Communication technique that can have beneficial impact for psychiatric nursing...
Restating
What is said is the AAA of the communication, while BBB is how it is said, i.e. the nonverbal cues a person gives tom substantiate (or contradict) the verbal message
A) Content
B) Process
When contentand processare in agreement, we have a AAA message. if not, then we have BBB message.
A) "Healthy"
B) confusing
When content and process are conflicting, we have AAA or BBB messages.
A) mixed
b) double
Therapeutic communication techniques include:
Use of silence
Active listening
Clarifying techniques
Clarifying (i.e. making sure you are understanding the Pt) techniques include:
Paraphrasing- restating content, often in fewer words.
Restating- uses same key words that Pt used plus puts into words, the information the Pt conveyed by "process".
Reflecting- could be a question or a statement, but it is a means of keeping the Pt talking on a specific subject.
Exploring - How is this different than "reflecting"?
When to use Closed-ended questions?
Sparingly to get specific need information.
Most useful during initial assessment t or intake interviews.
Ideal seating
90-120 degree angle, so nurse and Pt can look away w/o discomfort.
Avoid face-to-face.
Neither person should be or feel trapped, i.e. never have the Pt between the nurse and the door, nor vice versa.
Avoid a desk between the nurse and the Pt.
Introductions...
Ask the Pt how they would like to be addressed.
Two elements of Body Language
Kinesics - body movements and postures, facial expression, etc.
Proxemics - personal space. In U.S.
intimate: 0-18"
personal: (friends & colleagues) 18-40"
social: (strangers & acquaintances) 4-12'
public: (public speaking) 12+'
Process Recordings
notes made after the interview which
What is the focus during clinical supervision?
A. The nurse's behavior in the nurse-client relationship
Clinical supervision helps the nurse look at his or her own behavior and determine more effective approaches to working with clients. Text pages: 190, 191
Two main principles that can guide the communication process during the nurse-client interview are
D. clarity and giving recognition.
Clarity refers to mutual understanding of communication, and giving recognition indicates awareness of change and personal efforts (Note: this is DIFFERENT than "giving approval, agreeing). Both are desirable. Text pages: 181-183
A client shares that, "I can't stand his controlling ways. I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nursing using when responding, "Are you saying that things would be better if you left your husband?"
B. Clarification
Clarification verifies the nurse's interpretation of the client's message. Text page: 188
With which client would making direct eye contact help further the nurse-client relationship?
C. Mr. D, a recent immigrant from Germany
Eye contact conveys interest to most northern European individuals. Eye contact would be considered intrusive to the others. Text page: 187