THERAPEUTIC COMMUNICATION

Nursing is a caring profession that is becoming more and more evidenced based in its practice. As much as the scientific aspects of nursing is increasing due to the complex technological advancement of medicine and the machinery used at the patients bedside, the fact remains that the nurse is the first person that the patient usually comes in contact with any hospital setting. A large part of the nursing career therefore involves both verbal and non verbal transmission of information to the patient, his / her relations, members of the health care team and vice versa.

INTRODUCTION

 Communication is the process of transmitting messages and interpreting their meaning. It is the interchange of information between two or more people. Therapeutic communication on the hand, is the process of transmitting and interpreting messages in which the nurse seeks to elicit a response from the patient that is beneficial to the patients health (kimmel 2007). Berman et al (2008) also defined it as an interactive process between the nurse and client that helps the client overcome temporary stress, to get along with other people to adjust to the unalterable and to overcome psychological blocks that stand in the way of self realization

WHAT IS THERAPEUTIC COMMUNICATION

WHAT IS THERAPEUTIC COMMUNICATION CONTD

The act of communication includes collecting information, conveying information to others and influencing others. Therapeutic communication in nursing reinforces the nurse-patient relationship and makes the nurse appear more humane to a patient. It involves the human element of appropriate emotions in the nursing practice.

WHAT IS THERAPEUTIC COMMUNICATION CONTD

The quality of nurses communication often affects the patients return to health. At the core of nursing is the therapeutic nurse-patient relationship which is a product of therapeutic communication and is based on trust, respect, empathy and professional intimacy.this relationship also requires appropriate use of the power inherent in the nurses role in patient care.

Objectives of therapeutic communication

At the end of the session, participants should be able to: facilitate the establishment of nurse-client relationship promote clients participation in their care accelerate the process of recovery provide nursing care effectively and efficiently in all setting.

Principles of therapeutic communication

plan to interview the client at an appropriate time e.g. do not plan a talk with the client during visiting hours, change of shift or when the patient is distracted by another activity ensure privacy because clients are entitled to confidentiality. This can be achieved by screening the clients bed, closing the door to the room of finding a quite scheduled place. Establish guidelines for the interaction

Principles of therapeutic communication 2

Ensure clients comfort during therapeutic communication Accept the client exactly as he/she is. Do not be judgemental and remove personal feelings, values and prejudices Encourage the patient to speak freely and focus on the clients problems, needs or concern Be aware of your own felings during the interaction because nurses anxiety influences therapeutic communication.

Things to be considered in therapeutic communication

There are four things to be considered in therapeutic communication. These are The nurse needs to look at what the patient is seeing, hearing, feeling and smelling in the facility How is the stimulus affecting the patient? Are the patients needs being met or not? What does the patient require to have his/her needs met?

Techniques of responding in therapeutic communication

Identifying your self and respecting the patient through humble self introduction and addressing the patient by name and title Provide general leads for discussion Be silent while the patient is putting thoughts and words together

Techniques of responding in therapeutic communication

Paraphrasing: this involves restating what was said. It involves listening to the patients basic message and then repeating the thoughts or feelings in similar words Clarifying i.e. making the patients message more understandable by asking questions Using open-ended questions and statements Be specific, tentative and informative

contd
Touch the patient while talking Clarify, time or sequence Summarize discussions

Barriers to therapeutic communication

Communication barriers present real challenges to all nurse and makes it difficult to achieve quick recovery from illness. The followings are some barriers to therapeutic communication Language differences: an inability to communicate effectively with health care providers adversely affects clients response to interventions. Nurses should select words that are easily understood by the client Socio-cultural differences: there are variations in the use of language by cultures and subcultures. Nurses should avoid the use of medical jargons. Health status: ones health status affects communication. For example an oriented client will communicate more reliably than a delirious, confused or disoriented client.

Barriers to therapeutic communication 2

Gender women tend to decode non verbal cue than men Developmental level: communication with children requires the use of different approaches. It is necessary to relate with the clients at the clients developmental level. Knowledge difference: nurses should take note of the clients vocabulary and his/her educational background. Emotional status: when the nurse or client is anxious, communication may be difficult. Nurse should adopt proper approaches in cases of anxiety.

Barriers to therapeutic communication 4

Agreement/disagreement Probing Testing and challenging responses. These responses should be avoided so that patients can benefit from therapeutic communication

Non therapeutic communication

Despite the importance of therapeutic communication in patient care, many nurses are involved in non-therapeutic responses. These non-therapeutic responses include: Failure to listen to client Unwarranted reassurances Judgmental responses to client

Barriers to therapeutic communication 3

Approval/disapproval which tells patients that they must measure up to the nurses standards rather than their own goal. General advice Defensive responses to clients

Conclusion
Therapeutic communication in nursing allows for the patients and their families to feel that someone actually cares for them in their time of need. This can be a fundamental factor in the recovery of death process of a patient. When a patient receives therapeutic communication from the nurse, a level of trust is achieved and patients entire condition can change. His/her blood pressure, respiration and level of stress can simultaneously decrease and pain management, if any is involved, can be resolved more quickly.

Conclusion 2
When the nurse masters the technique of therapeutic communication, he/ she becomes caring, sensitive, skillful and professionally sound.

With therapeutic communication, the patients emotional state is considered as important.

The patient is made to fell that he/she is in caring and competent hands.

Thank you for listening