Additional Information
Book Details
Abstract
Effective communication is vital for nurses to provide quality care for patients and their families.
Patient & Person provides students with an essential framework to establish and build effective interpersonal skills in nursing practice.
Incorporating a person-centred approach, Patient & Person focuses on the importance of relating and interacting with patients as people - a concept central in providing quality nursing care and developing a therapeutic relationship in practice.
- Focus on interprofessional and team communication throughout
- A suite of scenario-based videos supporting key communication skills and concepts, including empathy, challenging behaviours, advocating for a patient and admitting a patient with reflections from both the nurse and patient perspective
- A series of video interviews - exploring diverse cultural backgrounds from the patient and practitioner perspective
- More than 40 Learning Activities to help develop featured skills and concepts
- Research highlights in each chapter covering the most recent research on communication in nursing
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Half title page | i | ||
| Dedication | ii | ||
| Patient & Person | iii | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Foreword | vi | ||
| Preface | viii | ||
| Acknowledgement | ix | ||
| How to use this book | x | ||
| Online videos – scenarios and interviews | xi | ||
| Activities | xiii | ||
| Author | xiv | ||
| Reviewers | xiv | ||
| 1 Introduction | 1 | ||
| Part 1 text | 1 | ||
| 1 Why interpersonal skills? | 3 | ||
| Chapter overview | 3 | ||
| Introduction | 4 | ||
| Patient-centred care | 5 | ||
| Patient participation in healthcare | 6 | ||
| The challenge ahead: reforming healthcare systems | 6 | ||
| Patient–nurse relationships in nursing practice | 8 | ||
| The nature of the patient–nurse relationship | 10 | ||
| Knowing the patient | 14 | ||
| Caring and the patient–nurse relationship | 15 | ||
| Interpersonal skills and caring | 17 | ||
| Practical know-how in relating to patients | 18 | ||
| References | 22 | ||
| 2 The patient–nurse relationship | 25 | ||
| Chapter overview | 25 | ||
| Introduction | 26 | ||
| Characteristics of helpful patient–nurse relationships | 26 | ||
| Social versus professional relationships | 27 | ||
| Differences in focus, intensity and perspective | 28 | ||
| Interpersonal distance versus involvement | 29 | ||
| Professional boundaries | 30 | ||
| Overinvolvement | 31 | ||
| Superficiality versus therapeutic intimacy | 32 | ||
| Mutuality and reciprocity | 34 | ||
| Mutual versus unilateral relationships | 34 | ||
| The negotiation of mutual relationships | 35 | ||
| The process of negotiation | 35 | ||
| Dislike between a patient and a nurse | 36 | ||
| Types of relationships | 37 | ||
| Relevance of skill focus and type of relationship | 38 | ||
| The clinical relationship | 38 | ||
| Focus of skill use in clinical relationships | 38 | ||
| The therapeutic relationship | 39 | ||
| Focus of skill use in therapeutic relationships | 40 | ||
| Connected relationships | 40 | ||
| Focus of skill use in connected relationships | 42 | ||
| Summary of skill use in various types of relationships | 42 | ||
| The progress of the relationship | 43 | ||
| Prior to interacting | 43 | ||
| Establishing the relationship | 44 | ||
| Trust | 44 | ||
| Mutual assessment | 46 | ||
| The initial interview | 46 | ||
| Process aspects of the initial interview | 47 | ||
| The exploration phase | 48 | ||
| Building the relationship | 49 | ||
| Control | 49 | ||
| Power | 50 | ||
| Ending the relationship | 51 | ||
| Emotionality | 51 | ||
| Review | 52 | ||
| References | 52 | ||
| 3 Nurse as therapeutic agent | 55 | ||
| Chapter overview | 55 | ||
| Introduction | 56 | ||
| Therapeutic use of self | 56 | ||
| Communication competence | 57 | ||
| Emotional intelligence | 58 | ||
| Emotional labour | 59 | ||
| The importance of self-understanding | 60 | ||
| Self-awareness versus self-consciousness | 62 | ||
| The relationship between self-understanding and professional growth | 64 | ||
| Developing the self as a therapeutic agent | 64 | ||
| Reflection and reflective practice | 65 | ||
| Processes for reflection | 68 | ||
| Pitfalls in reflection | 68 | ||
| Input from others / interactive reflection | 69 | ||
| Input from patients | 69 | ||
| Self-sharing | 69 | ||
| How self-sharing increases self-understanding | 70 | ||
| Risks of self-sharing | 71 | ||
| The climate conducive to self-sharing | 72 | ||
| Self-disclosure with patients | 73 | ||
| Areas of self-exploration | 73 | ||
| Personal philosophy about health | 74 | ||
| Personal values and beliefs | 76 | ||
| Personal needs | 77 | ||
| Characteristics that help interpersonal connectedness | 79 | ||
| Authenticity and congruence | 81 | ||
| Respect and warmth | 82 | ||
| Confidence and assertiveness | 82 | ||
| Developing a personal style | 83 | ||
| Learning the skills | 84 | ||
| The need to ‘unlearn’ | 84 | ||
| Reactions to learning the skills | 85 | ||
| Self-assessment of interpersonal skills | 87 | ||
| Advantages of self-assessment | 87 | ||
| Approaches to self-assessment | 88 | ||
| Reflection after interactions with patients | 90 | ||
| Focus on specific skills during an interaction | 91 | ||
| Maintaining an ongoing record | 91 | ||
| Soliciting help from other nurses | 91 | ||
| Pitfalls in self-assessment | 91 | ||
| References | 93 | ||
| 4 Considering culture | 95 | ||
| Chapter overview | 95 | ||
| Introduction | 96 | ||
| What is culture? | 96 | ||
| Cultural stereotyping | 97 | ||
| Culture and healthcare | 99 | ||
| The culture of healthcare | 102 | ||
| Perceptions of health and illness | 103 | ||
| Culturally congruent care | 104 | ||
| Cultural competence | 106 | ||
| Cultural safety | 106 | ||
| Language differences | 107 | ||
| Guidelines when using an interpreter | 109 | ||
| References | 112 | ||
| 2 The Skills | 115 | ||
| Part 2 text | 115 | ||
| 5 Encouraging interaction | 117 | ||
| Chapter overview | 117 | ||
| Introduction | 118 | ||
| The listening process | 118 | ||
| Hearing and listening | 119 | ||
| Active and passive listening | 119 | ||
| Benefits of listening | 120 | ||
| For the patient | 120 | ||
| For the nurse | 120 | ||
| For the relationship | 121 | ||
| Listening with nursing ears | 121 | ||
| Readiness to listen | 123 | ||
| Receptivity | 125 | ||
| Reducing interference | 125 | ||
| External interference | 125 | ||
| Internal interference | 126 | ||
| Thoughts as internal interference | 126 | ||
| Value judgments as internal interference | 127 | ||
| Feelings as internal interference | 127 | ||
| Nursing presence | 128 | ||
| The skills of listening | 129 | ||
| Attending | 129 | ||
| Some words of caution about attending | 130 | ||
| Attending within the clinical nursing context | 131 | ||
| Silence | 132 | ||
| Observing | 133 | ||
| The importance of non-verbal communication | 134 | ||
| Perceiving messages | 136 | ||
| Perceiving content | 137 | ||
| Perceiving feelings | 139 | ||
| Interpreting: listening for themes | 141 | ||
| Recalling messages | 142 | ||
| Evaluation of listening | 146 | ||
| References | 146 | ||
| Answers to activities | 147 | ||
| Activity 5.5: Listening for content | 147 | ||
| Patient story I | 147 | ||
| Patient story II | 147 | ||
| Patient story III | 147 | ||
| Patient story IV | 148 | ||
| Patient story V | 148 | ||
| Patient story VI | 148 | ||
| Activity 5.6: Listening for feelings | 148 | ||
| Activity 5.9: Responses that indicate listening | 148 | ||
| 6 Building meaning | 150 | ||
| Chapter overview | 150 | ||
| Introduction | 151 | ||
| The concept of empathy | 151 | ||
| The development of empathy | 152 | ||
| Empathy and sympathy | 153 | ||
| Empathy and compassion | 154 | ||
| Empathy in nursing | 154 | ||
| Can empathy be learnt? | 154 | ||
| Expressing empathy | 155 | ||
| Purpose of expressing empathy | 156 | ||
| Promoting understanding and empathy | 157 | ||
| Ways of responding | 160 | ||
| Questioning and probing | 161 | ||
| Paraphrasing and understanding | 161 | ||
| Reassuring and supporting | 167 | ||
| False reassurance | 167 | ||
| Analysing and interpreting | 168 | ||
| Advising and evaluating | 168 | ||
| Most common ways of responding | 169 | ||
| Responding with understanding | 170 | ||
| Internal and external understanding | 172 | ||
| Barriers to understanding | 172 | ||
| The skills of understanding | 173 | ||
| Paraphrasing | 173 | ||
| Interchangeable responses | 173 | ||
| Accuracy in paraphrasing | 174 | ||
| Overuse of paraphrasing | 175 | ||
| Reluctance to use paraphrasing | 175 | ||
| Seeking clarification | 175 | ||
| Clarification through questioning | 176 | ||
| Restatement | 176 | ||
| Clarification through self-disclosure | 177 | ||
| Reflecting feelings | 177 | ||
| A word of caution about reflecting feelings | 178 | ||
| Connecting thoughts and feelings | 179 | ||
| Summarising | 180 | ||
| References | 182 | ||
| Answers to activities | 183 | ||
| Activity 6.2: Recognising the types of responses | 183 | ||
| 7 Collecting information | 185 | ||
| Chapter overview | 185 | ||
| Introduction | 186 | ||
| Planned versus spontaneous exploration | 188 | ||
| Planned exploration | 189 | ||
| Spontaneous exploration | 189 | ||
| Patient-cue exploration | 190 | ||
| Cues and inferences | 192 | ||
| Communication cues | 193 | ||
| Patients’ questions as cues | 193 | ||
| Cue perception | 194 | ||
| Cue exploration: sharing perceptions | 194 | ||
| A word of caution about sharing perceptions | 195 | ||
| The difference between planned and spontaneous exploration | 197 | ||
| The skills of exploration | 198 | ||
| Prompting skills | 198 | ||
| Minimal encouragement | 198 | ||
| One-word/phrase accents | 199 | ||
| Gentle commands | 199 | ||
| Open-ended statements | 200 | ||
| Finishing the sentence | 200 | ||
| Self-disclosure | 201 | ||
| Probing skills | 201 | ||
| Open-ended questions | 201 | ||
| Closed questions | 202 | ||
| Focused, closed questions | 202 | ||
| Multiple-choice questions | 203 | ||
| Open-ended versus closed questions | 204 | ||
| Pitfalls of using probing skills | 206 | ||
| Overuse of questions | 206 | ||
| Continuous multiple questions | 206 | ||
| The ‘why’ question | 206 | ||
| The leading question | 207 | ||
| Focused exploration | 210 | ||
| Nurses’ control in exploration | 211 | ||
| References | 213 | ||
| Answers to activities | 213 | ||
| Activity 7.3: cues and inferences | 213 | ||
| Activity 7.7: recognising types of questions | 213 | ||
| Key: | 213 | ||
| 8 Intervening | 215 | ||
| Chapter overview | 215 | ||
| Introduction | 216 | ||
| Psychosocial actions that comfort, support and enable | 216 | ||
| Indications of the need for psychosocial action | 216 | ||
| Patient outcomes | 217 | ||
| Patient resources | 217 | ||
| Comforting | 218 | ||
| Reassuring patients | 219 | ||
| False reassurance | 219 | ||
| Comforting reassurance | 220 | ||
| Patients’ need for reassurance | 220 | ||
| Patient cues indicating uncertainty | 222 | ||
| Reassuring presence of the nurse | 223 | ||
| Reassuring manner of the nurse | 223 | ||
| Reassuring actions | 224 | ||
| Positive affirmation | 224 | ||
| Concrete and specific feedback | 225 | ||
| Providing explanations and factual information | 225 | ||
| Supporting patients | 226 | ||
| Types of support | 226 | ||
| Mobilising patient resources | 227 | ||
| Enabling patients | 228 | ||
| Sharing information | 230 | ||
| Effects of sharing information | 231 | ||
| A nursing perspective on sharing information | 231 | ||
| Sharing information versus giving advice | 232 | ||
| Approaches to sharing information | 233 | ||
| Readiness to learn | 234 | ||
| Beginning to share information | 234 | ||
| Limiting the amount of information shared | 235 | ||
| Using appropriate language | 235 | ||
| Tailoring information to the patient | 235 | ||
| The need for reinforcement | 235 | ||
| Checking a patient’s understanding | 236 | ||
| Expressing understanding when sharing information | 236 | ||
| A final word on sharing information | 236 | ||
| Challenging | 237 | ||
| The nature of challenging | 237 | ||
| The conditions needed for effective challenging | 238 | ||
| The need to challenge | 238 | ||
| Tentativeness of the challenge | 239 | ||
| Approaches to challenging | 239 | ||
| Exploring consequences | 239 | ||
| Sharing own experiences | 239 | ||
| Pitfalls of self-disclosure | 240 | ||
| Patients’ requests for personal information | 240 | ||
| References | 242 | ||
| 3 Skills in Context | 245 | ||
| Part 3 text | 245 | ||
| 9 Transitions through health and illness | 247 | ||
| Chapter overview | 247 | ||
| Introduction | 248 | ||
| Transitions and coping | 248 | ||
| Coping efforts | 251 | ||
| Denial | 252 | ||
| Cognitive appraisal | 252 | ||
| Coping effectiveness | 253 | ||
| Coping resources | 255 | ||
| Resilience | 255 | ||
| Sense of coherence | 257 | ||
| Social support | 259 | ||
| Facilitating transitions in illness | 261 | ||
| Illness representation | 262 | ||
| Working with a patient’s illness representation | 265 | ||
| Themes in illness | 266 | ||
| Uncertainty | 266 | ||
| Vulnerability | 267 | ||
| Loss and grief | 268 | ||
| Hope | 269 | ||
| Successful transition | 270 | ||
| References | 273 | ||
| 10 Challenging interpersonal encounters | 276 | ||
| Chapter overview | 276 | ||
| Introduction | 277 | ||
| Challenging situations | 277 | ||
| ‘Difficult’ patients | 277 | ||
| Interpersonal conflict | 278 | ||
| Conflict in the patient–nurse relationship | 280 | ||
| Strategies to resolve conflict | 281 | ||
| Process of negotiation | 283 | ||
| The skills of assertion | 283 | ||
| Responding to anger | 285 | ||
| Factors that can trigger anger in patients | 285 | ||
| Observable behaviours that indicate potential aggression | 286 | ||
| Effective approaches to patient anger | 286 | ||
| Relating to older people | 290 | ||
| Losses associated with ageing | 292 | ||
| Interacting with a person with a hearing impairment | 292 | ||
| Interacting with a person with a vision impairment | 293 | ||
| Interacting with a person with a cognitive impairment | 294 | ||
| References | 296 | ||
| 11 Building a supportive workplace | 298 | ||
| Chapter overview | 298 | ||
| Introduction | 299 | ||
| Productive nursing environments | 299 | ||
| The magnet hospital story | 300 | ||
| Professional autonomy | 301 | ||
| Control over nursing practice | 301 | ||
| Collaboration with doctors | 301 | ||
| Implications of magnet hospital research | 302 | ||
| Interprofessional communication | 302 | ||
| Shared mental models | 303 | ||
| Written communication | 305 | ||
| Documentation guidelines | 306 | ||
| Nurse–doctor interaction | 307 | ||
| Stress in the work environment | 308 | ||
| Consequences of work stress | 308 | ||
| Burnout | 309 | ||
| Compassion fatigue | 309 | ||
| Colleague interaction and work stress | 310 | ||
| Nurse–nurse interaction | 310 | ||
| Culture of horizontal violence | 312 | ||
| Reversing the culture of horizontal violence | 313 | ||
| Nursing leadership | 314 | ||
| Coping with work stress | 314 | ||
| Nursing colleagues as a coping resource | 315 | ||
| Effective conflict management | 316 | ||
| Assertiveness in the workplace | 317 | ||
| Caring for self: building resilience | 319 | ||
| Mindfulness | 320 | ||
| Self-compassion | 320 | ||
| Clinical supervision | 321 | ||
| References | 323 | ||
| Appendix Notes on the activities | 328 | ||
| Introduction | 328 | ||
| Experiential learning | 328 | ||
| Suggestions for facilitators of experiential learning | 330 | ||
| Guidelines for role-play | 331 | ||
| Before the action | 331 | ||
| After the action | 332 | ||
| Additional material for activities | 332 | ||
| Chapter 3 Nurse as therapeutic agent | 332 | ||
| Activity 3.1 What do I have to offer patients? | 332 | ||
| Activity 3.3 Beliefs about helping in nursing practice | 333 | ||
| Chapter 4 Considering culture | 333 | ||
| Activity 4.4 Working with an interpreter | 333 | ||
| Chapter 5 Encouraging interaction: listening | 333 | ||
| Activity 5.3 Attending and non-attending | 333 | ||
| Activity 5.5 Listening for content | 333 | ||
| Activity 5.6 Listening for feelings | 334 | ||
| Activity 5.9 Responses that indicate listening | 334 | ||
| Chapter 6 Building meaning: understanding | 334 | ||
| Activity 6.2 Recognising the types of responses | 334 | ||
| Activity 6.7 Connecting thoughts and feelings | 335 | ||
| Chapter 7 Collecting information: exploring | 335 | ||
| Activity 7.3 Cues and inferences | 335 | ||
| Activity 7.4 Ways of exploring: questions versus statements | 335 | ||
| Activity 7.7 Recognising types of questions | 335 | ||
| Activity 7.9 Patient interview | 335 | ||
| Chapter 8 Intervening: comforting, supporting and enabling | 336 | ||
| Activity 8.4 Sharing information | 336 | ||
| Guide for sharing information | 336 | ||
| Index | 338 | ||
| A | 338 | ||
| B | 339 | ||
| C | 339 | ||
| D | 343 | ||
| E | 343 | ||
| F | 344 | ||
| G | 345 | ||
| H | 345 | ||
| I | 345 | ||
| J | 347 | ||
| K | 347 | ||
| L | 347 | ||
| M | 348 | ||
| N | 348 | ||
| O | 349 | ||
| P | 349 | ||
| Q | 351 | ||
| R | 351 | ||
| S | 352 | ||
| T | 355 | ||
| U | 356 | ||
| V | 357 | ||
| W | 357 | ||
| Z | 358 |