Unit 1 Exam - Week 3 Flashcards
Therapeutic Communication
Why is good communication important for nurses?
They get the most face time with patients, and have to advocate for them with the rest of the interprofessional team.
Aspects of the nurse/patient relationship
4 points
- Professional caring
- Advocacy
- Confidentiality versus privacy
- Rapport
Advocacy
- patient doesn’t always have someone in their corner
- Support patient right to make decisions
-
May conflict with MD
viewpoint
important to have good team relationships to ease burden of advocacy
What can prevent a patient from making thier own decisions?
Power of attorney
confidentiality
- legally enforceable, HIPAA
- determines how we handle info once we have it
– mandated reporting
Privacy
- pulling a curtain
- patients have a **right to disclose what they want **
- speaking in confidence
- disclose ahead of time that you are a mandated reporter
Establishing trust
- Honesty and disclosure cannot exist without trust
- As trust grows, the client can more easily relay information and share feelings
To establish trust
- always greet the client by name and preferred pronoun
- listen actively
- respond honestly to their concerns
- provide competent, consistent care.
Rapport
- patient should feel safe with you, good relationship
- should not be friendship
Therapeutic Communication Characteristics
5 points
- Empathy
- Respect
- Genuineness
- Concreteness
- Confrontation
Therapeutic Communication basics
- Face-to-face interaction focused on patient’s concerns to increase patient well-being
Empathy
- people want empathy, not solutions
- The desire to understand and be sensitive to the feelings, beliefs, and situation of another person
- a connection and feeling with people on their level, feel their pain
- sit in their pain with them
- don’t say “I know how you feel”
- don’t start sentence with “at least”
Respect
- Communicate respect by valuing the client and being flexible to meet the client’s needs
- leave judgement out
- here to help, not responsible for pt decisions
Genuineness
- be real
- Requires honesty
- Involves a willingness to self-evaluate
Concreteness
- Must offer understandable responses to a client’s questions and concerns
- avoid jargon
- fact-based
Confrontation
- assertive not agressive
- don’t put pt safety at risk to avoid confrontaion
- client unable to express thoughts clearly, must ask them to say it in another way or clarify the point further.
Therapeutic communication techniques
8 points
- Silence
- Active empathetic listening
- Restatement
- Reflection
- Summarizing
- Clarifying
- Validating
- Touch
Silence
- Gives patient** time to process & respond**
- can include coming back to finish discussion after they think for a while
- client is emotionally upset, remaining silent demonstrates acceptance and allows the client to organize their thoughts to provide further information
Active
empathetic
listening
- nod, smile, eye contact
- arms open
- position body to be eye-to-eye level
- avoid multi-tasking
- Uses all of the senses to focus on the sender’s message and allows the sender the opportunity to complete comments without interruption
Restatement
- Repeat message content
- Use exact words or paraphrase
- makes people feel heard and gives them a chance to correct you
Reflection
- paraphrase message content
-
Name the underlying feelings
ex: I’m hearing that you feel anxious…
Summarizing
- recapping whole conversation
- good to use when educating pt
Clarifying
- Encourage elaboration
- Minimizes misunderstanding
- gets them to tell you more
Validating
- identifies/supports patient beliefs
- Demonstrates respect
- don’t validate if you don’t agree
touch
- Communicates caring
- Use cautiously
- let pt **body language cue touch **
- history of trauma etc, will not want touch
