1)
Practicing Specificity,	165	(2)
13 Asking Questions,	167	(12)
Importance of Asking Questions Effectively in Nursing,	168	(1)
Why, What, How, Who, When, and Where of Asking Questions,	168	(3)
Why of Asking Questions,	168	(1)
What and How of Asking Questions,	169	(1)
Who of Asking Questions,	170	(1)
When and Where of Asking Questions,	171	(1)
Common Tactical Errors in Asking Questions and What to Do About Them,	171	(5)
Long Winded Buildup,	171	(1)
Thunder Stealer,	172	(1)
Multiple Choice Mix-Up,	172	(1)
Incomprehensible and Cryptic Codes,	173	(1)
Offensive Misuse of "Why,"	173	(1)
Misuse of Open and Closed Questions,	174	(1)
Mystery Interview,	174	(2)
Practicing Asking Questions,	176	(3)
14 Expressing Opinions,	179	(10)
How to Differentiate Between Giving Advice and Expressing Opinions,	180	(1)
When to Express Your Opinions as a Nurse,	180	(1)
Your feelings About Expressing Opinions,	180	(2)
How to Express Your Opinions in an Assertive Way,	182	(2)
Get the Consent of Your Receiver Before Expressing Your Opinions,	182	(1)
Make Allowances for the Uniqueness of Your Client or Colleague,	182	(1)
Include the Rationale for Your Viewpoint,	183	(1)
How to Share Your Positive Regard for Others,	184	(1)
How to Master the Art of Not Expressing Your Opinions,	185	(1)
How to Empower Yourself by Expressing Opinions,	185	(1)
Practicing Expressing Opinions,	186	(3)
15 Humor,	189	(14)
Definition of Humor,	190	(1)
Positive Versus Negative Humor,	190	(2)
Criteria for the Appropriate Use of Humor,	192	(1)
Functions of Humor in Health Care,	193	(1)
Nursing Practice Confirms the Research,	194	(1)
Humor Strategies,	194	(4)
Try Gentle Banter,	194	(1)
Let Humor Take the Lead,	195	(1)
Look for the Positive,	195	(1)
Be Creative,	195	(1)
Use Toys and Props,	196	(2)
Ways in Which Humor Promotes Positive Communication,	198	(1)
Humor in Health Care Education,	198	(1)
He Who Laughs, Lasts,	198	(1)
Practicing Humor,	199	(4)
16 Spirituality,	203	(16)
Definition of Spirituality,	204	(1)
Themes of Spirituality,	204	(1)
FICA-Taking a Spiritual History,	205	(1)
The Nurse as a Spiritual Person and Caregiver,	205	(8)
Spiritual Care Begins with the Nurse,	206	(1)
Meeting the Spiritual Needs of the Client,	206	(1)
Being Fully Present,	207	(1)
Offering Prayer,	207	(1)
Being Silent,	208	(1)
Using "Oh ... ?," "Hmm and , "Really?,"	209	(1)
Recognizing Opportunities for Moments of Connection,	209	(1)
Tapping Resources,	209	(1)
Nearing Death,	210	(1)
Helping in Life Review and Life Repair,	210	(1)
Finding Meaning,	211	(2)
Spiritual Connection,	213	(1)
Practicing Spirituality,	214	(5)
PART 3 BUILDING CONFIDENCE,	219	(78)
17 Requesting Support,	221	(16)
Recognizing the Importance of Social Support for Health and Work Life,	222	(1)
Determining the Support You Need at Work or School,	222	(1)
Requesting the Support You Need at Work or School,	223	(10)
Making a Request for Cognitive Support,	225	(2)
Making a Request for Affective Support,	227	(2)
Making a Request for Physical Support,	229	(3)
Planning an Assertive Strategy for Making Requests,	232	(1)
Providing Support at Work and School,	233	(1)
Remembering That We're All in This Together,	233	(1)
Practicing Requesting Support,	234	(3)
18 Overcoming Evaluation Anxiety,	237	(14)
Defining Evaluation Anxiety,	238	(9)
Concern for Client Safety,	238	(1)
Concern for Our Own Security,	239	(1)
Characteristics of Evaluation Anxiety,	239	(1)
Gaining Control over Your Evaluation Anxiety,	240	(1)
Handling Job Performance Appraisals Assertively,	241	(1)
Assessing the Validity and Reliability of an Employer's Appraisal System,	242	(1)
Coping with the Anxiety of Written Examinations,	243	(2)
Dealing with Criticism,	245	(1)
Assertively Handling Difficult Situations in Nursing Student Performance Evaluations,	245	(2)
Moving from Reactive to Proactive Behavior,	247	(1)
Practicing Overcoming Evaluation Anxiety,	247	(4)
19 Feedback,	251	(10)
Why Feedback Is Important,	252	(1)
How to Give feedback,	253	(2)
Gain Permission to Give Feedback,	253	(1)
Be Specific,	253	(1)
Convey Your Perspective,	254	(1)
Use This Formula to Give Assertive Feedback,	254	(1)
Invite Comments from the Receiver,	255	(1)
Be Genuine,	255	(1)
Check Out How Your Feedback Is Being Received,	255	(1)
How to Receive Feedback,	255	(2)
Get Focused,	256	(1)
Arrange to Have Enough Time to Receive the feedback,	256	(1)
Make Sure You Understand the feedback,	256	(1)
Request Guidance on How to Change,	256	(1)
Show Appreciation for the Feedback,	256	(1)
Think About the Feedback You Receive,	257	(1)
How to Seek Feedback,	257	(1)
Be Sure You Are Ready to Receive feedback,	257	(1)
Be Specific in Your Request for Feedback,	258	(1)
Use Feedback as Caring Communication,	258	(1)
Practicing Giving and Receiving Feedback,	258	(3)
20 Relaxation,	261	(12)
Importance of Relaxing Your Body,	262	(1)
Stress of Nursing as an Occupation,	262	(1)
Meditation as a Way to Augment Your Relaxation Response,	263	(1)
Guidelines for Beginning to Practice Meditation,	264	(2)
Make Time to Meditate,	264	(1)
Set the Climate to Meditate,	264	(1)
Secure a Comfortable Position for Meditation,	264	(1)
Develop a Passive Attitude,	265	(1)
Select a Mental Device,	265	(1)
Relax Your Body,	265	(1)
Focus on Your Breathing,	265	(1)
Meditate for 10 Minutes,	265	(1)
Experience Your Unique Meditation,	266	(1)
End Your Meditation Peacefully,	266	(1)
Consider Mindfulness Meditation,	266	(1)
On-the-Spot Relaxation Exercises to Relieve Tension Caused by an Interpersonal Stressor,	266	(1)
Strategies for Relaxing Your Body When Your Stressor Is Immediate,	267	(2)
Exercises to help Cope with an Unexpected Stressful Interpersonal Encounter,	267	(2)
Advantages of On-the-Spot Relaxation Exercises,	269	(1)
Stretches to Create Relaxation in Preparation for a Stressful Interpersonal Encounter,	269	(1)
Practicing Relaxation,	270	(3)
21 Imagery,	273	(12)
Definition of Imagery,	274	(1)
Try This Experiment: The Tart Lemon,	274	(1)
History of Imagery,	274	(2)
Application of Imagery in Health Care,	276	(1)
Implications of Imagery,	276	(1)
Relationship Between Imagery and Interpersonal Communication,	277	(1)
Use of Imagery to Improve Your Ability to Communicate,	278	(3)
Be Clear About Your Desired Outcome,	278	(1)
Mentally Outline the Whole Interaction from Beginning to End,	279	(1)
Concentrate on Visualizing Details,	279	(1)
Envision the Best and Plan for the Unexpected,	280	(1)
Rehearse Repeatedly When Necessary,	280	(1)
Review Your Live Performance and Update Your Visualization,	280	(1)
Practicing Imagery,	281	(4)
22 Positive Self-Talk,	285	(12)
Definition of Self Talk,	286	(7)
Positive Self Talk: Assertive and Responsible,	288	(1)
Relationship Between Self Talk and Interpersonal Communication,	289	(4)
Use of Positive Self Talk to Enhance Your Interpersonal Communication,	293	(1)
A Final Thought,	294	(1)
Practicing Positive Self Talk,	294	(3)
PART 4 MEETING CHALLENGES,	297
23 Confrontation,	299	(10)
Different Kinds of Confrontation,	300	(1)
Situations in Which Confrontation Is Appropriate,	300	(1)
The CARE Confrontation,	301	(1)
Elements of the CARE Confrontation,	301	(1)
Examples of CARE Confrontations,	301	(1)
Confrontations with Clients or Colleagues,	302	(3)
Situations in Which Your Client's Behavior Is Self Destructive or Unproductive,	302	(1)
Situations in Which Your Colleague's Behavior Is Self Destructive or Unproductive,	303	(1)
Situations in Which Your Client's or Colleague's Behavior Is Bothersome to You or Others,	304	(1)
Situations in Which Your Colleague's Behavior Is Unpleasant for You or Others,	304	(1)
The Magic of a Little Word,	305	(1)
Confrontation as One Part of Empowerment,	305	(1)
Practicing Confrontation,	306	(3)
24 Refusing Unreasonable Requests,	309	(10)
Defining Unreasonable Requests,	310	(1)
Saying No Assertively,	311	(4)
Examples of Refusing Requests Assertively,	312	(3)
Saying No Effectively,	315	(1)
Daring to Hold last to Your Principles,	315	(1)
Practicing Refusing Unreasonable Requests,	316	(3)
25 Communicating Assertively and Responsibly with Distressed Clients and Colleagues,	319	(18)
Why Distressed Behavior Is a Problem for Nurses,	320	(1)
How to Improve Your Communication Skill with Distressed Clients and Colleagues,	321	(10)
Communicating with Upset Clients,	322	(1)
Communicating with Upset Colleagues,	323	(1)
Communicating with Clients Who Are Sad or Depressed,	324	(2)
Communicating with Colleagues Who Are Sad or Depressed,	326	(2)
Communicating with Clients Who Are Crying,	328	(1)
Communicating with Colleagues Who Are Crying,	329	(2)
Practicing Communicating Assertively and Responsibly with Distressed Clients and Colleagues,	331	(1)
Critique: Choices Of Responses To Distressed Clients And Colleagues,	332	(3)
How The Nurse Can Address Compassionate Fatigue Proactively,	335	(2)
26 Communicating Assertively and Responsibly with Aggressive Clients and Colleagues,	337	(24)
Why Aggressive Behavior Is Problematic for Nurses,	338	(1)
How to Communicate Effectively with Aggressive Clients and Colleagues,	338	(2)
Get to the Source of the Problem,	339	(1)
Increase Your Aggressor's Awareness of Abusive Behavior and Its Negative Effects,	339	(1)
Limit the Aggressive Behavior,	340	(1)
How to Improve Your Communication Skill with Aggressive Clients and Colleagues,	340	(14)
Communicating with Rejecting Clients,	340	(2)
Communicating with Rejecting Colleagues,	342	(2)
Communicating with Hostile Clients,	344	(1)
Communicating with Hostile Colleagues,	345	(2)
Communicating with Abusive Clients,	347	(1)
Communicating with Abusive Colleagues,	348	(2)
Communicating with Manipulative Clients,	350	(2)
Communicating with Manipulative Colleagues,	352	(2)
A Final Note,	354	(1)
Practicing Communicating Assertively and Responsibly with Aggressive Clients and Colleagues,	354	(1)
Critique: Choices of Responses to Aggressive Clients and Colleagues,	354	(7)
27 Communicating Assertively and Responsibly with Unpopular Clients,	361	(10)
Who Are the Unpopular Clients?,	362	(1)
Characteristics of Unpopular Clients and Their Effects on Nurses,	363	(1)
Nurses' Reactions to Unpopular Clients,	363	(1)
How to Overcome Negative Attitudes and Antagonistic Behavior Toward Unpopular Clients,	364	(3)
Situation 1,	364	(1)
Situation 2,	365	(2)
Practicing Communicating Assertively and Responsibly with Unpopular Clients,	367	(4)
28 Managing Team Conflict Assertively and Responsibly,	371	(18)
Definition of Conflict,	372	(1)
Facts,	372	(1)
Methods,	372	(1)
Goals,	372	(1)
Values,	372	(1)
Conflict-Resolution Approaches,	373	(1)
Assertive and Responsible Ways to Overcome Conflict,	374	(8)
Conflict Situation Involving the Whole Health Care Team,	374	(6)
Conflict Situation Involving Two Team Members,	380	(2)
Conflict Resolution and the Nursing Profession,	382	(1)
Practicing Managing Team Conflict Assertively and Responsibly,	383	(6)
29 Continuing the Commitment,	389
Putting It All Together,	390	(1)
Achieving Generative Balance,	390	(3)
Creating Success,	390	(1)
Finding Meaning,	391	(1)
Renewing Energy,	392	(1)
Continuing Connections,	393	(1)
Practicing Continuing the Commitment,	394