Therapeutic Communication Flashcards
● The hallmark of the nurse-client relationship
● Purposeful, directed toward a specific outcome
● Nonjudgmental and client-centered.
● Promotes understanding and can help establish a constructive relationship between the nurse and the client.
THERAPEUTIC COMMUNICATION
The amount of time the nurse spends with each client and the timing of an interaction has a significant impact on the outcome of the interaction.
Time and Place
The nurse should introduce and clarify the purpose of the interaction and the expected duration.
Setting the Stage
The nurse remains aware of his own biases and to approach each client from a perspective of acceptance.
ACCEPTING THE CLIENT
Communicates acceptance of the person’s thoughts and emotions
ACTIVE LISTENING
➔ Most important technique in nursing and is basic to all other techniques
➔ Involves paying attention to the total message, both verbal and nonverbal, and noting whether these communications are congruent.
➔ Absorb both the content and the feeling the client is conveying while putting aside your own judgements and ideas to really hear and focus on the client’s needs.
ATTENTIVE LISTENING
May be as important, or more important, than your words. Active learners are engaged physically and mentally in the listening process
Nonverbal Behavior
➔ Have good eye contact
➔ Communicate their interest with an intent facial expression
VISIBLY TUNING IN
ELEMENTS OF THERAPEUTIC COMMUNICATION
1. ________
2. ________
3. ________
4. ________
5. ________
6. ________
- Empathy
- Trust
- Honesty
- Validation
- Active Listening
- Caring
TRUE OR FALSE:
In Therapeutic Communication, the nurse must give reassurance to the patient at all times
FALSE
The nurse must not give FALSE REASSURANCE
Giving recognition, in a non-judgmental way, of a change in behavior, an effort that client has made or a contribution to a communication
ACKNOWLEDGING
Providing, in a simple & direct manner, specific factual information the client may or may not request
OFFERING / GIVING INFORMATION / EDUCATING
Suggesting one’s presence, interest or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse’s attention
OFFERING SELF
● “You appear hungry.”
● “You look uncomfortable when…”
● “I notice you are clenching your fists.”
STATING OBSERVATION
Making statements that are specific rather than general, and tentative rather than absolute
BEING SPECIFIC AND TENTATIVE
● Method of making the client’s broad overall meaning of the message more understandable
● Used when paraphrasing is difficult or when the communication is rambling or garbled
● Facilitates correct communication of information by asking the client to restate information or provide an example
CLARIFYING/SEEKING CLARIFICATION
● Using statements or questions that:
○ Encourage the client to verbalize
○ Choose a topic of conversation
○ Facilitate continued verbalization
● “And then…what?”
PROVIDING GENERAL NEEDS
● Asking broad questions that lead or invite the client to explore thoughts or feelings
○ Client: “I had a wonderful dream last night”
○ Nurse: “I’d like to hear more about that”
USING OPEN ENDED QUESTIONS
● Helping the client clarify an event, situation, or happening in relationship to time
○ Client: I vomited this morning
○ Nurse: Was that after breakfast?
CLARIFYING TIME OR SEQUENCE
● A method similar to clarifying that verifies the meaning of specific words rather than the overall meaning of a message
○ Client: “My wife never gives me any presents”
○ Nurse: “You mean she has never given you a present for your birthday or Christmas?”
PERCEPTION CHECKING OR SEEKING CONSENSUAL VALIDATION
● Directing ideas, feelings, questions or content back to clients to enable them to explore their own ideas & feelings about situation
○ Client: “What can I do?”
○ Nurse: “What do you think would be helpful?”
REFLECTING
● Helping the client expand on & develop a topic of importance
● Eliminates vagueness
● Limits the area of discussion
● Helps the interviewer to direct attention to the pertinent aspect of client’s message
★ Nurse must wait until client thinks about main concerns before attempting to focus
FOCUSING
● Providing appropriate forms of touch to reinforce caring feelings
★ With consent
USING TOUCH
● Offering a view of what is real without arguing with the patient
○ Client: “Somebody is calling me!”
○ Nurse: “I hear no voices”
PRESENTING REALITY
● Actively listening for the client’s basic message & then repeating those thoughts and/or feelings in similar words.
● Provides opportunity for the interviewer to validate information by asking the client to restate information or provide an example.
○ Client: “I had problem eating dinner last night”
○ Nurse: “You had difficulty eating dinner last night?”
PARAPHRASING or RESTARTING
● Accepting pauses / silence for several seconds/ minutes without interjecting verbal response.
● Promotes observations about the client and allows time for the client to organize thoughts
USING SILENCE
● Stating the main points of a discussion to clarify the relevant points discussed
● Useful at the end of interview or to review a health-teaching session
● Condenses data to further validate information and tonend a component of the interview or the interview itself
○ Nurse: “During the past half hour, we have talked about…”
SUMMARIZING and PLANNING
● Facilitates eye contact with the client and communicates interest in the client’s needs, concerns, and problems
❖ The other attentive listening in the 1st page is the same
ATTENTIVE LISTENING
Nurses need to recognize ________ or ________ responses to effective communication
barriers / non-therapeutic
● Takes decisionmaking away from the client
● Inhibits spontaneity, stalls problem solving & creates doubt
❖ Nurse: “If I were you, I’ll just go home & have my recovery there”
GIVING AN OPINION OR COMMON ADVICE
● Using cliches or comforting statements of advice as a means to reassure the client
○ Nurse: “This shot will make you feel better. Trust me.”
OFFERING FALSE REASSURANCE
● Suggests that the interviewee has no right to an opinion
➔ Attempting to protect an individual or healthcare services from negative comments.
➔ Prevents the client from expressing true concerns
➔ Defensive responses protect the nurse from admitting weaknesses in healthcare services, including personal weakness
BEING DEFENSIVE
● Can be as harmful to an interviewee-interviewer relationship
● Implies that the behavior being praised is the only acceptable one.
SHOWING APPROVAL OR DISAPPROVAL
● Are generalized beliefs held about people
➔ Categorizes clients and negate their uniqueness as individuals
STEREOTYPING
● Asking for information chiefly out of curiosity, rather than with the intent to assist the client
● “Why” questions can cause resentment, insecurity & mistrust.
PROBING
● Stalls progress of the communication process.
➔ Directing the communication into areas of self-interest rather than considering the client’s concern is often a self-protective response to a topic that causes anxiety.
CHANGING THE SUBJECT INAPPROPRIATELY
● Refusing to discuss certain topics with the client
○ Client: “Nurse, why do I have difficulty urinating?
○ Nurse: “Shut up! We’re having an endorsement here.”
REJECTING
● Giving a response that makes clients prove their statement or point of view
➔ This response indicates that the nurse is failing to consider the client’s feelings, making the client feel it is necessary to defend a position.
○ Client: “I felt nauseated after that red pill”
○ Nurse: “Surely you don’t think I gave you the wrong pill”
CHALLENGING
● Imply that the client must think as the nurse thinks, fostering client dependency
➔ Giving opinions and approving or disapproving responses, moralizing, or implying one’s own values
○ Client; does something
○ Nurse: “You should not do that!
PASSING JUDGEMENT
● Communication and culture are closely interconnected.
● Communicating effectively with clients of various ethnic and cultural backgrounds is critical to providing culturally competent nursing care.
● Consider cultural differences in expressing nonverbal communication.
TRANSCULTURAL THERAPEUTIC COMMUNICATION
