Post by annelieseRN on May 22, 2017 11:53:21 GMT -5
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Theraputic Communication: Approaches & Effectiveness
We communicate practically every minute of every day of our waking lives, yet few of us communicate effectively. How often have we heard the phrase, “No, I didn’t mean to say it that way?” and inevitable feelings get hurt or directions get messed up. Effective communication is a very powerful deed! It can calm the disparaging soul or it can start an all-out war! All good leaders know how to communicate effectively and as nurses, we are not exempt. For indeed, someone’s life may depend on our ability to communicate effectively.
Silence is very important in our ability to communicate effectively. In James 1:19 of the Holy Scriptures we are instructed to “…quick to listen, slow to speak, and slow to get angry….” Notice it said, “quick to listen” we cannot listen if we are talking constantly. Sometimes it more therapeutic just to stop and listen. No words needed.
Accepting is just as implied. Simply nod your head and say, “yes, I am following what you are saying” and then allow the individual to continue.
Giving Recognition is another technique often overlooked by some. This is simply acknowledging that the person exists. This is a wonderful way to brighten someone’s day even but a little especially when they are not feeling well. “Good Morning, Ms. Garrison. You look nice today.” Even if they respond in a negative way, one person acknowledged they exist and a kind word goes a lot farther than we know.
Offering Self every good leader does this whether you have been appointed to the leadership position such as a Reverend, Director Of Nursing, A college professor or like yourself, a natural born leader. The best leaders are the ones that can put themselves in other’s shoes. Never tell someone else to do something you yourself cannot do. “Anneliese, here you go. Let me help you put this IV in with your client so you can go on break”. Do this every once in a while, and your employees will know they have a leader who can do more than just bark out orders. When answer questions on your NCLEX exam, the word “Let’s” offers self. (i.e. Let’s see how your toddler will respond if we ……… “.
Giving Broad Openings works very well in staff meetings or at the beginning of a class session. “Is there anything you would like to talk about?” “Do you have questions about anything?” As leaders, this is a good way to get old business out of the way and talk about the new day that we are about to embark upon. As nurses, this is a very important step to do in order to make sure the client understands our take home instructions or to evaluate their understanding of their illness.
Offering General Leads / Facilitation What does facilitate mean. Yes, I am a Registered Nurse by profession but I also call myself an “Expert NCLEX facilitator” what am I saying to you the reader? A facilitator is a person who makes an action or process easier. So, as an NCLEX tutor, I am helping you to understand your Nursing Boards so that it will not be as difficult for you to pass your NCLEX. In like manner, nurses need to do this with their patients, or clients as the NCLEX likes to now call them. In doing so, we will bridge the gap between illness and wellness. When our client is trying to explain something, I often have to say “Slow down so I can understand you and explain your situation to me please. I am listening.” Those of us who are parents do this all the time with our children, don’t we?
Empathy is very different from sympathy. Sympathy is understanding what an individual is going through and as nurses, surely, we can sympathize with an individual. Our training has prepared us somewhat for this. Empathy is knowing what an individual is going through. i.e. one may know the terrible feelings of withdraw symptoms because we ourselves have undergone the same exact feelings. For example, I myself know the terrible hurt and frustration of failing the NCLEX because I myself failed twice in 1996. This type of communication works well when we have a client that will not cooperate and says, “You are not me. You have no idea what I am going through!” Be careful not to get drawn in too far and tell too much of your personal life at this point in time should you choose to use this technique.
Eye Contact is offered as much as the culture will allow. i.e. A person of Islamic culture if talking to a male and the nurse is a female, they do not allow for such contact. A person of India decent may look down when speaking. A person that may not being truthful about their illness may look away too. So too, may an individual who may be embarrassed of their illness. Mastering eye contact is a skill that takes practice but it is important as a sign to show the individual you care and respect them. If it is a child or an elderly person in a wheelchair, sit down and bring yourself to their level. It is said that the eyes are the window to the soul. More and more nursing is becoming a part of a holistic profession.
Humor is a burst of energy that makes a tense situation easier. I wrote a paper on this topic, :”Humor Helps the Medicine Go Down” and it does. But please use this cautiously. Do not use degrading humor. In fact, if you are not generally funny or maybe you are inappropriately funny at times, please think before you speak. Once someone came into the ER that was involved in a multi vehicle accident. I was the intake person for that day. The gentleman was being very uncooperative: “Mr. Smith, What do you do for a living?” I am a driving instructor, he yelled. Long pause … Blood pressure 210 over 190 …. “Well, what were you doing, a demonstration? Everyone laughed. Mr. Smith started to calm down and was much more cooperative. As mentioned, use with caution. One night a client died in the Nursing Home of which I was the Supervisor. I left the family in the room to be alone with the client. To be honest, I was relieved he had passed because he use to be combative with me on a few occasions kicking me in the abdomen and sending another aide to the hospital due to making her loose he balance and fall. Relieved yes, but waking down the hall to the aides singing “Celebrate goo times – come on!” was inappropriate humor! Every once in a while, what is meant to be funny, is not. Think before you speak when using humor.
Making Observations is verbalizing what you perceive to be true is a useful technique and one that I use often to make sure I understand what the person is trying to say. For your NCLEX This would be paraphrasing or repeating back to the client what they just said. This is always the answer for the NCLEX. However, I have to warn you if the client has their wits about them they may respond like they did to me, “Yes, I just said that. What’s the matter with you don’t you listen!” Do not take this personal and it is better than saying that you do not understand what they are trying to say.
Inclusion / Collaboration is not pointing any one single person out. When talking to a caregiver this works well. Always include the caregiver and the client when talking to the caregiver and when answering questions on the NCLEX. “What have family members been doing to help you care for your spouse?” is a better question than, “With the Latter question, Mr. Smith can have a respite and refreshed once again to continue to care for his loved one but with the first question, we may find out he does not have any family members to help him care for his loved one in which case, we as the nurse would take correct actions to help him in this situation. Always include all members of the group. This works well as leaders. The NCLEX would call this a multidisciplinary approach.
Giving Information is extremely valuable as a leader. Give facts and information whenever possible. In this way, your staff will know what is expected of you and your client will understand what they need to know to reach their optimal level of wellness.
Reflecting is used when the client asks you as the nurse your advice. As nurses, we must stay within the scope of our practice. Giving our clients personal advice is not to be done. i.e “Do you think I should tell the doctor?” your response as a nurse can be, “Do you think you should”. Every good leader in every profession will allow for an individual to make their own choices when they are able to do so. As leaders, we should give those around us some autonomy. You don’t want people to be so dependent on you that they become reliant on us because we will not be available at all times. Reflecting works best when you want your followers to have some autonomy.
Focusing is used when a client seems to be wondering in all different directions. If it is your staff you can simply state: “Please focus on the topic at hand”. But for your client and for the NCLEX, you can say something like, “This seems worth discussing a little bit more”. This technique will draw the individual into the topic you are trying to explain.
Summation is used when you want to tie everything together and be sure the staff understand your directions or as a leader to be sure that the people understand what you have been trying to get across to them. “For the past 15 minutes we have been talking about…” Today, we are going to accomplish ,,,” and so forth. This is very important when doing client teaching as a tool to make sure they understand everything before discharge. In fact, I will use this technique now.
In summary, when we learned about therapeutic communication in school, we were told never to ask a why question but we did not know why? Once should never ask a why question because for one thing the person may not know why and for another, it is a closed ended question. You may ask “Why? And they may say answer. The end. Go to next question. A why question is sometimes unexplorable because it is a closed question by nature. All these techniques mentioned here allow for continuous free-flowing communication even when the spoken word is not spoken, silence too, can be golden.
If you would like tutoring for your NCLEX, please contact me.
Anneliese Garrison, RN BSN CLNC NIS
caring4you.net
"healing the community one student at a time"
Please feel free to call: 1.856.392.9620 New Jersey
Expert NCLEX Facilitator since 1997
Theraputic Communication: Approaches & Effectiveness
We communicate practically every minute of every day of our waking lives, yet few of us communicate effectively. How often have we heard the phrase, “No, I didn’t mean to say it that way?” and inevitable feelings get hurt or directions get messed up. Effective communication is a very powerful deed! It can calm the disparaging soul or it can start an all-out war! All good leaders know how to communicate effectively and as nurses, we are not exempt. For indeed, someone’s life may depend on our ability to communicate effectively.
Silence is very important in our ability to communicate effectively. In James 1:19 of the Holy Scriptures we are instructed to “…quick to listen, slow to speak, and slow to get angry….” Notice it said, “quick to listen” we cannot listen if we are talking constantly. Sometimes it more therapeutic just to stop and listen. No words needed.
Accepting is just as implied. Simply nod your head and say, “yes, I am following what you are saying” and then allow the individual to continue.
Giving Recognition is another technique often overlooked by some. This is simply acknowledging that the person exists. This is a wonderful way to brighten someone’s day even but a little especially when they are not feeling well. “Good Morning, Ms. Garrison. You look nice today.” Even if they respond in a negative way, one person acknowledged they exist and a kind word goes a lot farther than we know.
Offering Self every good leader does this whether you have been appointed to the leadership position such as a Reverend, Director Of Nursing, A college professor or like yourself, a natural born leader. The best leaders are the ones that can put themselves in other’s shoes. Never tell someone else to do something you yourself cannot do. “Anneliese, here you go. Let me help you put this IV in with your client so you can go on break”. Do this every once in a while, and your employees will know they have a leader who can do more than just bark out orders. When answer questions on your NCLEX exam, the word “Let’s” offers self. (i.e. Let’s see how your toddler will respond if we ……… “.
Giving Broad Openings works very well in staff meetings or at the beginning of a class session. “Is there anything you would like to talk about?” “Do you have questions about anything?” As leaders, this is a good way to get old business out of the way and talk about the new day that we are about to embark upon. As nurses, this is a very important step to do in order to make sure the client understands our take home instructions or to evaluate their understanding of their illness.
Offering General Leads / Facilitation What does facilitate mean. Yes, I am a Registered Nurse by profession but I also call myself an “Expert NCLEX facilitator” what am I saying to you the reader? A facilitator is a person who makes an action or process easier. So, as an NCLEX tutor, I am helping you to understand your Nursing Boards so that it will not be as difficult for you to pass your NCLEX. In like manner, nurses need to do this with their patients, or clients as the NCLEX likes to now call them. In doing so, we will bridge the gap between illness and wellness. When our client is trying to explain something, I often have to say “Slow down so I can understand you and explain your situation to me please. I am listening.” Those of us who are parents do this all the time with our children, don’t we?
Empathy is very different from sympathy. Sympathy is understanding what an individual is going through and as nurses, surely, we can sympathize with an individual. Our training has prepared us somewhat for this. Empathy is knowing what an individual is going through. i.e. one may know the terrible feelings of withdraw symptoms because we ourselves have undergone the same exact feelings. For example, I myself know the terrible hurt and frustration of failing the NCLEX because I myself failed twice in 1996. This type of communication works well when we have a client that will not cooperate and says, “You are not me. You have no idea what I am going through!” Be careful not to get drawn in too far and tell too much of your personal life at this point in time should you choose to use this technique.
Eye Contact is offered as much as the culture will allow. i.e. A person of Islamic culture if talking to a male and the nurse is a female, they do not allow for such contact. A person of India decent may look down when speaking. A person that may not being truthful about their illness may look away too. So too, may an individual who may be embarrassed of their illness. Mastering eye contact is a skill that takes practice but it is important as a sign to show the individual you care and respect them. If it is a child or an elderly person in a wheelchair, sit down and bring yourself to their level. It is said that the eyes are the window to the soul. More and more nursing is becoming a part of a holistic profession.
Humor is a burst of energy that makes a tense situation easier. I wrote a paper on this topic, :”Humor Helps the Medicine Go Down” and it does. But please use this cautiously. Do not use degrading humor. In fact, if you are not generally funny or maybe you are inappropriately funny at times, please think before you speak. Once someone came into the ER that was involved in a multi vehicle accident. I was the intake person for that day. The gentleman was being very uncooperative: “Mr. Smith, What do you do for a living?” I am a driving instructor, he yelled. Long pause … Blood pressure 210 over 190 …. “Well, what were you doing, a demonstration? Everyone laughed. Mr. Smith started to calm down and was much more cooperative. As mentioned, use with caution. One night a client died in the Nursing Home of which I was the Supervisor. I left the family in the room to be alone with the client. To be honest, I was relieved he had passed because he use to be combative with me on a few occasions kicking me in the abdomen and sending another aide to the hospital due to making her loose he balance and fall. Relieved yes, but waking down the hall to the aides singing “Celebrate goo times – come on!” was inappropriate humor! Every once in a while, what is meant to be funny, is not. Think before you speak when using humor.
Making Observations is verbalizing what you perceive to be true is a useful technique and one that I use often to make sure I understand what the person is trying to say. For your NCLEX This would be paraphrasing or repeating back to the client what they just said. This is always the answer for the NCLEX. However, I have to warn you if the client has their wits about them they may respond like they did to me, “Yes, I just said that. What’s the matter with you don’t you listen!” Do not take this personal and it is better than saying that you do not understand what they are trying to say.
Inclusion / Collaboration is not pointing any one single person out. When talking to a caregiver this works well. Always include the caregiver and the client when talking to the caregiver and when answering questions on the NCLEX. “What have family members been doing to help you care for your spouse?” is a better question than, “With the Latter question, Mr. Smith can have a respite and refreshed once again to continue to care for his loved one but with the first question, we may find out he does not have any family members to help him care for his loved one in which case, we as the nurse would take correct actions to help him in this situation. Always include all members of the group. This works well as leaders. The NCLEX would call this a multidisciplinary approach.
Giving Information is extremely valuable as a leader. Give facts and information whenever possible. In this way, your staff will know what is expected of you and your client will understand what they need to know to reach their optimal level of wellness.
Reflecting is used when the client asks you as the nurse your advice. As nurses, we must stay within the scope of our practice. Giving our clients personal advice is not to be done. i.e “Do you think I should tell the doctor?” your response as a nurse can be, “Do you think you should”. Every good leader in every profession will allow for an individual to make their own choices when they are able to do so. As leaders, we should give those around us some autonomy. You don’t want people to be so dependent on you that they become reliant on us because we will not be available at all times. Reflecting works best when you want your followers to have some autonomy.
Focusing is used when a client seems to be wondering in all different directions. If it is your staff you can simply state: “Please focus on the topic at hand”. But for your client and for the NCLEX, you can say something like, “This seems worth discussing a little bit more”. This technique will draw the individual into the topic you are trying to explain.
Summation is used when you want to tie everything together and be sure the staff understand your directions or as a leader to be sure that the people understand what you have been trying to get across to them. “For the past 15 minutes we have been talking about…” Today, we are going to accomplish ,,,” and so forth. This is very important when doing client teaching as a tool to make sure they understand everything before discharge. In fact, I will use this technique now.
In summary, when we learned about therapeutic communication in school, we were told never to ask a why question but we did not know why? Once should never ask a why question because for one thing the person may not know why and for another, it is a closed ended question. You may ask “Why? And they may say answer. The end. Go to next question. A why question is sometimes unexplorable because it is a closed question by nature. All these techniques mentioned here allow for continuous free-flowing communication even when the spoken word is not spoken, silence too, can be golden.
If you would like tutoring for your NCLEX, please contact me.
Anneliese Garrison, RN BSN CLNC NIS
caring4you.net
"healing the community one student at a time"
Please feel free to call: 1.856.392.9620 New Jersey
Expert NCLEX Facilitator since 1997