Docstoc

Communication

Document Sample
Communication Powered By Docstoc
					            Unit 2
Communication And
Interpersonal Skills
   Nurse Aide I Course




     DHSR Approved Curriculum-Unit 2   1
      Communication And
      Interpersonal Skills

           Introduction
Nurse aides communicate with
residents, families, visitors and
co-workers.




           DHSR Approved Curriculum-Unit 2   2
         Communication And
         Interpersonal Skills
             Introduction
                (continued)
Nurse aides must frequently send and
receive information about the care and
observation of residents, report thoughts
and feelings as clearly and objectively
as possible and interact effectively with
others.
             DHSR Approved Curriculum-Unit 2   3
        Communication And
        Interpersonal Skills
            Introduction
                (continued)

Nurse aides need to be aware of
nonverbal communications and need to
develop skills in communicating with the
sensory impaired.


             DHSR Approved Curriculum-Unit 2   4
        Communication And
        Interpersonal Skills
            Introduction
               (continued)
In addition, nurse aides may document
on the medical record, which is a legal
document. Therefore, all documentation
must be in legible, clear and accurate
language so that there is no
misunderstanding of the meaning.
            DHSR Approved Curriculum-Unit 2   5
DHSR Approved Curriculum-Unit 2   6
2.0 Demonstrate appropriate and
    effective communication skills.




             DHSR Approved Curriculum-Unit 2   7
    Elements That Influence
   Relationships With Others

• Prejudices
• Frustrations
• Attitudes
• Life Experiences


              DHSR Approved Curriculum-Unit 2   8
 Requirements For Successful
       Communications


• A message
• A sender
• A receiver



         DHSR Approved Curriculum-Unit 2   9
2.1   Describe the importance of
      developing good listening skills.
2.1.1 Identify nine listening skills that
      can be used by the nurse aide.


              DHSR Approved Curriculum-Unit 2   10
             Listening Skills

•   Show interest
•   Hear message
•   Do not interrupt
•   Ask appropriate questions for
    clarification


               DHSR Approved Curriculum-Unit 2   11
Listening Skills
    (continued)

• Be patient and help
  resident express feelings
  and concerns
• Eliminate or reduce
  distractions
• Understand silence can
  be form of communication
 DHSR Approved Curriculum-Unit 2   12
2.1.2 Recognize barriers to effective
      communication.




             DHSR Approved Curriculum-Unit 2   13
Barriers to Effective Communication

•   Labeling
•   Talking too fast
•   Avoiding eye contact
•   Belittling a resident’s feelings
•   Physical distance


                DHSR Approved Curriculum-Unit 2   14
Barriers to Effective Communication
               (continued)

• Mental or sensory impairment on
  the part of the resident such as:
   –Confusion
   –Blindness
   –Aphasia
   –Hearing impairment

            DHSR Approved Curriculum-Unit 2   15
Barriers to Effective Communication
                  (continued)
•   Changing the subject
•   False reassurance
•   Giving advice
•   Ineffective communication
     –Disguised messages
     –Conflicting messages
     –Unclear meanings
     –Clichés
              DHSR Approved Curriculum-Unit 2   16
DHSR Approved Curriculum-Unit 2   17
2.2   Explain how the nurse aide will
      need to modify his or her
      behavior in response to the
      resident’s behavior.
2.2.1 Define the terms sympathy,
      empathy and tact.
             DHSR Approved Curriculum-Unit 2   18
Interpersonal Skills


 • Determined by
   –Standards and values
   –Culture and environment
   –Heredity
   –Interests


   DHSR Approved Curriculum-Unit 2   19
         Interpersonal Skills
               (continued)

• Determined by
  –Feelings and stress
  –Expectations others
   have for us
  –Past experiences


            DHSR Approved Curriculum-Unit 2   20
  Dealing With Resident Behavior

• Accept every resident
• Listen to every resident
• Comply with
  reasonable requests,
  when possible



             DHSR Approved Curriculum-Unit 2   21
  Dealing With Resident Behavior
                (continued)


• Display patience
  and tolerance
• Make an effort to
  be understanding



             DHSR Approved Curriculum-Unit 2   22
  Dealing With Resident Behavior
               (continued)
• Develop acceptable ways of coping
  with our own negative feelings
  –Leave the room after providing for
    safety
  –Talk with supervisor, in private,
    about negative feelings


            DHSR Approved Curriculum-Unit 2   23
  Dealing With Resident Behavior
               (continued)
• Develop acceptable ways of coping
  with our own negative feelings
  –Involve yourself in physical
    activity
  –Learn to use relaxation
    techniques that ease stress


            DHSR Approved Curriculum-Unit 2   24
  Dealing With Resident Behavior
               (continued)

• Be sensitive to residents’ moods
• Be able to handle disagreements
  and criticism




            DHSR Approved Curriculum-Unit 2   25
     Treat Residents As Unique
             Individuals

• Do things the
  residents’ way, when
  possible
• Anticipate their needs
• Give good care
• Ask for their opinions
             DHSR Approved Curriculum-Unit 2   26
     Treat Residents As Unique
             Individuals
                (continued)

• Be able to see things
  from the other
  person’s point of view




             DHSR Approved Curriculum-Unit 2   27
DHSR Approved Curriculum-Unit 2   28
2.3   Develop effective nonverbal and
      verbal communications skills.
2.3.1 List six examples of nonverbal
      communication and six examples
      of effective verbal
      communication.
            DHSR Approved Curriculum-Unit 2   29
     Nonverbal Communication

• Body language
  –Posture
  –Gestures
  –Level of activity
  –Facial expressions
  –Appearance
  –Touch
            DHSR Approved Curriculum-Unit 2   30
      Verbal Communication

• Speak clearly and
  concisely
• Give message by tone of
  voice
• Face resident, at eye
  level, when speaking


           DHSR Approved Curriculum-Unit 2   31
      Verbal Communication
               (continued)

• Avoid words having
  several meanings
• Present thoughts in
  a logical, orderly
  manner
• Learn to paraphrase

            DHSR Approved Curriculum-Unit 2   32
2.3.2 Identify proper telephone
      communication skills.




             DHSR Approved Curriculum-Unit 2   33
 Telephone Communication Skills

• Speak clearly in a pleasant tone of
  voice
• Identify the area, yourself and your
  position
• Ask, “May I help you?”
• Be courteous


            DHSR Approved Curriculum-Unit 2   34
  Telephone Communication Skills
                (continued)
• Take messages:
  –name of individual calling
  –phone number (including area
   code)
  –read back message for
   accuracy
  –date and time of call
            DHSR Approved Curriculum-Unit 2   35
  Telephone Communication Skills
                 (continued)
• Take messages (continued):
  –ask for assistance if you are unable
   to handle message
  –permit caller to hang up first
  –follow proper etiquette



             DHSR Approved Curriculum-Unit 2   36
2.3.3 Identify actions that would
      facilitate communication with
      residents’ family and visitors



             DHSR Approved Curriculum-Unit 2   37
Actions to Facilitate Communication
     with the Resident’s Family
            and Visitors
• Ask how they are doing
• Indicate that you are
  glad to see them
• Tell them about
  activities the resident
  has been involved with
  that day
             DHSR Approved Curriculum-Unit 2   38
Actions to Facilitate Communication
     with the Resident’s Family
            and Visitors
                (continued)

• Be warm and friendly
• Use talking and
  listening skills you
  would use with
  resident

            DHSR Approved Curriculum-Unit 2   39
Actions to Facilitate Communication
     with the Resident’s Family
            and Visitors
                (continued)
• Share knowledge about the unit
  – Visiting hours
  – Restrictions to visitors
  – Any restrictions on
    bringing food
  – Activities that include
    family
             DHSR Approved Curriculum-Unit 2   40
Actions to Facilitate Communication
     with the Resident’s Family
            and Visitors
               (continued)
• Report stressful or tiring visits to
  supervisor
• Refer requests for information on the
  resident’s condition to supervisor


            DHSR Approved Curriculum-Unit 2   41
Actions to Facilitate Communication
     with the Resident’s Family
            and Visitors
               (continued)
• Share information from family/visitors
  that would affect resident care with
  supervisor
• Report visitor concerns or complaints
  to supervisor


            DHSR Approved Curriculum-Unit 2   42
2.3.4 Identify actions that would
      facilitate communication with
      hearing impaired residents.



             DHSR Approved Curriculum-Unit 2   43
Actions to Facilitate Communication
 with Hearing Impaired Residents
• Encourage to use hearing aid
• Speak slowly using simple
  sentences
• Face resident at eye level when
  speaking
• Encourage resident to read lips, if
  that helps
             DHSR Approved Curriculum-Unit 2   44
Actions to Facilitate Communication
 with Hearing Impaired Residents
               (continued)
• Lower pitch of voice
• Direct speech to stronger ear but do
  not shout
• Use gestures when possible to clarify
  statements
• Write when necessary
• Learn basic signing, if appropriate
            DHSR Approved Curriculum-Unit 2   45
2.3.5 Identify actions that would
      facilitate communication with
      residents that have decreased
      vision.


            DHSR Approved Curriculum-Unit 2   46
Actions to Facilitate Communication
     with Residents Who Have
         Decreased Vision

• Sit where resident can best see you
• Make sure lighting is sufficient
• Encourage resident to touch
  objects and yourself
• Encourage resident to wear his/her
  glasses
            DHSR Approved Curriculum-Unit 2   47
Actions to Facilitate Communication
     with Residents Who Have
         Decreased Vision
              (continued)
• Use touch and talk frequently to
  communicate your location
• Use descriptive words and phrases




           DHSR Approved Curriculum-Unit 2   48
2.3.6 Identify actions that would
      facilitate communication with
      residents that have difficulty
      speaking.


             DHSR Approved Curriculum-Unit 2   49
Actions to Facilitate Communication
     with Residents Who Have
         Difficulty Speaking

• Encourage to use hands to
  point out objects
• Use communication
  boards/card
• Repeat what you heard to be
  sure you understood resident
            DHSR Approved Curriculum-Unit 2   50
Actions to Facilitate Communication
     with Residents Who Have
         Difficulty Speaking
                (continued)
• Encourage resident to cry or
  express anger/frustration
  when he/she has trouble
• Ask yes and no questions
• Let other staff members
  know meaning of a sound or
  movement
             DHSR Approved Curriculum-Unit 2   51
2.3.7 Identify actions that would
      facilitate communication with
      depressed residents.



             DHSR Approved Curriculum-Unit 2   52
Actions to Facilitate Communication
     with Depressed Residents

             • Exercise patience
             • Allow time for resident
               to say things
             • Sit quietly with resident
             • Return repeatedly until
               resident responds
           DHSR Approved Curriculum-Unit 2   53
2.3.8 Identify actions that would
      facilitate communication with
      residents with memory loss.



             DHSR Approved Curriculum-Unit 2   54
Actions to Facilitate Communication
 with Residents with Memory Loss

• Encourage to talk
• Talk about things resident
  remembers
• Ask one question at a
  time, containing one
  thought

            DHSR Approved Curriculum-Unit 2   55
Actions to Facilitate Communication
 with Residents with Memory Loss
               (continued)

• Keep questions simple
• Re-phrase questions not
  understood
• Avoid asking resident to
  make a choice

            DHSR Approved Curriculum-Unit 2   56
2.3.9 Identify actions that would
      facilitate communication with
      residents based on stage of
      development.


             DHSR Approved Curriculum-Unit 2   57
Actions to Facilitate Communication
  Based on Stage of Development

• Treat all residents with
  dignity and respect
• Encourage residents to
  make choices when
  appropriate
• Use simple sentences
• Emphasize positive
  qualities
              DHSR Approved Curriculum-Unit 2   58
Actions to Facilitate Communication
  Based on Stage of Development
                 (continued)

• Never attempt to exert power over
  residents
• Encourage residents to do all they
  can for themselves
• Be patient


             DHSR Approved Curriculum-Unit 2   59
Actions to Facilitate Communication
  Based on Stage of Development
                (continued)
• Take time to explain what residents
  are to do or what you are going to do
  for them
• Use age appropriate speech
• Encourage residents to express
  feelings, ideas and frustrations

             DHSR Approved Curriculum-Unit 2   60
Actions to Facilitate Communication
  Based on Stage of Development
               (continued)
• Gain resident’s attention and speak
  clearly, in a normal tone of voice
• Orient residents to reality when
  appropriate



            DHSR Approved Curriculum-Unit 2   61
Actions to Facilitate Communication
  Based on Stage of Development
               (continued)

• Never assume that you aren’t heard
  or understood
• Never address residents as if they
  are children.



            DHSR Approved Curriculum-Unit 2   62
DHSR Approved Curriculum-Unit 2   63
2.4   Observe by using the senses to
      report resident behavior to the
      nurse.



             DHSR Approved Curriculum-Unit 2   64
     Methods of Observation

Examples using sight:
• Rash
• Skin color
• Bruising




          DHSR Approved Curriculum-Unit 2   65
    Methods of Observation
             (continued)

Examples using hearing:
• Wheezing
• Moans
• Words spoken by resident



          DHSR Approved Curriculum-Unit 2   66
     Methods of Observation
              (continued)

Examples using touch:
• Lump
• Temperature of skin
• Change in pulse



           DHSR Approved Curriculum-Unit 2   67
   Methods of Observation
            (continued)


Examples using smell:
• Odor of breath
• Odor of urine
• Odor of body


         DHSR Approved Curriculum-Unit 2   68
               Reporting

• Reports are made:
   – immediately
   – thoroughly
   – accurately
• Use notepad and pencil to write down
  information for reporting

            DHSR Approved Curriculum-Unit 2   69
2.4.1 Discuss differences between
      objective and subjective data.




             DHSR Approved Curriculum-Unit 2   70
               Reporting
               (continued)

• Report only facts, not opinions
  –objective data - that observed using
   senses
  –subjective data - that told to nurse
   aide by the resident



            DHSR Approved Curriculum-Unit 2   71
             Reporting
             (continued)



Observe resident’s
environment and
report safety
hazards



          DHSR Approved Curriculum-Unit 2   72
               Reporting
               (continued)
• When reporting, consider:
  – care or treatment given
  – time of treatment
  – resident’s response to care




            DHSR Approved Curriculum-Unit 2   73
                Reporting
                (continued)

• When reporting, consider:
  –observations helpful to other health
   care workers
  –information resident has given that
   would affect his or her treatment
  –anything unusual about resident

             DHSR Approved Curriculum-Unit 2   74
DHSR Approved Curriculum-Unit 2   75
2.5   Identify the ways in which the
      nurse aide communicates with
      other staff members.




             DHSR Approved Curriculum-Unit 2   76
    Forms of Communicating

• Reporting or
  communicating orally


              • Body language


 • Written communications
           DHSR Approved Curriculum-Unit 2   77
      Written Communications:
        Resident Care Plans

• Resident care plans prepared by
  nurse
• One for each resident
• Kept at nurses’ station



            DHSR Approved Curriculum-Unit 2   78
      Written Communications:
        Resident Care Plans
                 (continued)

• Working record to provide
  consistent, well-planned care
  on a daily basis
• Changed and updated as
  needed by licensed nurse

             DHSR Approved Curriculum-Unit 2   79
     Written Communications:
       Resident Care Plans
               (continued)
• Information included:
   –Resident’s level of
    independence in ADL
   –Treatments
   –Statement of problems

           DHSR Approved Curriculum-Unit 2   80
     Written Communications:
       Resident Care Plans
                (continued)
• Information included (continued):
   –Short-term and long-term goals
   –Plan to attain goals
   –Date plan initiated and
    reevaluated

            DHSR Approved Curriculum-Unit 2   81
      Written Communications:
        Resident Care Plans
                (continued)

• Nurse aides contribute by:
  –Helping to identify
   problems
  –Attending care
   conferences

             DHSR Approved Curriculum-Unit 2   82
      Written Communications:
        Resident Care Plans
                (continued)
• Nurse aides contribute by (continued):
  –Directing questions about plan to
   supervisor
  –Reporting resident response to
   treatment and activities


             DHSR Approved Curriculum-Unit 2   83
2.5.1 Recognize the importance of
      maintaining the resident’s medical
      record.



             DHSR Approved Curriculum-Unit 2   84
    Written Communications:
    Resident‘s Medical Record


• Includes information
  from all disciplines
  providing direct service
  to residents


             DHSR Approved Curriculum-Unit 2   85
    Written Communications:
    Resident’s Medical Record
             (continued)
• A record of:
  –assessments, implementations,
    evaluations
  –management plans
  –progress notes
• Permanent legal record
           DHSR Approved Curriculum-Unit 2   86
      Written Communications:
      Resident’s Medical Record
                  (continued)
• Purpose
  –Organizes all information on care in
   one document
  –Accountability so care can be
   evaluated
  –Documentation so there is
   knowledge of what each discipline is
   doing
             DHSR Approved Curriculum-Unit 2   87
      Written Communications:
      Resident’s Medical Record
                  (continued)

• Confidential information
  available only to health
  care workers involved in
  care of resident



             DHSR Approved Curriculum-Unit 2   88
2.5.2 Review guidelines for charting in
      the resident’s medical record.




             DHSR Approved Curriculum-Unit 2   89
      Guidelines For Charting
       If Allowed By Facility

• Make sure entries are
  accurate and easy to read
• Always use ink
• Print, unless script is
  accepted form
• Do not use the term
  “resident”
            DHSR Approved Curriculum-Unit 2   90
Guidelines For Charting
 If Allowed By Facility
         (continued)

      • Use short, concise
        phrases
      • Always chart after care
        is performed
      • Make sure writing
        legible and neat

     DHSR Approved Curriculum-Unit 2   91
      Guidelines For Charting
       If Allowed By Facility
               (continued)

• Use only abbreviations accepted
  by facility
• Make sure spelling, grammar
  and punctuation are correct
• Do not record judgments or
  interpretations

            DHSR Approved Curriculum-Unit 2   92
Guidelines For Charting
 If Allowed By Facility
         (continued)

  • Record in a logical and
    chronological manner
  • Be descriptive
  • Make sure all forms added
    to the chart contain
    identifying information

     DHSR Approved Curriculum-Unit 2   93
      Guidelines For Charting
       If Allowed By Facility
                (continued)

• Avoid using words that have
  more than one meaning
• Use resident’s exact words in
  quotation marks whenever
  possible
• Always indicate the time of care
             DHSR Approved Curriculum-Unit 2   94
Guidelines For Charting
 If Allowed By Facility
        (continued)

     • Leave no lines blank
     • Sign each entry with first
       initial, last name and title
     • Correct errors using
       facility procedure

     DHSR Approved Curriculum-Unit 2   95
DHSR Approved Curriculum-Unit 2   96
2.6   Document observations using
      appropriate terms.




            DHSR Approved Curriculum-Unit 2   97
        Medical Terminology

• Medicine has a language of its own
  –Historical development
  –Composed mainly of Greek and
   Latin word parts
  –Consistent and uniform


            DHSR Approved Curriculum-Unit 2   98
        Medical Terminology
                (continued)
• Three components
  –Prefixes
  –Root words
  –Suffixes
• Medical dictionary
  –Used for reference
  –Spelling is important
             DHSR Approved Curriculum-Unit 2   99
DHSR Approved Curriculum-Unit 2   100
2.7   Recognize abbreviations used in
      documenting by the health care
      facility.



             DHSR Approved Curriculum-Unit 2   101
           Abbreviations

• Help health care workers
  communicate quickly and effectively
• Are shortened forms of words
• Reduce time needed to chart
  important information


            DHSR Approved Curriculum-Unit 2   102
            Abbreviations
                (continued)

• Conserve space on medical record
• Used primarily in written
  communication




             DHSR Approved Curriculum-Unit 2   103
DHSR Approved Curriculum-Unit 2   104
2.8   Demonstrate the ability to
      document accurate information
      following proper charting
      practices.


            DHSR Approved Curriculum-Unit 2   105
DHSR Approved Curriculum-Unit 2   106

				
DOCUMENT INFO