Ch 8 Therapeutic Commun. Flashcards
5 techniques that enhance communication
+ Reflecting
+ restating
+ focusing
+ broad openings, general leads
+ exploring
+ presenting reality
+ clarification
+ acceptance

Examples of non-therapeutic communication
+ Falsely reassuring
+ asking why questions
+ giving approval
+ giving advice
+ excessive questions - peppering
+ changing the subject
+ minimizing feelings
What is active listening?
Showing patient that you are involved in the conversation, Observing patients nonverbal cues, listening, understanding context, noticing inconsistencies, providing feedback 
Examples of “exploring” statements
+ Tell me more about…
+ describe that for me….
+ would you describe it more fully 
Examples of “focusing” statements
+ This point you are making is worth looking at more closely
+ you’ve mentioned many things, let’s go back to your thinking of ending it all
Example statements of “presenting reality”
+ That was the sound of a car backfiring
+ your mother is not here, I am a nurse
+ that was Dr. Todd, not a terrorist, stocking and trying to harm you 
Examples of “summarizing” statements
+ Have I got this right?
+ You said that…
+ During the past hour you and I have discussed… 
Steps that nurses take to formulate a plan for patients
+ assess
+ identify
+ set goals
+ implement
+ evaluate
Examples of “clarification” statements
+ I’m not sure I follow you
+ what would you say is the main point of what you just said
+ give an example of a time you thought that?
Four methods of communication that are not helpful and therapeutic settings
+ approving/agreeing
+ WHY questions
+ peppering with too many questions
+ premature advice
+minimizing/discounting feelings
+ disapproving/disagreeing
+ giving advice
+ changing subject
Communication definition
Process of information being passed back-and-forth between two or more entities
Five factors/filters that
affect/influence communication
+ Values, attitudes, beliefs
+ culture or religion
+ social status
+ gender
+ age or developmental level
+ power dynamic
+ prejudice
+ mood
+ agendas
environmental factors influencing communication
+ noise
+ lack of privacy
+ physical pain or discomfort
+ location
What distance should therapeutic interactions happen between nurse and patient? What is that called?
+ Social distance
+ 4 to 12 feet (according to class or book - at least 3 feet)
Words, you hear during report to watch out for concerning the patients
+ Unpredictable
+ unstable
+ agitated or escalating
+ labile
What is a safe location to meet with a patient who shows escalation
A quiet corner of the day room because the room provides some privacy in a neutral setting, while allowing access to distance/get away if the situation becomes unsafe
Why is empathy so important in the therapeutic relationship?
+ puts yourself in the patient’s shoes
+ patient feels understood
What does rapport provide in the therapeutic relationship
+ Provides warmth
+ is nonjudgmental
+ provides understanding
+ provides presence and listening
What is RTIS?
Why is it important?
+ responding to internal stimuli
+ encourages people to recognize and address any emotional or physical responses that may arise in response to internal stimuli, such as stress or fear
Ways to show that you are actively listening
+ Sit eye level to patient
+ relaxed demeanor
+ arms and legs uncrossed
+ leaning forward slightly
+ nodding head as person speaks
+ showing attentiveness
+ listening and understanding, patience, verbal and nonverbal cues
+ not looking away, or glancing around
+ reflecting back to patient
The importance of silence and therapeutic communication
+ Allows patient to process thoughts and feelings
+ increases self-awareness
+ provides time to interpret communication
+ gives a space to reflect
“Reflective listening” helps build….
+ trust
+ rapport
+ connection
Aspects of MI - motivational interviewing
+ evidence-based
+ patient-centered
+ promotes pt. exploration & motivation
+ incorporates active listening
+ pt. focused
What are process reports (IPR)
Written reports of verbal client interactions by nurse/student to improve communication techniques
Reasons pt. may exhibit difficult behaviors
+ pain/discomfort
+ frustration
+ poor coping
+ hopelessness/powerlessness
+ meds effects
+ mental illness/delirium
+ fear
+ grief
Deescalation techniques
+ normal tone
+ speak on developmental level of pt.
+ ask simple questions requiring simple answers
+ reduce tempo/sound in room
+ don’t rush/provoke pt
+ make sure to have pt attn
+ maintain eye contact if appropriate
+ respect personal space
+ set limits
+ offer choices
