Chapter 20

Communication- PRIMARY aspect- can be verbal or nonverbal

Encoder- person who starts message/communication uses a ‘medium/channel’

Decoder- receiver of communication

Gait- how people walk

Electronic communication- depends on the policy of where you work; ex/ e-mail

Four Levels of Communication

• Intrapersonal- self talk, communication with one self; ex/ positivity

• Interpersonal- occurs between 2 or more people with the goal to exchange 

messages

• Negative interpersonal behavior:

• Incivility, bullying (horizontal violence, eye rolling, negative 

communication)

• Small group- nurses interact with 2 or more individuals; ex/ project groups

• Organizational- individuals and groups within an organization communicate to 

achieve established goals; ex/ morbidity & mortality conferences (m&m’s)

• Group dynamics- how individual group members relate to each other during 

the process of working toward group goals

The Helping Relationship

• Patients tend to sue more if this relationship isn’t formed

• The nurse is the helper and the patient is the person being helped

• 3 phases of helping relationship:

• Orientation phase

• Establish tone and guidelines for the relationship

• Provide the patient with orientation to the healthcare system

• Working phase- longest phase

• Work together to meet the patients needs

• Provide teaching, counseling and assistance to achieve each goal

• Termination phase

• Make suggestions for future, if necessary

• Assist patient transferring from one agency to another; or even going 

home

• Help start a helping relationship with another nurse, if needed

**Remember ISBARQ patient hand-off technique