COMMUNICATION
REFERENCE: GROUP 1’S PPT / KOZIER’S BOOK: CHAPTER 26
THERAPEUTIC COMMUNICATION: Face-to-face process
of interacting that focuses on advancing the physical and
emotional well-being of a patient.
● Nurses use therapeutic communication techniques to
provide support and information to patients
○ 13 techniques
● A nurse–patient relationship with appropriate
professional role boundaries.
○ In correctional settings, nurses must be able to
communicate with patients, other health care
providers, correctional staff and outside providers.
● Often use open-ended statements and questions.
FOUR ELEMENTS
‣ Sender: message source
‣ Message: information transmitted
‣ Receiver: recipient or receiver; to whom the message is
addressed to
‣ Feedback: response to the message of the sender
CHARACTERISTICS
‣ Empathy: desire to understand and be sensitive to
feelings, beliefs, and situation of another person
‣ Respect: valuing the client and being flexible to meet the
client’s needs.
‣ Genuineness: ability to respond honestly
‣ Concreteness: being specific, definite, and vivid rather
than vague and general
GOALS
a. Establishing rapport (nurse - client relationship)
b. Identifying the most important client concern at the
moment
c. Being empathetic, genuine, caring, and
unconditionally accepting the person / patient
d. Developing problem - solving skills
e. Assess the client’s condition
PHASES
→ PRE INTERACTION PHASE: exploring own feelings,
fantasies and fears
→ INTRODUCTORY or ORIENTATION PHASE:
determining why patient needs help.
→ WORKING PHASE: The nurse and the patient explore
stressors and promote the development of insight of the
patient by linking perceptions, thoughts, emotions and
actions
→ TERMINATION PHASE: This is the time to exchange
feelings and memories and to evaluate mutually the
patient’s process and goal attainment.
13 TECHNIQUES
1. ATTENTIVE, ACTIVE LISTENING - nurse's hearing,
processing and purposefully comprehending the client's
words, as well as processing these words in the context
of the client's situation
2. SILENCE - to think about and reflect on the full meaning
of received message ; to give the client ample time to
fully and openly discuss their feelings, opinions and
beliefs
3. FOCUSING - facilitates the client's abilities to focus on
and pay attention to the matters at hand, which should
reflect the client's priorities
4. USING OPEN ENDED QUESTION - to attain fuller and
deeper information from the client and when the nurse
is facilitating the client's full and free ventilation and
expressions of their own feelings and beliefs
5. CLARIFICATION - to insure that the nurse has received
and interpreted the complete and correct message
without any errors, without any bias and without any
false assumptions
6. EXPLORING - encourage the client to provide more
details and information about a particular topic or health
care problem
7. PARAPHRASING - to clarify a client's message, is used
by the nurse to rephrase a client's comment or question
in a manner that is similar to what the nurse thinks that
they have heard and understood
8. RESTATING - to clarify the client's message by
repeating the same statement back to the client
9. REFLECTION - reflects and mirrors what the nurse
believes the client's feelings to be underneath the words
10. PROVIDING LEADS TO THE PATIENT - enables the
client to continue discussing things with the nurse and it
also facilitates the client's beginning a new discussion
that is focused on a particular thing
11. SUMMARIZING - sums up the primary and main points
that were discussed as well as the conclusion of the
discussion that was mutually decided up
12. RECOGNITION, ACKNOWLEDGEMENT AND
ACCEPTANCE - give the nurse the opportunity to let
the client know that you are interested in them and
respectful of them and their thoughts
13. OFFERING OF SELF - nurse's willingness and
unconditional offering of self and their time to the client
and their needs with only limited self-disclosure by the
nurse that directly assists the client with meeting their
needs
COMMUNICATING: Developing an effective
communication between healthcare providers and
FROM GROUP 1’S PPT & FUNDA BOOK PDF / AM
 COMMUNICATION
REFERENCE: GROUP 1’S PPT / KOZIER’S BOOK: CHAPTER 26

especially to patients is one of the most important tools we

have for providing great patient care and improving patient
satisfaction.

PROCESS AND MODES

Use the five "A's" to remember the critical steps of the
evidence-based practice process:

ASK the answerable clinical question.

⇢ Recognize the existence of problems (trigger)
⇢ Form a team

ACQUIRE the most relevant and best evidence to answer

the question.
⇢ Assemble relevant research and related literature

APPRAISE the evidence critically for validity, relevance,

and applicability.
⇢ Critique and synthesize research
APPLY the evidence, along with critical expertise and the
patient's preferences and values.
⇢ Determine the sufficiency of the research
⇢ Determine if change is appropriate to adopt into
practice
⇢ Institute change if appropriate
ASSESS the effectiveness and efficiency of the previous
four steps and seek ways to improve one's ability to ask,
acquire, appraise, and apply.

⇢ Monitor and analyze the structure, process, and

outcome data
⇢ Disseminate results throughout the unit or organization

ELDERSPEAK is a speech style similar to baby talk that

gives the message of dependence and incompetence and
is seen as patronizing by older adults (Morrow, 2013). It
does not communicate respect.

The characteristics of elderspeak include inappropriate

terms of endearment (e.g., “honey”, “grandma”),
inappropriate plural pronoun use (e.g., “Are we ready for our
bath”), tag questions (e.g., “You want to wear this dress”),
and slow, loud speech (Cunningham & Williams, 2007, p.
46).

PROCESS RECORDING is a verbatim (word-for-word)

account of a conversation. It can be taped or written and
includes all verbal and nonverbal inter- actions of both the
client and nurse. One method of writing a process recording
is to make two col- umns on a page. The first column lists
what the nurse and the cli- ent said along with the
associated nonverbal behavior.

FROM GROUP 1’S PPT & FUNDA BOOK PDF / AM

 COMMUNICATION
REFERENCE: GROUP 1’S PPT / KOZIER’S BOOK: CHAPTER 26

FROM GROUP 1’S PPT & FUNDA BOOK PDF / AM