References:
- Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, 11th Edition, ISBN 9780135428733, by Audrey Berman, Shirlee J. Snyder, and Geralyn Frandsen (Ch. 16, pp. 295–320)
Communication is generally carried out in two different modes: verbal (spoken, written) and nonverbal. Learning about nonverbal communication is important for nurses in developing effective communication patterns and relationships with clients.
Verbal Communication is largely conscious because people choose the words they use. The words used vary among individuals according to culture, socioeconomic background, age, and education. Nurses need to consider the following when choosing words to say or write:
- Pace and Intonation: the manner of speech, rate, rhythm, and tone that modify the impact of a message. Rate of speech can indicate interest, anxiety, boredom, or fear.
- Simplicity: using commonly understood words, brevity, and completeness. Nurses need to select appropriate, understandable, and simple terms based on the client’s age, knowledge, culture, and education.
- Clarity and Brevity— clarity refers to saying precisely what is meant, and brevity is using the fewest words necessary.
- Timing and Relevance are imperative for ensuring the client understands the message. No matter how clearly words are stated or written, timing needs to be appropriate to ensure that words are heard. Sensitivity to the client’s needs and concerns is required.
- Adaptability; the nurse must alter spoken messages in accordance with behavioral cues from the client, e.g., entering the room with a cheerful greeting then observing the client appears to be in distress warrants a shift of demeanor to one of concern.
- Credibility is the “worthiness of belief, trustworthiness, and reliability”. This may be the most important criterion for effective communication. Nurses foster credibility with consistency, dependability, and honesty.
- Humor can be a positive and powerful tool in the nurse-client relationship, but this must be used with care. The client’s perception of what is humorous should be considered.
Nonverbal Communication uses other forms, such as gestures, facial expressions, and touch. This is how most communication (55%+) is conveyed. This involves overall appearance, posture, gait, facial expressions, and gestures. However, the nurse should always take care to verify observations before acting upon them.
- Personal Appearance: things such as clothing and adornments can be sources of information about an individual. These may convey social and financial status, culture, religion, group association, and self-concept. Some adornments such as crystal bracelets can indicate health protection beliefs. How an individual dresses is often an indicator of how the individual feels. People who are tired or ill may fail to maintain their normal grooming.
- Posture and Gait are seen in how people walk and carry themselves. These are reliable indicators of self-concept, current mood, and health.
- Facial Expression is normally the most expressive part of the body
- Gestures may emphasize and clarify the spoken word, or may be used even without words to indicate a feeling or to give a sign.