NSE 101 Week 6 Therapeutic Communication & Interviewing PDF

Week 6 Therapeutic Communication and Interviewing © Communication Course Teaching Team, 2023 Let’s discuss the two standards of practice from this week’s readings including the College of Nurses of Ontario “therapeutic nurse-cli...

Week 6 Therapeutic Communication and Interviewing © Communication Course Teaching Team, 2023 Let’s discuss the two standards of practice from this week’s readings including the College of Nurses of Ontario “therapeutic nurse-client relationship” (2019, revised 2006) and the College of Nurses of Ontario “confidentiality and privacy” (2019). What is your legal responsibility as a nurse and nursing student in terms of confidentiality and privacy? What is your legal responsibility as a nurse and nursing student in terms of communication?  Therapeutic Communication Nurses use a wide range of effective What does it communication strategies and interpersonal mean to skills to establish, maintain, re-establish, and adhere to terminate the nurse-client relationships. the CNO Introducing self as a nurse (2019) Referring to client standard of Listening to the client and family practice Attending to, and tailoring, communication concerning style “confidential Collaborating and client choice ity and Recognizing that all behaviour has meaning privacy”? Refraining from self-disclosure unless it has therapeutic value Self-reflection CNO, 2019, Therapeutic nurse-client relationship  Therapeutic Communication A learned activity College of Nurses of Ontario (2019, revised 2006). One of four standard Therapeutic nurse- client relationship statements in the Therapeutic Nurse-Client Relationship (CNO, 2019) – Legal obligation (Lapum et al., 2020)  The Client Interview Communication with the client to collect subjective data Primary source and secondary source Care partners (Lapum et al., 2020)  Preparing for the Interview Review client record Leverage the environment (Lapum et al., 2020)  Preparing for the Interview Privacy and Confidentiality College of Nurses of – Clients have the right to have their Ontario (2019). Confidentiality and pri personal health information kept vacy - personal health i private (PHIPA, 2004) nformation – Who has access? – Who owns the data? – Disclosure of personal health information Child abuse and neglect. Elder abuse when living in a retirement or a long-term care home in Ontario. Must report to CNO, if you observe or a client discloses a nurse who poses a serious risk of harm to patients. (Lapum et al., 2020) Self-reflection Prior to the Interview Awareness of your own emotional state. Minimizing unintentional miscommunication. Self-reflecting – How are you feeling? – What is occupying your thoughts? – In what ways are you physically expressing your emotions and thoughts? – How is your health and well-being? – What is the environment surrounding you? (Lapum et al., 2020)  Beginning the Interview Introducing self and addressing the client Identifying purpose of encounter “Hello, I am Jennifer Lapum, I am your registered nurse today. My pronouns are she. How would you like me to refer to you?” “What pronouns do you use?” “Okay, today, I am hear to learn about your health. It will involve asking you some questions and take about 20 minutes.” (Lapum et al., 2020)  Types of Interviewing Questions Closed-ended questions Open-ended questions Probing questions (Lapum et al., 2020)  Communication Strategies Clear and simple Unconditional positive language regard Active listening – Avoid questions that – Facilitation begin with “why” – Paraphrasing Permission statements Silence One question at a time Empathetic responses Vocal qualities Honest Work collaboratively – Avoid false reassurance with client – Avoid unwanted advice (Lapum et al., 2020)  Non-verbal Communication Facial expressions, hand gestures, eye S – “Sit at angle to the contact, body client” language U – “Uncross legs and arms” Positioning R – “Relax” E – “Eye contact” Aligning with verbal T – “Touch” behaviours Y – “Your intuition” (Stickley, 2011) Physical touch (Lapum et al., 2020)  Cultural Considerations People are cultural beings Culture is socially transmissible (Kashima, 2019) From an Indigenous perspective, culture is an emergent property of individuals interacting with their natural and human environments (Kim et al., 2000). A relational inquiry approach to culture – Tell me about your culture – Tell me about a typical day for you – Tell me about what is important to know about your culture in order to care for you (Lapum et al., 2020)  Developmental Considerations Chronological age and developmental stage Young children – 5 years and younger which includes infants (under one year of age), toddlers (1-2 years of age), and preschoolers (3-5 years of age). Older children and adolescents – Older children 6-12 years of age and – Adolescents 13-17 years of age Adults and older adults – Adults 18 years of age and older – Older adults 65 years and older (Lapum et al., 2020)  Additional Considerations Language discordance Emotions Violence and trauma Hearing and visual impairment Intellectual impairment Substance impairment Escalation Inappropriate communication from the client (Lapum et al., 2020)  Concluding the Interview Brief summary Next steps (Lapum et al., 2020)