Therapeutic communication is a vital part of patient care that is often over looked. There are many reasons why therapeutic communication is not utilized as much as it should be in the clinical setting.The chief complaint from staff nurses is time. A great deal of staff feel pulled in so many directions that the thought of sparing a few minutes to really listen to what their patients are saying is over whelming. Nurses and other health care providers have to be very skilled at multitasking.There are often numerous directions they are being pulled in and unfortunately patients’ wants and even needs often fall through the cracks. I have actually heard patients say that the harried and rushed appearance of the nurse made them afraid to ask for something they wanted or even needed unfortunately. The focus has been lost in a lot of cases on what is important.Patients are often viewed simply as a body in the bed. I feel it is crucial that we don’t just nurse bodies, but minds and spirits as well. Many patients will sum up their entire experience in a hospital based on nothing more than how they were treated, if the staff was friendly and took an interest in their well being as a person. Patients are looking for a kind word and perhaps even a little sympathy from their nurses and other hospital staff.
Everyone has seen the individual that looks like they are either angry, stressed, feeling ill or maybe sad. These emotions are communicated to others not always by words, but by gestures and facial expressions. A nurse must always be aware of these expressions in clients, for these expressions may be the only way that the nurse can tell if there is something else going on that needs their attention. The term given to this type of non-verbal communication is called, meta-communication. In meta-communication, the client may look at their amputated stump and say that it doesn’t really look that bad, while at the same time tears are rolling down from their eyes. Kimmel N. (2007, June 05)
There are a number of ways to utilize therapeutic communication. A very important approach is to ask open ended questions. Open ended questions require the patient to give more than a yes or no response. Example: Does your leg hurt? Open ended: Where does your leg hurt? Open ended questions allow the nurse to get as much information from the patient as possible. Interviewing techniques are essential for building trust with the patient. There is nothing worse than finishing your shift believing you have done a good job only to find out the next day on report that your patient was in need of something or had a complaint that you did not address. Patients have to feel as though they can trust you and that you sincerely care about their well being. There are five components to the nurse-client
Relationship: trust, respect, professional intimacy, empathy and power. Therapeutic communication techniques are specific responses that encourage the expression of feelings and ideas and convey the nurse’s acceptance and respect. Potter, Perry (2001) The following is a list of Therapeutic techniques:
1.Active listening -Listening intentively with one’s whole being (mind, body and soul).
2.Sharing Observations – Stating observations helps the patient communicate without the need for extensive questioning, focusing or clarification.
3.Sharing Empathy – Builds trust. The ability to understand and accept another person’s reality, to accurately perceive feeling and to communicate this understanding to the patient.
4.Sharing Hope – Is essential for healing. Communicate a sense of possibility to others.
5.Sharing Humor – Helps nurse’s deal effectively with difficult situations and patients and creates a sense of cohesiveness between the two.
6.Sharing Feelings – Acknowledging the patients feels communicates that the nurse listened to and understood the emotional aspects of their illness situation.
8.Using Silence – Allows the patient time to think and the nurse time to observe.
9.Ask Relevant Questions – Allows the health care provider to seek information needed for decision making.
10.Provide Information – Tell the patient what they need or want to know so they can make educated decisions.
11.Paraphrasing, Clarifying, Focusing, and Summarizing – All help to ensure you are correctly interpreting what the patient was trying to communicate to you.
12.Self Disclosing – Revealing personal experiences, thoughts, ideas, values, or feelings in context of the relationship with the intent of helping the other person.
13.Confronting – Helping the patient become more aware of inconsistencies in their feelings, attitudes, beliefs and behaviors. Potter, Perry (2001)
Patient satisfaction weighs heavily on therapeutic communication.Patients in the hospital have to undergo many psychological changes in order to cope. The nurse plays a vital role in orchestrating how successful the person will be at coping. All patients have some degree of apprehension and need to be able trust their care givers and even rely on them for comfort and sympathy. When those components are not accessible to the patient the end result is always a negative experience.