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Communication
Unit Three
Objectives
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Describe Communications
Identify Verbal Communications
Identify Non-Verbal Communication
Describe Effective Communication
Describe Communication within the
Nursing Team
 Identify Responsibility in Record Keeping
Objectives
 Indentify Cultural Variations in
Communications
 Describe Basic Telephone Etiquette
 Discuss conflict: Causes and Management
Strategies
Describe Communication
 The exchange of
information
 Receiver gets the
message in the way
the sender intended
 Essential in reporting
observations and
implementing care
plan
Verbal Communication
 Using voice or written
words to get the
message across
 Used to give and
receive information,
facts, and sharing
experiences
 Main means humans
communicate
 Be alert to the
residents ability to
understand words or
read written
information
 Be aware of
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choice of words
Tone of voice
Speed of voice
Non- Verbal
 Getting message
across without words
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facial expressions
posture
gestures
touch
dress
Actions speak louder then
pacing
words!!
smiling
silence
Effective Communication
 Effective Communication takes time,
patience and skill
 Guidelines for effective communication
include:
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Reduce background noise
make certain your body language says you’re
listening
Pace your speech to what the resident
understands
Effective Communication
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Allow time for talking
Express an interest in what the resident is
saying
Maintain eye contact
Match body language to what you’re saying
speak clear and loud
Call resident by name
listen attentively
Keep conversation resident centered
Barriers to Effective
Communication
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Not Listening
Background noise
Belittling a person
Talking down to a
person as if they were
a child
 Avoiding eye contact
 Appearing too busy or
in a hurry
Barriers to Effective
Communication
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Making Judgements
Not acknowledging what was said
Giving false and inappropriate reassurances
Speaking in a language other then the
residents primary language
 Dominating the conversation
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Review handout 18
Communication for those
Visually Impaired
 Identify self and make
presence known when
approaching resident
 Knock before entering
room
 Call resident by name
preferred
 Reduce glare from
windows
 Assist resident to clean
and use eye glasses
 Maintain stability of
environment and
explain placement of
articles
 Offer arm to guide,
walk slightly ahead
 Speak clear and slow,
do not shout.
Communication for Residents
Hearing Impaired
 Realize some hearing
loss occurs in the
normal aging
process.Techniques to
use include:
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Face resident when
speaking
Speak clear and
distinctly
Hearing Impaired Residents
 Keep hands away
from mouth while
talking to allow for lip
reading/no chewing
gum or eating
 Stand or sit near
resident
 Assist with hearing
aids
 Reduce background
noise
Language- Speech Impaired
Residents
 Residents who have suffered strokes may
not be able to speak ( aphasia) or have
difficulty speaking (dysphasia). It is
important to realize that:
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The resident usually understands what is being
said, but cannot verbalize communication.
The resident may express frustration or anger
because words he says, do not make sense.
Ask short questions requiring short answers
Caring for those in a wheelchair
 Make eye contact with the resident
 When offering assistance wait for resident
to accept help
 Ask how to help. What works best.
 Make sure resident is ready before pushing
wheelchair.
Cultural Variations in
Communication
 Verbal communication:
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Choice of words.( formal vs informal)
Tone of voice. ( Soft vs loud)
Directness of speech. ( diplomatic vs impatient)
Use of silence. Some cultures this is essential,
some may interpret as anger.
Variations ( continued)
 Non-verbal communication
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Gestures. May indicate respect/ or anger.
Eye contact. Some consider rude, some
consider it shows modesty.
Personal space. Some like close, some prefer
distance.
Touch and posture. May indicate respect and
be therapeutic, or may indicate aggression.
Communicating within the
Nursing Team
 Nursing Assistants
have frequent and
close contact with the
resident; therefore the
nursing assistant has
the opportunity to
observe the resident
more closely then the
nurse in charge.
Nursing Team Communication
 Communication is
necessary for
continuity of care.
 Care plans are an
essential tool
regarding resident
care. They are
developed with
guidelines from
Federal Regulations.
Nursing Team Communications
 Nursing Assistants
contribute to the
resident care plan by
making careful
observations and
actions to the charge
nurse.
 Report must be
specific, accurate and
confidential.
 Report:
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Resident reactions,
behavior
Statement made by
resident regarding
physical symptoms
(pain, dizziness)
Care that works best/or
care that does not work
well for the resident.
Abnormal Signs &Symptoms
 Signs:
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Shortness of breath
rapid respiration's
fever
cough
blue lips/dusky nails
vomiting
drowsiness
sweating
Abnormal Signs and Symptoms
 Signs:
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Swelling in feet or
ankles
watery or hard stool
dark or bloody stool
blood in urine
urinating frequently,
strong odor, dark
colored urine
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Red or warmth over
bony prominences
breaks, tears, bruises
on skin
Sudden incontinence
sudden confusion/
memory loss
changes in behavior
anything unusual
Abnormal Symptoms
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Chills
Pain in chest
Pain in abdomen
Nausea
excessive thirst
difficulty urinating
pain when urinating
pain when moving
 Change in appetite
 difficulty
swallowing/chewing
 Any pain
Incidents
 Any event which does
not fit the routine care
of the resident or
operation of a facility
is an incident. Any
time an incident or
accident occurs a
written report must be
made.
 Incidents include:
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lost dentures, glasses,
broken teeth.
Resident, staff, or
visitor accidents,
injuries or thefts.
 REPORT TO
CHARGE NURSE
IMMEDIATELY
NAR RECORD KEEPING
 Most facilities require
NAR’s to do checklist
charting. Examples:
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ADL sheets
Bowel and bladder
records
I&O
Food Consumption
TPR and BP
Residents Charts
 The resident chart is a
legal record.
 Information must be
accurate, not an
opinion
 Entries must be
written clearly
 Entries must be signed
 Contents of chart are
confidential.
(most are now
computerized)
Abbreviations and Medical
Terminology
 Communication with the nursing staff will
involve knowing some commonly used
medical abbreviations. Knowledge of basic
medical abbreviations and medical terms
assist in making communication clear and
concise.
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Review handout 22 and 23.
Basic telephone etiquette
 State name of facility
 State name and title
 Speak in a friendly voice, speak clearly. Do
not be chewing gum when talking.
 Thank the caller before hanging up.
 Make personal call while on break.
 Do not have cell phones on during resident
cares.
Taking messages
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Date
Time
Callers name
Who the message is for
Callers phone number
Reason for call
A good time to return the call
Conflict
 Conflict is tensions between different
groups, such as dietary and housekeeping.
 May be because of unfair assignments, or
increased work loads.
 May cultural differences or job insecurity.
 May threaten worker safety and security.
Conflict Management
 Identify accurately the problem and those
who are involved.
 Keep an open mind. Problem is mutual, not
one sided.
 Brainstorm for a workable solution.
Implement the solution and evaluate if it is
working.
Home Health Aide
Unit Three
Communication
 Discuss Home Health Aide’s Relationship
with Clients Family
 Discuss Communication with Home Health
Agency
 Discuss Recording Client Care
Relationships with Clients
Family
 A Home Health Aide
is a guest in a clients
home.
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Be non-judgmental
when listening to client
and family
Do not state personal
opinions
Do not take sides in
family arguments.
 Report to the
supervisor the role the
family plays in the life
of the client.
 Listen to comments
and suggestions from
family
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They care for the client
when you’re not there.
Demonstrate Empathy
 Empathy shows
understanding, respect
and caring for client
and family situations
 Sympathy shows
“feeling sorry” for
client and may not be
therapeutic
 Sympathetic feelings
may get into the way
of a home health aide
doing a procedure
while caring for a
client.
 It is not your job to do
family requests if they
are not included in
instructions from the
Home Health Agency.
Respect Religious Practices and
beliefs
 Religious practices
and beliefs will be
evident in home
decorations, menu
planning, and some
daily activities.
 Practices may be more
evident in times of
illness. Be sensitive to
client needs.
Client’s Language
 Client and family
primary language may
not be English
 Communication cards
can be used which
have requests or
directions illustrated
 Assure client’s needs
are met.
Relationships with children
 Talk with all children, all ages at their level
 Keep child's routine
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Meal time. Play time, nap time
 Listen to child, give positive reinforcement
 Remember each child is an individual
 Disciplinary guidelines are important
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Never use physical discipline
Discipline is not punishment.
Communication with Home
Health Agency
 Home Health Aide
worksheets and Client
Care plan identify
tasks to be completed.
 Report care completed
and amount of time in
home.
 Report and record if
client refuses care.
Identify when to call Supervisor
 Notify supervisor if
client or family
continually ask you to
do tasks you have not
been instructed to do.
 Consider
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What to do if client
does not have a phone.
Best time to reach
supervisor
 Consider
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Telephone numbers to
use
Back up person if
supervisor is not
available.
What to report verbally
and what must be in
writing.
How to manage
incident reports.
Call Supervisor
 After calling 911 for emergencies
 Before leaving a clients home.
 Client changes you observe. If information
is sensitive you may want to assure privacy
of report and call from home.
 Agency staff conferences are often problem
solving meeting. Report concerns.
 Report anything you are unsure of.
Legal Aspects of charting:
 The chart is a legal
record.
 You are liable for your
actions and what you
record.
 Entries must be
accurate.
 Charting provides
proof of care.
Objective vs Subjective
 Objective charting is
what you see, hear,
feel, smell, or taste.
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HHA sees client
vomiting. “Had emesis
of 200 cc of undigested
food 1/2 hour after
breakfast,”
 Subjective charting is
what the client says.
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“I don’t feel good, my
stomach hurts.”
 Do not chart your own
opinions about
objective information.
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Correct: Bandage on
arm has green
drainage.
Observations HHA is responsible
for.
 Alertness, thinking and decision making
abilities.
 Mobility
 Appetite and fluid intake.
 Resistance to fatigue, stamina and
endurance.
 Sudden and gradual changes noted.
Narrative charting:
 Use objective and
Subjective
observations
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Accurate, clean,concise
Do not skip lines in
charting
Correct spelling is
important
Write in ink. Never
erase or use white out.
Narrative Charting Includes:
 Use appropriate
medical terms and
abbreviations
 Use appropriate
language
 Complete sentences
are not necessary.
 Subjective
observations begin
with client states “ “
 Chart when in clients
home or right After
visit.
 Sign and date each
entry with full name
and title.