The nurse is alert to avoid using blocks to effective communication that include: (Select all that apply.)
asking probing questions.
using nonjudgmental remarks.
changing the subject.
using clichés.
giving advice.
offering hope.
Correct Answer : A,C,D,E
A. Asking probing questions. Probing questions can feel invasive, leading to discomfort or defensiveness from the patient.
B. Using nonjudgmental remarks. Nonjudgmental remarks foster open communication, so this is not a communication block.
C. Changing the subject. Changing the subject shows disregard for the patient’s thoughts or feelings, which can block effective communication.
D. Using clichés. Clichés can make patients feel as though their concerns are not truly heard or understood.
E. Giving advice. Giving advice without patient input can make the patient feel undervalued and less autonomous.
F. Offering hope. Offering realistic hope and encouragement can actually facilitate communication, as long as it’s not false reassurance.
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Correct Answer is D
Explanation
A. Avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned.
Avoiding eye contact can make the patient feel ignored or unheard and is generally not effective in active listening.
B. Ask probing questions to direct the conversation and obtain the information needed as efficiently as possible.
Active listening involves allowing the patient to lead the conversation rather than directing it with probing questions.
C. Anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence.
While well-intentioned, finishing sentences can prevent the patient from expressing thoughts fully.
D. Use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.