Therapeutic communication/ relationships

• how can you assess data using therapeutic communication?

  • Sit when communicating with a patient.
  • Be alert and relaxed and take your time.
  • Keep the conversation as natural as possible.
  • Maintain eye contact if appropriate.
  • Use appropriate facial expressions and body gestures.
  • Think before responding to the patient.
  • Do not pretend to listen.
  • Listen for themes in the patient’s comments.
  • Use silence, therapeutic touch, and humor appropriately.
• how can you use self in therapeutic communication?

  • Confident; open body posture
  • Use of clear, concise “I” statements
  • Ability to share effectively one’s thoughts, feelings, and emotions
  • Working to capacity with or without supervision
  • Remaining calm under supervision
  • Asking for help when necessary
  • Giving and accepting compliments
  • Admitting mistakes and taking responsibility for them
• What are the communication techniques to conduct a client-focused interchange?

  • Open-ended questions or comments
  • Closed questions or comments
  • Validating questions or comments
  • Clarifying questions or comments
  • Reflective questions or comments
  • Sequencing questions or comments
  • Directing questions or comments
• when might a patient identify immediate issues or concerns?

  During the working phase
• what are the orientation phase goals?

  • The patient will call the nurse by name.
  • The patient will accurately describe the roles of the participants in the relationship.
  • The patient and nurse will establish an agreement about:
  • Goals of the relationship
  • Location, frequency, and length of the contacts
  • Duration of the relationship.
• what are the working phase goals?

  • The patient will actively participate in the relationship.
  • The patient will cooperate in activities that work toward achieving mutually acceptable goals.
  • The patient will express feelings and concerns to the nurse.
• What are the termination phase goals?

  • The patient will participate in identifying the goals accomplished or the progress made toward goals.
  • The patient will verbalize feelings about the termination of the relationship.
• how does culture affect therapeutic communication?

  The culturally determined context, values, beliefs and practices will strongly influence patient expectations, preferences and behaviours
• How does spirituality affect therapeutic communication?

  beliefs about life, health, illness, death, and one’s relationship to the universe; involves the essence of a person’s being and their beliefs about the meaning of life and the purpose for living
• What are the factors that influence communication?

  • Developmental level
  • Gender
  • Sociocultural differences
  • Roles and responsibilities
  • Space and territoriality
  • Physical, mental, and emotional state
  • Values
  • Environment
• Social media guidelines are regulated

  Both the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN)
• E-mail and text messages

  The risk for violating patient privacy and confidentiality exists any time a message is sent electronically
• The Nursing Process:  Assessment

  • Assess for factors that are detrimental to establishing therapeutic communication
  • Accurate data collection
• The Nursing Process:  Analysis/Diagnosis

  • The statement of the nursing diagnosis must be clear and concise
  • What are some possible NANDA diagnoses?
• The Nursing Process:  Planning

  • Involves accurate communication among all members of the healthcare team, as well as with the client and the family.
  • Individualized outcomes and goals depends on the nursing diagnosis 
  • Encourage client to explore possibilities and give input regarding solutions to his/her problem.
• The Nursing Process:  Intervention

  • The nurse communicates with the client and family
  • The nurse communicates his or her impressions and observations to other members of the healthcare team
  • Specific interventions depend on the problem and goals identified
• The Nursing Process:  Evaluation

  • Did the client receive your messages accurately?
  • How will you assess this?
  • Does Plan of Care need to be revised?
• What is the therapeutic relationship?

  Trust, genuine interest, empathy, acceptance, and positive regard
• What is the nurses' role in a therapeutic relationship?

  communication skills, personal strengths, and understanding of human behavior to interact with the client
• what is the patient's role in a therapeutic relationship?

  the social or intimate relationship in many ways because it focuses on the needs, experiences, feelings, and ideas
• What is the emotional impact of illness on the client and the family?

  stressed, confused, vulnerable
• what might be a patient's relationship within their family?

  Supportive or not in any contact
• what might be a patient's relationship within their occupation?

  Maslow hierarchy

  is needed for the feeling of security
• what might be a patient relationship within their community?

  may not have resources to help the patient heal
• What are the psychosocial benefits of the therapeutic nurse-client relationship?

  improvements in patient satisfaction, adherence to treatment, quality of life, levels of anxiety and depression, and decreased healthcare costs
• What are the physiological benefits of the therapeutic nursing-client relationship?

  Improved outcomes
• What is the difference between therapeutic and social relationships?

  therapeutic - it focuses on the needs, experiences, feelings, and ideas of the client only

  social - primarily initiated for the purpose of friendship, socialization, companionship, or accomplishment of a task
• What is the  “Nurse Know Thyself” tenet

  It is about the nurse's self-awareness to prevent prejudice.

  as well as knowing when to leave things at work and not causing themselves compassion fatigue
• What are some reasons for the confidentiality of information received from the client?

  Privacy, trust, legal requirements.

  allows for a clear boundary