NUR1 222 Week 3 Part 2 Therapeutic Relationships and Clinical Conversations PDF

Therapeutic Relationships and Clinical Conversations (conʼt) Part 2 Sept 21. 2023 Outline - Review Discussion Posts - Continuation of Therapeutic Relationships and Clinical Conversations - Well office Presentation - Quiz Explores eightyseven emotions and experiences that define what it means to...

Therapeutic Relationships and Clinical Conversations (conʼt) Part 2 Sept 21. 2023 Outline - Review Discussion Posts - Continuation of Therapeutic Relationships and Clinical Conversations - Well office Presentation - Quiz Explores eightyseven emotions and experiences that define what it means to be human. (Findings from research) Social Worker, Professor Brené Brown Chapter 7 “Places We Go with Others”: Compassion, Pity, Empathy, Sympathy, Boundaries, Comparative Suffering “Whatʼs the most effective way to be in connection with and in service to someone who is struggling, without taking on their issues as our own?” Brené Brown Compassion “Is the daily practice of recognizing and accepting our shared humanity so that we treat ourselves and others with loving kindness, and we take action in the face of suffering.” p. 118 Empathy (Brené Brown) v An emotional skill set; most powerful tool of compassion. v “Allows us to understand what someone is experiencing and to reflect back that understanding.” p. 120 v “Understanding what someone is feeling, not feeling it for them v Not ” Walking in someone elseʼs shoes”. “I want to listen to your story/tell me about what itʼs like to be in your shoes. Understand the personʼs perspective. Sympathy (Brené Brown) “Near enemy of empathy.” “I feel sorry for you.” Form of disconnection “That must be terrible.” with others. (Person standing at a safe distance) Empathy is not about relating “How can I be empathic with to an experience, itʼs someone if I haven't had their connecting to what someone is experience?” feeling about an experience. (Brown p. 125) "We can respond empathically only if we are willing to be present to someoneʼs pain. If weʼre not willing to do that itʼs not real empathy.” p. 121 (Brene Brown, 2021) Person Centered Communication “A Way of Being” - Person and family at the center of care and decision making - Focus not only one health issues also on social care - culture, values, family, diversity,environment, social economic status, lifestyles - Connecting with person and family to improve Health Outcomes Person Centered Communication Nurses - Inform - Support - Care - Educate - Empower - ….. To assist patients in Manage their Health – Related Issues … Unique Ways of Communicating - Every person has a unique way of communicating (personal characteristics, culture, previous life and health experiences, language, education..) • Open, like to talk, comfortable with sharing • Closed, shy, uncomfortable sharing with others Close Ended Questions - Narrow focus - Single Answer - Assessment - “Do you have allergies?” - Useful in emergency situations - Obtain information quickly - “Does the pain radiate down your lef t shoulder and arm?” - “When was your last meal?” Active Listening Responses (Mallette et al., 2021) p. 83 Negative Listening Responses (Mallette et al., 2021) p.86 Patient: “I donʼt have any questions.” Nurse: “One question I am frequently asked is…” Common Errors in Communication (Gottlieb, 2013 Table 8.15 p.309) Avoid “Why” questions. Patient may feel like he is being judged/blamed. Avoid Leading questions. May suggest to patient how he should be feeling/what he should be thinking.. Avoid Negative Phrasing. Avoid Unfamiliar Language • e.g. “Why did you not call your family doctor before coming to the emergency?” • e.g. ”Do you think your migraines are due to the stress you are experiencing?” • e.g. “You are not worried, are you? • e.g. “Your ECG shows that you are experiencing tachycardia? Verbal Responses - Choice of words matter - Words canʼt be erased - but can be explained or modified - Words may be misinterpreted - Check for cues (clarify) -Clear, concise, understandable to the listener Tips - Introduce yourself at the beginning of the shift - Inform patients when you are going on your breaks - Say goodbye at the end of the shift - Introduce yourself to visitors Phases of Therapeutic Relationship (Kozier et al., 2018) Pre – interaction Phase Introductory Phase Working Phase Termination Phase Reviewing information that nurse already has about patient/family Get to know patient/family Explore patient/family situation Exploring and understanding thoughts and feelings Saying goodbye may be difficulty May involve planning Developing trust Facilitating and taking Patient/family may action – establishing experience feelings of goals and working loss towards them together May involve dealing with any feelings related to interaction e.g. anxiety Nurse makes patient/family feel understood and respected Sharing feelings about termination openly and honestly Phases of a Person – Centered Relationship (Mallette et al., 2021 Chapter 11) Ø Pre – Interaction Phase Ø Orientation Phase (Introductory in Kozier) Ø Working Phase Ø Termination References B r o w n , B. 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