tag:blogger.com,1999:blog-77165343520262136642024-03-13T21:58:08.938-07:00Learning CommunicationThis blog is about my journey through a communications course I'm taking. I am a nurse and work in the area of oncology and believe that nurses can never reflect enough on their communication styles. I also happen to be taking a course in EHealth and I thought it would be neat to try to combine the two courses. I hope you find this blog helpful.Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-7716534352026213664.post-27033973991385110732011-04-04T20:17:00.000-07:002011-04-04T20:17:57.466-07:00Inuit Culture and Multicultural Competency<!--StartFragment--> <br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilodMYYFF81KftWdqwjE2rUPPiC2ymhAY9UOo0zfZJ4SVancfckZDbmVexnzb3tz_AuSA5TuGIHnyI8Sc4reU7Jw1SVxsKK7dBvN8h4eAioZXroocV3HP2NGshnHlcyNyCjveM-C49L5Q/s1600/ice+patterns.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="212" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilodMYYFF81KftWdqwjE2rUPPiC2ymhAY9UOo0zfZJ4SVancfckZDbmVexnzb3tz_AuSA5TuGIHnyI8Sc4reU7Jw1SVxsKK7dBvN8h4eAioZXroocV3HP2NGshnHlcyNyCjveM-C49L5Q/s320/ice+patterns.jpg" width="320" /></a></div><div class="MsoNormal"><span class="Apple-style-span" style="color: red; font-size: x-large;"><span class="Apple-style-span" style="font-size: 19px;"><i><br />
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</span></i></div><div class="MsoNormal"><span class="Apple-style-span" style="font-size: 19px;"><i>When I think of multicultural competence I think of ice patterns on a window...multifaceted, layer upon layer and intricate.</i></span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-size: 19px;"><br />
</span></div><div class="MsoNormal"><span class="Apple-style-span" style="font-size: 19px;"><i></i>We are called as nurses to consider three aspects in the quest for multicultural competency….</span></div><div class="MsoNormal" style="margin-left: 40.0pt; mso-list: l1 level1 lfo1; text-indent: -.25in;"><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Awareness of own assumptions, values, biases<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 40.0pt; mso-list: l1 level1 lfo1; text-indent: -.25in;"><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Knowledge about the culture.<span style="mso-spacerun: yes;"> </span>Separation from the client’s community may be especially difficult in this client population.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 40.0pt; mso-list: l1 level1 lfo1; text-indent: -.25in;"><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>Skills.<span style="mso-spacerun: yes;"> </span>It seems to me that with individuals from an Inuit cultural background that attention to non-verbal communication would be particularly important.<span style="mso-spacerun: yes;"> </span>The 3 V’s and B<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 58.0pt; mso-list: l0 level1 lfo2; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: red; font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Visual:</span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"> patterns of eye contact<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 58.0pt; mso-list: l0 level1 lfo2; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: red; font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Vocal Qualities:<span style="mso-spacerun: yes;"> </span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">tone and speech rate<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 58.0pt; mso-list: l0 level1 lfo2; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: red; font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Verbal Tracking:</span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"> following the client<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: 58.0pt; mso-list: l0 level1 lfo2; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: red; font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Body Language:</span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>attentive authentic and mirroring would be important.<span style="mso-spacerun: yes;"> </span>Caution with physical contact.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Other communication strategies??<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Minimize direct questions.<span style="mso-spacerun: yes;"> </span>I am cringing at my memories of past interactions with members of this culture when I think back to how many direct questions I asked.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Translation services<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Be conscious of the power dynamic with the nurse-client relationship<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Be aware of own expressions of emotions and sensitive with eliciting information about the patient’s emotions and feelings.<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Be aware that the client may visually express an emotion but is actually feeling a very different emotion. i.e. incongruence between verbal and non-verbal is more of a possibility with this client population<o:p></o:p></span></div><div class="MsoNormal" style="margin-left: .5in; mso-list: l2 level1 lfo3; text-indent: -.25in;"><span style="font-family: Symbol; font-size: 14.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span>The use of silence may be helpful in eliciting communication.<o:p></o:p></span></div><div class="MsoNormal"><br />
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</div><div class="MsoNormal"><span style="font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Please feel free to share any strategies you have found helpful in communicating to individuals from this cultural background.<o:p></o:p></span></div><div class="MsoNormal"><br />
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</div><div class="MsoNormal"><i style="mso-bidi-font-style: normal;"><span style="color: red; font-size: 14.0pt; mso-bidi-font-size: 12.0pt;">Bibliography<o:p></o:p></span></i></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14.0pt; mso-bidi-font-family: Regular; mso-bidi-font-size: 8.0pt;">Ivey, A. & Ivey, M.<span style="mso-spacerun: yes;"> </span>(2010).<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Intentional interviewing and counselling.<span style="mso-spacerun: yes;"> </span></i>California; Brooks/Cole.<o:p></o:p></span></div><!--EndFragment-->Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com0tag:blogger.com,1999:blog-7716534352026213664.post-62647310711587957552011-04-04T20:07:00.000-07:002011-04-04T20:07:35.753-07:00Inuit Culture<div class="separator" style="clear: both; text-align: center;"><br />
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<div class="MsoNormal"><i style="mso-bidi-font-style: normal;"><span style="color: red; font-size: 14pt;">Inuit Culture<o:p></o:p></span></i></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">I have read some very interesting information about Inuit culture and would like to share this with you. As always however we are cautioned as nurses to treat all as individuals and not to automatically attribute cultural traits to all members of a given culture…<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">In traditional Inuit culture children are taught to be non-competitive and not to ask direct questions. Direct questions are considered impolite.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">In Inuit society the traits of independence, innovation, patience and perseverance are valued.</span><span style="font-size: 18pt;"> </span><span style="font-size: 14pt;">In traditional society these traits would greatly increase the chance of survival for the individual and the group.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">The ability to accept realities that are beyond one’s control is also a valued character trait. There can exist a dichotomy here however. The Inuit admire people who manage to work out a solution to an identified problem. However, submission in the face of a problem one can do nothing about is acceptable also. It should be noted that this cultural characteristic can equate to resignation and fatalism when dealing with a public servant or nurse as in some instances in dealing with these sectors of society, the Inuit may feel their input is unwelcome or irrelevant. They may also feel they are at the mercy of the “authority figure” and respond this way. The result of this response is that they may not volunteer necessary information or ask questions needed to clarify the situation.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">In Inuit culture, displays of anger or frustration are considered childish. Tact and humility are desirable qualities.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">There exists a tradition of not displaying emotions. Public display of emotions is considered immature. Emotions are expressed more freely in smaller, intimate groups and if an Inuk feels he/she must express emotion, it is believed that this expression should only involve those people that he/she feels are responsible for his/her emotional state. Emotions are displayed in a very subtle way e.g. with a different tone of voice or the lifting of eyebrows. These subtle emotional cues are usually almost imperceptible to those from a different culture but the Inuit are adept at recognizing slight vocal intonations and facial expressions that reflect emotional states.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">Although Inuit culture respects autonomy, community is also valued. Desirable adult behaviour is considered to be maintaining one’s independence while also being a fully responsible member of society.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">Physical contact also differs from North American culture. Public displays of affection are reserved for children. Display of affection between adults is considered improper adult behaviour.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">Inuit tend to withdraw in unfamiliar situations. With health professionals they may seem withdrawn or uncommunicative if this is a new situation for them because they are unsure of what is expected.<o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: 14pt;">Some Inuit feel that non-Inuit are aggressive, prying, domineering and opiniated. However, the Inuit cultural value of non-interference may prevent Inuit from telling others how they really feel about the situation. It apparently can be very difficult for non-Inuit to detect the subtle signs of Inuit disapproval. This may result in some Inuit withdrawing from close contact with non-Inuit for a period of time as they may experience too much strain in their dealings with non-Inuit.<o:p></o:p></span></div><div class="MsoNormal"><span style="font-size: 14pt;"><br />
</span></div><div class="MsoNormal"><span style="font-size: 14pt;">Thought I would end with a video of a beautiful Inuit woman who explains the intricacies of throat singing</span><br />
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<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/KNb2ZDjeiU4?feature=player_embedded' frameborder='0'></iframe></div><span style="font-size: 14pt;"><br />
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</span></div>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com2tag:blogger.com,1999:blog-7716534352026213664.post-50969296284351696212011-04-04T16:43:00.000-07:002011-04-04T16:43:10.452-07:00Embrace Life - always wear your seat belt. I'm thinking of my communication prof who is an ER Nurse also. This video says SO much with non-verbal communication. Very powerful video<iframe allowfullscreen="" frameborder="0" height="295" src="http://www.youtube.com/embed/h-8PBx7isoM?fs=1" width="480"></iframe>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com1tag:blogger.com,1999:blog-7716534352026213664.post-71014177312203749102011-03-23T11:22:00.000-07:002011-03-23T11:22:03.679-07:00Picking Up the Pieces: Communication Strategies<!--StartFragment--> <br />
<div align="center" class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly; text-align: center;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 16.0pt; mso-bidi-font-size: 12.0pt;">The Shock of a Cancer Diagnosis<o:p></o:p></span></i></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><br />
</div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">Setting the Scene</span></i><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;"><o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Gyne-oncology patients are counselled pre-operatively about the high probability of a cancer diagnosis.<span style="mso-spacerun: yes;"> </span>However the shock experienced postoperatively is challenging for patients and for the staff caring for them.<o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><i style="mso-bidi-font-style: normal;"><span style="color: #993300; font-family: "Times New Roman"; font-size: 12.0pt;">Case Study</span></i><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;"><o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">It is your patient’s first day after surgery and morning rounds have just finished. You enter your patient’s room after rounds and find her either crying or on the verge of tears.<span style="mso-spacerun: yes;"> </span>She has just found out that the growth in her abdomen is cancerous and she will need to have chemotherapy.<span style="mso-spacerun: yes;"> </span>She <i style="mso-bidi-font-style: normal;">heard</i> she has 3 years left to live.<span style="mso-spacerun: yes;"> </span>What do you say?<span style="mso-spacerun: yes;"> </span>What do you do?<span style="mso-spacerun: yes;"> </span>You literally feel like your task is to “pick up the pieces”.<span style="mso-spacerun: yes;"> </span>You have 4 patients in your assignment, you need to give 0800 meds, answer call bells, do assessments and hopefully get at least one bed bath started before 0900.<o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">On weekdays you can rely upon your multidisciplinary team (e.g. our liaison nurse or social worker) to follow-up and help. However, on the weekend it is the nurse who becomes frontline psychosocial support.<span style="mso-spacerun: yes;"> </span>This newsletter focuses on some communication strategies to use when patients have just been given “bad news”.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoNormal"><br />
</div><div align="center" class="MsoNormal" style="text-align: center;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-size: 16.0pt; mso-bidi-font-size: 12.0pt;">Effective Communication Strategies<o:p></o:p></span></i></div><div class="MsoNormal"><br />
</div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">Attending Behavior<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 12.0pt;"><i style="mso-bidi-font-style: normal;"><u><span style="color: maroon;">Visuals</span></u><span style="color: maroon;">: </span></i><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">eye contact<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 12.0pt;"><i style="mso-bidi-font-style: normal;"><u><span style="color: maroon;">Vocals</span></u><span style="color: maroon;">: </span></i><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">vocal quality<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 12.0pt;"><i style="mso-bidi-font-style: normal;"><u><span style="color: maroon;">Verbal</span></u><span style="color: maroon;">s: </span></i><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">verbal tracking<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 12.0pt;"><i style="mso-bidi-font-style: normal;"><u><span style="color: maroon;">Body languag</span></u><span style="color: maroon;">e: </span></i><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-size: 10.0pt; mso-bidi-font-size: 12.0pt;">attentive, authentic and congruent<o:p></o:p></span></i></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><br />
</div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Also known as unconditional positive regard. <span style="mso-spacerun: yes;"> </span>Body language is an important aspect of communication and needs to be congruent with verbal communication.<span style="mso-spacerun: yes;"> </span>You are in action mode with an already prioritized set of tasks.<span style="mso-spacerun: yes;"> </span>SLOW DOWN, take a deep breath and sit beside the patient, use touch and eye contact if culturally appropriate.<span style="mso-spacerun: yes;"> </span>“Mirror” your patient’s body language.<o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Buckman’s research with medical students has shown that empathic communication takes less time than anticipated.<span style="mso-spacerun: yes;"> </span>Silence may be effective if the patient is crying.<span style="mso-spacerun: yes;"> </span>Tears can be therapeutic and a great release of tension. <o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">Acknowledge Feelings<o:p></o:p></span></i></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Using both verbal and non-verbal communication,</span><span style="font-family: "Times New Roman"; font-size: 12.0pt;"> acknowledge the feelings.<span style="mso-spacerun: yes;"> </span>Saying something like,<span style="mso-spacerun: yes;"> </span>“You look upset” may be all you need to say to encourage the patient to share. Avoid premature reassurances such as “Don’t worry.<span style="mso-spacerun: yes;"> </span>It will be okay.”<o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">Patient’s Perception<o:p></o:p></span></i></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">It is important to find out what the patient knows/has understood about his/her condition.<span style="mso-spacerun: yes;"> </span>Find out from the physician what was discussed and hopefully the physician can return to clarify information.<span style="mso-spacerun: yes;"> </span>If not, call the physician and let him/her know that follow-up and clarification is needed.<span style="mso-spacerun: yes;"> </span>For example, with the patient who thought she had 3 years left to live, misinterpretation of what was said was the case.<span style="mso-spacerun: yes;"> </span>The patient had asked the physician about treatment options and in the course of the discussion he had mentioned that the effectiveness of chemotherapy decreased after 3 years. </span><span style="font-family: "Times New Roman"; font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div><div class="MsoBodyText" style="line-height: 12.0pt; mso-line-height-rule: exactly;"><br />
</div><div class="MsoBodyText"><i style="mso-bidi-font-style: normal;"><span style="color: #943634; font-family: "Times New Roman"; font-size: 12.0pt;">Re-prioritize<o:p></o:p></span></i></div><div class="MsoBodyText"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Attempt to stay with the physician while he/she clarifies and communicates with the patient.<span style="mso-spacerun: yes;"> </span>This allows you to know what has been discussed.<o:p></o:p></span></div><div class="MsoBodyText"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span></span><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">SPIKES</span></i><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;"> is an acronym for delivering bad news.<span style="mso-spacerun: yes;"> </span>Delivering a diagnosis is not a nursing act, however nurses can use aspects of the </span><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">SPIKES</span></i><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;"> method for communicating bad news.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.0pt;"><i style="mso-bidi-font-style: normal;"><span style="color: maroon;">SPIKES: a physician aid for breaking bad news<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 12.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">S</span></b>etting</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">P</span></b>atient perception</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">I</span></b>nvitation</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">K</span></b>nowledge</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">E</span></b>mpathy/exploring</div><div class="MsoNormal" style="line-height: 12.0pt;"><b style="mso-bidi-font-weight: normal;"><span style="color: maroon;">S</span></b>trategy/summary</div><div class="MsoBodyText"><br />
</div><div class="MsoBodyText"><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Re-prioritizing your workday at this stage may help or perhaps other nurses can cover for you for a short period.<span style="mso-spacerun: yes;"> </span>If not, let the patient know her needs are important to you and set a time when you can return.<span style="mso-spacerun: yes;"> </span>Offer to phone a family member or friend.<o:p></o:p></span></div><div class="MsoBodyText"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 12.0pt;">Summary Points<o:p></o:p></span></i></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Build trust.<span style="mso-spacerun: yes;"> </span>Follow-up on your promise to check back.<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Encourage and strengthen past coping strategies<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Listen more.<span style="mso-spacerun: yes;"> </span>Talk less.<span style="mso-spacerun: yes;"> </span>The patient is the focus.<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Elicit feedback (paraphrasing, summarizing are effective strategies)<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">The relationship between patient and nurses/physicians has a power differential that can inhibit communication. Try to remove barriers.<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Use open-ended questions to encourage patient communication.<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Be culturally sensitive. <o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt; mso-list: l0 level1 lfo1; text-indent: -18.0pt;"><span style="color: windowtext; font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span style="color: windowtext; font-family: "Times New Roman"; font-size: 12.0pt;">Be genuine.<o:p></o:p></span></div><div class="MsoBodyText" style="margin-left: 36.0pt;"><br />
</div><div class="MsoBodyText"><i style="mso-bidi-font-style: normal;"><span style="color: #3366ff; font-family: "Times New Roman"; font-size: 12.0pt;">“The art of communication is an important part of therapy: occasionally it is the only constituent.<span style="mso-spacerun: yes;"> </span>It usually requires greater thought and planning than a drug prescription and unfortunately it is commonly administered in sub-therapeutic doses.”<span style="mso-tab-count: 1;"> </span><span style="mso-tab-count: 1;"> </span><span style="mso-tab-count: 1;"> </span>R. Buckman<o:p></o:p></span></i></div><div class="MsoBodyText"><br />
</div><div class="MsoBodyText"><i style="mso-bidi-font-style: normal;"><span style="color: maroon; font-family: "Times New Roman"; font-size: 16.0pt; mso-bidi-font-size: 12.0pt;">Bibliography<o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 17.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;"><span style="font-size: 10.0pt;">Anderson, I.<span style="mso-spacerun: yes;"> </span>(2000).<span style="mso-spacerun: yes;"> </span>Continuing education program on end-of-life care. <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 17.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;"><span style="font-size: 10.0pt;"><span style="mso-spacerun: yes;"> </span>Retrieved from<span style="mso-spacerun: yes;"> </span></span><span style="font-family: Times; font-size: 10.0pt;"><a href="http://www.cme.utoronto.ca/endoflife/Modules.htm">http://www.cme.utoronto.ca/endoflife/Modules.htm</a><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><span style="font-family: Times; font-size: 10.0pt;">Baile, F., Buckman, R., Lenzi, R., Glober, G., Beale, E. & Kudelka, A.<span style="mso-spacerun: yes;"> </span>(2000).<span style="mso-spacerun: yes;"> </span>SPIKES- a six step protocol for delivering bad news.<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">The Oncologist, </i>5: 303-311<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><span style="font-family: Times; font-size: 10.0pt;">Ivey, E., Ivey, M. & Zalaquett, C.<span style="mso-spacerun: yes;"> </span>(2010).<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Intentional interviewing & counselling. </i><span style="mso-spacerun: yes;"> </span>(7<sup>th</sup> Ed.)<i style="mso-bidi-font-style: normal;"> </i>Brooks/Cole: Belmont, CA.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><span style="font-family: Times; font-size: 10.0pt;">Malloy, P., Virani, R., Kelly K. & Munevar, C.<span style="mso-spacerun: yes;"> </span>Beyond bad news-communication skills of nurses in palliative care.<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Journal of Hospice and Palliative Nursing 12</i>(3): 166-174<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 17.0pt; margin-left: 57.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: -57.0pt;"><span style="font-family: Times; font-size: 10.0pt;">Pereira, J.<span style="mso-spacerun: yes;"> </span>(2008).<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">The Pallium Palliative Pocketbook.<span style="mso-spacerun: yes;"> </span></i>Canada.<span style="mso-spacerun: yes;"> </span>The Pallium Project.<span style="mso-spacerun: yes;"> </span>For more information go to <a href="http://www.palliativetool.info/">http://www.palliativetool.info</a></span><span style="color: #943634; font-family: "Trebuchet MS";"><o:p></o:p></span></div><div class="MsoBodyText"><br />
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</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIVWFJ4rHMsutFMqMrOgoSp4H3OVlUs9-sMY2w0suuI5wmfT07L11iDk6RmRYqDbg62cVtttbCkppBw1QByqMZRONDsNjlrwMghJtSBR0xcm_G4ZEFEXe7-tP6DlJN2L2wifUh5vR5Idw/s1600/where+i+want+to+be.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="204" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIVWFJ4rHMsutFMqMrOgoSp4H3OVlUs9-sMY2w0suuI5wmfT07L11iDk6RmRYqDbg62cVtttbCkppBw1QByqMZRONDsNjlrwMghJtSBR0xcm_G4ZEFEXe7-tP6DlJN2L2wifUh5vR5Idw/s320/where+i+want+to+be.jpg" width="320" /></a></div><div class="MsoNormal"><br />
</div><!--EndFragment-->Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com0tag:blogger.com,1999:blog-7716534352026213664.post-27280348445133453702011-02-13T07:59:00.000-08:002011-04-05T06:04:58.935-07:00The Kiss<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUUYJJF9M5m3r4oTLMtbxKFoIKFhJo1o4QgXFyHNNTa83bUqbUoiW7WaUAQa8gVADdmn7lhqM3d4PIiUs9tT5BtgAUCQ2Fx0YMhDjcjxi_6XJ1DB-fHRYTft_pmF6KNN_b2ZxRLNlBG7M/s1600/The+Kiss.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUUYJJF9M5m3r4oTLMtbxKFoIKFhJo1o4QgXFyHNNTa83bUqbUoiW7WaUAQa8gVADdmn7lhqM3d4PIiUs9tT5BtgAUCQ2Fx0YMhDjcjxi_6XJ1DB-fHRYTft_pmF6KNN_b2ZxRLNlBG7M/s320/The+Kiss.jpg" width="277" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The Kiss by Gustav Klimt</td></tr>
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Learning goals #1, 3 & 5. As Valentine's Day approaches I'm pondering the kiss (the act, not the painting) and the power of non-verbal communication. It all started with a quote from renowned actress, Ingrid Bergman in our local paper who is purported to have said, <span class="Apple-style-span" style="font-family: 'Times New Roman';">" A kiss is a lovely trick designed by nature to stop speech when words become superfluous.” Fans of the movie Casablanca might disagree. The kiss between Humphrey Bogart and Ingrid Bergman in that movie was memorable but not nearly as memorable as Bogie's classic line " Here's looking at you kid." I digress. Klimt's painting on the other hand speaks to the power of the non-verbal. The couple are enveloped in a transcendent-like oneness of being. The only representation of their individualism within the act being the differing patterns of the beautiful gold object covering them. The couple's body language is totally congruent with romantic love. For those of you who may wish to read more about this beautiful painting follow this link:</span><span class="Apple-style-span" style="font-family: 'Times New Roman';"><a href="http://ezinearticles.com/?Gustav-Klimt---The-Kiss&id=4138409">http://ezinearticles.com/?Gustav-Klimt---The-Kiss&id=4138409</a></span><span class="Apple-style-span" style="font-family: 'Times New Roman';"> </span><br />
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<span class="Apple-style-span" style="font-family: 'Times New Roman';">Yesterday, I started googling "kiss as communication". Well, there are kisses for every occasion and for very different reasons according to which culture you belong. I learned that kissing between couples in some African and Asian cultures was unheard of before colonialization. </span><br />
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<span class="Apple-style-span" style="font-family: 'Times New Roman';"> Cultural misinformation continues despite all our efforts to move away from an ethnocentric world-view. I viewed a youtube video about "Eskimo kissing". Yes, I'm ashamed to say that the Inuit are still being referred to as "Eskimos", a term the Inuit find offensive. In fact, I was amazed at the LACK of information about Inuit culture on the web...so yet another reason to continue with my blog. I'm going to try hard to find some accurate, first-hand info about this very rich culture. In any case the Inuit "kiss" is a form of greeting that truly uses the senses as communication. Touch, smell and the visual are used. Please watch the youtube video with apologies for the "eskimo" reference. </span><span class="Apple-style-span" style="font-family: 'Times New Roman'; font-size: 22.464px;"> <span class="Apple-style-span" style="font-size: small;"><a href="http://www.youtube.com/watch?v=gB4P0B5gT0U">http://www.youtube.com/watch?v=gB4P0B5gT0U</a></span></span><br />
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<span class="Apple-style-span" style="font-family: 'Times New Roman';">Does anyone have information about reliable websites on Inuit culture? Please share if you do and as for learning goal #5 (self help strategies to prevent compassion fatigue and therefore facilitate empathic communication), well, contemplating the positive aspects of the human species like love is a good start and I've joined a gym. Hooray for me! </span><br />
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<span class="Apple-style-span" style="font-family: 'Times New Roman';">Speaking of the positive aspects of the human species check out this link about "survival of the kindness", an American social psychologist, Dacher Keltner gives us good news about our species. He talks about compassion triumphing over self-interest and "the sympathy breakthrough". <a href="http://www.cbc.ca/tapestry/episode/2011/01/30/survival-of-the-kindest-3/">http://www.cbc.ca/tapestry/episode/2011/01/30/survival-of-the-kindest-3</a></span><br />
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</span>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com0tag:blogger.com,1999:blog-7716534352026213664.post-88059303516175880302011-02-01T07:25:00.000-08:002011-02-01T07:25:53.513-08:00Adolescent and Young Adult Cancer, 1: Delayed Diagnosis<iframe width="480" height="295" src="http://www.youtube.com/embed/vmwh4LzubSk?fs=1" frameborder="0" allowfullscreen=""></iframe>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com2tag:blogger.com,1999:blog-7716534352026213664.post-28671980772647622722011-01-29T15:16:00.000-08:002011-01-29T15:16:02.784-08:00What's new on this topic in the media this week?So we have 2 articles in the media directly concerning communication. One is on the Power of Listening...something I've heard before but hard to do just as Susan Schwartz relates. Most powerful message from this article? SLOW DOWN, STOP COMPETING FOR 'AIR TIME' Here's the link and the capitalization is for my benefit (trying to be conscious of online etiquette).<br />
<span class="Apple-style-span" style="font-family: Helvetica;"><a href="http://www.ottawacitizen.com/news/todays-paper/power+listening/4189198/story.html">http://www.ottawacitizen.com/news/todays-paper/power+listening/4189198/story.html</a></span><br />
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<b><span class="Apple-style-span" style="font-family: Helvetica;"><span class="Apple-style-span" style="font-weight: normal;"><a href="http://www.ottawacitizen.com/news/todays-paper/power+listening/4189198/story.html"></a></span></span><span class="Apple-style-span" style="font-weight: normal;">The second article</span> </b>is about a report from CMAJ (Journal of the Canadian Medical Association) about doctors needing more training in empathy. Also interesting reading. I would just like to comment however that I have worked with physicians who are very good communicators. The article leaves you with the impression that most aren't. To read more go to:<br />
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<span class="Apple-style-span" style="font-family: Helvetica;"><a href="http://www.canada.com/Doctors+need+more+training+empathy+CMAJ+report/4156797/story.html">http://www.canada.com/Doctors+need+more+training+empathy+CMAJ+report/4156797/story.html</a></span><br />
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</span>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com3tag:blogger.com,1999:blog-7716534352026213664.post-51708028823237547722011-01-29T09:39:00.000-08:002011-03-28T17:17:14.117-07:00mastering bloggerOkay so I just learned a few blogger communication strategies<br />
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<ol><li>There is a youtube video on how to create a blog...you can follow it @http://www.youtube.com/watch?v=ryb4VPSmKuo</li>
<li>I couldn't add an attachment so I had to cut and paste my learning goals</li>
</ol>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com0tag:blogger.com,1999:blog-7716534352026213664.post-1761418965522815052011-01-29T09:05:00.000-08:002011-04-05T08:41:32.572-07:00Assignment #1 Learning GoalsPlease bear in mind folks that I've never written a blog before so probably my learning goals should include mastering that as well but I am going to try to attach the 5 learning goals we were asked to write at the beginning of this course. <br />
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<div align="center" class="MsoNormal" style="line-height: 150%; text-align: center;"><span class="Apple-style-span" style="line-height: 32px;"><b style="mso-bidi-font-weight: normal;">Learning Objectives</b></span></div><ol start="1" style="margin-top: 0cm;" type="1"><li class="MsoNormal" style="line-height: 200%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><span class="Apple-style-span" style="color: #990000;">Increase congruence between non-verbal and verbal communication</span></li>
</ol><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Benefit to Practice</u>: I have a tendency to continue or commence tasks while I am interacting with patients. My words may convey positive regard but my non-verbal behaviour does not.</div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Success Indicators</u>: I will reflect on my daily interactions with patients and will rate a decrease in this behaviour </div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Strategies</u>: I will make a notation on my worksheet as a daily reminder and elicit feedback from my peers. Review CNO Practice Standard: Therapeutic Nurse-Client Relationship.</div><ol start="2" style="margin-top: 0cm;" type="1"><li class="MsoNormal" style="line-height: 200%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><span class="Apple-style-span" style="color: #990000;">Explore strategies to improve patient information capture while maintaining therapeutic communication</span><b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></li>
</ol><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Benefit to Practice</u>: One of my positions as an RN involves postoperative pain assessments. Time restraints are a daily occurrence with this position and I would like to improve the efficiency of my data collection but maintain effective communication</div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Success Indicators</u>: Patients will continue to express satisfaction with pain assessment visits and I will see a decrease in the number of repeat visits to capture missed information</div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Strategies</u><b style="mso-bidi-font-weight: normal;">:</b> Make a template of all the information I wish to capture and review this with each patient before termination of the visit. Review CNO Practice: Standard Therapeutic Nurse-Client Relationship. </div><ol start="3" style="margin-top: 0cm;" type="1"><li class="MsoNormal" style="line-height: 200%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><span class="Apple-style-span" style="color: #990000;">Increase knowledge of communication strategies for patients from Inuit cultural background</span><b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></li>
</ol><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Benefit to Practice</u>: Our hospital receives many Inuit patients for care and I would like to become more culturally competent with this patient population</div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Success Indicators</u><b style="mso-bidi-font-weight: normal;">: </b>I will become more knowledgeable of cultural traditions of this population and document and share communication strategies with my peers. </div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Strategies</u><b style="mso-bidi-font-weight: normal;">: </b>Review CNO Practice Guideline: Culturally Sensitive Care and RNAO BPG: Embracing Cultural Diversity. Research articles on communication with this patient population, search hospital database for communication strategies and presentations on this topic. </div><ol start="4" style="margin-top: 0cm;" type="1"><li class="MsoNormal" style="line-height: 200%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><span class="Apple-style-span" style="color: #990000;">Explore strategies of effective communication for patients receiving “bad news” in the postoperative period.</span><b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></li>
</ol><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Benefit to Practice</u>: One of my nursing positions is on a surgical oncology floor and it is not unusual to arrive in a patient’s room after rounds to find them in a state of distress regarding operative findings.</div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Success Indicators</u>: Patient satisfaction if possible before end of course, positive feedback from peers regarding applicability of information and strategies. </div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Strategies</u>: Review CNO Practice Standard: Therapeutic Nurse-Client Relationship and Practice Guideline: Guiding Decisions About End-of-Life Care. Research articles, review attending behaviours and active listening skills and reflect on daily practice. Share findings with peers.</div><ol start="5" style="margin-top: 0cm;" type="1"><li class="MsoNormal" style="line-height: 200%; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt;"><span class="Apple-style-span" style="background-color: white;"><span class="Apple-style-span" style="color: #990000;">Increase practice of reflective/meditative strategies </span></span><b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></li>
</ol><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Benefit to Practice</u>: I am finding that the end of life issues facing the patients for whom I care increasingly impacts me emotionally. I know that I need to devote more time to self-health to maintain therapeutic relationships. </div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Success Indicators</u>: I will be able to leave at the end of a shift feeling I have delivered compassionate care and communicated therapeutically and not feel burdened by issues facing my patients. </div><div class="MsoNormal" style="line-height: 200%; margin-left: 36.0pt;"><u>Strategies</u>: Decrease number of weekly shifts. No overtime hours. Review self- help strategies. Devote minimum of one hour daily to self-help strategies. Review RNAO BPG: Healthy Work Environment. <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></div>Anniehttp://www.blogger.com/profile/03914039305033842606noreply@blogger.com0