Nurses Pledge

NURSES PLEDGE
 1. I acknowledge that the special training I have

received has prepared me as a responsible
member of the community.
 2. I promise to care for the sick with all the skill

I possess, no matter what their race, creed,
color, political, or social status, sparing no effort
to conserve life, alleviate pain and promote
health.
 3. I promise to respect at all times the dignity of
the patient in my charge.
 4. I promise to hold in confidence all personal
information entrusted to me
 5. I promise to keep my knowledge and skill at
the professional level and to give the highest
standard of nursing care to my patients.
 6. I promise to carry out intelligently and loyally

medical instructions given to me.
 7. I promise that my personal life shall at all
times bring credit to my profession.
 8. I promise to share in the responsibility of

other professions and citizens for promotion of
health locally, nationally and internationally.
 SO HELP ME GOD
COMMUNICATION IN NURSING
Introduction
 "We all use language to communicate, to

express ourselves, to get our ideas across,
and to connect with the person to whom we
are speaking.
 When a relationship is working, the act of
communicating seems to flow relatively

effortlessly.
 When a relationship is deteriorating, the act
of communicating can be as frustrating as

climbing a hill of sand."
 (Chip Rose, attorney and mediator)
Introduction contd
 On a daily basis we work with people who have
different opinions, values, beliefs, and needs
than our own.
 Our ability to exchange ideas with others,

understand others' perspectives, solve problems
and successfully utilize the steps and processes
presented in this training will depend
significantly on how effectively we are able to
communicate with others.
Definition of communication
 Is a process of transferring information from one
entity to another
 The imparting or interchange of thoughts,

opinions, or information by speech, writing or
signs
 Is a process whereby information is enclosed in a

package and is channeled and imparted by a
sender to a receiver via some medium. The
receiver then decodes the message and gives the
sender a feedback.
 Although there is such a thing as one-way
communication, communication can be
perceived better as a two-way process in which
there is exchange and progression of thoughts,
feelings or ideas towards a mutually accepted
direction
COMPONENTS OF COMMUNICATION
 The act of communicating involves verbal,
nonverbal, and paraverbal components.
 The verbal component refers to the content of
our message‚ the choice and arrangement of our

words.
 The nonverbal component refers to the message
we send through our body language.

 The paraverbal component refers to how we say
what we say - the tone, pacing and volume of
our voices.
 These three components are important
ingredients in communication
 In order to communicate effectively, we must
use all three components to do two things:
 1. Send clear, concise messages.
 2. Hear and correctly understand messages the

patient is sending to us.
Elements of communication
 The source
 The message
 The channel- seeing, hearing, feeling etc
 The receiver
 The feedback- interpretation of message

Verbal messages
 Sending effective messages requires that we
state our point of view as briefly and succinctly
as possible.
 Listening to a rambling, unorganized speaker is

tedious and discouraging - why continue to
listen when there is no interchange?
Effective Verbal Messages
 1. Are brief, succinct, and organized
 2. Are free of jargon
 3. Do not create resistance in the listener

Nonverbal Messages
 The power of nonverbal communication cannot

be underestimated.
 The messages we send through our posture,

gestures, facial expression, and spatial distance
account for 55% of what is perceived and
understood by others (Professor Albert
Mehrabian)
 In fact, through our body language we are

always communicating, whether we want to or
not!
 Nonverbal messages are the primary ways that
we communicate emotions:
 Facial Expression
 The most common expressions are interest,
enjoyment, surprise, distress, shame, contempt,

anger, and fear.
 In conversations, facial expressions are a

principal source of feedback.
Eye Contact
 Often described as the "windows of the
soul," eyes are the most expressive
element in face-to-face communication.
 Among North Americans, individuals who

maintain direct eye contact are usually
considered to be open, honest, and
trustworthy.
 "Shifty"
eyes suggest dishonesty; and
a downward gaze may be interpreted
as a sign of submission, inferiority, or
humility.
Posture
 The way you stand and hold your body
also sends messages about your self
confidence.
 Stooped or bowed shoulders may signal

that you are burdened, lacking
confidence, submissive, beaten, guilty, or
afraid
Gestures
 Some hand gestures are recognized and

easily interpreted.
 For most North Americans a circle formed

with the index finger and thumb signals
satisfaction, shaking the index finger
indicates a warning, and showing the
palm symbolizes a peaceful greeting.
How Appearances Influence Communication
 The image an individual projects and the

objects surrounding that person can
communicate nonverbally.
 Clothing, for example, tells a great deal about

an individual's status, occupation, self-image,
and aspirations
 Gait – your manner of walk also speaks a lot
 Crying – this could be a sign of sadness

 Nonverbal Messages:
 1. Account for about 55% of what is

perceived and understood by others.
 2. they are conveyed through our facial

expressions as well as our postures and
gestures
Paraverbal Messages
 Paraverbal communication refers to the

messages that we transmit through the
tone, pitch, and pacing of our voices.
is how we say something, not what we

 It
say.
 Paraverbal
message account for
approximately 38% of what is
communicated to someone.
A sentence can convey entirely different
meanings depending on the emphasis on
words and the tone of voice.
 For example, the statement, "I didn't say

you were stupid" has six different
meanings, depending on which word is
emphasized.
Barriers to Effective Communication
A barrier to communication is something

that keeps meanings from meeting.
 Barriers
exist between all people, making
communication much more difficult than
most people seem to realize.
Verbal Communication Barriers
 1.Attacking (interrogating, criticizing,

blaming, shaming) can scare patients or
compel them to become resistant
 "Ifyou were doing your job and

supervising nurses under your charge as
required we probably wouldn't be in this
situation, would we?“
 2.
"Your Messages" (moralizing,
preaching, advising, diagnosing)
 3.Showing Power (ordering, threatening,

commanding, directing) makes it difficult
for both patients and nurses to get closer
to ward in-charges
Nonverbal Communication Barriers
 1. Flashing or rolling eyes
 2. Quick or slow movements
 3. Arms crossed, legs crossed
 4. Gestures made with exasperation
 5. Slouching, hunching over

 6. Poor personal care
 7. Doodling
 8.
Staring at people or avoiding eye
contact
 9. Excessive fidgeting with materials

Communicating Effectively
 Avoid the use of jargons, figures of speech,
slang, and idioms. The words we use can mean
different things to different individuals such as
“she heard it straight from the horse’s mouth”
 provide simple and direct answers (concise) to

patients when they ask questions or refer to
your superior if beyond your scope
 Use of touch which is non verbal
communication, may be viewed differently by
different cultures. Although it may be comforting
to some, others may see it as invasion of
personal space
 Be culturally sensitive in communication. In
some cultures (western culture) it is not
acceptable to make eye contact when talking
because it is a sign of disrespect
 Communicating effectively involves active

listening. It tells others that you value both what
they have to say and their membership of the
team.
 Avoid blocking communication- when unhelpful
responses are made. E.g. making judgmental
statements, belittling others’ feeling,
disapproving or being defensive
 Communication should maintain a positive

approach. When problems arise, individuals
respond better to communications that give
positive direction and not fault finding or
accusatory
Non- Effective communication
 Failure to listen to patient
 Unwarranted statement
 Judgmental responses
 Defensive responses e.g. patient says food is
not good; the nurse retorts, did you come here

because of food?
 Language barrier
 Hearing and speech defects

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NURSES PLEDGE

 1. I acknowledge that the special training I have

 2. I promise to care for the sick with all the skill

 6. I promise to carry out intelligently and loyally

 8. I promise to share in the responsibility of

 "We all use language to communicate, to

communicating seems to flow relatively

of communicating can be as frustrating as

 Our ability to exchange ideas with others,

 The imparting or interchange of thoughts,

 Is a process whereby information is enclosed in a

our message‚ the choice and arrangement of our

we send through our body language.

 1. Send clear, concise messages.

 2. Hear and correctly understand messages the

 The channel- seeing, hearing, feeling etc

 The feedback- interpretation of message

 Listening to a rambling, unorganized speaker is

 1. Are brief, succinct, and organized

 2. Are free of jargon

 3. Do not create resistance in the listener

 The power of nonverbal communication cannot

 The messages we send through our posture,

 In fact, through our body language we are

enjoyment, surprise, distress, shame, contempt,

 In conversations, facial expressions are a

 Among North Americans, individuals who

 Stooped or bowed shoulders may signal

 Some hand gestures are recognized and

 For most North Americans a circle formed

 The image an individual projects and the

 Clothing, for example, tells a great deal about

 Gait – your manner of walk also speaks a lot

 Crying – this could be a sign of sadness

 1. Account for about 55% of what is

 2. they are conveyed through our facial

 Paraverbal communication refers to the

is how we say something, not what we

 For example, the statement, "I didn't say

A barrier to communication is something

 1.Attacking (interrogating, criticizing,

 "Ifyou were doing your job and

 3.Showing Power (ordering, threatening,

 1. Flashing or rolling eyes

 2. Quick or slow movements

 3. Arms crossed, legs crossed

 4. Gestures made with exasperation

 5. Slouching, hunching over

 9. Excessive fidgeting with materials

 provide simple and direct answers (concise) to

 Communicating effectively involves active

 Communication should maintain a positive

not good; the nurse retorts, did you come here

 Hearing and speech defects

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