Unit 2

Communication And Interpersonal Skills

Nurse Aide I Course

DHSR Approved Curriculum-Unit 2 1

Communication And Interpersonal Skills Introduction

Nurse aides communicate with residents, families, visitors and co-workers. DHSR Approved Curriculum-Unit 2 2

Communication And Interpersonal Skills Introduction

(continued) Nurse aides must frequently send and receive information about the care and observation of residents, report thoughts and feelings as clearly and objectively as possible and interact effectively with others.

DHSR Approved Curriculum-Unit 2 3

Communication And Interpersonal Skills Introduction

(continued) Nurse aides need to be aware of nonverbal communications and need to develop skills in communicating with the sensory impaired. DHSR Approved Curriculum-Unit 2 4

Communication And Interpersonal Skills Introduction

(continued) In addition, nurse aides may document on the medical record, which is a legal document. Therefore, all documentation must be in legible, clear and accurate language so that there is no misunderstanding of the meaning.

DHSR Approved Curriculum-Unit 2 5

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2.0 Demonstrate appropriate and effective communication skills.

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Elements That Influence Relationships With Others

• Prejudices • Frustrations • Attitudes • Life Experiences DHSR Approved Curriculum-Unit 2 8

Requirements For Successful Communications

• A message • A sender • A receiver DHSR Approved Curriculum-Unit 2 9

2.1

Describe the importance of developing good listening skills.

2.1.1 Identify nine listening skills that can be used by the nurse aide.

DHSR Approved Curriculum-Unit 2 10

Listening Skills

• Show interest • Hear message • Do not interrupt • Ask appropriate questions for clarification DHSR Approved Curriculum-Unit 2 11

Listening Skills

(continued) • Be patient and help resident express feelings and concerns • Eliminate or reduce distractions • Understand silence can be form of communication DHSR Approved Curriculum-Unit 2 12

2.1.2 Recognize barriers to effective communication.

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Barriers to Effective Communication

• Labeling • Talking too fast • Avoiding eye contact • Belittling a resident’s feelings • Physical distance DHSR Approved Curriculum-Unit 2 14

Barriers to Effective Communication

(continued) • Mental or sensory impairment on the part of the resident such as: –Confusion –Blindness –Aphasia –Hearing impairment DHSR Approved Curriculum-Unit 2 15

Barriers to Effective Communication

(continued) • Changing the subject • False reassurance • Giving advice • Ineffective communication –Disguised messages –Conflicting messages –Unclear meanings –Clichés DHSR Approved Curriculum-Unit 2 16

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2.2

Explain how the nurse aide will need to modify his or her behavior in response to the resident’s behavior.

2.2.1 Define the terms sympathy, empathy and tact.

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Interpersonal Skills

• Determined by –Standards and values –Culture and environment –Heredity –Interests DHSR Approved Curriculum-Unit 2 19

Interpersonal Skills

(continued) • Determined by –Feelings and stress –Expectations others have for us –Past experiences DHSR Approved Curriculum-Unit 2 20

Dealing With Resident Behavior

• Accept every resident • Listen to every resident • Comply with reasonable requests, when possible DHSR Approved Curriculum-Unit 2 21

Dealing With Resident Behavior

(continued) • Display patience and tolerance • Make an effort to be understanding DHSR Approved Curriculum-Unit 2 22

Dealing With Resident Behavior

(continued) • Develop acceptable ways of coping with our own negative feelings –Leave the room after providing for safety –Talk with supervisor, in private, about negative feelings DHSR Approved Curriculum-Unit 2 23

Dealing With Resident Behavior

(continued) • Develop acceptable ways of coping with our own negative feelings –Involve yourself in physical activity –Learn to use relaxation techniques that ease stress DHSR Approved Curriculum-Unit 2 24

Dealing With Resident Behavior

(continued) • Be sensitive to residents’ moods • Be able to handle disagreements and criticism DHSR Approved Curriculum-Unit 2 25

Treat Residents As Unique Individuals

• Do things the residents’ way, when possible • Anticipate their needs • Give good care • Ask for their opinions DHSR Approved Curriculum-Unit 2 26

Treat Residents As Unique Individuals

(continued) • Be able to see things from the other person’s point of view DHSR Approved Curriculum-Unit 2 27

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2.3

Develop effective nonverbal and verbal communications skills.

2.3.1 List six examples of nonverbal communication and six examples of effective verbal communication.

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Nonverbal Communication

• Body language –Posture –Gestures –Level of activity –Facial expressions –Appearance –Touch DHSR Approved Curriculum-Unit 2 30

Verbal Communication

• Speak clearly and concisely • Give message by tone of voice • Face resident, at eye level, when speaking DHSR Approved Curriculum-Unit 2 31

Verbal Communication

(continued) • Avoid words having several meanings • Present thoughts in a logical, orderly manner • Learn to paraphrase DHSR Approved Curriculum-Unit 2 32

2.3.2 Identify proper telephone communication skills.

DHSR Approved Curriculum-Unit 2 33

Telephone Communication Skills

• Speak clearly in a pleasant tone of voice • Identify the area, yourself and your position • Ask, “May I help you?” • Be courteous DHSR Approved Curriculum-Unit 2 34

Telephone Communication Skills

(continued) • Take messages: –name of individual calling –phone number (including area code) –read back message for accuracy –date and time of call DHSR Approved Curriculum-Unit 2 35

Telephone Communication Skills

(continued) • Take messages (continued): –ask for assistance if you are unable to handle message –permit caller to hang up first –follow proper etiquette DHSR Approved Curriculum-Unit 2 36

2.3.3 Identify actions that would facilitate communication with residents’ family and visitors DHSR Approved Curriculum-Unit 2 37

Actions to Facilitate Communication with the Resident’s Family and Visitors

• Ask how they are doing • Indicate that you are glad to see them • Tell them about activities the resident has been involved with that day DHSR Approved Curriculum-Unit 2 38

Actions to Facilitate Communication with the Resident’s Family and Visitors

(continued) • Be warm and friendly • Use talking and listening skills you would use with resident DHSR Approved Curriculum-Unit 2 39

Actions to Facilitate Communication with the Resident’s Family and Visitors

(continued) • Share knowledge about the unit – Visiting hours – Restrictions to visitors – Any restrictions on bringing food – Activities that include family DHSR Approved Curriculum-Unit 2 40

Actions to Facilitate Communication with the Resident’s Family and Visitors

(continued) • Report stressful or tiring visits to supervisor • Refer requests for information on the resident’s condition to supervisor DHSR Approved Curriculum-Unit 2 41

Actions to Facilitate Communication with the Resident’s Family and Visitors

(continued) • Share information from family/visitors that would affect resident care with supervisor • Report visitor concerns or complaints to supervisor DHSR Approved Curriculum-Unit 2 42

2.3.4 Identify actions that would facilitate communication with hearing impaired residents.

DHSR Approved Curriculum-Unit 2 43

Actions to Facilitate Communication with Hearing Impaired Residents

• Encourage to use hearing aid • Speak slowly using simple sentences • Face resident at eye level when speaking • Encourage resident to read lips, if that helps DHSR Approved Curriculum-Unit 2 44

Actions to Facilitate Communication with Hearing Impaired Residents

(continued) • Lower pitch of voice • Direct speech to stronger ear but do not shout • Use gestures when possible to clarify statements • Write when necessary • Learn basic signing, if appropriate DHSR Approved Curriculum-Unit 2 45

2.3.5 Identify actions that would facilitate communication with residents that have decreased vision.

DHSR Approved Curriculum-Unit 2 46

Actions to Facilitate Communication with Residents Who Have Decreased Vision

• Sit where resident can best see you • Make sure lighting is sufficient • Encourage resident to touch objects and yourself • Encourage resident to wear his/her glasses DHSR Approved Curriculum-Unit 2 47

Actions to Facilitate Communication with Residents Who Have Decreased Vision

(continued) • Use touch and talk frequently to communicate your location • Use descriptive words and phrases DHSR Approved Curriculum-Unit 2 48

2.3.6 Identify actions that would facilitate communication with residents that have difficulty speaking.

DHSR Approved Curriculum-Unit 2 49

Actions to Facilitate Communication with Residents Who Have Difficulty Speaking

• Encourage to use hands to point out objects • Use communication boards/card • Repeat what you heard to be sure you understood resident DHSR Approved Curriculum-Unit 2 50

Actions to Facilitate Communication with Residents Who Have Difficulty Speaking

(continued) • Encourage resident to cry or express anger/frustration when he/she has trouble • Ask yes and no questions • Let other staff members know meaning of a sound or movement DHSR Approved Curriculum-Unit 2 51

2.3.7 Identify actions that would facilitate communication with depressed residents.

DHSR Approved Curriculum-Unit 2 52

Actions to Facilitate Communication with Depressed Residents

• Exercise patience • Allow time for resident to say things • Sit quietly with resident • Return repeatedly until resident responds DHSR Approved Curriculum-Unit 2 53

2.3.8 Identify actions that would facilitate communication with residents with memory loss.

DHSR Approved Curriculum-Unit 2 54

Actions to Facilitate Communication with Residents with Memory Loss

• Encourage to talk • Talk about things resident remembers • Ask one question at a time, containing one thought DHSR Approved Curriculum-Unit 2 55

Actions to Facilitate Communication with Residents with Memory Loss

(continued) • Keep questions simple • Re-phrase questions not understood • Avoid asking resident to make a choice DHSR Approved Curriculum-Unit 2 56

2.3.9 Identify actions that would facilitate communication with residents based on stage of development.

DHSR Approved Curriculum-Unit 2 57

Actions to Facilitate Communication Based on Stage of Development

• Treat all residents with dignity and respect • Encourage residents to make choices when appropriate • Use simple sentences • Emphasize positive qualities DHSR Approved Curriculum-Unit 2 58

Actions to Facilitate Communication Based on Stage of Development

(continued) • Never attempt to exert power over residents • Encourage residents to do all they can for themselves • Be patient DHSR Approved Curriculum-Unit 2 59

Actions to Facilitate Communication Based on Stage of Development

(continued) • Take time to explain what residents are to do or what you are going to do for them • Use age appropriate speech • Encourage residents to express feelings, ideas and frustrations DHSR Approved Curriculum-Unit 2 60

Actions to Facilitate Communication Based on Stage of Development

(continued) • Gain resident’s attention and speak clearly, in a normal tone of voice • Orient residents to reality when appropriate DHSR Approved Curriculum-Unit 2 61

Actions to Facilitate Communication Based on Stage of Development

(continued) • Never assume that you aren’t heard or understood • Never address residents as if they are children.

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2.4

Observe by using the senses to report resident behavior to the nurse.

DHSR Approved Curriculum-Unit 2 64

Methods of Observation

• • •

Examples using sight:

Rash Skin color Bruising

DHSR Approved Curriculum-Unit 2 65

Methods of Observation

(continued) • • • Examples using hearing:

Wheezing Moans Words spoken by resident

DHSR Approved Curriculum-Unit 2 66

Methods of Observation

(continued) Examples using touch: •

Lump

•

Temperature of skin

•

Change in pulse

DHSR Approved Curriculum-Unit 2 67

Methods of Observation

(continued) Examples using smell: •

Odor of breath

•

Odor of urine

•

Odor of body

DHSR Approved Curriculum-Unit 2 68

Reporting

• Reports are made: – immediately – thoroughly – accurately • Use notepad and pencil to write down information for reporting DHSR Approved Curriculum-Unit 2 69

2.4.1 Discuss differences between objective and subjective data.

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Reporting

(continued) • Report only facts, not opinions –objective data - that observed using senses –subjective data - that told to nurse aide by the resident DHSR Approved Curriculum-Unit 2 71

Reporting

(continued) Observe resident’s environment and report safety hazards DHSR Approved Curriculum-Unit 2 72

Reporting

(continued) • When reporting, consider: – care or treatment given – time of treatment – resident’s response to care DHSR Approved Curriculum-Unit 2 73

Reporting

(continued) • When reporting, consider: –observations helpful to other health care workers –information resident has given that would affect his or her treatment –anything unusual about resident DHSR Approved Curriculum-Unit 2 74

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2.5

Identify the ways in which the nurse aide communicates with other staff members.

DHSR Approved Curriculum-Unit 2 76

Forms of Communicating

• Reporting or communicating orally • Body language • Written communications DHSR Approved Curriculum-Unit 2 77

Written Communications: Resident Care Plans

• Resident care plans prepared by nurse • One for each resident • Kept at nurses’ station DHSR Approved Curriculum-Unit 2 78

Written Communications: Resident Care Plans

(continued) • Working record to provide consistent, well-planned care on a daily basis • Changed and updated as needed by licensed nurse DHSR Approved Curriculum-Unit 2 79

Written Communications: Resident Care Plans

(continued) • Information included: –Resident’s level of independence in ADL –Treatments –Statement of problems DHSR Approved Curriculum-Unit 2 80

Written Communications: Resident Care Plans

(continued) • Information included (continued): –Short-term and long-term goals –Plan to attain goals –Date plan initiated and reevaluated DHSR Approved Curriculum-Unit 2 81

Written Communications: Resident Care Plans

(continued) • Nurse aides contribute by: –Helping to identify problems –Attending care conferences DHSR Approved Curriculum-Unit 2 82

Written Communications: Resident Care Plans

(continued) • Nurse aides contribute by (continued): –Directing questions about plan to supervisor –Reporting resident response to treatment and activities DHSR Approved Curriculum-Unit 2 83

2.5.1 Recognize the importance of maintaining the resident’s medical record.

DHSR Approved Curriculum-Unit 2 84

Written Communications: Resident‘s Medical Record

• Includes information from all disciplines providing direct service to residents DHSR Approved Curriculum-Unit 2 85

Written Communications: Resident’s Medical Record

(continued) • A record of: –assessments, implementations, evaluations –management plans –progress notes • Permanent legal record DHSR Approved Curriculum-Unit 2 86

Written Communications: Resident’s Medical Record

(continued) • Purpose –Organizes all information on care in one document –Accountability so care can be evaluated –Documentation so there is knowledge of what each discipline is doing DHSR Approved Curriculum-Unit 2 87

Written Communications: Resident’s Medical Record

(continued) • Confidential information available only to health care workers involved in care of resident DHSR Approved Curriculum-Unit 2 88

2.5.2 Review guidelines for charting in the resident’s medical record.

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Guidelines For Charting If Allowed By Facility

• Make sure entries are accurate and easy to read • Always use ink • Print, unless script is accepted form • Do not use the term “resident” DHSR Approved Curriculum-Unit 2 90

Guidelines For Charting If Allowed By Facility

(continued) • Use short, concise phrases • Always chart after care is performed • Make sure writing legible and neat DHSR Approved Curriculum-Unit 2 91

Guidelines For Charting If Allowed By Facility

(continued) • Use only abbreviations accepted by facility • Make sure spelling, grammar and punctuation are correct • Do not record judgments or interpretations DHSR Approved Curriculum-Unit 2 92

Guidelines For Charting If Allowed By Facility

(continued) • Record in a logical and chronological manner • Be descriptive • Make sure all forms added to the chart contain identifying information DHSR Approved Curriculum-Unit 2 93

Guidelines For Charting If Allowed By Facility

(continued) • Avoid using words that have more than one meaning • Use resident’s exact words in quotation marks whenever possible • Always indicate the time of care DHSR Approved Curriculum-Unit 2 94

Guidelines For Charting If Allowed By Facility

(continued) • Leave no lines blank • Sign each entry with first initial, last name and title • Correct errors using facility procedure DHSR Approved Curriculum-Unit 2 95

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2.6

Document observations using appropriate terms.

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Medical Terminology

• Medicine has a language of its own –Historical development –Composed mainly of Greek and Latin word parts –Consistent and uniform DHSR Approved Curriculum-Unit 2 98

Medical Terminology

(continued) • Three components –Prefixes –Root words –Suffixes • Medical dictionary –Used for reference –Spelling is important DHSR Approved Curriculum-Unit 2 99

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2.7

Recognize abbreviations used in documenting by the health care facility.

DHSR Approved Curriculum-Unit 2 101

Abbreviations

• Help health care workers communicate quickly and effectively • Are shortened forms of words • Reduce time needed to chart important information DHSR Approved Curriculum-Unit 2 102

Abbreviations

(continued) • Conserve space on medical record • Used primarily in written communication DHSR Approved Curriculum-Unit 2 103

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2.8

Demonstrate the ability to document accurate information following proper charting practices. DHSR Approved Curriculum-Unit 2 105

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