Chapter 6 Flashcards
Offering self
Making self available and showing interest and concern
Ex:
“I’ll sit with you for a while.”
“I’ll stay with you.”
Active listening
Paying close attention to verbal and nonverbal communications, patterns of thinking, feelings, and behaviors
Face the patient; maintain eye contact; be open, alert, and patient; respond appropriately.
Silence
absence of verbal remarks to allow patients to think and say more
Maintain eye contact; convey interest and concern in facial expressions.
Empathy
Recognizing and acknowledging patients’ feelings
“I can hear how painful it is for you to talk about this.”
Questioning
Using open-ended questions to achieve relevance and depth in discussion (not closed/yes-no questions)
“Who?”
“What?”
“Where?”
“What did you say?”
“What happened?”
“Tell me about it.”
General leads
Using neutral expressions to encourage patients to continue talking
“Go on; I’m listening.”
“I hear what you are saying.”
Restating
Repeating the exact words of patients to remind them of what they said, to let them know that they are heard
“You say you are going home soon.”
“Your mother wasn’t happy to see you?”
Verbalizing the implied
Rephrasing patients’ words to highlight an underlying message
Patient: “There is nothing to do at home.”
Nurse: “It sounds as if you might be bored at home.”
Clarification
Asking patients to restate, elaborate, or give examples of ideas or feelings
“What do you mean by ‘feeling sick inside’?”
“Give me an example of feeling ‘lost.’”
Making observations
Commenting on what is seen or heard to encourage discussion
“You seem restless.”
“I noticed you had trouble making a decision about …”
Presenting reality
Offering a view of what is real and what is not without arguing with the patient
“I know the voices are real to you, but I don’t hear them.”
“I don’t see it the same way.”
Encouraging description of perception
Asking for patients’ views of their situations
“What do you think is happening to you right now?”
“What do you think is the issue with your wife?”
Voicing doubt
Expressing uncertainty about the reality of patients’ perceptions and conclusions
“Is that the only way to interpret it?”
“What other conclusion could there be?”
Placing an event in time or sequence
Asking for relationships among events
“When did you do this?”
“Then what happened?”
“What led up to …?”
“What is the connection between …?”
Encouraging comparisons
Asking for similarities and differences among feelings, behaviors, and events
“How does this compare with the last time?”
“What is different about your feelings today?”
Identifying themes
Asking patients to identify recurrent patterns in thoughts, feelings, and behaviors
“What do you do each time you argue with your wife?”
“What feeling do you get when you see your father?”
“Let’s see, so far you have said …”
Summarizing
Reviewing main points and conclusions
“Let’s see, so far you have said …”
Focusing
Pursuing a topic until its meaning or importance is clear
“Explain more about …”
“What bothers you about …?”
“What happens when you feel this way?”
Interpreting
Providing a view of the meaning or importance of something
“It sounds as if this is very important to you.”
“You seem to get in trouble when you …”
Encouraging evaluation
Asking for patients’ views of the meaning or importance of something
“So what does all this mean to you?”
“How serious is this for you?”
“How important is it to change this behavior?”
Suggesting collaboration
Offering to help patients solve problems
“I can help you understand this better.”
“Let’s see if we can find an answer.”
Encouraging goal setting
Asking patients to decide on the type of change needed
“What do you think needs to change?”
“What do you want to do differently?”
Giving information
Providing information that will help patients make better choices
“I can tell you about your medicines.”
“There are self-help groups available.”
“What would be the advantage of trying …?”
“What might happen if you tried …?”
Encouraging consideration of options
Asking patients to consider the pros and cons of possible options
“Which is the best alternative for you?”
“What would work best?”
Encouraging decisions
Asking patients to make a choice among options Encouraging the formulation of a plan: Probing for step-by-step actions that will be needed
“What exactly will it take to carry out your plan?”
“What else do you need to do?”
Rehearsing
Requesting a verbal description of what will be said or done
Role playing
Practicing behaviors; the nurse plays a particular role
Supportive confrontation
Acknowledging the difficulty in changing, but pushing for action
Limit setting
Discouraging nonproductive feelings and behaviors, and encouraging productive ones
Feedback
Pointing out specific behaviors and giving impressions of reactions
Encouraging evaluation
Asking patients to evaluate their actions and the outcomes
Reinforcement
Giving feedback on positive behaviors
ex:
“Tell me exactly what you will say to your wife on Friday.”
“I’ll play your wife. What do you want to say to me?”
“I know this isn’t easy to do, but I think you can do it.”
“It’s hard, but give it a try.”
