Nursing 109

N109: Foundations in Nursing Practice Study Guide • Adolescents respond well to the nurse who uses active listening skills and really involves them in the conversation. The nurse must avoid communicating in a judgmental way. • The elderly may have physical or cognitive problems that may inhibit communication, which requires the nurse to take special care with this population. Hearing andvisual impairments may cause problems on a sensory level; dementia may require the use of special techniques and the inclusion of family in conversations. CommunicationBarriers Communication can also be non-therapeutic when either the sender or receiver uses techniques that block the communication process. These barriers include: • The constant use of closed questions requiring only a one word or yes/no response. Although occasionally useful, the constant use of closed-ended questions tends to end communication. • False reassurance is typified by giving reassurance not based on reality. When the nurse tells a patient with cancer that “everything will be fine”, the patient eventually begins to distrust the nurse as everything else in the patient’s situation tells himthat things are not fine. • Using clichés and overused phrases will tend to give the impression that the nurse is not listening but is, instead, resorting to tried and true phrases that are meaningless. • Defending positions or treatments may result in the patient feeling that it is not permissible to criticize. • Stereotyping, or categorizing a patient based on race, religion, gender, occupation, or any other attribute, may imply to the patient that the nurse does not really care about them as an individual. While patient attributes are important to the nurse, those attributes should not determine how the patient is treated until verified with the patient or family. • Giving advice should be avoided because the patient may infer that the nurse thinks the patient is not able to make decisions, resulting in greater dependence on the healthcare team. Giving advice may end an otherwise therapeutic communication session. • Judgmental responses based on the nurse’s personal beliefs or values will imply right or wrong, and typically will result in the patient ending the conversation if their family or personal beliefs conflict. • Asking a patient why she feels a certain way can be intimidating. Instead, the astute nurse will use open-ended questions to explore the patient’s thoughts and feelings. 2.7 Factors Influencing Comfort and Communication Gender Within a culture, there may be perceived gender differences related to how patients respond to pain and comfort measures. In many cultures, males are not supposed to show emotion, so assessment of pain and comfort may be more difficult. Age/Developmental Level Age and developmental level will definitely have an influence on how pain and discomfort are

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