Therapeutic Communication for nurses
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Must haves for therapeutic communication
- Know self
- Clarify values
- Explore own feelings
- Genuineness and respect
- Empathy –feeling with the patient
- Unconditional positive regard
- Be in control of own life and emotions
How can you tell visual, tactile, auditory type listeners?
- "I see what you're saying..."
- "I get it," "I feel that!"
- "I hear you..."
You want to identify it and then mirror it to get into the best rapport.
What is congruence and incongruence?
- Congruence: body language and spoken words agree.
- Incongruence: body language and spoken words are incongruent.
What is the difference between pity and sympathy?
- Sympathy: feeling badly for someone.
- Pity: an unconscious feeling of sadness for someone and being glad it wasn't you.
Both are bad for therapeutic communication.
- Therapeutic: You were talking about such and such and now you're silent. What happened?
- Thoughtful: I'd love to know what you're thinking about...
- Resistive: I'm not talking to you. Hurumph.
What is fogging?
Agreeing with the complaint (as long as it's valid) and apologizing for the inconvenience.
Don't agree with something that isn't true.
What is a sandwich technique?
When you need to make a critique, use a positive, then the negative, followed by another positive.
What is the DESC Script?
- Describe the situation
- Express feelings
- Specify what you want
What are some elements to psych pt problem solving interactions?
- Define problem
- When and how?
- Propose solutions or alternatives
- Pros and cons
- Select solution
- Evaluate application of solution
- Make changes
What are some techniques that pts will use to resist
- Keeping pertinent information to self
- Symptoms get worse
- Short lived recovery
- Intellectual talk
- Nothing on the mind
- Acting out
- Superficial talk
- Verbalizes understanding but continues destructive behavior
- Transference/Countertransference: Projecting feelings you have about one person onto another person who reminds you of the first. Transference is pt-->nurse, countertransference is nurse--> pt.
Acceptable Roles of the Nurse in Therapeutic Communication
- Role model
- Friend vs. friendly- role of the nurse. Being a friend may prevent you from doing your job.
What sorts of nursing responses are not beneficial?
- Lacks empathy
- Feels depressed after talking with patients
- Careless with contract
- Late, runs over
- Drowsy during 1:1
- Anger at patient’s lack of change
- Argues with patients
- Encourages dependency
- Helps patients in matters not related to goals
- Defends nursing interventions to others
Don't work harder than the pt is willing to work for himself, and don't do anything for the patient that he/she can do alone.
What are some boundaries to remember when working with the mental health?
- Don’t go into patient rooms in mental health
- Clothing- dress appropriately
- Language- address with first/last name & age appropriate
- Self-disclosure- do not do
- Watch physical contact, especially with schizophrenics.
- Be mindful of time spent with patients; don't overtax them.
- Maintain professional role
- Maintain confidentiality
What is a MSE?
See chapt. 6 in Stuart.
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