Nurse's Pocket Guide

eadiness for enhanced COMMUNICATION
honest expression. It communicates a belief that the client is
a capable and competent person.
• Sit down, maintain eye contact as culturally appropriate,
preferably at client’s level, and spend time with the client.
Conveys message that the nurse has time and interest in
communicating.
• Observe body language, eye movements, and behavioral cues.
May reveal unspoken concerns; for example, when pain is
present, client may react with tears, grimacing, stiff posture,
turning away, or angry outbursts.
• Help client identify and learn to avoid use of nontherapeutic
communication. These barriers are recognized as detriments
to open communication and learning to avoid them
maximizes the effectiveness of communication between
client and others.
• Obtain interpreter with language or signing abilities, as
needed. May be needed to enhance understanding of words
and language concepts or to ascertain that interpretation of
communication is accurate.
• Suggest use of pad and pencil, slate board, letter/picture board
when interacting or to interface in new situations. When
client has physical impairments that challenge verbal communication,
alternate means can provide clear concepts
that are understandable to both parties.
• Obtain/provide access to voice-enabled computer. Use of
these devices may be more helpful when communication
challenges are long-standing and/or when client is used to
working with them.
• Respect client’s cultural communication needs. Different cultures
can dictate beliefs of what is normal or abnormal (i.e.,
in some cultures, eye-to-eye contact is considered disrespectful,
impolite, or an invasion of privacy; silence and
tone of voice have various meanings, and slang words can
cause confusion).
• Encourage use of glasses, hearing aids, dentures, electronic
speech devices, as needed. These devices maximize sensory
perception/speech formation and can improve understanding
and enhance speech patterns.
• Reduce distractions and background noises (e.g., close the
door, turn down the radio/TV). A distracting environment
can interfere with communication, limiting attention to
tasks and making speech and communication more difficult.
Reducing noise can help both parties hear clearly, thus
improving understanding.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
174 Cultural Collaborative Community/Home Care