ORE CONCEPTS ON positive aspects of the resume of what has transpired

THERAPEUTIC patients
COMMUNICATION. NURSE PATIENT
personality. RELATIONSHIP
Communication – refers to the - Series of interaction between the
Example: “I noticed that
reciprocal exchange of ideas you combed
between or your hair today.” nurse and patient in which the nurse
among persons. To establish rapport and assist the patient to attain positive
build trust behavioral change.
Elements of Communication: - Giving information:
• Sender – originator of responding with CHARACTERISTICS
information. the needed facts. • It is goal directed, focused on the
• Message – information being needs of the patient, planned,
transmitted. - Use of silence: time limited and professional.
• Receiver – recipient of refraining from sppech
information. to give the patient a time
• Channel – mode of BASIC ELEMENTS
communication. to sort out
thoughts and feelings. Trust
• Feedback – return response.
• Context – the setting of Rapport
communication. To gather information
Criteria of successful - Focusing: assisting a
Unconditional positive regard
communication: patient to
• Feedback explore a specific topic. Setting limits
• Appropriateness Example: Patient: “I
• Flexibility can’t decide Therapeutic communication
• Efficiency about…”
Common problems in PHASES
communication Nurse:
• Dysfunctional communication “Let’s talk about that. A.PRE-INTERACTION PHASE
• Double blind communication • Begins when the nurse is
Perhaps if we talk about
• Differences between the assigned to a patient.
denotative and connotative it, it will help • Phase of NPR in which the patient
meaning. you to decide.” is excluded as an active
• Incongruent communication. participant
Common techniques in - Validating: confirming • Nurse feels certain degree of
communication one’s anxiety
To initiate conversation: observation. • Includes all of what the nurse
Example: “Are you thinks and does before interacting
- Giving broad openiong: giving saying that…” with the patient
- Relflecting: directing • Major task of the nurse: develop
the back ideas, self awareness
patient an opportunity to set the feelings and content. • Data gathering, planning for first
direction of the conversation. Example: “You feel interaction
tense when you B. ORIENTATION PHASE
Example: “Is there anything that fight.” • Begins when the nurse and the
you - Restating: repeating patients interacts for the first
want to talk about?” what the patient time
had said. • Parameters of the relationship
- Giving recognition: focusing on - Summarizing: are laid
the developing a concise • Nurse begins to know about the
patient COMMON
• Major task of the nurse: develop PROBLEMS
a mutually acceptable contract AFFECTING
• Determine why the patient COMMUNICATION
sought help • Transference – the
• Establish rapport, develop trust, development
assessment of an emotional attitude
of the
C. WORKING PHASE patient either positive or
• It is highly individualized negative
• More structured than the towards the nurse
orientation phase • Resistance –
• The longest and most productive development of
phase of the NPR ambivalent feeling
• Limit setting is employed towards self-
• Major task: Identification and exploration
resolution of the patient’s • Counter transference –
problems transference as
• Planning and implementation experienced by
the nurse
D. TERMINATION PHASE
• It is a gradual weaning process PRINCIPLES OF
• It is a mutual agreement CARE IN
• It involves feelings of anxiety PSYCHIATRIC
• It should be recognized in the SETTINGS
orientation phase
• Major task: to assist the patient • The nurse views the
to review what he has learned patient as a
and transfer his learning to his Holistic human being
relationship with others with
• Evaluation interdependent and
When to Terminate? interrelated
• When goals have been needs
accomplished • The nurse accepts the
• When the patient is emotionally patient as
stable a unique human being
• When the patient exhibits with
greater independence inherent value and worth
• When the patient able to cope exactly
with anxiety separation, fear and as he is.
loss • The nurse should focus
How to Terminate? on the
• Gradually decreased interaction patient’s behavior non-
time judgmentally, while
• Focus on future oriented topics assisting the
• Encourage expression of feelings patient to learn more
• Make the necessary referral adaptive
ways of coping