Nurses communication skills and the therapeutic relationship

nurses communication skills and the therapeutic relationship

A therapeutic nurse-patient relationship is defined as a helping relationship that's physical, emotional, and spiritual needs through your knowledge and skill. nonverbal communication is an important part of the nurse-patient interaction. Here are 10 communication skills for nurses to master (with clear examples). The relationship between Lisa and her siblings is complicated, and all of them have .. That is the best therapeutic gift you can give your patient. Explore aspects that foster a therapeutic nurse-client rela- tionship and those that Communication skills used in social relationships may include giving advice.

The concept is also interrelated with that of patient-centered care. Patient-centered care also known as person-centered or patient- and family-centered care describes a standard of care that ensures the patient and their family are at the center of care delivery. Therefore, the aim of this review is to identify strategies to enhance therapeutic interpersonal relationships between patients and health care professionals in the acute care setting.

Methods Integrative review process An integrative review is a research strategy involving the review, synthesis, and critique of extant literature. In addition, the reference lists of potential papers retrieved were examined to identify any further material that met the inclusion criteria. Both versions of British and American spellings were used to construct the search strategy as to reflect a systematic and comprehensive approach.

The concept of therapeutic interpersonal relationships is not confined to any specific time period or type of peer-reviewed publication, and so no limitations were placed on these parameters to ensure a broad and diverse scope of knowledge. Papers that focused on pediatrics and adolescence were also excluded as this review focused on adult patient—staff interaction.

In addition, papers involving student cohorts were also excluded as were papers that reported solely on satisfaction surveys. Data evaluation The search strategy initially identified papers after removal of duplicates Figure 1.

The authors RK and KW independently identified 37 potential papers for inclusion based on titles and abstracts. Patient Rights v Family Rights Patients have the right to competent care, protection from reasonable risks, and advocacy from their nurse. If the relatives are disturbing the patient, working them up, or causing more stress, the nurse has to step in and remove the family. It is a difficult situation to be put in because no one wants to separate a family from their loved one.

Is this helping them or hurting them? Most families will not cause stress, but sometimes even the most laid back family may cry, focus only on the negative, or in other ways upset the patient. In these cases, it is important to talk to the patient and the family member.

Communication Skills for Nurses - 10 Tips for Improvement| Ausmed

Ask the patient if they are comfortable with their family and if they would like the family to have restricted access to them. Most will decline, but at least you are offering the opportunity to the patient.

Next, talk with the family. Explain that their behaviours are upsetting the patient and that a different approach is needed. There is no reason to be falsely happy, but tell them to simply be with the patient instead of focussing on the negative. In the end, talking to a patient may be easier than talking to their family. Patients may not understand what is going on with them, and their relatives are basically in the same position.

However, they also have the added stress of not knowing if their loved one will make it through. Acknowledge the fear they are feeling and offer them the same compassion you would offer your patients. This makes sense, because as a person ages they may require more frequent care. Communicating with patients is a skill that you need to practice. Memory and cognitive disturbances can also make talking to this population challenging.

It is hard to dedicate the time necessary to talk properly to an older person, but this is the way to open the communication channel.

It is only over time that you get the whole story.

Communication Skills for Nurses

This is especially true of doctors, but they may feel the same reticence when talking to nurses. If you are there and available for their concerns, they may be more willing to talk to you than to the doctor who might only spend five minutes in the room. You may find out something that is vital to the care and comfort of that patient just by spending an extra few minutes with them. Yes, nurses are busy, but older people need time to express their pain, fear, and questions, and you need to allow for that in your schedule.

Explain Things Simply As with children, it is best to avoid medical jargon when speaking with older people. It is a fine line to walk, and you need to base your language on the questions and cognitive ability of the patient you are speaking with. Click To Tweet Try to use language that is simple, clear, and non-threatening.

Communication in Nursing Practice

You should also strive to be as honest as possible. Some older patients need to write down what you are telling them so that they will remember it. Be prepared to repeat yourself and express concepts in different ways so that your patient can grasp what you are trying to say.

One of the most important parts of helping your elderly patients is acting as a kind of interpreter for the doctor. Try to be on hand when the doctor talks to the patient so you can explain later what they said. They will wait and ask you later to get a better understanding.

Although she is forgetful, she is still able to live a relatively independent life. She experienced an episode of fainting that was witnessed by several people at church, and she was taken to her primary care physician.

It took a great deal of talking to her to help her understand that the fainting spell was, in fact, a major problem that needed to be investigated. In addition to restricting her driving privileges, Carolyn needed several tests to rule out different probable causes of her fainting spell.

Each test needed to be carefully explained to Carolyn and the information repeated so that she could grasp what each one required. She wrote down all the key information in a system that she had developed to keep herself from forgetting important points. It takes careful reminding to keep her from driving her car or performing other actions that may put her in danger.

Include Family in the Conversation Finally, including family is a big part of communicating with older people.

nurses communication skills and the therapeutic relationship

You should always try to keep your older patient in the conversation, although not much of it may be understood. Often children, spouses and family friends can help the older person understand what is needed from them. Family and friends can help you to communicate with an older patient because they know how that person thinks.

It may help to have a three-way conversation between the patient, their caregiver, and yourself. When everyone works together to help the patient understand, you stand a much better chance of putting him or her at ease with all that is happening around them. Not only are you trying to explain a difficult situation to a child, but you are trying to include the parents in the conversation as well.

It is natural for a child to be scared, unreasonable and resistant to medical treatment, and it takes a skilled nurse to work through these roadblocks to achieve understanding. As with most communication, listening and allowing the patient to be heard will serve you well in talking to children. Communicating with Children When talking to children you want to avoid medical jargon. For very young children, you have to use words that are as simple as possible.

Even then, you may not get them to understand because their fear response is overriding everything else. However, you have to use care when talking to older children. You have to make a mental note of the age of the patient and their level of understanding, and tailor your speech to meet their needs.

nurses communication skills and the therapeutic relationship

You need to moderate your language, get down on the level of the child, and use a soft tone of voice. Sometimes, though, you need to do something that will cause them discomfort, and you must explain this with honesty and using straightforward language.

Talking to Parents Part of communicating with children is communicating with their parents. Again, you are likely to be dealing with someone who is in a great deal of distress and fear. It is helpful to try to allay their fears, answering all their questions as honestly as possible.

Some parents may get emotional and you need to be aware of possible outbursts of anger or sorrow. Either of these can upset your patient and that can go against what you are trying to accomplish.

Try talking to parents away from the child and use active listening techniques, as you would for any other patient, family and relatives. Case Study Daniel was a two-year-old heart patient who was preparing for his second open-heart surgery. Already, starting the IV line had been a traumatic event.

nurses communication skills and the therapeutic relationship

Then one of the nurses from the OR came into the room the night before the operation with a bag of items. She got down on her knees with Daniel and showed him the hairnet he would wear, the tubes that would come out of him, and the mask that would be placed over his face.

Instead of being afraid, Daniel was fascinated with the new toys in front of him and played with them all. During this time, the nurse took the time to talk to the parents about their concerns.

nurses communication skills and the therapeutic relationship

She helped them to understand what would happen, explaining the procedure, the heart-lung machine, and the estimated time of the surgery. When the nurse prepared to leave after half an hour of talking, both Daniel and his parents were much more at ease. Although all of them were still afraid of the surgery, it helped to know a little bit about what would happen so not everything would come as a shock. Click To Tweet Including the Child Finally, it is important to include the child when talking about procedures or their health.

It is so much easier to talk to the parents that you may have a tendency to ignore the child. Children are very sensitive to this, and they do not appreciate being ignored.

You should address the child at the beginning of your explanation and try to focus your talk on them and their needs. At the end, you should also ask the child if he or she has any questions. They may not, but it helps them to feel included if you treat them like more than just a parcel to be taken here and there. Talk to the child as much as possible, and then take the parents out of the room for more adult conversation, if needed.

It is challenging and often awkward to face the person. You might be too professional and distant, or you may go the other way, and be more emotional and connected than you should be.

Communication in Nursing Practice

Remember, you have a roster of patients, and the wear and tear from becoming too emotionally involved can lead to burnout. How do you successfully balance all of the emotional roadblocks that can arise when dealing with a patient who has a poor prognosis? It is important for you to be mentally healthy when working as a nurse, but especially when working with a population of patients who are in the process of dying.

This means taking care of yourself and having ways to de-stress and unwind. When you go home you need to leave the sadness and emotion of the job at work. If you take it home you could end up becoming a victim of compassion fatigue—a syndrome that can lead to anger, depression, substance abuse, and other problems.

Communicating with dying patients is difficult and taking care of yourself emotionally should always come first. Most people who are dying are aware of what is happening. However, if you enter the room tongue tied and sad the patient could feel as if you pity them.

Neither of these approaches will make your patient feel supported through this difficult time. Instead, you should approach the patient with neutrality. You are an open, loving caregiver. You tend to their needs and answer their questions with honesty. It can be challenging to be open. When a patient asks a difficult question you may be tempted to pass the buck to other caregivers or to gloss over it. However, your patients have the right to know what their condition is.

That is part of ethical nursing. Your patient may also need to open up to someone and trusts you because you are their nurse. Although it may be difficult, always tell your patient the truth when they ask questions. Being Present Sometimes, in this situation the best communication is not saying anything at all. This is not always easy; one part of you may want to draw the person out to explore their feelings while another part of you would just like the distraction of talking to avoid awkwardness.

Neither of these approaches is helpful to a dying person. You just need to be present. In some cases, silence is more helpful than talking. Maybe your patient has been talked to so much that the quiet helps to finally give them a chance to talk.

They could also be tired of talking because everyone wants to know everything about what they are feeling. Helping Families Families of dying patients are also suffering, and it can be challenging to communicate with them as well. Honesty is always the best course of action to take with families. They will know you are hiding the truth and may resent you for telling them something false.

One of the best ways to talk to families is through active listening. Since these people may be highly emotional they have the need to be heard as much as the patient. Active listening means that you reflect back to the person what they are communicating to you.

Can you tell me more about that? Is that what you are trying to say? This can help with any emotional situation from anger to sorrow to apathy. Nurses teach and help patients communicate their needs, but something about silence is therapeutic too.

Once again, openness and the willingness to be with the patient will either help them to talk or give them a much-needed rest.

That is the best therapeutic gift you can give your patient. Chances are, this strategy of communicating with doctors is not going to get you far. You have a very busy, often impatient, person listening to you. You have to make the most of your time, and the best way to do that is with organisation.

It stands for identify, situation, background, assessment, and recommendation. Merely having this structure in your head when picking up that phone to the doctor can make the call flow a bit more smoothly. The doctor on the other end will get a clear picture, you will get all of your information out concisely, and the patient will get the treatment they need. Identification First, identify who you are, your role and who you are talking about your patient or client.

Situation The situation part of ISBAR seems self-explanatory, but it can often throw you off when dealing with a patient you are not sure about or just have a bad feeling about. It gets a little more difficult to state the situation when the patient is not presenting something black and white, so you should take some time to think about what is prompting your call to the doctor.

What exactly is it that is bothering you? What do you think the doctor can do for you? In this section of the report, state concisely whom you are calling about and what prompted the call. Background The background section of this approach has the most variability built into it. However, if the patient has been going to this doctor for 30 years, you probably wont need to give as much background. The timeline leading up to the situation is important. What was the patient doing earlier in the day that may have an impact on the current situation?

Did they have some incident or event that has some bearing on how they are acting now? Assessment All doctors will ask for them, regardless of the reason you are calling. Pathology, recent test data and any other collected information from the history can also be given at this time.