Nursing Week 6: Therapeutic Communication

Week 6: Therapeutic Communication and Interviewing

• Therapeutic communication and interviewing are crucial skills for nurses and nursing students.
• Two key standards of practice are:
  • The College of Nurses of Ontario's "therapeutic nurse-client relationship" (2019, revised 2006)
  • The College of Nurses of Ontario's "confidentiality and privacy" (2019)
• Nurses and nursing students have a legal responsibility regarding confidentiality and privacy, as well as communication.

Therapeutic Communication Strategies

• Nurses use various strategies and interpersonal skills to build, maintain, and end nurse-client relationships.
• These strategies include:
  • Introducing oneself as a nurse
  • Attending to the client and family, adjusting communication styles to be appropriate.
  • Collaborating with the client, and acknowledging that client behavior has a meaning
  • Refraining from self-disclosure unless it has therapeutic value
  • Practicing self-reflection

The Client Interview

• Interviews are used to gather subjective data from the client.
• Primary and secondary sources of information may be used in the interview.
• This can include the client's family or care partners, depending on the need.

Preparing for the Interview

• Review the client's medical record before the interview.
• Consider the interview environment and how it can support effective communication.
• Understand the client's privacy and confidentiality rights, per PHIPA (2004).
• Understand who owns the data, who has access, and disclosure of personal health information.
  • Child abuse and neglect
  • Elder abuse (retirement or long-term care in Ontario)
  • Nurse posing a risk to a patient (must be reported to the College of Nurses of Ontario, CNO)

Self-reflection Before the Interview

• Recognizing and managing personal emotions and thoughts.
• Reflect on how personal feelings/thoughts might influence the interview, and consider how the environment impacts the interview.

Beginning the Interview

• Introduce oneself and address the client.
• Define the purpose of the visit
• Get clarification on preferred pronouns, and respect their choices.
• Explain that the interview will take approximately 20 minutes.

Types of Interview Questions

• Use closed-ended questions.
• Use open-ended questions
• Use Probing questions

Communication Strategies

• Clear and simple language
• Active listening (facilitation and paraphrasing)
• Silence
• Empathetic responses
• Honest responses (avoid false reassurance)

Nonverbal Communication

• Important non-verbal cues to consider are facial expressions, hand gestures, eye contact, body language, positioning, aligning nonverbal cues with verbal behaviors, and physical touch.

Cultural Considerations

• Consider culture as a major factor in interactions.
• Use a relational, inquiry-based approach to learn about the client's culture.
• Ask open-ended questions like "Tell me about your culture" to enable the client to define their culture for you.

Developmental Considerations

• Assess the client's stage of development when planning the communication.
• Young Children (under 5 years of age)
• Older children and adolescents (6-17 years)
• Adults (18 years and older)
• Older Adults (65 years and older)

Additional Considerations

• Language differences
• Emotions and trauma
• Hearing and/or visual impairment
• Intellectual impairment
• Substance use
• Escalation
• Inappropriate communication from the client

Concluding the Interview

• Summarize the key information gathered.
• Outline the next steps.

Explore the key concepts of therapeutic communication and interviewing essential for nurses and nursing students. This quiz covers the standards of practice set by the College of Nurses of Ontario, focusing on the development of effective nurse-client relationships while maintaining confidentiality and privacy.