Communication is an exchange of thoughts, ideas, information, feelings, etc. It is a process that humans use to convey a message to another person with symbols/signs. There is variation in communication types like Interpersonal, Transpersonal, Group, Public. Nurses use interpersonal communication it is a most powerful type of communication, as it influences people’s feelings, beliefs, people expressing inner thoughts to some other person.
It is believed that a patient is in direct contact with the nurse in an initial period they develop a positive self-concept that expresses increases self-expression.
What do you mean by Therapeutic Communication Technique?
An interaction between the nurse and a patient helps both nurse and patient to develop a mutual understanding between them. This therapeutic communication technique is used by nurses to gather information from patients and to take proper quality care of that patient.
With this technique, nurses take proper precautions considering the mental, physical, and emotional condition of those patients to communicate with them. With therapeutic communication techniques, nurses usually repeat questions asked by the patients.
Other definitions of Therapeutic Communication Techniques
“It is a process, in which the utilizes a planned approach to learn about the client” – Potter A, 1997
“The nurse directs the communication towards the patient to identify his current health problems, plan, implements and evaluates the action taken.” – Bimala kapoor, 2002
Nurses actions through therapeutic communication techniques
A nurse observes how a patient is communicating with her, what are her/his expressions, is the patient using hand movements for describing any incident, how his eyes are reacting, how are the patients reacting to certain statements.
A nurse nods as a way of communication and responds to patients while he is saying something. Or simply say Yes, I follow what are you saying. The nurses attentively listen to what patients have to say.
A nurse repeats what the patient is been saying to her, a nurse repeats the question, or a statement asked by the patient.
Patient: My parents will face financial problems as I am sick
Nurse: Your parents are going through financial issues because you fell sick
The nurse just repeated what the patient has said just to increase the patient’s awareness.
Validation Patients Information
Nurses use this method to confirm the accuracy and the reassurance that what patients are giving the information.
Patient: I get upset when my mom beats me if I fight with my younger cousin
Nurse: you get upset when your mom beats you if you fight with your younger cousin – so would you like to explain that further
What the nurse is doing here, is confirming that the accuracy and appropriateness of the information given by the patient that he/she is upset about of mom beating him/her.
The Nurse highlights the patient’s feelings that are not clearly expressed, nurse, highlights the affective content of the patient’s communication.
Patient: I am angry with my parents
Nurse: It seems you are really angry with your parents
With the help of reflection, the nurse wants to confirm or want to make additional clarification from the patient to confirm his statement. It is a great tactic in therapeutic communication technique.
Clarification from Patient
Here nurse wants to gather more information on what is stated by the patient. The nurse wants to know an in-depth clear view of the incidence of what has happened.
Patient: I am feeling low or sad today
Nurse: you said you are feeling low or sad today, would you elaborate on what has happened to you.
Here nurse wants to know from a patient the reason being low or the cause of being sad today, what incident made the patient feel that way. It is a good Therapeutic communication technique.
Rephrasing or Paraphrasing
In this technique, a nurse will repeat what he/she has heard from the patient.
Patient: Sister all my father says I will not allow you to step into our house again that made me sad.
Nurse: So, you are saying that your father will not take you back home, and that makes you feel more sad.
Here nurse is paraphrasing the statement made by the patient and giving patient the feeling that he/she has understood what he (patient) wants to say.
Here nurse pays close attention to what the patient is saying and pinpoints what he is saying and how is the patient is reacting when he is placing his statement.
Patient: My parents do not like my girlfriend and they are not happy if I get married to her, they think she is not the girl for me.
Nurse: So, your parents are not happy that your girlfriend is not right for you to get married. Nurse pointing out that the patient is saying this with a smile on his face.
A Nurse will try to link 2 situations, persons, or the feelings
Patient: I do not like it when my boyfriend talks to his friends on phone, he does not pay attention when I am talking to him, I feel sad.
Nurse: So, you feel sad when your boyfriend talks to his friends and does not pay attention to you.
Questioning the Patient
Questioning is for seeking clear information or to validate the statement. There are 2 types of questions asked to patient’s Open-end and Close-end questions. Close-end is Right or Wrong and Yes or No, Open-end questions are questions that give patients to share more information.
Focusing is when the patient says a statement and mentions a particular thing, the nurse focuses on that and will question surrounding that one particular thing.
Nurse: So, since when you were taking that medicine
Patient: Since 2months from now
Nurse: Do you have a prescription?
Patients are going through their bad phase, they are emotionally and mentally imbalanced to lightened their mood nurse has to build a rapport quickly with the patient.
A nurse may build the nearly close incident and share with the patient and help him to recover from that state of mind. The patient should feel some care and hope and feel positive.
Summarizing the incident
Nurse highlights or discussed what they have been talking about just to make sure the patient’s attentiveness and the patient would like to add or remove anything. The nurse ends the conversation with the ‘Does that sounds correct’ phrase giving patients to make necessary changes if necessary.
Therapeutic communication also works well when patients conduct the discussion and decide what to discuss and what not to discuss. Nurse gives a broader opening like ‘How are you feeling today’ ‘What’s on your mind today?’ this is allowing patients to clear their mind or let them speak what they feel like.
As patients are going through their tough time, some of them lose their hope and think of unusual things, nurses explain motivational situations where they would feel or change their negative thoughts to positive ones. It should help patients to solve their problems easily.
What are the Characteristics of Therapeutic Communication Techniques?
- Constructive Engagement
- Giving space a freedom to the patient
- Accept how the patient is
- Supportive think
- Honoring others
Skills Required for a Psychiatrist Nurse for the therapeutic Communication.
These are the abilities or the qualities that a Psychiatrist Nurse should have or need to develop to make therapeutic communication with their patients to offer them a great service.
- Capability to listen
- Capability to translate
- Capability to read
- Capability to speak in written words
- Capability to speak
- The power to observe and evaluate observation
- Ability to direct nurse patient contact to accomplish goals
- The capacity to assess when contact takes place between the patient and the nurse
- The ability to decide when to speak; the ability to stay silent; to establish a sense of timing
- Waiting capacity
- Capability to measure a patient’s interest in a relationship among the nurse patients
Barriers to Therapeutic Communication Techniques
- No listening correctly what nurse or patient is saying
- There should be a limit to advice to patient’s too much advise is not good
- Unrealistic expectations will not lead to treatments
- Going too much into personal matters should be avoided, it may go wrong
- You should listen to the patient’s feelings and problems completely