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Uses the spoken or written word Largely conscious The words used vary among individuals according to culture, socioeconomic background, age, and education


Modifies the feeling and impact of the message The intonation can express enthusiasm, sadness, anger, or amusement. The pace of speech may indicate interest, anxiety, boredom, or fear.

includes the use of commonly understood words, brevity, and completeness. Words as vasoconstriction or cholecystectomy are meaningful to the nurse and easy to use but are ill advised when communicating with clients The nurses will be catheterizing you tomorrow for a urine analysis. Tomorrow we need to get a sample of your urine, so we will collect it by putting a small tube into your bladder.


a message that is directed and simple will be more effective
clarity is saying precisely what is meant

brevity is using the fewest words necessary

When the nurse tells the client, I am interested in hearing what you have to say, the non verbal behavior would include the nurse facing the client, making eye contact, and leaning forward.


no matter how clearly or simply words are stated or written, the timing is to be appropriate to ensure the words are heard this involves sensitivity to the clients needs and concerns another in timing is asking several questions at once

spoken messages need to be altered in accordance with behavioral cues from the client
this requires astute assessment and sensitivity on the part of the nurse it is important for the nurse to then modify her tone of speech and express concern in her facial expression while moving toward the client

worthiness of belief, trustworthiness, and reliability
maybe the most important criterion of effective communication nurses should convey confidence and certainty in what they are saying, while being able to acknowledge their limitations I dont know the answer to that, but I will find someone who does.

the use of humor can be a positive and powerful tool in the nurse-client relationship, but it must be used with care humor can be used to help clients adjust to difficult and painful situations
when using humor, it is important to consider the clients perception of what is considered humorous.

MacDonald (2004) states that while humor and laughter can help reduce stress and anxiety in the early and recovery stages of a crisis, it may be considered offensive or distracting at a peak crisis period