Communication is the basis for all human interactions. It is one of the most vital components of all nursing practice. Communication consists of all signals made by one person that have meaning for another person which affect their behavior and action, leading to interaction. Nurses communicate with the patients for developing an interpersonal relationship and to give instructions for medications, health teaching to the patient and relatives. This will ask for clear and effective communication, for effective care.
- Communication is the process of exchanging ideas, information, thought and feelings from one person to another.
- Communication is the process of passing message, ideas, facts, opinions, attitudes, information and understanding from one person to another.
- Communication means the exchanging of thoughts or information's conveyed to a person in such a way that the meaning received is equivalent to those which the initiator of the message intended.
- Communication is the transmission and receiving of information, feelings, and/or attitudes with the overall purpose of having understood, producing a response.
TYPES/METHODS/FORMS OF COMMUNICATION
The flow of communication is “one-way” from the communicator to the audience. The familiar example is the lecture method in class rooms. The drawbacks of the didactic method are:
- Knowledge is imposed
- Learning is authoritative
- Little audience participation
- No feedback
- Does not influence human behavior.
The Socratic method is a two-way method of communication in which both the communicator and the audience take part. The audience may raise questions, and add their own information, ideas and opinions to the subject. The process of learning is active and “democratic”. It is more likely to influence behavior than one- way communication.
The use of a spoken or written words are the ways for transmission of information, feeling, ideas and thoughts from one person to another.
Examples of written words are: News paper, Books, Magazines, Notes, Letters and Records.
The unspoken events or it is the exchange of a information or message without the use of words.
Examples of unspoken events are: Facial expression, body posture, eye contact.
Formal and Informal Communication
Communication has been classified into formal (follows lines of authority) and informal (grape-vine) communication. Informal network (e.g. gossip circles) exist in all organizations. The informal channels may be more active. If the formal channels do not cater to the information needs.
The visual forms of communication comprise: charts and graphs, pictograms, tables, maps, posters, etc.
Telecommunication and Internet
Telecommunication is the process of communicating over distance using electromagnetic instruments designed for the purpose. Radio, TV and Internet, etc. are mass communication media, while telephone, telex (or teletype) and telegraph are known as point- to-point telecommunication systems. The point-to-point systems are closer to interpersonal communication. With the launching of satellites, a big explosion of electronic communication has taken place all over the world.
NEED/IMPORTANCE/PURPOSE OF COMMUNICATION
- Communication is important for the nurse to understand and to exchange ideas to the client and their relatives, the doctors and other members of the health team.
- Poor communication results in poor patient care and poor interpersonal relationship.
- Good communication helps the nurses to improve quality care for the patients.
- Delegate authority and responsibility.
- It reduces the interpersonal tension and improves the interpersonal relationship.
- Good communication prevents disorders in the ward and hospital organization.
- Recruit, select, train and develop the personnel in the organization.
- It also helps to improve employer-employee relationship.
- Good communication helps the nurse to change or modify her behavior and at the same time, she will be able to influence the behavior of co-workers or subordinators.
- Encourage the participation in decision-making.
- It helps in the grievance procedure and disciplinary actions.
- Ensures job satisfaction.
- Improve public relation with government and other agencies.
- Include motivation, cooperation and coordination the employees.
Communication between two or more persons involves a series of elements. This is called communication process. We shall now see the elements of communication, steps in the process of communication and the process of communication itself.
Elements of Communication
In order to communicate, we should have to have the following basic elements.
- Sender or the communicator or source: The person which passes informations or ideas to another person is known as sender.
- Ideas: This is the subject matter of communication. This might be opinions, attitudes, feelings, views, suggestions, orders, etc.
- Encoding: The process of transmission of message to symbols (words, actions, pictures, etc.) is called encoding. Symbols are transmitted from the sender to the receiver.
- Channel: The symbols are transmitted through certain channels, e.g. radio, telephone, speech, written message, etc. the choice of channel usually depends upon the nature, importance and urgency of the message.
- Receiver: It is listener or the one who receive the message.
- Decoding: Receiver converts the symbols received from the sender to give him the meaning of the message.
- Response or feedback: It is the message that the receiver returns to the sender.
CHANNELS OF COMMUNICATION
By channel is implied the “physical bridges” or the media of communication between the sender and the receiver.
The total communication effort is based on three media systems:
- Interpersonal communication
- Mass media
- Tradition of folk media.
The most common channel of communication is the interpersonal or face-to-face communication. Interpersonal communication is particularly important in influencing the decision of the undecided persons.
When the message relayed via mass-media gets diffused in the community, it is picked up by the interpersonal and informal networks. The message is then subject to debate and discussion by interpersonal communications.
In mass communication the channel is one or more of the following “mass media” Viz TV, radio, printed media, etc. Mass media have the advantage of reaching a relatively larger population in a shorter time than is possible with other means. Being one-way channels of the communications mass media carry messages only from the center to the periphery; feedback mechanisms are poorly organized.
Every community has its own network of traditional or folk media such as folk dances, singing, dramas, caste or religious meetings. These are important channels of communication close to the cultural values of the rural population. Health messages may be communicated through these traditional media.
BARRIERS OF COMMUNICATION (Fig. 1.1)
There are several factors that can:
- Emotional factors: Such as fear, suspicion, jealousy, anger, anxiety, grief, lack of interest, lack of listening.
- Physical factors: Such as fatigue, illness, speech, defects, deafness, pain.
- Intellectual factors: Such as low IQ, lack of knowledge, difficult words, unfamiliar words.
- Social factors: Such as differences in culture, language, race, professional status, socioeconomic status, etc.
- Environmental factors: Such as noise, lack of privacy, uncomfortable accommodations, etc.
Communication may be blocked by:
- Changing the subject.
- Lack of listening.
- Inappropriate use of knowledge.
- Jumping into conclusion.
- False and inappropriate reassurance.
- Stating one's own opinions and ideas.
METHODS OF OVERCOMING BARRIERS OF COMMUNICATION
A nurse need to have a good background knowledge of the importance of effective communication and also practice the same, for effective patient care, and health education. He/she needs to practice good vocabulary so that he/she can communicates effectively to deliver her/his goods to the public through the network of health care delivery system.
- Have clarity in idea—the sender must be clear about what he wants to communicate.
- The sender and the receiver uses the same languages and express the ideas in simple words. The ideas should be expressed in commonly understood words, with brevity and completeness.
- Have adequacy of the message that is to be communicated.
- The sender should have a thorough knowledge of the subject being discussed and the informations that are given by her should be accurate in order to create confidence in others.
- Be sensitive to the receiver's needs, feelings and perceptions.
- Be a good listener. Follow LADDER pattern:
L - Look at the other person, maintain good eye contact.
A - Ask appropriate questions.
D - Don't interrupt.
D - Don't change subject.
E - Express emotions with control.
R - Responsively listen.
TECHNIQUES OF COMMUNICATION
Specific techniques are considered that contribute to the nurses practice in communication therapeutically and creating learning experience, in which the client can achieves a greater awareness of self and a higher regard for self.
The following are the techniques of communication:
- Providing information
Observation: Observation is made by the nurse by wringing of hand, wiping perspiration, dry lips, speaking in a very low tone. The nurse is making the observation of a non verbal communication.
Listening: As the patient is talking, the nurse responds by nodding her neck, e.g. maintain eye contact.
Restating: Nurse restates or respect what the patient has been saying it can be in the form of a question or a statement.
Validating: It is a technique by which with nurse uses to confirm the accuracy of data or information given by the patient.
Providing information: Providing personal, social and therapeutic information increases the patient's resources.
Clarifying: The nurse's formation of a patient's statement or expression of feelings in cleaner terms without indicating approval or disapproval.
Paraphrasing: In which nurse restates whatever she has learned from the patient. Nurse paraphrasing gives a feeling to the patient to test whatever she has understood what she wanted to communicate.
Pinpointing: The nurse pays attention to certain consistent statements made by the patient. She pinpoints the difference in what the patient says and what he does.
Linking: The nurse tries to link the patient's two events feeling of persons together.
Questioning: Questioning in communication is used when the nurse wants clear information. Too many questions showed are avoided. The nurses use open ended or close-ended questions.
– Close ended question or the answer of yes or no, right or wrong.
– Open ended questions give more chances to the patient to speak.
Focusing: Concentrating on a single patient
Sharing: The nurse thinks about the patient other than the time she looks after him. She may evaluates whether the interaction are helping the patient.
Summarizing: In summarizing, the nurse highlights the main theme of what has been discussed. It is useful in focusing the patient's attention on what has been discussed. It is careful in following the patient's attention on what he has discussed.