NRSG139 Lecture Notes - Lecture 2: Active Listening, Occupational Safety And Health, Proxemics
Communicating as a professional and with colleagues:
● Levels of communication:
○ Intrapersonal
○ Interpersonal
○ Group communication
■ ISBAR
○ Group dynamics
● Forms:
○ Verbal
■ Language
○ Non verbal
■ Touch
■ Facial expression
■ Posture
■ Gait
■ Gestures
■ Appearance
■ Dress/grooming
■ Sounds and silence
The health assessment interview
● Health history is first step of patient assessment
● The health assessment interview is the meeting between you and the person seeking
health care
● It is a purposeful, time limited, goal directed, verbal interaction
● Collects subjective data - what the person says about themselves
Communication factors
● Internal factors:
○ Liking others
○ Empathy
○ Listening
○ Biases and preconceptions
● External factors:
○ Privacy
○ Interruptions/time/duration
○ Environment
○ Dress
○ Notes and note taking
Stages of the interview process
● Stage I - Joining stage or orientation phase:
○ Establishment of trust, building of rapport
○ Define relationship and set goals
● Stage II - Working stage:
○ Bulk of the patient data is collected
○ Nurse’s responsibility to keep interview goal directed
○ Open ended and closed/direct questions
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● Stage III - Termination stage:
○ Last stage: Summary and validation
○ Opportunities to give additional information and make comments or
statements
Factors affecting good communication
Effective communication
● Using open ended questions
● Using closed ended questions
● Facilitating
● Using silence
● Grouping of techniques
Factors affecting communication
● Listening - particularly active listening
● Non-verbal communication
● Distance
● Personal space
Communication techniques
Listening responses - received, processed and responded to messages:
- Making observations
- Restating
- Reflecting
- Clarifying
- Interpreting
- Sequencing
- Encouraging comparisons
- Summarising
Action responses - stimulate change in thinking or behaviour
- Focusing
- Exploring
- Presenting reality
- Confronting
- Informing
- Collaborating
- Limit setting
- Normalising
Interview techniques to avoid
Problematic techniques
● Requesting an explanation/justification
● Probing
● Offering false reassurance
● Giving approval or disapproval
● Defending
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Document Summary
Health history is first step of patient assessment. The health assessment interview is the meeting between you and the person seeking health care. It is a purposeful, time limited, goal directed, verbal interaction. Collects subjective data - what the person says about themselves. Stage i - joining stage or orientation phase: Bulk of the patient data is collected. Nurse"s responsibility to keep interview goal directed. Opportunities to give additional information and make comments or statements. Listening responses - received, processed and responded to messages: Action responses - stimulate change in thinking or behaviour. 30-60 minutes for full history - less for focused history. Call the person by formal name e. g. mr" or mrs adams" unless asked otherwise. Biographical data - name, dob, address etc - always re-checked source of information - next of kin (nok) Reasons for seeking health care - primary complaint = Present health - reason for seeking health care now.