Communicating and the Therapeutic Relationship

Communication is very important in nursing to get information from clients, for patient education and for therapeutic reasons.This podcast is a summary for the therapeutic communication chapter hope you find it helpful.

Lecture notes

Therapeutic Communication differs from normal communication in that it introduces an element of EMPATHY into what can be a traumatic experience for the patient.
It imparts a feeling of comfort in the face of even the most horrific news about the patient’s prognosis.
The patient is made to feel validated and respected.

Communication cycle includes
Sender
Message
Receiver
Feedback

Types of communication
Verbal
Non verbal

Communication Skills

1. USING SILENCE...utilizing absence of verbal communication.
Silence in itself often encourages the patient to verbalize if it is an interested, expectant silence. This kind of silence indicated to the patient that the nurse expects him to speak, to take the initiative, to communicate that which is most pressing. It gives the patient the opportunity to collect and organize his thoughts, to think through a point, or to consider introducing a topic of greater concern to him than the one being discussed. A positive and accepting silence can be a valuable therapeutic tool.

(1) It encourages the patient to talk;

(2) directs his thoughts to the task at hand--the consideration of his problem;

(3) reduces the pace of the interview when either the nurse or the patient is pressing or pushing too hard;

(4) gives the patient time to consider alternative courses of action, delve deeply into his feelings, or weigh a decision;

(5) and allows the patient to discover that he can be accepted even though he is silent, that even though he is shy and quiet, he has worth and is respected by another person.

Much nonverbal communication occurs during these interludes. The nurse needs to be alert to what she is communicating as well as perceiving. Even momentary loss of interest can be interpreted as indifference. Schwartz and Schockley state that the utilization of silence is often difficult for nursing personnel, since they think that nothing is happening and that they are wasting their time. In long periods of silence, they may become bored and their attention wanders from the patient. If the nurse could observe the patient and herself carefully, she might discover that a great deal happens between then at these times.

2. ACCEPTING...giving indication of reception.
"Yes." "Uh hmm." "I follow what you said." Nodding.
An accepting response, such as "I'm with you" or "I follow what you're saying," indicates that the nurse has heard and has followed the trend of thought. Such responses signify that the nurse is attuned to the patient, that communication is occurring, and that she is a participant rather than a passive observer. Accepting does not indicate agreement but is nonjudgemental in character. "It is simply a verbalization of the attitudes of permissiveness and acceptance of the counselor which say in effect: "Go on, it's safe, you needn't be ashamed of expressing how you really feel."

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Communicating & the Therapeutic Relationship Video Tutorial