Which are nursing actions that support active listening? select all that apply.

Communication is not a one-way process. It requires, at least, someone to give the message and someone to receive it. Demonstrating active listening shows the person that their message is both received and understood.

To enhance your listening skills, you need to let the other person know that you are listening to what they are saying.

To understand the importance of this, ask yourself if you’ve ever been engaged in a conversation where you wondered if the other person was listening to what you were saying. You wonder if your message is getting across, or if it’s even worthwhile continuing to speak.

You cannot allow yourself to become distracted by whatever else may be going on around you, or by forming counter arguments while the other person is still speaking. You cannot allow yourself to get bored and lose focus on what the other person is saying.

What is active listening? [Can also mean attentive listening]

Active listening simply means actively listening. This means fully concentrating on what is being said rather than just passively ‘hearing’ the message of the speaker. Active listening involves listening with all your senses.

Active listening is a skill that can be learnt and developed with practice. However, active listening can be difficult to master and will take time and patience to develop.

As a leader you need to ensure that you are fully present when speaking and listening to individuals and your team. People know when you’re NOT truly listening, it is displayed your body language. As a leader you need to ensure that your body language is congruent with your verbal language and engaged with the individuals and groups that are communicating with you. By developing your listening skills, it demonstrates your interest in the other party; it helps you become more empathetic and shows that you care; it’s a sign of respect and it help build trusting relationships.

Did you know we make 11 Decisions in 7 Seconds, for example on the below?

  1. Education level
  2. Status – how much they earn
  3. Perceived as creditable and believeable
  4. Trust worthiness
  5. Sophistication level
  6. Sexual identification
  7. Success level
  8. Political background
  9. Religion
  10. Ethnicity
  11. Social & Professional desirability

Active listening involves five elements

  1. Paying attention
  2. Show that you are listening
  3. Feedback
  4. Summarising
  5. Defer Judgement/ Respond Appropriately

Paying attention

Give the speaker your undivided attention and acknowledge the message. Recognise that non-verbal communication also “speaks” loudly.

Look at the speaker directly.

Promote understanding by clarifying what the person has said so that you have the correct facts demonstrating you have understood. Eliciting facts is one of the basics of active listening. A simple way of demonstrating this is to rephrase or paraphrase what has been said by the person.

Communicate to the person using;

  • Can I just clarify? You’re saying that …
  • My understanding is that …
  • Let me make sure I’ve got this right, you’re saying …

Do not just repeat what the person has said. Rephrase the highlights or key points of what has been said but take care not to distort the meaning.

Clarifying to increase your understanding in this way can benefit you by;

  • Knowing you have received the message correctly and,
  • The person knows that you have been listening, which can boost their confidence and morale by making them feel valued.

There will be occasions when clarification of what has been said is necessary to find out more to increase your understanding. Asking probing questions allows you to do this

while also demonstrating that you have been listening to all the person has to say:

  • And what were the details of those actions?
  • Could you tell me some more about …?

Reflect on what has been said by paraphrasing. “What I’m hearing is…,” and “Sounds like you are saying…,” are great ways to reflect back.

Ask questions to clarify certain points. “What do you mean when you say….” “Is this what you mean?”

Summarise the speaker’s comments when they stop talking, do not interrupt them.

Show That You’re Listening

Use your own body language and gestures to show that you are engaged.

  • Nod occasionally.
  • Smile and use other facial expressions.
  • Make sure that your posture is open and interested.
  • Encourage the speaker to continue with small verbal comments.

Verbal signs of attentive or active listening

Remembering

The human brain is notoriously bad at remembering details, especially for any length of time. As mentioned previously, we can only process 7 +/- 2 chunks of information at any given time. Our brain is more of an association tool, it remembers through using our 5 senses and associating them to events, time, people and places. One strategy is to remember a few key points: even the name of the speaker can help to reinforce the messages sent have been received and understood. Remembering details, ideas and concepts from previous conversations proves that attention was kept and is likely to encourage the speaker to continue.  Note taking is also appropriate to aid memory and retention.

Questioning

The listener can demonstrate that they have been paying attention by asking relevant questions and/or making statements that build or help to clarify what the speaker has said.  By asking relevant questions the listener also helps to reinforce they have an interest in what the speaker has been saying.

Clarification

Clarifying is a crucial skill in the communication process. Clarifying involves asking questions of the speaker to ensure the correct message has been received.  Clarification involves the use of open questions which enables the speaker to expand and clarify their message.

Summarisation

Summarising what has been said by the speaker involves taking the main points of the received message and reiterating them in a logical and clear manner, giving the speaker time to correct or add too, if necessary.

Reflection

Reflection is a powerful skill that can reinforce the message of the speaker and demonstrate understanding. Reflecting is repeating or paraphrasing what the speaker has said in order to show comprehension.

Non-verbal signs of attentive or active listening

NOTE – these signs may not be appropriate in all situations and across all cultures.

Smile

Smiles combined with nods of the head can be a powerful form of acknowledgment that messages are being listened to and understood. Smiles show the listener is paying attention to what is being said; as a way of agreeing; or being happy about the messages.

Eye Contact

Eye contact is important in communication and listening, but it can be intimidating, especially for shy speakers. One challenge is trying to gauge how much eye contact is appropriate for any given situation.  It is normal and encouraging for the listener to engage in eye contact with the speaker.

Body Language

Our body language speaks volumes about the sender and receiver in interpersonal communication.  The attentive listener tends to lean slightly forward or sideways whilst sitting.  Other signs of active listening may include a slight slant of the head or resting the head on one hand.

Mirroring

Mirroring is a part of the rapport building process. Mirroring of any facial expressions used by the speaker or receiver is a sign of attentive listening. Facial expressions can help to show emotions and feeling associated with conversation, so pay attention.

Distraction

The active listener will not be distracted and therefore will refrain from fidgeting, looking at a clock or watch, doodling, playing with their hair or picking their fingernails.

Barriers to listening

  1. Environmental – physical barriers and external stimuli [noise].
  2. Technology – is a major distraction – meet away from computers, phones and your office in a neutral area.
  3. Culture – values, beliefs, attitudes, gender and age, religion.
  4. Stress – when we are stressed, we are in a fight or flight mode and it becomes difficult to listen/hear.
  5. Our internal dialogue – ego, previous preconceptions and questions.
  6. Personal – our own values, attitudes and beliefs are constantly filtering the external world.

Strategies to enhance active listening skills

  • Be more present – mindfulness practice
  • Become more consciously aware of how you are communicating
  • Repeat the speaker’s words in your head – blocks the internal voice
  • Listen with your heart…Listen for the meaning
  • Relax, and start the “Matching & Mirroring” process

It takes a lot of concentration and determination to be an active listener. Old habits are hard to break, and if your listening skills are as bad as many peoples are, then you will need to do a lot of work to break these bad habits.

Active listening skills are critical for effective patient-centred care, especially for obtaining important medical information. Active listening shows patients that you care and establishes a foundation of trust.

It may be appropriate to do this after each defined topic, especially when a decision has been taken.

Alternatively, it is sometimes preferable to save the summarising to the very end of the conversation and then go over the notes to collate what has been said and agreed. A good way of beginning to summarise may be:

  • So, let’s recap on what has been said and agreed.
  • OK, let me note down the key points we’ve discussed.

Feedback

Active listening also involves giving feedback to the speaker about how their message affected you. Reflecting back feelings and emotions enables you to check you have understood the speaker’s sentiments and allows you to empathise. It also gives the speaker a chance to correct any misconceptions that may have inadvertently been conveyed.

Feedback should follow the following five rules. It should be:

  • Non-judgemental
  • Clear
  • Honest
  • Immediate
  • Brief

Defer Judgment

Interrupting is a waste of time. It frustrates the person and limits full understanding of the message.

  • Allow the speaker to finish each point before asking questions.
  • Don’t interrupt with counter arguments.

Respond Appropriately

Active listening is designed to encourage respect and understanding. You are gaining information and perspective. You add nothing by attacking the speaker or otherwise putting them down.

  • Be open and honest in your response.
  • Assert your opinions respectfully.
  • Treat the other person in a way that you think she would want to be treated, that you would want to be treated.
  • Be mindful of your tone of voice and attitude.

Reflection

Q&A: What are you going to do with this new information now [within your professional and personal life]?

[Write 2-3 paragraphs]

Q&A: Where can you apply it?

[Write 2-3 paragraphs]

Q&A: Do you feel this will help you in your current role?

[Write 2-3 paragraphs]

Q&A: Can you see this helping you in other areas of your life?

[Write 2-3 paragraphs]

Which medication has been found to be effective as a treatment in ADHD?

ADHD is a prevalent neurodevelopmental disorder and there are effective pharmacological agents to treat it, including amphetamines and methylphenidate. Different adverse events should be monitored closely, depending on the medication prescribed.

Which characteristic behavior would the nurse assess for in a child diagnosed with attention Deficit hyperactivity disorder?

ADHD, also called attention-deficit disorder, is a behavior disorder, usually first diagnosed in childhood, that is characterized by inattention, impulsivity, and, in some cases, hyperactivity. These symptoms usually occur together; however, one may occur without the other[s].

Which observation would demonstrate that the adolescent client suffers from attention deficit hyperactivity disorder ADHD ]?

Signs of hyperactivity and impulsivity may include: Running, dashing around, or climbing at inappropriate times or, in teens, often feeling restless. Being unable to play or engage in hobbies quietly. Being constantly in motion or on the go and/or acting as if driven by a motor. Talking excessively.

Which is an inattentive behavior seen in attention deficit hyperactivity disorder ADHD?

People with ADHD experience an ongoing pattern of the following types of symptoms: Inattention means a person may have difficulty staying on task, sustaining focus, and staying organized, and these problems are not due to defiance or lack of comprehension.

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