Communication

  • Importance of Communication in Healthcare: it builds trust (rapport) 

  • Nonverbal: body language- eye contact, gestures, gross motor; Positioning- leaning forward vs leading back; Stance- how close?, arms and legs crossed, relaced or restless? 

  • Double messages: Incongruent- occurs when verbal and nonverbal messages conflict 

  • Facilitators to Communication: Open ended statements vs closed ended statements 

  • Incomplete sentience- allow patient to finish 

  • Exploring 

  • Silence 

  • Redirecting 

  • Suggesting 

  • Focusing (exploring) in more detail 

  • Open-ended questions: encourage discussion and elicit longer responses. Usually “how”, “why”, or “what”; should be the first type of question 

  • Closed-ended questions: require specific, simple answers such as “yes” or “no”; often begins with “is”, “are”, “do”, or “did” 

  • Barriers to Effective Communication: judgmental, changing the subject, giving advice, self-disclosure, excessive questioning, false reassurance, avoid asking “why”, avoid explosive terms 

  • Active listening: making a conscious effort to hear and understand someone else, no blockers- leaning forward, on same level, ideally same position 

  • Characteristics of a Therapeutic relationship: mutually defined roles, defined goals, established boundaries, content, confidentially, problems are solved through partnership 

  • Establishing Trust/Rapport: should be started at the very beginning and continued throughout the therapeutic relationship, can start with something you have in common with the client-> called self-sharing 

  • Transference: occurs when a client unconsciously redirects feelings from significant people in their past onto the nurse or another person 

  • Countertransference: Occurs when a nurse displaces personal feelings from past relationships onto a patient. Often arises in response to the patient’s transference 

  • If patient express suicidal thoughts, what is the best nurse response? Treat as seriously, assess for plan and lethality, and share with the team. Never promise confidentiality when safety is involved.