Chapter 10: Communication, Collaboration, and Technology in the 21st Century

Ineffective communication can lead to a long list of undesirable outcomes . It is actually one of the major causes of preventable adverse events in acute care settings.

Effective communication isn't a core competency needed in public health nursing, but it's still a very important skill for the public health nurse.

Why is communication so important in nursing?

Which of the following is NOT a part of the communication process?

What are the 2 important considerations that influence the clarity and effectiveness of message sending?

Nonverbal messages are important, but they aren't as important as verbal messages.

Select the methods of nonverbal communication.

Which of the following is NOT a basic rule for effective sending of messages to patients?

Effective receiving skills require attending to verbal and nonverbal messages, as well as seeking feedback to understand their meaning.

Active listening relies on the nurse having genuine interest in what the patient is saying. This allows the nurse to understand the message from the sender's perspective.

Is this nurse demonstrating good active listening skills? A patient is talking about a highly traumatic event in her life. The nurse is mostly quiet, sitting back in her chair with her arms crossed. She is maintaining eye contact with the patient, nodding her head, and saying things like "uh huh", "go on", and "I understand". Her facial expression is relaxed and concerned.

Is this nurse demonstrating good communication skills? A patient is upset after being diagnosed with HIV. She tells the nurse "I probably got it from an affair I had with a co-worker about 6 months back. I feel so stupid!" The nurse is sitting back in her chair with his arms crossed and her hands in a fist. She is making eye contact, and her facial expression is neutral. The nurse coolly says to the patient "now that you've contracted HIV, you'll have to tell your husband that you cheated on him. He'll probably be devastated."

Is this nurse demonstrating good communication skills? A patient is upset after being diagnosed with HIV. She tells the nurse "I probably got it from an affair I had with a co-worker about 6 months back. I feel so stupid!" The nurse nods his head. He is sitting forward in his chair with his hands together in a ball in his lap. He is making eye contact, and his facial expression is neutral. The nurse calmly responds with the following: "So about 6 months prior, you had an affair, and you believe that you contracted HIV from this. Am I correct?" After the patient nods in agreement, the nurse asks "What do you believe is the best course of action from here?"

Which interpersonal skill is this nurse demonstrating? A nurse walks into a patient's room in the nursing home. She cheerfully states "Good morning, Mr. Howard! It's time for your meds!" Mr. Howard refuses to take his meds. The nurse sits down next to him, leans forward, and politely asks him "what's making you not want to take your medication?" She listens silently, occasionally nodding her head, while he explains that he doesn't like taking his meds because they make him feel "tired, nauseated, dizzy, and old and run down." The nurse tells the patient that she'll talk to his doctor about alternative medications and dosings, and documents his refusal in the EMAR.

Which interpersonal skill is this nurse demonstrating? A patient is describing to the nurse a sexual assault he experienced at a club earlier that night. The following exchange occurs: Patient, in a hysterical tone of voice: "I'm so stupid! I shouldn't have been flirting with him. This is all my fault for being a tease." Nurse, in a calm tone of voice: "It sounds to me like you feel that you feel guilty for the incident because you were flirting with the man who assaulted you. Am I correct?" Patient: "Yes, I feel like I'm the person to blame for it." Nurse: "It seems like you're placing all the blame on yourself. Is that true?" Patient: "Yes."

Which interpersonal skill is this nurse demonstrating? A nurse is caring for a patient in the ICU following a suicide attempt. The following conversation takes place: Patient: "My family thinks I'm selfish for attempting suicide. I bet you do, too." Nurse, gently: "You believe that both me and your family thinks you're selfish for attempting suicide?" Patient: "Yes." Nurse: "What makes you think that?" Patient: "Everybody thinks suicide is selfish." Nurse, tenderly: "Regardless of how people generally feel about suicide, I'm not here to judge you. I'm here to help you get better. I'll be back to check on you in 30 minutes." 30 minutes later the nurse checks in on the patient and the following exchange takes place: Patient: "Do you think my family will ever forgive me for trying to kill myself?" Nurse: "Well, I can't say yes or no to that. Hopefully, with time and some family therapy, your relationship with your family will get better."