Exam I: Therapeutic Communication

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JARoberts
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99702
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Exam I: Therapeutic Communication
Updated:
2011-10-03 21:20:55
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NURS1921 EXAM EFFECTIVE THERAPEUTIC COMMUNICATION
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Based on Lecture by Ms. Crawford
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  1. Empathy vs. Sympathy
    Empathy: Imagine thoughts of person you feel sympathetic for.

    Sympathy: Feel sorry for; Feel pity for; Feel bad for
  2. Helping vs. Social Relationships
    • Shared characteristics:
    • Care
    • Trust
    • Growth

    • Helping characteristics:
    • Time limited
    • Focus on Client's Needs
    • Unequal Sharing
    • Purposeful/Intentional

    • Social Characteristics:
    • Ongoing
    • Focus on the needs of both individuals
    • Similar Sharing
    • Spontaneous
  3. What are the two KEY goals of a helping relationship?
    1. Development of trust and acceptance between nurse and patient

    2. Underlying belief that the nurse cares and wants to help the patient
  4. Orientation Phase of a Helping Relationship
    • "Getting to know you" phase
    • Sets the tone
    • Define roles
    • Initiated by Nurse
    • Agreement/contract/goals set - Confidentiality
    • Trust Develops
  5. Working Phase of a Helping Relationship
    • "Problem Solving" Phase
    • Attend to clients needs
    • Nurse assumes role of teacher/counselor
    • Active participation by client
    • Gather further data
    • Facilitate Change
    • Evaluate problems and goals
  6. Terminiation Phase of a Helping Relationship
    • "Ending" Phase
    • Identify progress (met vs. not met) towards mutually set goals
    • Ackowledge Feelings
  7. Factors which promote effective communication
    • Language
    • Comfortable Environment
    • Same verbal and non-verbal message
    • Confidentiality
    • Client Focus
    • Optimal Pacing
    • Providing Personal Space
    • Privacy
    • Use of Nursing Observations
  8. Examples of Non-Verbal Communication (Body Language)
    • Touch - caring touch vs. task touch
    • Eye Contact
    • Facial Expression
    • Posture
    • Gait
    • Gestures
    • Physical Appearance
    • Dress/Grooming
    • Sounds
    • Silence
  9. Components of Active Listening
    • Observing nonverbal behaviors
    • Listening to or understanding verbal messages or underlying concerns
    • Understanding in the context of life
    • Listening for inconsistencies
    • Giving Feedback
  10. Open-Ended Questions
    • Can obtain a lot of information b/c it allows the client to express ideas and feelings as they are experiencing them
    • Allows the patient to chose what they want to elaborate on. "What is making you feel bad today?"
  11. Closed-Ended Questions
    • Narrows the range of possible answers.
    • Most appropriate when consise information is needed quickly
    • For specific information. "On a scale of 0-10, how is your pain?"
  12. Clarification
    To obtain more information when data is incomplete.

    Repeating the statement or question. "How did you come to that conclusion?"
  13. Exploring Questions
    "You're overwhelmed about....?"
  14. Offering general leads
    "Go on, tell me more."
  15. Offering Self
    Sit down with patient
  16. When is Reflection Used?
    When you want to determine underlying feelings
  17. The nurse enters the room of an agitated client with which she has an established helping relationship. When the nurse asks the client, "what is the matter?" the client replies, "oh, nothing's wrong, I'll be fine in a little while." What is the nurse's best response?
    • Allow the client a few minutes alone & return to complete care.
    • Say, "that's okay."
    • Ask the client to tell you what's bothering them
    • Sit down at the client's bedside and wait a few minutes in silence
  18. Assessment Questioning vs. Therapeutic Communication
    • Assessment: Gathering Data
    • Closed-ended questions
    • Directive approach

    • Therapeutic: Developing a Relationship
    • Open-Ended questions
    • Listening for themes
  19. How can a nurse help a client best feel cared for?
    • Provide Comfort Measures
    • Provide Individualized Care (will include the other 3 options)
    • Assure Care Plans and Treatments are Implemented
    • Demonstrate a Positive Attitude While Delivering Care
  20. A nurse is caring for a male client who has suffered a stroke and has difficulty speaking but understands messages. The client lifts his right hand as instructed by the physical therapist and replies with garbled speech. Which part of the communication process does the nurse assess this client is having difficulty with?
    • Decoding
    • Endcoding
    • Timing
    • Tone of Voice
  21. Components of the Communication Process
    • Encoder - Person sending the message
    • Message - What needs to be communicated
    • Channel - Means of communication
    • Decoder - Person receiving the message
    • Feedback - Evaluation of the effectiveness of the message
  22. Erica is considering terminating her pregnancy. She is discussing her
    situation with a registered nurse at the local family planning center. As Erica cries and vents her frustration at not being able to deal with her pregnancy, the nurse sits quietly and listens attentively. What is this an example of?

    A. Lack of interest in the patient's problems
    B. The use of silence as a non-verbal communication technique
    C. A values conflict between patient and nurse
    D. A situation that requires immediate verbal input by the nurse
    B. The use of silence as a non-verbal communication technique
    (this multiple choice question has been scrambled)

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