N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide • Body position may be indicative of a person's attitude. For example, a person with arms crossed across the chest signals he might be resistant to the ideas being presented. • Facial expressions are extremely variable from person to person. Very subtle facial expressions can give the nurse clues to questions about the worries that the patient might have. • Gestures may help emphasize an idea or may simply be stress relievers. For example, fidgeting of the patient may indicate that he is nervous, upset, tense, or bored. • Eye contact may indicate attentiveness and lack of eye contact may indicate avoidance or disinterest. Various cultures have different meanings attached to eye contact, so the astute nurse will understand the patient's culture and respect the differences. • Touch can be used to communicate understanding, caring, and reassurance. The absence of touch may indicate the opposite. Again, the astute nurse will understand cultural differences that may make touching inappropriate. Verbal and non-verbal communication may send conflicting messages. The patient may say, "I'm feeling fine,” while at the same time, grimacing and holding her abdomen. The astute nurse will monitor verbal and non-verbal discrepancies and will investigate messages that seem to be in conflict. Effective communication with a patient, caregiver, or other team member will be: • Simple to understand and based on the patient's level of prior knowledge. • Brief and to the point; being concise while communicating the entire story. • Relevant to the current needs and concerns of the patient. • Paced according to the message being delivered. General conversation is typically more rapid than when instructions are being given. • Clear and authentic, so that the receiver understands and believes the message being conveyed. • Timed such that the receiver is ready to hear. For example, when a patient is stressed or in severe pain, it is not the best time to provide discharge education. Therapeutic Communication Therapeutic communication is the process the nurse uses to influence the patient to produce a better outcome. Therapeutic communication can be used to obtain or provide information to the patient, caregiver, or other team members to develop trust and show caring and concern, and to explore feelings and ultimately reduce anxiety. Exceptional communication skills can be developed using techniques of therapeutic communication: • Focusing is the technique of steering the conversation to keep the communication focused on the topic. For the patient who is telling story after story about his children, the nurse might say, "I can tell your family is very important to you. Did your symptoms start after your last family reunion?" • Attending is the technique of actively listening to the patient. Non-verbal cues will tell the patient if the nurse is really listening or if she is pre-occupied with other thoughts. • Validating is the technique of double checking the data to ensure that it is accurate. "So, the symptoms started two weeks ago, correct?"

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