NURSING FOUNDATION
COMMUNICATION AND NURSE PATIENT RELATIONSHIP
METHOD OF COMMUNICATION
Definition of Attending Skills
Attending is a skill that involves the nurse observing client
verbal and nonverbal behaviours as one way of understanding
what clients are experiencing, and displaying effective nonverbal
behaviours to clients.
Egan (1994) elaborates upon these two major aspects of
attending, which he refers to as “psychological attending,” and
“physical attending,” respectively.
The attending cluster consist of the following Skills:
› A Posture of Involvement
› Appropriate Body Motion
› Eye Contact
› Creating a Non distracting Environment
The body can be used as a tool to facilitate good communication.
This is done through positioning the parts of the body so that they
invite and hold an interpersonal relation.
A relaxed alertness expressed by body posture seems best suited
for fostering good communication
Bolton offers these suggestions to establish a
posture of involvement:
Lean toward the speaker. This will communicate energy and
attentiveness.
Face the other squarely (i.e., your right shoulder to the speakers left).
This communicates your involvement.
It is especially important for you to position yourself so that you are
at eye level with the speaker if you are seen as a authority figure.
This will circumnavigate feelings of threat and can greatly aid in
forming an interpersonal relationship.
Body motion is good but it can be over done if you are not
careful.
The purpose of gesturing when you are listening is to encourage
the speaker to continue speaking.
This can most easily be done with a periodic head nod.
A good listener moves his or her body in response to the speaker.
Effective eye contact says that you are visually attuned to what the
speaker is saying.
Good eye contact involves focusing on the speakers face and
occasionally shifting the focus to other parts of the body.
The key is that the other is aware that they have your attention because
your eyes are "on them".
Good eye contact should seem natural to the other person. What ever
you do, don't "stare them down." This makes you seem anxious and
sometimes critical of them.
The environment where the communication takes place is
also an important factor in whether an interpersonal
relationship can be formed.
It is not always possible to move the conversation into a
private room or office, but every attempt should be made
to reduce the number of distractions that are present.
What Is Rapport?
Rapport forms the basis of meaningful, close and
harmonious relationships between people.
Rapport building relationship
How to Build Rapport?
Rapport must be a two-way connection between people, so it's not something that you
can create by yourself.
to stimulate rapport by following these six steps.
1. Check Your Appearance
2. Remember the Basics
3. Find Common Ground
4. Create Shared Experiences
5. Be Empathic
6. Mirror and Match
techniques to build rapport:
Watch the other person's body language , including gesture, posture and expression.
Adopt a similar temperament. If the other person is introverted or extroverted, shy or
exuberant, you should behave in the same way.
Use similar language . If he uses simple, direct words, then you should, too. If he speaks
in technical language, then match that style. You can also reiterate key or favourite words
or phrases.
Match the other person's speech patterns, such as tone, tempo and volume. For ex, if he
speaks softly and slowly, then lower the volume and tempo of your voice.
Re-Establishing Rapport
It takes time to rebuild rapport when it has been lost.
First, address why you lost rapport in the first place.
Be humble and explain honestly and simply what happened. If you need to
apologize , do so.
Next, focus on ways of repairing any broken trust. Put in extra work if you
need to, and keep your word.
Transparency and genuine concern for the other person's needs will go a
long way to rebuilding trust and re-establishing rapport.
FACTORS THAT INFLUENCE
COMMUNICATION
DEVELOPMENT
It helps in modifying both the message and the response.
Example: a message to an astronaut requires modification if sent
to either a lay person or a ten years old child.
Gender
Itis male and female develop differently and so have some
difference communicate, even in adulthood.
Values
The standards (personal, communal and societal)
that influence behavior – therefore, personal value
traits and experiences do influence the perception of
communication and behaviors of others as well as
the response to them.
Perception
Perception is a personal view of any situation, which in effect,
influences the perception and response to events.
Attitude = caring, concern, interest, etc., They are portrayed or
betrayed by either good or bad mood.
Roles = student/teacher, father-mother/son- daughter, roles etc.
Relationships = this is a similar role as the teacher/student
relationship above.
The environment = a comfortable surrounding with controlled
temperature, and noise-free, etc
Congruence (agreement or harmony) = this refers to
compatibility of verbal and non-verbal messages – that they both
match and not seen as giving two or more different messages.
Barriers to communications
occur principally as a result of non-therapeutic communication.
Good examples to this failure include:
Wrong or improper decoding of the message.
Poor choice of words.
Wrong tone – raised voice, etc.
Failure to listen – not listening by looking away or doing other things as a
sign of disinterest.
Wrong environment or poor environmental control – noisy surrounding or
environment.
Wrong timing – while or when client is eating or doing something or in pain.
Inconsideration by the nurse or health professional- client eating or sleeping,
with nurse not willing or ready to wait.
