Therapeutic Talk
A patient says, “I’m scared about my surgery tomorrow.” The nurse responds, “Tell me more about what is worrying you.” What type of question is the nurse using?
Open-ended question.
What does the S in SBAR represent?
Situation.
The nurse reviews a patient's medical record before entering the room for the first time. Which phase of the helping relationship is occurring?
Pre-interaction.
A nurse's facial expression, posture, gestures, and eye contact are examples of what type of communication?
Nonverbal communication.
The nurse tells a frightened patient, “Don't worry. Everything will be fine.” What nontherapeutic technique is this?
False reassurance.
A patient says, “Since my diagnosis, I feel like everything has changed.” The nurse responds, “It sounds like this diagnosis has affected many parts of your life.” Which therapeutic technique is demonstrated?
Paraphrasing.
The nurse tells the provider, “His BP is 84/46, HR 128, skin is cool and clammy, and urine output has decreased.” Which SBAR component is being communicated?
Assessment.
A patient's discharge is scheduled for today. The nurse reviews progress, discusses whether goals were achieved, and acknowledges the patient's feelings about ending the relationship. Which phase is demonstrated?
Termination.
A nurse sits next to a patient instead of standing over the patient during a conversation. What does this positioning help communicate?
Equality and openness in the relationship.
A patient says, “I stopped taking my medication.” The nurse responds, “Why would you do that?” What communication barrier is demonstrated?
Asking for explanations/using a “why” question.
The nurse says, “You have been looking toward the door throughout our conversation.” Which therapeutic communication technique is being used?
Sharing observations.
During an SBAR report, the nurse states, “The patient was admitted yesterday with pneumonia and has a history of COPD.” Which component is this?
Background.
The nurse and patient actively explore feelings, practice coping strategies, and evaluate progress toward established goals. Which phase is occurring?
Working.
During an interview, a nurse says, “I'm listening,” while repeatedly looking at the clock, crossing their arms, and standing near the door. Why could communication be ineffective?
The nurse's nonverbal communication is inconsistent with the verbal message.
A patient says, “I'm afraid my cancer has returned.” The nurse responds, “Did you watch the football game last night?” What nontherapeutic technique occurred?
Changing the subject.
A patient who recently received a cancer diagnosis tells the nurse, “I don't think I can handle chemotherapy.” What therapeutic communication technique should the nurse use to encourage the patient to discuss the specific concerns behind this statement?
Exploring
A nurse is calling the provider about a patient with an active GI bleed. The nurse has already communicated the patient’s current condition, relevant history, and assessment findings. Which part of SBAR should the nurse communicate next?
Recommendation
The nurse introduces herself, describes her role, and begins identifying the patient's concerns. Which phase is this?
Orientation.
During an assessment, a patient consistently maintains less eye contact than the nurse expects and increases the physical distance between them when the nurse moves closer. The patient remains attentive, answers questions appropriately, and shows no other signs of distress. What communication concept should the nurse consider before interpreting these behaviors, and how should this influence the nurse’s approach?
Cultural and individual differences in nonverbal communication and personal space.
A nurse says to a patient considering treatment options, “If I were you, I would definitely have the surgery.” Why is this response nontherapeutic?
It gives personal advice and can interfere with the patient's independent decision-making and autonomy.
A patient tells the nurse, “My family keeps telling me to have the surgery, but I'm not sure I want it. They keep asking me what I'm going to do, and I don't know what to tell them.” The nurse responds, “It sounds like you're feeling pressure from your family while you're still trying to decide what is right for you.” Identify the therapeutic communication technique being demonstrated.
Paraphrasing
“Mr. Lewis was admitted yesterday with pneumonia and has a history of COPD. His oxygen saturation has decreased from 94% to 84%, his respiratory rate is 32/min, and he is increasingly confused. I need the provider to evaluate him for his worsening respiratory status.” Which SBAR component is missing from this communication?
Situation
A patient is nearing the end of a long hospitalization. During the final scheduled interaction with the nurse, the patient begins discussing concerns about managing independently after discharge and expresses discomfort about no longer having the same nurse available. Identify the phase of the helping relationship.
Termination
An older adult with hearing loss is having difficulty understanding discharge instructions even though the patient is alert and cognitively intact. Identify three communication strategies the nurse should use to improve the patient’s understanding
A patient newly diagnosed with cancer tells the nurse, “I’m terrified. My mother died from cancer, so I know I’m going to die too.” The nurse responds, “You shouldn’t think like that. Treatments are much better now, so I’m sure you’re going to be fine.” Identify the two communication barriers demonstrated in the nurse’s response and describe why each interferes with therapeutic communication.
Disapproval/minimization and false reassurance.