module 3 communication interpersonal skills section 1 define key terminology a review the terms listed in the terminology section b spell the listed terms accurately c pronounce the terms correctly and d use the terms in their proper context section two the five basic psychological and psychosocial needs of all humans as described by maslow's hierarchy of needs a basic human needs and how they can be met by nurse assistant number one physiological oxygen food water elimination shelter sleep and sex example delivers meal trays assist patients or residents with setup and feeding is needed number two safety and security clothing protection from harm or danger freedom from fear stability and order family and economics example responds promptly to patient or residents call white number three belonging meaningful relationships with others acceptance by peers and community love intimacy and formal and informal social and work groups example encourages family and friends to visit patient or resident number four esteem respect recognition approval self-confidence self-respect and self-esteem example addresses each patient or resident by the name they prefer 5. self-actualization achievement creativity success full use of individual talents example sincerely acknowledges a patient or resident's accomplishments b value of using maslow's hierarchy of needs satisfactory achievement of each level is based on meeting the needs of prior levels meeting basic physiological needs is essential to life provides a way to set priorities and organize activities encourages a holistic approach to patient or resident care planning increases awareness of reasons for patient or resident behaviors and unmet basic needs may result from and or contribute to illness disease or injury section 3 patient or resident behaviors that reflect unmet human needs a behaviors that demonstrate unmet human needs number one physiological needs unmet irritability weakness complaints of hunger complaints of being cold or too warm changes in vital signs and level of consciousness 2. psychosocial needs unmet anxiety depression anger withdrawal isolation physical ailments with no apparent cause expressions of feelings of loneliness and worthlessness b responses to patient or resident behavior suggesting unmet basic needs look beyond uncooperative demanding and rude behavior recognize that a patient or resident has underlying needs for comfort and understanding respond with patience caring concern kindness and empathy and if a problem continues ask a licensed nurse for assistance section 4 communication and therapeutic communication and identify two routes of communication a communication is a sharing of ideas thoughts information and feelings with at least one person b communication may be verbal or non-verbal c therapeutic communication is used to promote optimum wellness patient or resident centered and goal oriented and can be verbal or non-verbal d two roots of communication what is seen heard touched internal senses or what is spoken written or gestured external senses section five the key steps involved in the communication process and methods used in communication a important steps in communication message sender receiver and interpretation b methods number one verbal or spoken words number two nonverbal conscious or unconscious types such as body language touch eye contact at patient's eye level written labels stickers or armbands for patient or residence precautions room numbers and unit signs visual labels name tag picture uniform picture board number three electronic devices to create sounds of words verbal number four computers are touch pads to type words or phrases into screens for non-verbal number five specialized communication skills a dementia related communication skills including person-centered care validation therapy gentle orientation to time and place re-ensure with words and touch b use of continuum of verbal and non-physical techniques such as redirect for combative patients section 6 reasons for communication breakdown a verbal factors can be the patient or resident or the health care worker criticism value statements interruptions judgment language differences changing subjects excessive talking cliche or automatic answers such as don't worry it will be okay i know how you feel b nonverbal factors can be patient or resident or healthcare worker body language eye contact cultural beliefs customs and practices environmental time and space c physiological and aging factors hearing loss vision loss slowing of response time medication cognitive changes and speech loss d not listening can be either the patient or resident or health care worker lack of concentration preoccupied distracting noises monotone voice or negative attitude selective hearing what one wants or expects to hear c emotional verbal or non-verbal responses to words or situations section 7 effective communication or interpersonal skills used with patients or residents and their families and guests a communication or interpersonal skills for use with patient or resident family or guest introduce yourself use the patient or residence formal name initially after initial introductions ask the patient or resident how he or she would like to be addressed add this information to the nursing care plan so all staff members have the information explain all tasks to the patient or resident before doing them be patient and a good listener use short sentences ask for feedback use eye contact speak clearly avoid criticizing and avoid interruption clarify information or conversation as needed be aware of body language of self and others verbal and nonverbal messages should agree use words that are easily understood show interest and respect use a friendly tone of voice be positive while being appropriate to each interaction and ensure confidentiality be additional skills when communicating with patient or residents with special needs number one language or cultural differences ask for an interpreter if the patient or resident or family speaks little or no english or the language of the nurse assistant no cultural beliefs and practices for word meanings and uses personal space time and timing gestures and touching two visual impairment describe surroundings to a visually impaired patient or resident encourage use of other senses identify self when entering the patient or residence room speak aloud before touching the patient or resident explore the room with patient or resident do not rearrange the room provide the patient or resident with explanations about what will be and what is being done let the patient or resident know when you are entering and leaving the room keep doors open assist is needed with meals set up and eating and speak in a normal tone of voice 3. hearing impaired gain the attention of the patient or resident using touch as appropriate determine which ear has hearing loss it may be both errors check to see if hearing aids are in turned on and working face the patient or resident directly do not block or cover your mouth or chew gum reduce or eliminate background noise and other distractions speak slowly directly and clearly when addressing a hearing impaired patient or resident do not speak loudly use short sentences and simple words repeat and rephrase statements as needed ask the patient or resident to repeat instructions to ensure understanding and be aware of messages set by facial expressions and body language 4. speech impairment such as dysphagia or aphasia provide writing materials and assistance as needed let the patient or resident use their own words allow sufficient time for response use picture boards or point boards stand in front of the patient or resident and avoid finishing words and sentences for the patient or resident five mental impairment such as confusion or dementia keep directions simple repeat information is needed offer frequent general reassurance and always have the patient or resident's attention before speaking section 8 conflict and measures for conflict resolution definitions conflict a disagreement or controversy when what a person has and what a person wants is different a pattern of energy nature's primary motivation for change conflict resolution a range of processes aimed at alleviating or eliminating sources of conflict conflict myths conflict is negative conflict is a contest the presence of conflict is a sign of poor management conflict if left alone will take care of itself conflict must be resolved conflict handling modes characteristics and uses competing assertive and uncooperative power oriented accommodating unassertive and cooperative self-sacrifice avoiding unassertive and uncooperative doesn't address the conflict collaborating assertive and cooperative seeks mutual satisfaction compromising somewhat assertive and cooperative mutual satisfaction middle ground potential areas of conflict for the nurse assistant attendance punctuality safety including personal and patient or resident professional behavior attitude appearance and hygiene performance and confidentiality the four ease of giving constructive feedback number one engage to prepare link feedback with goals focus discussion number two empathize environment and timing number three educate describe your observations identify impact of behavior remain objective and number four enlist elicit a response guide towards a solution section nine touch as a form of communication including body language and personal space cultural beliefs regarding touch modesty the covering of the head face or arms gender of caregiver touching of the body after death hugging and kissing observing body language hand in extremities eyes gesture posture regression to childlike posture or behaviors personal space section 10 identify common psychological defense mechanisms denial projection anger rationalization regression displacement conversion repression sublimation substitution or compensation and identification section 11 family communication or interaction patterns and the role of the nurse assistant a general principles when communicating with patient or resident families show respect for all family structures and members listen to family members and show courtesy respect and support allow uninterrupted time and provide privacy as indicated avoid involvement with family matters maintain patient or resident confidentiality encourage family to participate in care planning and care as allowed by the facility policy b provide information about the facility telephone numbers cell phone regulations visiting hours location of cafeteria or vending machines gift shop public restrooms orient to patient or resident activities social services and the chaplain c encourage family to provide information about patient or resident preferences [Music] section 12 social and cultural factors influencing communication and emotional reactions to illness and disability a culture shared learned customs belief and values of a group of people includes attitudes beliefs religions values likes and dislikes rituals celebrations food and language culture influences the reaction of residents and families to health and health care services rituals ceremonies to cure or protect from disease based on beliefs about health health care and causes of illness b physical and psychosocial reactions to illness and disability one stress responses common physiological responses vary with each individual can become a pattern of responses based on experiences and have desirable and undesirable effects 2. physical loss or disability loss of spouse family or friends loss of homes employment economics and security loss of control of life independence and driving loss of control and function of body and mind and fewer choices and options three emotional reactions anger uselessness fear grief feelings of damage dependency depression suspicion sense of helplessness loneliness anxiety guilt and frustration c helpful nurse assistant actions observe the patient or resident for indications of emotional stress be a good listener take time to visit be patient and understanding meet needs promptly help the patient or resident function as independently as possible focus on their abilities not disabilities let patients or residents know that the staff cares about his or her well-being be non-judgmental always treat all patients or residents with dignity be respectful of all cultures and belief systems and take time to learn about cultures and practices section 13 communication between the members of the healthcare team healthcare communication one methods of communicating verbal nonverbal written such as chart patient summary care plan report sheets activity of daily living form and weight and vital sign forms electronic computer fax telephone intercom system two legal aspects of communications must document what has been reported verbally to a licensed nurse must document statements heard from the patient or resident and family that are important b rules for effective communication identify self by name and title in any form of communication verbal reports should be brief organized appropriate and focused on diagnosis allergies activity intolerance elimination special needs diet and appetite vital signs and weight and code status timely respectful of patient and resident confidentiality telephone communication take notes during the call name of the person the message is for verify correct spelling of caller's name indicate time of call clarify the message with the caller by repeating it and repeating the telephone number clearly sign full name and title to the message answering a patient or resident call signal answer promptly quietly and in a friendly manner if an intercom is used call the patient or resident by name identify self and politely inquire as to the patient or residents needs make sure the patient or resident can always reach the call light