Therapeutic 1
Active listening
being attentive to what the client is saying verbally and non-verbally
Sympathy
Sympathy focuses on the nurse’s feelings rather than the client’s. Shows concern but more sorrow and pity than trying to understand how the client feels.
Asking relevant questions
Seeking information for decision making. Fully explore a topic before moving on to another
Using silence
Allows the nurse to temporarily slow the pace of conversation, time to observe for non-verbal clues, and to assemble the nurse’s own thoughts.
Using touch
Most potent form of communication. Comfort touch such as holding a hand, is especially important for vulnerable clients who are experiencing severe illness.
Using broad opening statements
Gives clients an opportunity to begin to express themselves. Initiates discussion, while at the same time allowing the client to determine what will be discussed.
When a patient is reaching for understanding these phrases that are not based on fact or based on reality can do more harm than good
Ex: “Don’t worry, everything will be alright.” “you’ll be fine.” Or “there’s nothing to worry about.”
Empathy
The ability to understand and accept another person’s reality, to accurately perceive feelings, and to communicate understanding
Giving information
Provides the client with specific information which could answer questions or dispel misconceptions, while helping the client to better evaluate options
Summarizing
Pulls together information for documentation. Give the client a sense you understand. It is a concise review of key aspects of an interaction.
Using general leads
Serves to encourage the client to continue, that nurse has understood what the client has said, that the nurse wishes that the client proceeds, while leaving direction of conversation to the client.
Ex: "Yes", "Oh?", "Um hmm", or non-verbally
Cryptic codes
Use of medical terminology and abbreviations, unfamiliar to patients. May make the patient feel stupid and uncomfortable
Sharing hope
Communicating a “sense of possibility” to others. Encouragement when appropriate and positive feedback.
Ex: “I believe you will find a way to face your situation, because I have seen your courage in the past.”
Clarifying
Requests that the client make his/her meaning clearer. Prevents ambiguity or misunderstanding from hindering communication as the conversation proceeds,
Self-disclosure
Subjectively true personal experiences about the self, are intentionally revealed to another person for the purpose of emphasizing both the similarities and the differences of experiences
Reflecting
All parts of the clients statement is repeated or slightly rephrased to encourage the client to express their feelings
Making stereotype comments
By using social clichés or trite phrases, this may lead the client to respond in a like manner, thus keeping conversation at superficial social level.
Sharing humor
Contributes to feelings of togetherness, closeness, and friendliness. Promotes positive communication in the following ways: prevention, perception, perspective.
Encouraging formulation of a plan of action
Allows patient to identify alternative actions for interpersonal situations
Confrotation
Helping the client become more aware of inconsistencies in his or her feelings, attitudes, beliefs, and behaviors. Only to be used after trust has been established
Stating observations
The nurse shares with client observations regarding the client’s behavior. Attempts to find out the meaning of the client’s behavior, rather than assuming the nurse knows.
Defending
Tells the client that these negative comments are unfounded and implies that the Client does not have the right to express these concerns. Discourages the client from continuing to express their concerns
Sharing feelings
Nurses can help clients express emotions by making observations, acknowledging feelings, and encouraging communication, giving permission to express “negative” feelings and modeling healthy anger.
Validating
When the nurse feels that the client’s need has been met, the nurse should validate this impression with the client, rather than assume.
Paraphrasing
The nurse re-words the content of the client's message. Put message into different words without changing the meaning.