Effective communication takes a committment to analyze our communication style and to look for ways to improve.   Go to the link below to hear some thoughts on effective communication.
http://www.voki.com/pickup.php?scid=5431522&height=267&width=200

The link below looks at a system of three basic communication styles, aggressive, assertive, and passive.  It stresses the importance of an assertive communication style but also states there are times when an aggressive style or passive style is appropriate.  Do you agree or disagree with that? 


 SBA Online Women's  Business Center.  (1999).  Understanding your communication style.  Retrieved from http://www.au.af.mil/au/awc/awcgate/sba/comm_style.htm

What influences whether communication is going to be therapeutic or non-therapeutic?  In the following movie a nurse and a patient have difficulty communicating effectively.  So many things can affect our responses.  Fear, anger, impatience, misunderstanding, annoyance, among many other factors can influence us to lash out rather than respond therapeutically.  Watch this movie and pinpoint where communications started to break down.  What could the nurse do to keep this conversation from escalating?  Re-write this conversation using therapeutic communication.


http://www.xtranormal.com/watch/13077520/playgoz-movie

WELCOME BACK!

A huge issue in communication today is what is being called incivility or horizonal hostility or lateral violence.  It is very common in the workplace and at schools.  Being civil is more than being polite, it is a real respect for other people that is demostrated not only in words but by behavior Although this is a growing concern in the workplace with many nurses reporting they have witnessed disruptive behaviors from fellow nurses, there is also a concern that intimidating and incivil behaviors are also prevalent in nursing schools (Stokowski, 2011). 

Research the topic of incivility in nursing and then view the following video.  Who is being incivil, the instructor, the student, or both?  In what ways are they demonstrating incivility?  What could the instructor have done to keep this exchange from becoming incivil?  Re-write the script to have a positive outcome for the student.

References:

[nd56553].  (2009, April, 7).  YouTube video student incivility [videofile].  Retrieved from
http://www.youtube.com/watch?v=PsJRHRRjkxA&context=C33228acADOEgsToPDskLEHiIqkH-r5NvXOrhuI36E

Stokowski, L. A. (2011).  The downward spiral: Incivility in nursing.  Retrieved from
www.medscap.com/viewarticle/739328

  This week we discussed communication difficulties. 

 What do we do if the patient flys into a rage?  Is overcome with grief?  Curses or throws objects? 

 We deal with individuals at the most difficult times in their lives and we need to be able to identify what the real issue or problem is and assist the person (it is not always the patient) to solve their problems. 

 An unexpected death can cause individuals to have strong emotions and look for someone to blame.  It is difficult to remember when someone is screaming angrily at you that it is not personal but is a coping behavior for the individual.  

A great way to illustrate ideas is by using a mind map.  This is a way to group like concepts together.  You have probably used it in the clinical setting.  We will be experimenting with mind maps in class this week. Using your role-play script that you created you will create a mind-map to share with the class.

I have included an example, just click on the URL below.

http://www.webspirationpro.com/view/1095928a19e29


References:

Schuster, P. M. (2000).  Communication the key to the therapeutic relationship.   Philadelphia, PA:

                Davis.

Zwirn, E. E., & Muehlenkord, A.  (2009).  Using media, multimedia, and technology-rich learning

                environments.  In D. M. Billings & J. A. Halstead (Eds.), Teaching in nursing: A guide for

                faculty (3rd  ed.)  (pp.335-350).  St. Louis, MO: Saunders/Elsevier.

This weeks lesson was on using touch therapeutically. One of the aspects of touch is the concept of personal space. Nurses need to get close to their patients but they also need to respect the social rules of contact. 

Sometimes we need to ask permission to come into a patient's space.  At other times it would be inappropriate to discuss personal matters at a distance. 

Take this quiz and remember that this quiz is based on the typical European North American culture. 

Quizzes by Quibblo.com | SnapApp Quiz Apps

NOTICE:  Although this looks blank if you select the Quibblo.com line above it will take you to the quiz.

Reference:

Schuster, P. M. (2000).  Communication: The key to the therapeutic relationship.  Philadelphia, PA: Davis.

There are many barriers to communication.  How many can you think of?  One that we always think about is the language barrier, which we talked about. 

 Here is an assignment:  choose a barrier to communication and illustrate it with a film clip or YouTube video.  Embed your film or video on a PowerPoint slide and include speaker notes and a reference.  See below for an example.

https://r.office.microsoft.com/r/rlidPowerPointEmbed?p1=1&p2=1&p3=SDB6392CDBD3E5A253!107&p4=&ak=!APRK3NygaDTwPVA&kip=1&authkey=!APRK3NygaDTwPVA"></iframe>
Here are some references to use for your assignment:

compellingtv. (2011, September, 1).  Embed YouTube video into PowerPoint 2010.  Retrieved from http://www.youtube.com/watch?v=8Sbah9iIrlk&feature=fvsr

Andrews University. (n.d.)  Barriers to Communication.  Retrieved from http://www.andrews.edu/~tidwell/bsad450/CommunicationBarriers.html

What does our appearance communicate about us? Is that right?  I had a student who was tatooed on his neck and both arms (like sleeves).  His head was shaved.  He was a nursing student and he was good with the patients and was respectful to instructors and fellow students.  However, he looked like you wouldn't want to meet him in a dark alley.  He came in late to school one day and said he had been pulled over.  He complained that, "the police are always pulling me over, I don't understand it!"  The other students and I had a hard time understanding why he did not get it.  Although we have a right to wear what we want and to express ourselves by the jewelry we wear or what we put on our body, how does professionalism in nursing fit in with self-expression? 

Go to the link below.  (You will need audio for this).

http://www.voki.com/pickup.php?scid=5309164&height=267&width=200

What do nurses need to communicate to their patients, co-workers, or the general public?  Is this changing?  Do we need to be concerned about this form of communication?  Let me know what your opinion is on the subject of professionalism and self-expression as it pertains to communication.

When you look at this video clip ask yourself what is being communicated between the actors or between the actors and the audience.  What importance does nonverbal communication have for nurses?  Wat can we convey with a look, a sniff, a raised eyebrow?  How important is it that we remain aware of our body language, gestures, facial expressons, and posture?  How about tone of voice?  Describe a situation where communication took place between you and another person without a word being exchanged.

  As a cinical instructor I have communicated a great deal through facial expressions and raised eyebrows!  Should I give the injection here (the look on the students face, the needle poised over the skin) No not there! (the slight shake of the head, the raised eyebrow-all with the smile on the face for the patient). How about here? (a movement of the hand, a tilt of the head, a waiting expression) Yes, that is fine! (Big smile, slight nod, eyebrows down). Now it is your turn!

Reference:
SunshineStudiosInc. (2007, December, 8) Nonverbal communication.  Retrieved from http://www.youtube.com/watch?v=VfDWQG47pAQ

As we discussed during our last class, communication skills vary.  Some people always seem to know what to say and how to say it while others struggle with communicating their thoughts and feelings.  Here is a quiz to take about your communication skills. 

http://www.surveymonkey.com/s/8G5Q8RD


What are some barriers to the communication process? 
Write a story about a blocked communication using the communication process.

What is more important, what we say or how we say it?  It is hard to choose because words, tone of voice, body language, gestures, and facial expressions can all communicate.

  It is most important that they match, that they are congruent or a mixed message will be conveyed.  In nursing it is very important that  we do not give a double message.  Specialized communication from nurses is called therapeutic communication.  Schuster (2000) says, therapeutic communication is the foundation of professional practice" (p. 7). 

I think that one of the most important treatments that nurses can perform is to use their communication techniques therapeutically.  To find out what the patient, or famiy member, or co-worker needs through the use of appropriate listening, or open-ended questions or affective touch is part of the art of nursing.  It is worth making every effort to hone our communication skills every bit as much as we strive to improve our othr nursing skills.

Schuster, P. M. (2000).  Communication the key to the therapeutic relationship. Philaelphia, PA:
F. A. Davis Company.

Communication 4 Us

Welcome to communication 4 nurses. 

Being able to communicate effectively is essential for nurses.  We need to be able to be aware of all the communication tools in our tool kits to help us care for our clients.  

We need to have not only safer communications, but therapeutic healing encounters as well.  The ability to see past behaviors and angry words to determine what the needs of our cients really are, in order to help them reach their goals, that is part of the art of nursing.

In the next few weeks we will be exploring many facets of better communication techniques, including active listening, body language, and the well chosen word.  The goal is  transforming our  interactions with clients, co-workers, and everyone we come in contact with.

. 

I would be interested in your comments.  I would like to know what you think the biggest communication problems are in nursing?  What can nurses do to improve communication? 

When I was an L & D nurse I took care of a patient from Cambodia.  She spoke little English so her husband translated even though his English was limited.  She was hooked up to the fetal monitor and the baby's little heart beat was loud in the room.  The Dr. came in and told the patient's husband that a C-section would have to be performed.  When the husband told his wife this she started to cry and the husband cried too as if their hearts were breaking.  What we did not know was that in their country at that time the only surgeries were done if the baby was dead.  They thought their baby had died even though the baby's heart beat was making a huge racket.  What we failed to communicate was that the sound was their baby's heart and that the surgery was to help the baby be born safely.  When I realized (finally) what agony they had been going through I was very ashamed that we had not tried harder to communicate what was going on.

Have you had any experiences where poor communication caused a problem with patients, fellow nurses, or other health care workers? 

Nursing Educator