Communication Skills

INTRODUCTION

Communication is the activity of conveying information. Communication has been derived from the Latin word “communis,” which means “to share.” Communication requires a sender, a message, and an intended recipient. However, the receiver need not to be present or be aware of the sender's intent to communicate at the time of communication; thus, communication can occur across vast distances in time and space. Communication requires that the communicating parties share an area of communicative commonality. The communication process is complete once the receiver has understood the message of the sender. Feedback is critical for effective communication between parties.

Communication is part and parcel of our day-to-day professional as well as social life. It is interwoven in all nursing activities and is an inseparable part of the nursing process. The nurse has to communicate patient information and other facts to the members of health care team to achieve health-related goals of the patient. Similarly, she has to communicate with the patients while assessing, planning, implementing, and evaluating nursing care.

DEFINITION of communication

Communication can be defined as the exchange of opinion, ideas, information, facts, feelings, and values between two or more persons (sender and receiver/s) with the help of some channels to accomplish the desired purpose.

Vestal (1995) defined communication as “the exchange of meanings between and among individual through a shared system of symbols (verbal and nonverbal) that have the same meaning for both the sender and receiver of the message.”

Murphy and Hildebrandt defined communication as “a process of transmitting and receiving verbal and non-verbal messages that produce a response.”

Joseph A. Devito mentioned that “communication refers to the act by one or more persons of sending and receiving messages that are distorted by noise, occur within a context, have some effect, and provide some opportunity for feedback.”

Communication is a cyclic process that involves initiation, transmission, and reception of information. The reception of information is followed by the feedback, which in turn can repeat the cycle of communication.

 PROCESS, ELEMENTS, AND CHANNELS OF COMMUNICATION

Process of Communication:

Communication is a cyclic process that starts when the sender feels that there is a need to communicate with the receiver for a particular reason (purpose).

The sender creates a message either in the written or in verbal or nonverbal form. The message is dispatched to the receiver with the help of channels of communication. The receiver takes the delivery of the message and provides feedback to the sender. The sender gets the feedback and determines whether the receiver has received the same message and meaning that the sender had intended to communicate with him; if the sender feels that the receiver has not received the same message and meaning, he/she again initiates the cycle of communication.

Elements of Communication

On the basis of figure, the elements of communication are as follows:

1. Sender
2. Message
3. Channel of communication
4. Receiver
5. Feedback

Sender: The sender is the person who initiates the process of communication. Whenever the sender feels that there is a need to communicate some information to the other person (receiver), he/she starts the process of communication. The sender must be aware of the purpose of the communication and the receiver's abilities to understand the message in terms of language, interest, etc.

Message: The message is created by the sender to convey the information, facts or opinion to the receiver. The message should be clear and simple so that the receiver can understand it in the same way as the sender desires. While creating a message, the sender should take care of words, language, and meaning of the message if the message is to be communicated in verbal or written form or he/she should take care of body language and facial expression if the message is to be communicated in nonverbal form, along with the abilities and professional competencies of the receiver.

Channels of communication: Communication channels are the medium through which the message is communicated to the receiver. Channels of communication play an important role in the process of communication. If the sender selects an appropriate medium or channel of communication, there are more chances that the receiver will receive the same message; or else, there are chances that the message may get distorted. In this hi-tech era, there are a number of channels that can be used to communicate message, e.g., mobile, e-mail, voice mail, person, radio, TV, Internet, blogs, etc. “Through proper channel” is a common phrase used among the nurse administrators/managers that signifies the importance of communication channels. For example, a student of B.Sc nursing, II year, wants to communicate hostel problems to the director of the institute. In order to reach to the intended receiver first, he/she should communicate his/her message in the form of written application to the class teacher; the class teacher will forward the application (message) to the principal and finally the principal will forward the application to the director. That is how communication through proper channel takes place. In this case, the class teacher and principal were the channels of communication through which the message was communicated to the receiver (director).

Receiver: The receiver is the person who receives the message. The receiver may be a single person or a group of persons. The receiver understands the meaning of the message and provides feedback to the sender. The receiver should have the same language ability, comprehension, and cultural background as the sender. If not, it may lead to distorted understanding of the meaning of the message by the receiver.

Feedback: It is the most crucial element of communication. It is provided by the receiver to the sender. Receiving feedback is important for the sender to know that the receiver has received the message and interpreted the meaning of the message in the desired way. Without feedback, the process of communication cannot be complete. For example, when you send a mobile SMS to your friend, you get feedback in the form of  delivery report that informs you whether your message has been delivered or not to the intended receiver; it also happens in the same way in the case of e-mail.

TYPES OF COMMUNICATION

Communication may be of different types depending upon the context in which the term communication is used. The important types of communication are shown in figure.

Verbal Communication

When the sender conveys information, facts, and opinion either verbally or in writing to the receiver using different channels of communication, it is known as verbal communication. The sender should select appropriate words and language to communicate the message to the receiver. Figure highlights the guidelines that should be followed to make the verbal communication effective.

Nonverbal Communication

Nonverbal communication takes place without the use of words. Nonverbal communication involves the unconscious mind acting out emotions related to the verbal content, the situation, and the environment. The sender uses the body language, facial expression, hand movements, eye movements, etc. to convey the feelings, emotions, and other information to the receiver. This type of the communication can be useful when both the sender and the receiver don’t have an understanding of a common language. This technique of communication is especially useful when you are dealing with a client who is deaf and dumb.

The interesting fact about nonverbal communication is that it reflects a more accurate description of one's true feelings because nonverbal reactions cannot be controlled easily by the people. Nonverbal communication may include:

§  Vocal cues

§  Gestures

§  Posture

§  Physical appearance

§  Distance or spatial territory

§  Position or posture

§  Touch

§  Facial expression

Meta Communication

Meta communication is an important and useful tool for the effective interpersonal interaction. It is “communication about communication” so that the deeper “message within a message” can be uncovered and understood (Wood, 1999). This type of method is useful among a group of experts in a particular area.

Formal Communication

Formal communication is a type of communication which is used in the context of organization where a large group of employees work together to accomplish goals of organization. Formal communications usually take place in the form of written communication, which follows the lines of authority or scalar chain of command.

Informal Communication

Informal communication refers to the gossip or informal talks that take place among the various groups of people working in an organization that don’t follow organizational line of authority or hierarchy.

Therapeutic Communication

Therapeutic communication is a type of communication that takes place in the health care environment between nurse and patient. Therapeutic communications is a planned, deliberate, and professional act that uses communication techniques to achieve a positive relationship and shared understanding of information for the desired patient-care goals. The purpose of therapeutic communication is to explore the client's problems, planning the interventions along with the client and implementing these interventions. During therapeutic communication, the nurse encourages the client to communicate fear, anxieties, expectations, and self-care deficit needs. The nurse uses special techniques while engaging in the therapeutic communication with the client, e.g., active listening, asking open-ended questions, paraphrasing, etc.