1 of 30

Dealing with Communication Challenges

Unit 1 Lesson 3

Contact info: info@nursesinternational.org

2 of 30

COPYRIGHT

NI Privacy Policy and Terms of Use.

Contact info: info@nursesinternational.org

3 of 30

Explain techniques to deal with clients with various physical impairments
Describe methods to respond to clients with mental health and behavior issues
Define the stress response and preferred healthy responses
Define stress triggers and methods to deal with client and family stress triggers
Describe preferred methods to deal with conflict

Student Learning Outcomes

Contact info: info@nursesinternational.org

4 of 30

Communication Challenges

Occurs with physical, mental, or emotional barriers
Good communication skills improve care quality and build trust
Nurse’s Aide role is to provide compassionate care while recognizing limits
Always report complex situations to nursing staff

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

5 of 30

Communicating with Hearing Impairments

Get the person's attention before speaking

Gentle touch on shoulder

Reduce background noise and face the person directly
Stand 2-3 feet away in good lighting for lip-reading
Speak clearly but do not shout
Use simple hand gestures when needed to support words
Ensure hearing aids are working and properly placed

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

6 of 30

Critical Thinking Question

A client with hearing impairment is becoming frustrated during a conversation with the nursing aide. They seem unable to follow what is being said, even though the aide is speaking clearly.

What are some immediate steps that can be taken to improve communication with the client?

Contact info: info@nursesinternational.org

7 of 30

Communicating with Vision Impairments

Always identify yourself when entering the room
Keep eyeglasses clean and help client wear them during waking hours
Provide adequate room lighting while avoiding glare
Describe what is being done as care is being provided
Read important information aloud to the client
Keep personal items in consistent locations

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

8 of 30

Communicating with Speech Impairments

Aphasia

Difficulty understanding or speaking due to brain injury

Ask simple yes/no questions instead of complex questions
Give the person time to process information and respond
Use pictures, writing, or gestures to help communicate
Stay calm and patient
Keep the call light within reach and report changes to nurse

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

9 of 30

Mental Health and Behavioral Issues

Common Behaviors and Appropriate Responses

Confusion about time/place

Stay calm
Redirect gently
Do not argue about facts

Agitation (restless, upset)

Keep environment quiet
Offer familiar activities

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

10 of 30

Mental Health and Behavioral Issues (cont’d)

Common Behaviors and Appropriate Responses

Aggression (hitting, yelling)

Ensure safety
Step back
Call for help immediately

Hallucinations (seeing/hearing things)

Do not contradict
Focus on feelings
Ensure safety

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

11 of 30

Mental Health and Behavioral Issues (cont’d)

Common Behaviors and Appropriate Responses

Refusing care

Respect choice
Try later
Offer alternatives
Report to nurse

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

12 of 30

Validation Communication Approach

Validation focuses on the person's feelings rather than correcting facts
Agree with emotions even when the situation is not based in reality
Example: Client says "I need to go home to feed my children"
Response: "Tell me about your children" instead of "Your children are grown/adults"
This approach reduces agitation and shows respect for the person

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

13 of 30

Critical Thinking Question

A patient with dementia keeps stating that they need to go to work, despite being retired for many years. They become increasingly agitated when corrected.

�How should the nurse’s aide respond to this patient to de-escalate the situation?

Contact info: info@nursesinternational.org

14 of 30

The Stress Response Cycle

Sandquist-Reuter, 2023

Physical/Emotional Response

Stress Trigger

Need for Coping Strategy

Contact info: info@nursesinternational.org

15 of 30

Client and Family Stress

Common Client/Family Stress Triggers

Loss of independence and familiar surroundings
Fear about health condition and medical procedures
Being cared for by strangers
Financial worries about care costs
Feeling like a burden to family members

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

16 of 30

Critical Thinking Question

During a shift, a client refuses to participate in their usual daily activities and remains withdrawn. As a nursing aide, what is the best approach to encourage participation?

Insist that participation is mandatory for their health
Offer alternative activities that the client enjoys
Schedule a meeting with the nurse immediately
Tell the client they need to follow the routine

Contact info: info@nursesinternational.org

17 of 30

Recognizing Stress in Clients

Physical signs

Fast heartbeat
Sweating
Trouble sleeping
Loss of appetite

Emotional signs

Irritability
Withdrawal
Crying
Restlessness

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

18 of 30

Recognizing Stress in Clients (cont’d)

Signs of Stress and CNA Interventions
Physical signs

Fast heartbeat, sweating, trouble sleeping, loss of appetite

Emotional signs

Irritability, withdrawal, crying, restlessness

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

19 of 30

CNA Interventions

Use calm, reassuring tone of voice
Listen actively to client concerns without judgment
Maintain consistent daily routines
Provide privacy during personal care
Allow extra time for activities - do not rush
Offer comfort measures (adjust pillows, provide blanket)

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

20 of 30

Report to Nurse Immediately When:

Client expresses thoughts of harming self or others
Client shows extreme anxiety (panic, difficulty breathing)
Client refuses meals for multiple days
Client becomes physically aggressive
Depression interferes with daily care activities

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

21 of 30

Critical Thinking Question

A client is showing signs of stress, including restlessness and irritability. What is the most effective way for a nursing aide to address this situation?

Provide the client with detailed information about upcoming care tasks to reduce uncertainty
Suggest that the client take time to speak with family members for additional support
Redirect the client’s attention to another activity to help reduce focus on their stress
Use a calm tone, slow pace, and provide reassurance

Contact info: info@nursesinternational.org

22 of 30

Managing Stress as a Nurse’s Aide

Deep breathing

In through nose, out through mouth (repeat 3 times)

Healthy lifestyle

Regular exercise
Adequate sleep
Nutritious meals

Progressive relaxation

Tense and relax muscle groups systematically

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

23 of 30

Managing Stress as a Nurse’s Aide (cont’d)

Time management

Organize tasks
Ask for help when needed

Professional support

Talk to supervisor about challenging situations

Self-care

Take breaks
Avoid excessive caffeine and junk food

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

24 of 30

Dealing with Conflict Situations

Client refuses care

Try later
Offer alternatives
Respect choice
Report to nurse

Family concerns

Listen actively,
Acknowledge feelings
Involve nurse for medical questions

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

25 of 30

Dealing with Conflict Situations (cont’d)

Coworker disagreements

Use "I" messages
Talk directly first
Suggest solutions

24-hour rule

Wait one day before addressing conflict if emotions are high

Escalation

Involve supervisor when direct communication fails

Remember

Focus on safety and professional communication always

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

26 of 30

Critical Thinking Question

A family member of a patient is upset about the care plan and questions the nursing aide about the details. What is the most appropriate action for the nursing aide?

Acknowledge their concerns and direct them to speak with the nurse
Provide general reassurance and continue with the patient’s care
Offer to share what you know about the care plan
Suggest that they wait and bring up their concerns at the next scheduled care meeting

Contact info: info@nursesinternational.org

27 of 30

Communication Adaptations for Challenges

For physical disabilities

Use assistive devices, visual aids, and clear positioning

For stress

Use calm tone, slow pace, and short simple sentences

For behavioral issues

Maintain safe distance
Avoid sudden movements

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

28 of 30

Communication Adaptations for (cont’d)

For conflicts

Use respectful language
Avoid blame
Focus on solutions

For all situations

Stay within scope of practice
Report complex issues to nurse

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

29 of 30

References

Sandquist-Reuter, M. (2023). Nursing Assistant. WisTech Open. https://wtcs.pressbooks.pub/nurseassist/

Contact info: info@nursesinternational.org

30 of 30

Please go to

My Learning Experience

to provide feedback on your experience.

Thank you, and come back soon!

Contact info: info@nursesinternational.org