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INTRODUCTION
Being able to communicate is an essential skill for all health pro-fessionals and it is
particularly important for nurses who are with people and their families for many hours a
day. It is not always easy to understand what people are saying or to get them to
understand what you are trying to tell them. Sometimes nurses
who qualified in the UK have difficulties understanding people who have regional accents
and many patients use different words for feelings and everyday events.
Nurses need to communicate so they can find out about the people in their care by
taking a nursing history, give them information about their care and teach them about
managing their illness. Short case histories that focus on a particular activity are included
to help you with some common situations. There are extracts from dialogues
(conversations) between nurses and peo-ple/clients/relatives that give you examples of
what they may say to you in answer to your questions. These case histories will be useful
when you deal with similar situations at work, and later reflect on the positive and negative
features of a particular con-versation you had with a patient/client and their family.
Therapeutic Communication Techniques
When communication is incomplete, inappropriate, or absent, patients may
experience fear and confusion that leads to increased risk to their safety (Peplau, 1952).
Nursing practice is equipped with a strong basis of communication skill. Therapeutic
communication promotes understanding that helps establish a constructive relationship
between the nurse and the client (Berman et.al: 2008, p. 467). Unlike the social
relationship where there may not be a specific purpose or direction, the therapeutic helping
relationship is client and goal directed
Technique
Using silence
Description
Accepting pauses or silences
that may extend for several
seconds or minutes without
interjecting any verbal
response.
Examples
Sitting quietly (or walking with the
client) and waiting attentively until
the client is able to put thoughts and
feelings into words.
Providing general
Leads
Using open-ended
questions
Using touch
Providing appropriate forms
of touch to reinforce caring
feelings. Because tactile
contacts vary considerably
among individuals, families,
and cultures, the nurse must
be sensitive to the differences
in attitudes and practices of
clients and self.
Restating or
Paraphrasing
Seeking
clarification
Perception
checking
or seeking
consensual
validation
Offering self
Giving information
Acknowledging
10
Clarifying time or
Sequence
11
Presenting reality
unreal.
Focusing
12
13
Reflecting
coverings."
"Your magazine is here in the drawer.
It has not been stolen."
Client:"My wife says she will look
after me, but I don't think she can,
what with the children to take care
of, and they're always after her about
somethingclothes, homework,
what's for dinner that night."
Nurse:"Sounds like you are worried
about how well she can manage.
14
Summarizing and
Planning
15
16