Therapeutic Communication in Healthcare CH 24

Effective Communication in Nursing

• Effective communication skills promote working relationships, improve patient outcomes, increase patient satisfaction, and reduce the risk of errors.
• Communication is a lifelong learning process.

Therapeutic Relationships

• Therapeutic relationships are formed between a nurse and a patient, and are characterized by effective communication, empathy, and trust.
• Nurses use their understanding of culture, previous experiences, and critical thinking to gather comprehensive information about patients.
• Critical thinking attitudes and ethical standards of care lead to clinical decisions that promote effective communication.

Types of Communication

• Intrapersonal communication: self-talk, influences perceptions, feelings, behavior, and self-esteem.
• Interpersonal communication: one-on-one interaction between a nurse and another person, occurs face-to-face or via electronic format.
• Small-group communication: interaction between a small number of people, outcome-oriented, requires understanding of group dynamics.
• Public communication: interaction with an audience, occurs through presentations, education, or public speaking.
• Electronic communication: use of technology to create ongoing relationships with patients and health care teams.

Communication Process

• Circular transactional model includes: referent, sender, receiver, message, channels, context, feedback, and interpersonal variables.
• Communication is continuous and interactive, influenced by perception, culture, and experiences.
• Effective messages are clear, direct, timely, and understandable.

Nonverbal Communication

• Personal appearance, facial expressions, posture, and gait convey emotions and attitudes.
• Eye contact shows respect, engagement, and willingness to listen.
• Gestures, sounds, and territoriality are important aspects of nonverbal communication.

Caring Relationships

• Caring relationships are the foundation of clinical nursing practice.
• Nurses assume a professional role, caring about patients and their unique needs.
• Motivational interviewing encourages patients to share thoughts and goals, promoting behavioral change.

Nurse-Patient Relationships

• Forming caring relationships with patients and families requires understanding of family dynamics and needs.
• Effective communication with patients and families affects patient outcomes, safety, and work environment.

Nurse-Health Care Team Relationships

• Effective communication with other health care team members affects patient outcomes, safety, and work environment.
• Lateral violence or workplace bullying can occur, leading to job dissatisfaction and poor teamwork.

Nurse-Community Relationships

• Nurses form relationships with community groups through participation, volunteering, and political activity.
• Providing clear and accurate information to the public promotes change and prevents errors.

Communication Skills

• Trust is built through consistency, reliability, honesty, competence, and respect.
• Assertiveness allows expression of feelings and ideas without judgment.
• Active listening involves attention to verbal and nonverbal cues.
• Empathy is understanding and accepting another person's reality.
• Humor is a coping strategy that reduces anxiety and promotes positive feelings.
• Touch is a potent form of communication, expressing concern and caring.
• Silence can be a powerful tool for observation and reflection.
• Providing relevant information promotes decision-making, reduces anxiety, and increases feelings of safety and security.

Therapeutic Techniques

• Clarifying involves restating unclear messages to ensure understanding.
• Focusing centers a conversation on key elements of a message.
• Paraphrasing restates a message in one's own words.
• Validation recognizes and acknowledges a patient's thoughts, feelings, and needs.
• Asking relevant questions seeks information for decision-making.
• Summarizing is a concise review of key aspects of an interaction.
• Self-disclosures involve sharing subjective personal experiences to build trust.
• Confronting involves helping others become aware of inconsistencies in feelings, attitudes, and behaviors.

Professional Communication

• Asking personal questions that are not relevant to a situation is inappropriate and invasive.
• Suggestions should be presented as options, and the final decision should be made by the other person.
• The problem and its solution belong to the other person, not to the communicator.

Avoiding Miscommunication

• Changing the subject when someone is trying to communicate is rude and shows a lack of empathy.
• Automatic responses based on stereotypes can threaten relationships and reflect poor judgment.
• False reassurance can discourage open communication and prevent further expression of feelings.

Empathy vs. Sympathy

• Sympathy is a subjective look at another person's world and can prevent a clear perspective on their issues.
• Empathy is a more therapeutic approach, allowing for a clear understanding of the other person's situation.

Effective Communication

• Avoid asking "why" questions, which can cause resentment and mistrust.
• Instead, ask open-ended questions to encourage communication, such as "What's on your mind?"
• Listen nonjudgmentally to patients' concerns and avoid giving approval or disapproval.
• Help patients explore their own beliefs and decisions.

Dealing with Criticism

• Listen to patients' criticism without becoming defensive.
• Avoid passive or aggressive responses, and instead use assertive communication.
• Challenging perceptions can deny their validity; instead, present reality in a non-confrontational way.

Cultural Awareness

• Be aware of cultural patterns of interaction, but avoid bias and respect individuality.
• Adapt communication techniques based on patient preferences and cultural context.

Special Communication Needs

• Interact with people who have speech or language impairments with thought and sensitivity.
• Use appropriate interventions based on patient needs and adapt communication techniques.

Evaluating Communication

• Evaluate the success of the plan of care in facilitating communication.
• Determine a patient's perception of the success of the plan of care.
• Modify the plan of care if expected outcomes are not met or progress is unsatisfactory.

This quiz assesses therapeutic communication skills in healthcare, focusing on effective team communication, patient satisfaction, and clinical standards of care.