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Module 3 Communication & Interpersonal Skills. Maslows Hierarchy of Needs Levels build upon each other Lowest level- Physiological Second level – Security.

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Presentation on theme: "Module 3 Communication & Interpersonal Skills. Maslows Hierarchy of Needs Levels build upon each other Lowest level- Physiological Second level – Security."— Presentation transcript:

1 Module 3 Communication & Interpersonal Skills

2 Maslows Hierarchy of Needs Levels build upon each other Lowest level- Physiological Second level – Security Third level – Belonging Fourth level – Esteem Fifth level – Self Actualization

3 Recognize/Report Behaviors Reflecting Unmet Human Needs Physical Needs unmet: –Irritable, cold, weak, c/o hunger or cold –Changes in VS & LOC Psychological Needs unmet: –Anxious, depressed, aggressive, angry –Physical ailment with no apparent cause –Expresses feelings of loneliness & worthlessness Unmet needs may result from illness, disease,or injury, but may also contribute to development of illness

4 CNA Response to Behavior Look beyond the behavior – rude, uncooperative, demanding Remember there is an underlying need for comfort & understanding Respond with patience, caring, sympathy, concern, kindness, empathy If problem continues, ask licensed nurse

5 Communication Definition – sharing of ideas, thoughts, information, & feelings with at least one person, even if unspoken Therapeutic communication – used to promote optimal wellness Routes –Internal senses – see, hear, touch –External senses – spoken, written, gesture

6 Steps in Communication Message Sender Receiver Interpretation What happens when you play the telephone game?

7 Methods of Communication Verbal – the spoken word Nonverbal – most honest –Conscious vs. unconscious –Body language –Touch –Written – red dots, name tags, uniforms, falling stars –Electronic – devices to create sound, computers, touch pads

8 Reasons for Communication Breakdown Verbal barriers – –Criticism –Value statements –Interruptions –Judgment –Language differences –Changing subjects –Excessive talking –Pat answers – Dont worry, I know how you feel

9 Communication Breakdown Non-verbal –Body language –Eye contact –Cultural differences

10 Communication Breakdown Physiological/aging factors –Hearing loss –Vision loss –Response time –Medications

11 Communication Breakdown Not listening –Lack of concentration – preoccupied, distracting noises, monotone voice, negative attitude Selective hearing Emotional response to word/situation

12 Effective Communication Skills Introduce self Call person by formal name or request Explain all tasks Use short sentences, ask for feedback Eye contact Speak clearly, avoid criticizing Clarify information Use words that are understood Friendly/positive tone Ensure confidentiality

13 Effective Communication for Special Needs Language/cultural differences –Ask for INTERPRETER –Know cultural beliefs – word use, gestures, touching Visually impaired –Describe surrounding –Identify self, dont touch until theyre aware –Explore room with resident, dont rearrange –Explain, let resident know when finished –Keep doors open, dont speak loudly –Monitor meals

14 Effective Communication for Hearing Impaired Gain attention of resident, may use touch Determine which ear has loss Check for hearing aid function Determine % or loss & high/low tone loss Face resident – dont chew gum, eliminate background noise, stand on side of better ear Speak slowly, directly, clearly, NOT LOUDLY Short sentences, simple words, repeat if need Watch nonverbal cues, ask to repeat info

15 Effective Communication for Aphasia (physically impaired) Provide writing materials if speech difficulty Let use own words, give time to speak Use picture or point boards

16 Conflict IS Occurs when what a person has & what a person wants are different A pattern of energy Natures primary motivation for change

17 Conflict IS NOT Always negative Always a contest Always a sign of poor management Able to take care of itself if left alone Always resolvable

18 Conflict Handling Modes Competing –Assertive & uncooperative –Power-oriented –Useful for: Standing up for rights Defending an important position Trying to win

19 Conflict Handling Modes Accommodating –Unassertive & cooperative –Involves self-sacrifice –Useful for: Charitable causes/ generosity Obeying orders Yielding to another point of view

20 Conflict Handling Modes Avoiding –Unassertive & uncooperative –Does not address the conflict –Useful for: Diplomatic side-stepping Avoiding until a better time Withdrawing from a threatening situation

21 Conflict Handling Modes Collaborating –Assertive & cooperative – seeks to satisfy both sides –Useful for: Gaining additional insights Avoiding negative competition for resources Solving interpersonal problems

22 Conflict Handling Modes Compromising –Somewhat assertive & cooperative –Solutions mutually satisfying – acceptable to all –Middle ground mode –Useful for: Splitting the difference Making concessions Finding a quick middle ground position

23 Areas of Concern for Conflict Attendance & Punctuality Safety – Personal & Resident Professional Behavior Attitude Appearance & Hygiene Performance

24 Lines of Authority Communication with employee: Inquiry & Advocacy –Bracket – create an open mind so people can listen to another point of view –Paraphrase – validate & confirm what they heard –Check perceptions – Reads between the lines, helps to understand/empathize –Ask probing questions – get more information & deepen understanding

25 Lines of Authority Communication with first line supervisor: objective reporting Timely reporting: when & where Plan for remediation –Clarification of concerns –Goals setting for behavior changes –Expectations & Time frame for remediation –Follow-up

26 Line of Authority Confidentiality Constructive Feedback –Info given to & received by an individual about their performance –Goal is to improve performance –Vehicle to promote constructive relationships –Monitors how things are going –Creates a way to review ongoing issues –Keeps lines of communication open

27 4 Es of Constructive Feedback Engage – set the stage –Preparation & link feedback to common goals –State what you want to discuss Empathize –Environment & Timing Educate –Describe observations & impact of behavior –Remain objective Enlist –Elicit persons response & guide towards soln

28 Touch as Communication Cultural beliefs regarding touch –Modesty – covering face, arms, head –Touch of body after death –Hugging Body Language –Hands, eyes –Gestures –Posture –Regression Personal Space

29 Basic Defense Mechanisms Regression – reverting to childish behavior (thumb sucking) Rationalization – unconscious, developing socially acceptable reasons to explain behavior (cant give up smoking because you might gain wt) Projection – unconscious, places own intolerable feelings onto others (Cheater accuses others of cheating)

30 Basic Defense Mechanisms (cont) Displacement – substituting one innocent person for another (mad at your mom so you hit your brother) Denial – cant believe that it is true (my children would never do that) Conversion – substituting acceptable physical symptoms for unacceptable emotions (feel sick when it is time to take the test)

31 Basic Defense Mechanisms (cont) Repression – pushes thoughts & ideas into the subconscious where they do not recall them (has fond memories of an abusive mother) Sublimation – unacceptable emotions are expressed in socially acceptable way (exercises when angry)

32 Basic Defense Mechanisms (cont) Substitution – replacing an unattainable goal with an acceptable one (cant sing on tune so plays the guitar) Identification – patterning self after another, hero-worship (I want to be just like Mrs. McGrory)

33 Family Communication Family structures differ – single parent, two parents, primary caregiver, extended family, & appointed guardian, conservator, or responsible party Show respect for all family structures –Listen, courteous, respectful, supportive –Avoid involvement in family matters – give privacy –Maintain confidentiality –Allow family to help with care

34 Family Communication Family needs info –Telephone & visiting hours –Location of refreshments & business office –Gift shop & public restrooms –Orient to resident activity & appointment areas –Use family as resource to gather info about preferences

35 Socio-cultural Factors Culture – characteristics of a group of persons (attitudes, beliefs, religion, values, likes, & dislikes) –Influences reaction of residents to health care like food preference, family practices, hygiene habits, & clothing styles –Rituals – beliefs, ceremonies –Beliefs about health care

36 Emotional reactions to illness Stress as a result of illness –Individual differences Heredity, experiences, environment Physical loss or disability –Many losses Spouse, family, friends Homes, control of life, disease, meals, driving Function & independence

37 Emotional response to illness Emotional reactions –Anger, grief, dependency –Suspicion, loneliness, guilt –Uselessness, feelings of damage –Depression, helpless –Anxiety, frustration, fear To help: –Observe for signs of stress & listen –Patience & understanding, promptly meet needs –Focus on abilities –Treat with dignity, be non-judgmental

38 Communication Patterns Organizational chart of nursing unit –Methods of communication Verbal vs. nonverbal Written – chart, Kardex/care plan, report sheets, ADLs. What do you do when resident asks to see the chart? Electronic – computer, fax, telephone, intercom Legal aspects –Must document what is reported verbally to nurse –Must document statements from family or resident –Subjective vs. objective data

39 Effective Communication Identify self Verbal reports – brief, organized –Appropriate – diagnosis, changes, allergies, activity, elimination, special needs, diet, VS, code status –Timing – when to report changes –Place & location

40 Effective Communication Take notes when on telephone –Name of person the message is for –Correct spelling of callers name –Time called –Clarify message by repeating it & telephone number to caller –Sign your name & title to the message

41 Answering call lights Go to resident at once, quietly, and friendly manner If on intercom, call resident by name, I.d. yourself, politely inquire to need Make sure call light is ALWAYS within reach

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