Therapeutic Communication Flashcards
Orientation Phase
Introduction, guidelines, duration and roles
Working Phase
Longest phase
Nurse works with patient to meet pt’s physical/psychosocial needs
Termination Phase
Conclude the relationship
Occurs at change-of-shift, pt D/C, or nurse is on vacation or employment elsewhere
Blocks to communication
Failure to listen cliches leading questions/comments judgmental comments/giving advice false assurance changing the subject
Nursing interventions for communication
Respect autonomy Open-ended questions Reframe/restate Express empathy Encourage reflection
Rapport
A feeling of mutual trust experienced by people in a satisfactory relationship, facilitates open communication
How can you build good rapport with a patient?
Specific objectives Comfortable environment Privacy Confidentiality Patient vs. task focus Using nursing observations Optimal pacing
Example of open-ended question or comment
Nurse: What did your health care provider tell you about your need for this hospitalization?
Patient: He told me that my BP is dangerously high and that I need some special tests done while I am here
Example of closed question/comment
Nurse: What medicines have you been taking at home?
Patient: Let me see, my doctor gave me a water pill and a blood pressure pill to take every day
Example of validating question/comment
Nurse: at home, you have been taking both a water pill and a BP pill everyday. Did you take them today?
Patient: Yes, I took one of each with my breakfast
Example of clarifying question/comment
Patient: I have never needed to take medicine before in my life.
Nurse: Is this the first health problem you have had?
Patient: Yes, I’ve always been healthy
Example of reflective question/comment
Patient: I’ve been really upset about my BP and have to take these pills.
Nurse: You’ve been upset…
Patient: I guess I’m worried about what could happen if my BP gets too bad
Example of sequencing question/comment
Patient: I don’t feel like myself anymore since I’ve been taking my BP medicine. I’m tired and don’t have any energy
Nurse: Your tiredness began after you started taking your medicine?
Example of directing question/comment
Nurse: You mentioned your dad earlier, did he develop complications related to high BP?
Patient: Yes
Nurse: What sort of complications?
Patient: Kidney failure. He was on dialysis for years before getting a transplant
Nurse: Are you afraid this might happen to you?
CUS
“I’m (C)oncerned
I’m (U)ncomfortable
This is un(S)afe (this is a (S)afety issue)”
