Communication Techniques: A Guide for Nurses PDF

The Nurse-Client Relationship A relationship is an association between two or more people that develops over time. It is established between the nurse and the client when nursing services are provided. The nurse-client relationship requires the nurse to respond to the client’s needs. To meet these c...

The Nurse-Client Relationship A relationship is an association between two or more people that develops over time. It is established between the nurse and the client when nursing services are provided. The nurse-client relationship requires the nurse to respond to the client’s needs. To meet these client’s needs, the nurse performs four basic roles: 1- The nurse as caregiver: …… 2- The nurse as educator ……. 3- The nurse as collaborator …… 4- The nurse as delegator …… The Therapeutic Nurse – Client Relationship A therapeutic relationship is one whose desired outcome is improving health. A therapeutic relationship differs from a social relationship in that the therapeutic relationship is client-centered with a focus on goal achievement. It is also time-limited, meaning that the relationship ends when the goals are achieved. Principles: A therapeutic nurse-client relationship develops when the nurse treats each client as a unique person and respects the client’s feelings. The nurse strives to promote the client’s physical, emotional, social, and spiritual well- being, and encourages the client to participate in problem solving and decision-making. Phases of a nurse-client relationship (Helping relationship): 1- Introductory phase: is the period of getting acquainted. Techniques for facilitating a positive first impression include: Dressing appropriately Being well-groomed Smiling Making eye contact Greeting with a handshake Showing confidence Avoiding offensive personal odors. After the initial formalities, the client initiates the relationship by identifying one or more health problems for which he or she is seeking help. It is important for the nurse to demonstrate active listening, empathy, competency, and appropriate communication skills to ensure that the relationship begins on a positive note. 2- Working phase: is the period during which tasks are performed. It involves mutually planning the client’s care and implementing the plan. Both the nurse and the client should participate. During the working phase, the nurse should not retard the client’s independence. 3- Terminating phase: is the period when the relationship comes to an end. It is self- limiting, and occurs when the nurse and client agree that the client’s health problems have improved. A caring attitude and compassion help facilitate the client’s transition of care to other health care services or to independent living. Barriers to a therapeutic relationship: Failing to identify oneself …. Showing disinterest…. Sharing personal or work-related problems with the client… Using distasteful language… Revealing confidential information about other clients, staff, … Being inattentive to the clients’ needs … Leaving the client in a stressful situation…. Failing to keep promises….  COMMUNICATION Communication is exchange of information, and it involves both sending and receiving messages between two or more people followed by feedback indicating that the information was understood, or requires further clarification. Communication can be verbal as well as nonverbal. Verbal Communication is communication that uses words. It includes speaking, reading, and writing. Both the nurse and the client use verbal communication to gather facts, instruct, clarify, and exchange ideas. Purposes / Functions of communication include: To give information To receive information To answer questions To express feelings For clarification To give a message To offset isolation and loneliness To share ideas ** Therapeutic communication should be brief, clear, and concise (to the point). ** During therapeutic communication never ask personal questions or give personal opinions. This is non- therapeutic. Do NOT be judgmental. Do NOT belittle the client’s feelings. Do NOT give advice. Do NOT give false reassurances. Do NOT ….. Do NOT ………. Elements of the communication process include: Message ….. Sender ….. Receiver ….. Channels …. Feedback ….. Factors affecting verbal communication include: Attention and concentration ….. Language compatibility ….. Verbal skills ….. Hearing and visual acuity ….. Motor functions involving the throat, tongue, and teeth…… Sensory distractions….. Interpersonal attitudes ….. Literacy ….. Cultural similarities ….. Therapeutic verbal communication is extremely important, especially when the nurse is exploring the client’s problems, or when trying to encourage the client to express feelings. The nurse should never assume that a quiet, uncommunicative client is problem-free or understands everything Therapeutic verbal communication techniques include: Broad opening statements Giving information Open-ended questions Reflecting ….. Paraphrasing (re-stating what the client says)….. General leads ….. Sharing perceptions ….. Clarification Summarizing SILENCE ***** Listening is as important during communication as speaking. ACTIVE listening includes attending to and becoming fully involved in what the client says. Giving attention to what clients say provides a stimulus for meaningful interaction. It is important to avoid giving signals that indicate boredom or impatience. EXAMPLE ….. Eye contact …. Nodding ….. SILENCE plays an important role in communication. A common obstacle to effective communication is ignoring the importance of silence and talking excessively. “The manner in which a person conveys verbal communication affects its meaning.”  NONVERBAL COMMUNICATION Is an exchange of information without using spoken or written words. It involves what is not said. Words can be chosen with care, but a facial expression and other forms of body language are harder to control. People often communicate nonverbally through the following techniques: 1- Body language (kinesics) includes facial expressions, posture, gestures, and body movements. To create a positive impression during a client interaction, the nurse should: Assume a position at eye level with the client. Relax arms, legs, and feet. Do not cross any body part. Maintain eye contact. Lean forward to demonstrate interest and attention. Keep the legs as still as possible. 2- Paralanguage are vocal sounds that are not actually words. They also communicate a message. 3- Touch can be task-oriented or affective….. In general, affective touch is therapeutic when a client is: Lonely Uncomfortable Near death Anxious or frightened Disoriented Comatose Disfigured Visually impaired Active listening is demonstrating full attention to what is being said, hearing both the content being communicated as well as the unspoken message. Giving clients the opportunity to be heard helps them organize their thoughts and to evaluate their situation. Because clients do not always communicate their feelings, nurses use empathy to perceive the client’s emotional state and need for support. Empathy is the intuitive awareness of what the client is experiencing.