Potter & Perry
Chapter 8


Denise Coe RN MSN HNC


Incorporated Slides from Cathie Hansen and Anita Kovalsky


What is Communication?

•      A process in which people affect one another through the exchange of information.

•      Process of Transmitting Messages and Interpreting the Meaning of the Other persons message

•      Cannot not communicate.

Why are Communication Skills Important?


•      We use communication skills throughout the nursing process to effectively work with clients, families, and health care team.


•      It is the BASE of a nurse patient relationship


More on Communication

•      An exchange of energy.

•      A sharing

•      The means we use to establish helping-healing relationships.

•      The method by which we express caring.

More About Developing Communication Skills

•      To communicate effectively the nurse must be willing to examine his/her own thinking.

•      Willing to look at and overcome personal biases

•      Why are Communication Skills Important?

•   We use communication skills throughout the nursing process to effectively work with clients, families, and health care team.




Communicating within the Nursing Process

•      Communication will assist in setting the tone and in the collection of the information.

•      Communication will assist in collaborating with the patient and health care team to establish a plan of care.

•      Communicating will help in compliancy issues.

•      Communication will help in gathering the information to evaluate and in reporting the outcomes.

Process of Communication

•      Referent

•      Sender

•      Message

•      Channel

•      Receiver

•      Environment

•      Feedback



Levels of Communication

•      Intrapersonal

–    People talk to themselves and form thoughts internally


•      Interpersonal

–    Interaction that occurs between people/groups

•    (This is the one we are primarily concerned with at this point)


•      Public

–    Interaction of one person with large groups


Purpose of the Communication Process

•      Key point-  the nurse must use critical thinking to focus on each aspect of communication so the  interactions can be purposeful and effective.

•      The communication is focused on the needs of the patient, goal directed, and planned.

•      Want to convey caring and reduce anxiety.

Forms of Communication


•      What effects it?

•      Connotations of words- “ take your vital signs”.

•      Pace of the communication.

•      Intonation-tone of voice. Example?

•      Clear, to the point.

•      Timing- best timing is when patient expresses an interest in communication. What about hidden ways of expressing interest?

Forms of Communication


 the message is communicated through body language.

•      Examples of body language. Sometimes is more loud than our words.

•      Appearance- We assess patients on appearance and they assess  us. How do we look?

Forms of Communication

•      Nonverbal- posture, gait, facial expression,

•      Eye contact, gestures, sounds, personal space.

•      Lots of room for error if we rely on non- verbal messages alone. Must validate.

•      Distance- intimate, personal, social

•      Boundaries need to be set to establish trust and safety.

•      Touch- be mindful that clients may not perceive touch as you may be.




Forms of Communication


•    Metacommunication-the message within the message.  Patient says he feels fine about going to surgery, yet his body is tense, is listening to depressing music, and doesn’t eat dinner. Validate. Ask.

Professional Nursing Relationships

•      What is it?

•      We use communication to help patient’s achieve successful outcomes to the problems which are preventing them from optimum health.

•      How does it differ from social relationship?

•      What is the role of social talk?

Element of Professional Communication

•      Courtesy- sets the emotional tone. Use of please, thank you and other courteous remarks

•      Use of names- who are you and your purpose. No terms of endearment!

•      Decreased stress makes for a more engaged patient in learning and healing.

•      Professional appearance, demeanor and behavior

•      Availability- being there when needed

Elements of Professional Communication

•      Privacy and confidentiality- What are we saying at the desk? Sets a tone of emotional safety.

•      Trustworthiness- patient is vulnerable. Without trust the nurse-patient relationship rarely progresses beyond the social interaction and superficial care.

•      Self introduction- introducing self

Ingredients for the Development of a Therapeutic Relationship

•      Non judgmental approach

•      Acceptance

•      Warmth

•      Empathy

•      Authenticity

•      Congruency

•      Respect


•      Trust-

•      Patience- trust may take a while to establish

Establishing a Nurse-Client Helping Relationship

•      Created through THERAPEUTIC COMMUNICATION!!!


•      Builds the TRUST of the Client in the Nurse!!!


•      Phases of the helping relationship:

1. Preinteraction phase   3. Working  phase

2. Orientation phase                    4. Termination phase

Phases of the Nurse-Client Relationship


•      Preinteraction. Get centered

•      Empty ourselves of preconceived ideas about the client.

•      Gather information 

•      Examine one’s own feelings about what has been  heard.







Phases of the Nurse Patient Relationship

•      Orientation or Introductory Stage

•      Set the parameters of the relationship- builds trust

Phases of the Nurse-Client Relationship

•      Working phase-

Phases of the Nurse Patient Relationship

•      Termination phase

•      Have goals been reached?

•      Client may have to be discharged?

•      Student rotation is over?

Tips for Effective Communication

•      A learned process: You will learn techniques in next weeks seminar!

•      Avoid “why” questions which tend to put people on the defensive

•      “What” questions evoke facts

•      “How” questions tend to lead to a discussion of feelings and client views


More Tips

•      Active listening- nursing presence.

•      Sharing empathy- accept the other’s reality without trying to change it. To accurately perceive and communicate that perception to the other.

•      Sharing hope- essential for healing. Communicate a sense of possibility. Seeing the “more” of the patient. The inherent worth of every person. Pointing out strengths.

•      Sharing humor-helps both patient and nurse deal with difficult situations.

•      Using touch- may convey caring. The nurse needs to understand that touch is perceived differently by different people based on previous experiences and expectations. May have to modify our behaviors.