Therapeutic Communication

Phases of the Relationship

100

nurse gathers information to be discussed, specific information pertinent to the patient is identified 

Preinteraction phase

200

orientation phase is also known as this, nurse and patient observe each other, judgements are formed , nurse tries to overcome resistive behaviors

orientation phase

300

active part of the relationship, verbal & nonverbal communication, specific skills are needed here 

working phase

400

depends on the evolution of the relationship, parts of this phase should be started in adequate time prior to discharge/end of relationship,  summarizing & review

Termination phase

500

these individuals may have a difficult time navigating the phases of the relationship, introductions and reorientation strategies may need to be implemented

dementia/cognitive impairment

talk the talk, walk the walk

100

nurses ability to understand & acknowledge as well as respect the patient's feelings

empathy

200

nurse shows condolence, agreement, pity. Not an effective communication strategy

sympathy

300

often referred to as the most important technique in communication, this is where you need to CHECK YO SELF, patient decides when to close the conversation

Active listening 

400

nonverbal, being present, 5 adaptable methods

physical attending 

500

must give nurses name, title position, avoid giving details to avoid conflict. no social media! must know the difference between information and advice, new grad nurses often find this concept difficult

imparting information

walk the walk, talk the talk

100

ask the patient to provide examples to better understand the premise of the patients statement, language barriers may cause an issue here

clarifying

200

deflection, includes honesty, benign curiosity, refocusing, interpretation, clarification, limit setting

avoiding self-disclosure

300

hard concept to learn, maintain an open posture, you do not use this technique when uncomfortable or unsure, allows patient time to think through their thoughts

using silence

400

verbalizing implied feelings, attempting to identify connotative meanings, encourages clarification 

reflecting

500

reflective style approach, nurse uses own words to restate patient statement, helps the nurse ensure they are correctly understanding the patient

paraphrasing

examples

100

Can you tell me more about your alcohol use?

open-ended questions

200

You say you are happy but you are frowning and tearful

pinpointing

300

validates clients feelings; "it is normal/ok to feel this way"

respect

400

I noticed you dragging your right foot when you were walking in 

informational confrontation

500

"If i were you I would choose not to have that medicine" THIS IS NOT GOOD 

Giving advice

examples continued

100

"well you know there are alot sicker patients here, you should be thankful" NOT GOOD

Minimizing or discounting patients feelings

200

" I know how you feel, dont be afraid. Everbody does just fine with this surgery." the opposite of empathy

sympathy

300

should know the patients cultures and history prior to using this technique, has to be used with caution and intentional, southerners have a bad habit of using this TOO much

touch

400

Can you give me an example of how your medicine made you feel 

clarifying

500

I understand you are here for quite a few things and we will address all of them, can you tell me which symptom is most worrisome to you at this moment?

structuring