Nontherapeutic Communication Table 9.3

Question 1

Giving premature advice

Answer 1

Assumes the nurse knows best and the patient can’t think for oneself. Inhibits problem solving and fosters dependency.

Question 2

Example of Giving Premature Advice

Answer 2

“Get out of this situation immediately.”

Question 3

More helpful Response for Giving Premature Advice

Answer 3

Encouraging problem-solving:

“What are the pros and cons of your situation?”
“What were some of the actions you thought you
might take?”
“What are some of the ways you have thought of to
meet your goals?”

Question 4

Minimizing feelings

Answer 4

Indicates that the nurse is unable to understand or empathize with the patient. Here the patient’s feelings or experiences are being belittled, which can cause the patient to feel small or insignificant.

Question 5

Examples of Minimizing feelings

Answer 5

Patient: “I wish I were dead.”
Nurse: “Everyone gets down in the
dumps.”

“I know what you mean.”
“You should feel happy you’re getting better.”
“Things get worse before they get
better.”

Question 6

More helpful Response for Minimizing feelings

Answer 6

Empathizing and exploring:
“You must be feeling very upset. Are you thinking of hurting yourself?”

Question 7

Falsely reassuring

Answer 7

Underrates a person’s feelings and belittles a person’s concerns.

May cause the patient to stop sharing feelings if not taken seriously.

Question 8

Examples of Falsely reassuring

Answer 8

“I wouldn’t worry about that.” “Everything will be all right.”
“You will do just fine, you’ll see.”

Question 9

More helpful response to False reassuring

Answer 9

Clarifying the patient’s message:

“What specifically are you worried about?”
“What do you think could go wrong?” “What are you concerned might happen?”

Question 10

Making value judgments

Answer 10

Prevents problem-solving. Can make the patient feel guilty, angry, misunderstood, not supported, or anxious to leave.

Question 11

Examples of Making value judgments

Answer 11

“How come you still smoke when your wife has lung cancer?”

Question 12

More helpful response for Making value judgments

Answer 12

Making observations:

“I notice you are still smoking even though your wife has lung cancer. Is this a problem?”

Question 13

Asking “why” questions

Answer 13

Implies criticism; often has the effect of making the patient feel defensive.

Question 14

Examples of Asking “why” questions

Answer 14

“Why did you stop taking your medication?”

Question 15

More helpful response for Asking “why” questions

Answer 15

Asking open-ended questions; giving a broad opening:

“Tell me some of the reasons that led up to your not taking your medications.”

Question 16

Asking excessive questions

Answer 16

Results in the patient not knowing which question to answer and possibly being confused about what is being asked.

Question 17

Examples of Asking excessive questions

Answer 17

Nurse: “How’s your appetite? Are you losing weight? Are you eating enough?”

Patient: “No.”

Question 18

More helpful response for Asking excessive questions

Answer 18

Clarifying:
“Tell me about your eating habits since you’ve been depressed.”

Question 19

Giving approval, agreeing

Answer 19

Implies the patient is doing the right thing—and that not doing it is wrong.

May lead the patient to focus on pleasing the nurse or clinician; denies the patient the opportunity to change her mind.

Question 20

Examples of Giving approval, agreeing

Answer 20

“I’m proud of you for applying for that job.”
“I agree with your decision.”

Question 21

More helpful response for Giving approval, agreeing

Answer 21

Making observations:
“I noticed that you applied for that job.”
“What factors will lead up to your changing your mind?”

Asking open-ended questions; giving a broad opening:
“What led to that decision?”

Question 22

Disapproving, disagreeing

Answer 22

Can make a person defensive.

Question 23

Examples of Disapproving, disagreeing

Answer 23

“You really should have shown up for the medication group.”
“I disagree with that.”

Question 24

More helpful response for Disapproving, disagreeing

Answer 24

Exploring:
“What was going through your mind when you decided not to come to your medication group?”

“That’s one point of view. How did you arrive at that
conclusion?”

Question 25

Changing the subject

Answer 25

May invalidate the patient’s feelings and needs.
Can leave the patient feeling alienated and isolated and increase feelings of hopelessness.

Question 26

Examples of Changing the subject

Answer 26

Patient: “I’d like to die.”
Nurse: “Did you go to Alcoholics Anonymous like we discussed?”

Question 27

More helpful response for Changing the subject

Answer 27

Validating and exploring:
Patient: “I’d like to die.”
Nurse: “This sounds serious. Have you thought of harming yourself?”