Communication - Nursing Education (3rd Semester Notes)

1. Definition of Communication

"Communication is a dynamic, continuous, and complex transactional process in which the participants simultaneously create shared meaning in an interaction." - Nursing Fundamentals (NCBI)

2. Elements / Components of Communication (The Communication Model)

3. Types of Communication

A. Based on Mode

1. Verbal Communication - Use of words (spoken or written)
   • Advantages: Clear, direct, immediate feedback possible
   • Disadvantages: No record, misinterpretation possible
2. Nonverbal Communication - Body language, gestures, facial expressions, posture, touch, eye contact, appearance, proxemics (personal space)
   • Often conveys more than words
3. Written Communication - Reports, notes, records, emails
   • Advantages: Permanent record, reference-able
   • Disadvantages: One-way, no immediate feedback, needs literacy

B. Based on Flow

1. One-way Communication - Sender to receiver only (e.g., lecture method). No feedback. Knowledge is imposed.
2. Two-way Communication - Both sender and receiver exchange roles. Interactive, allows feedback, more effective.

C. Based on Level

1. Intrapersonal - Communication within oneself (self-talk, reflection)
2. Interpersonal - Between two people (nurse-patient, face-to-face)
3. Group Communication - Among three or more people (team meetings, health education)
4. Mass Communication - To a large, general audience (TV, radio, social media)

4. Process of Communication

1. Sender has an idea/thought
2. Sender encodes the message (puts it into words/symbols)
3. Message is sent through a channel
4. Receiver receives the message
5. Receiver decodes the message (interprets)
6. Receiver sends feedback to the sender
7. Cycle continues

5. Barriers to Communication

Physical Barriers

• Noise, poor lighting, physical distance
• Telephone interruptions, uncomfortable environment

Physiological Barriers

• Sensory deficits: hearing loss, vision defects
• Poor concentration, pain, fatigue
• Low intelligence, ear problems

Psychological Barriers

• Fear, anxiety, worry, aggression, suspicion
• Emotional disturbances
• Pre-formed attitudes and biases

Language Barriers

• Use of medical jargon or complex terminology
• Poor vocabulary, pronunciation, fluency
• Confusion between symbols and meaning

Cultural Barriers

• Differing cultural norms, symbols, and behaviors
• Different meanings of gestures across cultures

Perceptual Barriers

• Different personal perspectives and attitudes
• Stereotyping, assumptions

Interpersonal Barriers

• Lack of trust, poor listening skills
• Emotional outbursts, limited vocabulary

6. Therapeutic Communication (Key for Nursing Practice)

Therapeutic Communication Techniques

Benefits of Therapeutic Communication

• Improved patient healing and health outcomes
• Reduced symptoms of depression
• Decreased medical errors
• Builds trust between nurse and patient

7. Non-therapeutic (Blocking) Communication - What to Avoid

8. Professional Communication in Nursing

Key principles:

• SBAR technique (Situation, Background, Assessment, Recommendation) - used for handovers
• Formal, civil, and professional tone
• Clear, accurate, complete, and concise messaging
• Respect confidentiality (HIPAA principles)
• Maintain appropriate personal space (proxemics)

9. Factors Affecting Communication

1. Perception - How the message is interpreted
2. Values and beliefs - Personal and cultural values
3. Emotions - Emotional state of both parties
4. Sociocultural background - Language, norms
5. Gender - Communication styles may differ
6. Knowledge level - Use appropriate vocabulary
7. Environment - Privacy, noise level
8. Age and developmental stage - Child vs. adult communication

10. Communication in Nurse-Patient Relationship

1. Pre-interaction phase - Nurse reviews patient data
2. Orientation/Introductory phase - Nurse establishes trust ("Hello, my name is...")
3. Working phase - Active therapeutic communication, problem-solving
4. Termination phase - Summarizing care, closure

Qualities of a Good Communicator in Nursing:

• Empathy and genuineness
• Nonjudgmental attitude
• Respecting boundaries
• Awareness of health literacy
• Cultural sensitivity
• Ensuring patient understanding

11. Written Communication in Nursing

• Nursing documentation / Charting - Records assessments, interventions, outcomes
• Nursing care plans - Written communication for continuity of care
• Incident reports - Formal written records of adverse events
• Referral letters / Discharge summaries

12. Quick Exam Summary Points

• Communication = sending + receiving + feedback (essential element that confirms understanding)
• Most powerful form of nonverbal communication = facial expression
• Therapeutic relationship starts with trust
• Biggest barrier in nurse-patient communication = use of medical jargon
• One-way communication = no feedback (e.g., lecture)
• Two-way communication = feedback present = more effective
• SBAR = handover/reporting technique
• Silence is a therapeutic technique (not a barrier when used purposefully)