At the end of this class you will be able to:
- Define communication.
- Describe different kinds of
- Communicate with people using
empathy, respect, caring and other therapeutic ways.
- Detail some special ways to
communicate when the person has a problem.
WHAT IS COMMUNICATION?
Communication is the one and only way that human beings share thoughts,
ideas and feelings with others.
The purpose of communication is to send a message from one person to
another. This has been done since the beginning of time. We would not be able
to express our feelings and thoughts or ask a question without it. We could not
relate to others, as a social being, without it. We need it in our work life
and in our personal life. We can satisfy our needs with it. All people want to
be heard and needed, so respect is a very important part of it.
A message can be sent with spoken words, by writing and with the person's
body and body signs.
Communication can be done with:
- oral words,
- sign language,
- body language,
- touch, and
- eye contact.
Some examples of written communication are letters, notes and signs, like
the ones you see on the street. Nurse's notes, Christmas cards, birthday cards
and e-mail messages are all examples of this type.
examples of spoken, or oral, communication are:
- singing a song,
- videos and
- TV shows
Sign language uses hand gestures and signs to communicate with people who
are deaf or hard of hearing. This type has to be learned by both the sender and
the receiver of the message.
Body language is the use of one's body to send a message. This type is often
not conscious or done on purpose. It most often tells a person's about the
feelings of the other person. Some people say that this language sends an even
stronger signal than the spoken word.
Some examples of this kind of communication are:
- A person that has a sad face is
sending a message to another that they are unhappy. A smile means that the
person is happy.
- Tight teeth may tell you that
the person is angry or in pain.
- When a person grunts or taps
their table with their hand, they may be trying to get you to look at
- When you stand in front of a
person with your arms crossed in front of you or on your hips while you
tap your foot on the floor, you are telling the person that you are in a
hurry. You do not even have to say one word. The person may know right away
that you are in a hurry with the signs that your body is sending to them.
The use of touch also sends a message. You communicate caring when you touch
a person gently on their shoulder or their cheek.
Eye contact and how your eyes look also send another person a message. Your
eyes can send feelings like understanding, caring, anger, hatred and love.
communication has a:
- sender of the message,
- receiver of the message and
- a message.
The sender is the one who gives the other person information or asks
the other person a question. The receiver is the person who gets the
information or the question from the sender. The message is the information
that is sent.
The sender of the message has the job of making the other person understand
what they are trying to say to the other person. The other person has the job
of trying to understand exactly what the other person is trying to communicate
THE BASIC RULES OF COMMUNICATION
- Be polite and use respect at
- Use simple words that the other
person can understand.
- Stay calm and without emotion.
- Be a very active and good
- Give the person feedback. Tell
them what you think you heard from them. Ask the person to repeat the
message in another way if you do not understand what the person is trying
to tell you. Ask the person a question when you have to.
Therapeutic communication requires these three things:
- Respect and
- A positive sense of self
Empathy is understanding the other person's feelings, attitudes, beliefs and
values. You are able to "walk a mile in someone else's shoes". You
must be objective and listen actively. You have to keep your own feelings out
of it so you are really able to understand the other person's feelings, even if
you think they are wrong. These feelings are VERY real to the person.
Respect involves unconditional:
- interest, and
- no judgments about the person
or their feelings.
You must accept the person for who they are and what they think, even if you
do not agree with it. You must NOT label the patient. Do NOT call the client,
"the diabetic" or "room 233". People are people. They are
not a room number and they are not their illness. They are human beings. Always
call a person by their name.
Call the person by their first name if they are a child. Call the adult man
or lady by Mr. or Mrs. unless they ask you to call them by their first name.
NEVER call a person "honey" or "dear" or "mom" or
"pop". These labels do not show respect.
You must look in the mirror and look at yourself to develop a positive sense
of self. You must know about yourself. You must know your own values, attitudes
and beliefs in order to communicate with others in the best way.
GOOD COMMUNICATION TECHNIQUES
These things help to promote good communication:
- Know your patient.
- Establish trust in the
relationship. Keep it open and trusting.
- Ask open-ended questions,
rather than "yes" or "no" questions. You get much more
information with open questions like, "Tell me about how your day has
been so far." When you ask a question like, "Are you OK",
you may only get a yes or no answer with no details.
- Offer yourself to the person.
Ask the person if there is something that they would like to talk about.
Say something like, "Tell me about your life" or your jobs,
especially when the person appears bored or seems agitated.
- Listen well.
- Use silence when that is the
right thing to do. Say, "I would like to sit here with you for
awhile". Use silence when the person has a concern but they are not
yet able to talk about it.
- Use body language that shows
caring, respect and patience.
- Ask the person to repeat
something if you do not understand what they are trying to tell you.
- Ask the person questions if you
do not know what they are trying to say. Ask, for example, "Did I
hear you say that you are afraid of falling?", if you are not sure
what the person is saying and you heard some things about their fears that
may be related to falling. Do not answer a person's question or give the
person any advice until you know exactly what the person is asking of you
or trying to tell you.
- Reflect the
person's feelings. Say, "You look sad today" if the person has a
sad face. This may help the person to speak about their feelings and maybe
they will feel better. This also lets the person know that you care about
them and their feelings.
Some communication stoppers are:
- Reassurance. Do NOT
reassure a person when they have a concern. A person must be able to air
their concerns. If you say something like, "You have a good doctor so
do not worry" , the person will not want to talk anymore about their
concern. They will stop telling you about their fears and concerns.
- Rejection. Do NOT argue
with a person when they are talking about their feelings or beliefs even
if you feel that their beliefs and feelings are not true. They must be
able to air their own feelings. Do NOT judge the person. These things will
stop a person from talking.
- Probing. Do NOT force
the person to speak about things that they are not ready to talk about.
People like to keep some personal things to them self. They will stop
talking when they do not feel comfortable.
- Poor body
Look open and interested in what the person wants to say. A person will
stop talking if you look like you are not listening or you look like you
are in a hurry or bored.
Nursing assistants, and other people who take care of patients and
residents, must be able to send and get messages from the people that they take
The sender of the message must send the message in a way that the receiver
of the message understands it. Our patients must be able to understand the
message that we are trying to send to them.
We must also be able to understand a message that a patient or resident is
trying to send to us. We must be able to understand what our patients are
trying to tell us, even when they are confused and/or not able to speak. We
must be a good receiver of the message.
Sending and getting a message with a confused, sleepy or unconscious person
is not always easy. It takes special skills. It also takes special skills when
a person has a mental problem or illness. You must use simple, plain words that
a person can understand. Do not use words like "hospital",
"NPO", "ambulate" or "void" if the person does
not know what these special healthcare words mean. You should say, "You
can not eat or drink anything after 12 midnight", instead of saying
"NPO". You may want to ask the person if they "would like to
walk", instead of asking them if they "would like to ambulate".
Also, use the word "urinate" or show the male patient the urinal,
instead of using the word "void" unless the person understands that
Some of the other things that you should do to help are:
- include the family and friends
in the communication when a patient or resident is not able to understand
what you are trying to say;
- ask the family and friends how
the person can be helped to communicate with you;
- speak in a plain way, using
words that are simple. For example, instead of asking if the person is
hungry, ask, "Would you like to eat some eggs?";
- talk to
patients and residents in a place that is quiet and that does NOT have a
lot of distractions. Turn off the radio and TV while you are talking to
the person, after you ask them if you can;
- make sure that the person can
see you. Turn on the lights if the room is too dark;
- keep the message as short and
simple as you can. Many people do best with short talks rather than long
ones with a lot of information at one time. It is better to talk for a
couple of short sessions, rather than one or two long ones;
- discuss one
thing at a time;
- repeat the message as often as
- ask one question at a time and
listen to or observe for the answer;
- draw pictures or write things
down for the person if this helps them understand what you are trying to
- let the
patient draw a picture or write things down for you if this makes it
easier for them to tell you what they want or need;
- ask "yes" or
"no" questions. For example, if you want to know if a patient
wants to eat fruit, ask "do you want an apple or a pear?",
instead of "do you want to eat a piece of fruit?";
- use real
objects whenever you can. For example, show the person the real object,
like an apple, if you are asking the patient if they would like to eat it.
- speak slowly and in a clear
- talk with a low pitch, not with
a high pitched voice;
- face the person that you are
- make eye contact with the
- listen to the
- look at the person's face. Is
the person trying to tell you something? Do they look like they are in
pain? Are they holding a part of their body, like their hand or their
head? Do they look sad? Do they look angry?;
- give the person their
eyeglasses and hearing aid, if they wear them;
- always show
respect and caring; and
- communicate with touch and a
calm voice when you want to tell a person that you care and they can not
understand the spoken word.
Communication is necessary in order for human beings to interact with
others. Communication is not as simple as it may seem. People that work with
others in health care and all other places must develop the skills necessary to
communicate well and with respect at all times.
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Barbara Kozier and Glenora Erb. (2010). Kozier & Erb's Fundamentals of
Nursing: Concepts, Process, and Practice. 8th Edition. Pearson Prentice
Marilyn J. and David Wilson. (2010).Wong's Essentials of Pediatric Nursing.
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Monahan, Frances Donovan and Wilma
J. Phipps (2007). Phipps’ Medical-Surgical Nursing: Health and Illness
Perspectives. 8th Edition. Elsevier Mosby.
Nettina, Sandra M. (2009). The Lippincott Manual of Nursing Practice.
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Wikipedia Encyclopedia. (2010) "Communication" [online].
Copyright © 2010 Alene Burke