Nursing Week 2: Communication

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Therapeutic Communication : 

3/8/2010 1 Therapeutic Communication The psychiatric mental health nurse’s single most important tool Difficult Safe Purposeful Client Focus Learned Skills Private Feelings Nurse & Patient Effective communication is a major factor in client satisfaction, treatment compliance, and recovery

Modes of Communication : 

3/8/2010 2 Modes of Communication Written communication – description of the patient’s behavior should be clear Verbal communication Nonverbal communication: Conguent Body Language Paralinguistics – sounds not words Space (proxemics) Touch Appearance

Types of Communication : 

3/8/2010 3 Types of Communication Intrapersonal communication: self-talk Interpersonal communication Social communication Collegial communication Therapeutic communication: purpose to enhance client growth

Traits of Therapeutic Communication : 

3/8/2010 4 Traits of Therapeutic Communication Genuineness Positive Regard Empathy Trustworthiness Clarity Responsibility Assertiveness

Responding Techniques that Enhance Therapeutic Communication : 

3/8/2010 5 Responding Techniques that Enhance Therapeutic Communication Methods that encourage clients to interact in ways that promote growth (table 4-3) Silence: purposeful Active listening Support and reassurance Sharing observations Acknowledging feelings Summarize

Obstacles to Therapeutic Communication : 

3/8/2010 6 Obstacles to Therapeutic Communication Resistance Transference: client unconsciously associates the nurse with someone significant in his or her life Countertransference: nurse’s emotional response to a specific client, irrational, highly charged Boundary Violations

Responding Techniques that Hinder Therapeutic Communication : 

3/8/2010 7 Responding Techniques that Hinder Therapeutic Communication Methods that are counterproductive to healthy outcomes (table 4-4) Silence: purposeful Not listening Offering false reassurance Giving advice Defending Interpreting or analyzing prematurely

Therapeutic Communication and the Nursing Process : 

3/8/2010 8 Therapeutic Communication and the Nursing Process Beginning or Orientation Phase Introduction, assessment, nursing diagnosis Working Phase Develop the care plan (planning) Therapeutic communication skills help clients deal with issues (intervention) Termination Phase Evaluation and discharge planning

Purposes of Therapeutic Communication : 

3/8/2010 9 Purposes of Therapeutic Communication Allow clients to express thoughts, feelings, behaviors, and life experiences in a meaningful way to promote growth To understand the significance of the client’s problems and the role of the client in perpetuating those problems To assist in the identification and resolution of the processes of the client’s health related behaviors

A client tells the nurse therapist that she thinks she may divorce her husband despite being 3 months pregnant. Which of the following would be a therapeutic response by the nurse? : 

3/8/2010 10 A client tells the nurse therapist that she thinks she may divorce her husband despite being 3 months pregnant. Which of the following would be a therapeutic response by the nurse? “It seems that you are considering a very drastic move.” “I wonder if you have considered having an abortion.” “Does divorce fit into your religious beliefs?” “Let’s discuss this option further.”

Which of the following would be analyzed as therapeutic communication on the part of the nurse? : 

3/8/2010 11 Which of the following would be analyzed as therapeutic communication on the part of the nurse? “Things will get better, you will see.” “I’m sorry. What did you say?” “That’s nothing compared to other client’s problems” “That’s a difficult problem for you.”