NURSE-PATIENT-INTERCATION

Communication Skills

 Subjective Cues: Interviewing Clients/gathering of data

 Objective Cues:
 Are abilities used when giving and receiving different kinds of information (name, age,
birthday, birthday, occupation etc.)
 Regular part of day to day work life, in a communicating in a clear, effective way is an
extremely special and useful skill
 Allows to understand and be understood by others
 Include but are not limited to effectively communicating ideas to others, actively
listening in conversation, giving and giving critical feedback and public speaking.

“Hi I am Le Vosotros, I will be your nurse today.”

TYPES OF COMMUNICATION SKILLS

1. Active Listening
 Paying close attention to your clients
 You feel your clients
 This skill is hard to develop and improve
 Be an active listener by focusing on the speaker, avoiding distractions like
cellphones, laptops or other projects by preparing questions, comments or ideas to
thoughtfully respond.
2. Adapting your communication style to your audience
 It is important to consider your audience and the most effective format to
communicate with them.
 Speak to the client in the medium of their comfort ability.
3. Friendliness
 Honesty and Kindness foster trust and understanding
 Approach your interactions with positive attitude, keep an open mind and ask
question to help you understand where they’re coming from.
 Small gestures such as asking how they’re doing, smiling as they speak or
offering praise for work well done can help you foster productive relationship
with both colleagues and managers
4. Confidence
 People are most likely to respond to ideas that are presented with confidence
 Making eye contact when addressing someone, sitting up straight with your
shoulders open and preparing ahead of time.
 5. Giving and Receiving Feedback
 Strong communicators can accept critical feedback and provide constructive input
to others.
 Feedback should answer questions, provide or help strengthen the project or topic
at hand.
6. Volume and Clarity
 When you’re speaking, it’s important to be clear and audible.
 Adjusting your speaking voice so you can be heard in variety of settings is a skill
and it’s critical to communicating effectively.
 Speaking too loudly may be disrespectful or awkward in certain settings.
 If unsure, read room to see how others are communicating.
7. Empathy
 Mean you can understand and share the emotions of others
 This communication skill is important in both team and one-on-one settings
 In both cases you need to understand other people’s emotions and select an
appropriate response.
8. Respect
 A key aspect of respect knows when to initiate communication and respond.
 In a team or group setting, allowing others to speak without interruption is seen a
necessary communication skill,
 Respectfully communicating also means using your time with someone else
wisely – staying on topic, asking clear questions and responding fully any
questions you’ve been asked.
9. Understanding Nonverbal Cues
 A great deal of communication happens through nonverbal cues such as body
language, facial expressions and eye contact.
 When you’re listening to someone, you should be paying attention to what they’re
saying as well as their nonverbal language.
 Be patient
 By the same measure, you should be conscious of your body language when
you’re communicating to ensure you’re sending appropriate cues to others.
10. Responsiveness
 Communicators are viewed as more effective than those who are slow to respond.
 One method is to consider how long your response will take.

THREE PRINCIPLES OF EFFECTIVE NURSE-PATIENT COMMUNICATION

 Effective communication is one of the foundations of good nursing care. The honest
forms of nurse-patient communication include verbal and non-verbal communication
(e.g. body language, facial expression, gestures, and distance between you and your
patients.)
Effective nurse-patient communication can improve quality of care, clinical
outcomes, and a nurse-patient relationship that enhances patient satisfaction.
However, effective nurse-patient communication is the biggest challenge for nurses
and requires much more than experience and skills.

1. Always put the patients first

 Putting patients first takes shift of mind
 Start your conversation with the patients by taking the time to introduce
yourself and thell them how you are going to take care of them.
 Smile and use a calm and welcoming voice
 Provide comfort when they need to be comforted
 Always show respect to your patients.
 Understanding who the patients are as individuals will help the nurse connect
with them and will make the patients feel more comfortable while receiving
care and treatment.
 These approaches can make the patients feel really cared for and can improve
relationship.
2. Practice Active Listening
 It is important part of communication and requires listening for the content,
intent, and feeling of the speaker.
 It involves paying attention to what the patient say and allowing them to finish
3. Talk with heart
 It is feeling the patient.
 Communicating with patients requires ample time
 Honesty and frankness are important parts of effective communication
between nurses and patients
 To achieve effective nurse-patient communication, nurses need to have a
sincere intention to understand what concerns the patients have and show
them their kindness and courtesy.

THERAPEUTIC COMMUNICATION TECHNIQUES

 Therapeutic communication techniques are a standard part of nurse and therapist training
because;
 Nurses spend more time with hospital patients than do other clinicians
 Many patients require extensive physical, occupational, or speech

PURPOSE OF THERAPEUTIC COMMUNICATION TECHNIQUES

 Quality care goes beyond just completing tasks to your patient.

 Quality care means interacting with your patient to learn how their healing is progressing,
then tailoring your behavior to suit the unique physical and emotional needs of your
patient, at that moment. And that’s where therapeutic communication comes in.
 Therapeutic communication – an interpersonal interaction between the nurse and the
client during which the nurse focuses on the client’s specific needs to promote an
effective exchange of information. Skilled use of therapeutic communication techniques
helps the nurse understand and emphasize with the client’s experience. – Nurseslabs.com
 “Therapeutic communication is essential to the use of the self as an instrument of
healing. It is the use of verbal and non-verbal messages to establish a professional
therapeutic nurse-client relationship that will be the context for meeting the client’s
physical and psychological needs.’ Therapeutic Interaction in Nursing (Book)

By using therapeutic communication methods, a nurse can respectfully and

compassionately lead a patient to share the most patinent information about;
1. Their physical, mental, and emotional health
2. Their needs
3. Their effectiveness of treatments

The healing process for most patients involves a collection of clinical tests and treatments. But
for many patients, therapeutic communication contributes just as much to their overall healing.

Think of it like this: Clinical test look at physical attributes to assess the organs,
structure and systems of the physical body and clinical treatments seek to fix problems found by
the tests.

Therapeutic communication combines testing and treatment in a single process. It uses

observation and emphatic skills to assess and manage the patient’s emotions, determination,
feelings and attitude – their spirit and soul.

PURPOSE: To help clinicians build trust with patients while also helping clinicians and patients
collaborate and effectively toward the patient’s physical and emotional wellness.

The nurse will carry out doctor’s order; doctors diagnose

 TECHNIQUE DESCRIPTION EXAMPLE
1. Using Silence Accepting pauses or silence that may Sitting quietly (or walking
extend for several seconds or minutes with the client) and waiting
without interjecting any verbal attentively until the client is
response. able to put thoughts and
feeling into words.
2. Using Touch Providing appropriate forms of touch to Putting an arm over the
reinforce caring feelings. Because client’s shoulder.
tactile contacts vary considerably Placing the hand over the
among individuals, families and clients hand.
cultures, the nurse must be sensitive to
the differences in attitudes and practices
of clients and self.
3. Providing general Using statements that are specific that Perhaps you would like to
leads a. Encourage the client to verbalize talk about….”
b. Choose a topic conversation What are you feeling”
c. Facilitate continued
verbalization
4. Restarting or Actively listening for the client’s basic Client: I couldn’t manage to
paraphrasing message and then repeating those eat any dinner last night, not
thoughts and0or feelings in similar even the dessert
words. This conveys that the nurse has Nurse: You had difficulty
listened and understood the clients basic eating yesterday
message and also offers clients clear
idea of what they have said. C: I have troubled talking to
strangers
N: You find it difficult
talking to people you do not
know
5. Using open-ended Questions that lead or invite client to “I’d like to hear more about
questions explore (elaborate, clarify, describe, that”
compare, and illustrate thoughts or
feelings.) Tell me about

“How have you been feeling

lately?”
6. Seeking A method of making the client’s broad “Would you please say that
Clarification overall meaning of the message more again?”
understandable. It is difficult or when
the communication is garbled. “I mean this rather than that”
To clarify the message, the nurse can
restate the basic message or confess “Let me clarify what I said”
confusion and ask the client to repeat or
restate the message. The nurse can also
clarify their own message with
 statements.

7. Offering Self Suggesting one’s presence, or with I’ll stay with you until your
interest to understand the client without daughter arrives
making any demands or attaching
conditions that would make the client We can sit here quietly for a
comply while

We don’t need to talk unless

you would like to

If you need anything I’m just

at the nurse station

I’ll help you to dress when

you go home
8. Giving Providing, in a simple and direct “Your surgery is scheduled
Information manner, specific, factual information for 11 AM tomorrow”
the client may or may not request.
When information is not known, the “I do not know the answer to
nurse states this and indicates who has that, but will found out from
it or when the nurse will obtain it. Mrs. King, the nurse in-
charge
9. Acknowledgement Giving recognition, in a nonjudgmental “You trimmed your beard
way of a change in behavior; an effort and mustache.”
the client has made
“I notice you keep on
squinting your eyes.”
10. Clarifying time or Helping the client clarifying an event, Client: I vomited this
sequence situation, or helping in relationship to morning
time Nurse: Was that after
breakfast?

Client: I feel that I have been

asleep for weeks
Nurse: You had your
operation Monday, and today
is Tuesday
11. Presenting Reality Helping the client to differentiate the “That’s not a dead mouse in
real from unreal the corner. It is a discarded
washcloth.”

“Your magazine is here in the

drawer. It has not been
stolen.”
12. Reflecting Directing ideas, feelings, question or Client: What can I do?
consent to clients to enable them to Nurse: What do you think
explore their own ideas and feelings would be helpful?
about a situation C: Do you think I should tell
my husband?
N: You seem unsure about
telling your husband?
13. Summarizing Stating main point discussed. This “During the past half hour we
technique is useful at the end of an have talked about?”
interview or a review a helth teaching
session. It often acts as an introduction “Tomorrow afternoon we
to future care planning may explore this further”

Phase TASKS
A. Pre-interaction Phase The nurse pertinent knowledge, considers
potential areas of concern, and develops plan
for interaction
B. Introductory Phase Both client and nurse identify each other by
name.
1. Opening the relationship
2. Clarifying the Problem
3. Structuring and formulating the contact Nurse and client develop a degree of trust and
(obligation to be met by both the nurse verbally agree about;
and client) a. Location, frequency, and length of
meetings
C. Working Phase Nurse and client accomplish the tasks outlined
1. Exploring and understanding thoughts in the introductory phase, enhance trust and
and feelings rapport, and develop caring.
2. Facilitate and taking action The nurse assists the client to
The nurse
D. Termination Phase Nurse and client accept feelings of loss. The
client accepts the end of the relationship
without feelings of anxiety or dependence.