THERAPEUTIC COMMUNICATION

SCENE: A nursing dealing with a victim of sexual abuse.

CHARACTERS:
Nurse: Abigail (Krizha Angela Nicolas)
Patient: Sofia (Kazlle Sheen V. Miniano)

PRE-ORIENTATION PHASE

OBJECTIVES
During this phase, the nurse will be able to:
● Obtain available information about the client from her charts, significant others or other health team members.
This initial information may also allow the nurse to become aware of personal response to the knowledge about the client.
● Examine one’s feelings, fears and anxieties.
● Plans how she is going to interact with the patient, what to achieve from this interaction and how she is going to help the patient.

[Nurse POV]
A nurse starts for a new day. She starts her day with a prayer.
Pray: Dear Lord, help me remember what a difference it makes when I make time with you, you’re a priority in my morning. Thank you
for waking me each day. You speak words of affirmation, assurance and wisdom over my heart as I prepare to go into my day.
 After her prayer, she arranges her bed, prepares her breakfast, and takes the shower. She prepares herself physically, emotionally,
spiritually and mentally to face things today.

[30 minutes before the session]

Nurse Abigail prepares herself before the session. She looked into the patient’s information and examine how she is going to interact
with the patient. She plans her objectives in the interaction and set goals in able to deliver a patient-centered care.

ORIENTATION PHASE

OBJECTIVES
During this phase, the student will be able to:
● To build rapport to gain the trust and cooperation of the patient
● To gather necessary information about the patient
● Introduce the patient to what he could expect from the student nurse.
● Establish a therapeutic environment ensuring safety and privacy

NURSE PATIENT THERAPEUTIC RATIONALE

COMMUNICATION
 TECHNIQUE
Verbal Non - Verbal Verbal Non - Verbal

Good morning Ms. ● Waves hand No Response ● No reaction at all ● Giving Recognition ● Greeting acknowledge
Sofia! ● Smile client’s presence as well as
creating a good start and
knowing client disposition.

I am nurse Abigail, ● Maintains moderate No Response ● No reaction at all ● Giving Information ● Introducing and informing
your psychiatric eye contact the client about facts is
nurse. It’s nice to ● Smiling important in developing a
meet you Sofia. ● Good and open foundation for therapeutic
posture relationship.

● Clarifies the purpose and

● Good and open No Response ● Stares at the ● Establishing specifics of the nature of the relationship.
I am here to help you. posture nurse relationship time, date, place and Providing information about
We will be having a ● Smile duration of meetings the appointment and describing
one-on-one casual ● Maintain nurse’s role.
talk so that I would professional
know a little more boundaries
information about
you. This session
lasts for an hour every
Friday, 9-10 in the
morning.
● Smile ● Teary-eyed and ● Data Collection ● This question gains basic but
How are you these ● Good and open embarrassed vital information to identify
days? posture health status and functioning. It
● In face to face No Response also helps the nurse to
position to the client understand the client more in
● Moderate eye able for her to promote trust
contact and reduce anxiety by being
genuine, respectful and
informative.

● Good and open ● Looked down ● Giving Assurance and ●Helps the client to relieve her
Don’t worry, Sofia. posture Encouragement discomfort, fear and distress. It
No one will know ● In face to face helps to promote an open and
what we are going position to the client No Response honest communication.
to talk about. I ● Moderate eye
assure you that all contact
information will be ● Pleasing eyes
treated with strict ● Encoura-ging
confidentiality and voice.
highest ethical
standards.

WORKING PHASE
 OBJECTIVES
During this phase, the nurse will be able to:
● To work with the patient to solve problems and accomplish goals
● To encourage and helps client to set goals
● Takes action to meet the goals set with the patient
● Provides information needed to understand and change behavior

NURSE PATIENT THERAPEUTIC RATIONALE

COMMUNICATION
TECHNIQUE

I am sorry for what ● Good and open No Response ● Lift her head ● Encouraging and informing ● Giving ideas to the patient
happened to you but posture ● Face the nurse the client what to expect from the student
Sofia what ● In face to face ● Teary-eyed nurse will allow the patient to
happened to you is position to the client prepare, gain knowledge and to
not your fault at all. ● Encouraging voice be aware to the nursing
I can’t imagine what interventions that will be done.
happened to you. I
know this might be
uncomfortable for
you but I wanted to
know. I am here to
listen.

I wasn’t in your ● Good and open No Response ● Stares at the

shoes but I wanted posture nurse
to understand so ● In face to face ● Teary-eyed
that I can help you. position to the client
I’m just here, Sofia. ● Encouraging voice
I will listen. If
you’re not yet
ready. I can wait.

SILENCE ●Giving Recognition ● Recognition,

(3 minutes) acknowledgment and
acceptance of the thoughts and
feelings. It is an opportunity to
That must have been ● In face to face How long I am ● Crying let the client know that the
really difficult. position to the client going to feel like nurse is interested in her story
this? It’s terrible. and respect her.
How can I put it
into words? It’s
too much for my
soul alone.

How long have you ● In face to face Since that day, I ●Encouraging description ● To understand the client, the
been feeling this way? position to the client struggle too nurse must see things from her
much. I always perspective. Encouraging the
remember it. client to discuss ideas fully
may relieve the tension that the
client feels.

Can you tell me ● In face to face I remember ● Crying ●Seeking information ●Questions asking for more
what’s that like for position to the client everything in information to gain additional
you? detail that day. I details and encourage patient to
was attacked and provide more information
so helpless. I did about a particular topic.
everything to
escape but I can’t
defend myself.
The force is too
strong. I feel so…

You’re doing fine. ● In face to face I feel so unworthy ● Crying ●Giving Recognition ●Indicates awareness or noting
Just tell me what position to the client and dirty. I went the efforts the client has made.
happened. there to celebrate
my friend’s
birthday but I
ended up like this.
I am drunk but I
still know what I
am doing. I went t
to the room to get
some sleep
because I feel
dizzy. He went
after me and
locked the door. I
don’t want such
thing to happen. It
was all his evil
acts! I resisted
but I don’t have
enough energy to
 defend myself.

● In face to face 3 months ago, on ● Crying

When was that ●Seeking information ●Questions asking for more
position to the client Alilea’s birthday
happened? information to gain additional
party. After that I
can’t face anyone. details and encourage patient to
My life is ruined. provide more information
It feels like it is about a particular topic.
happening all
over again. It
becomes
miserable day by
day.

So that moment keeps ● In face to face Yes, it’s like a ● Crying ●Restating & Seeking clarification ●This encourages the client to
on flashing back and position to the client curse. It keeps on continue sharing her thoughts.
it made you miserable haunting me.
day by day? Can you Most of the time I
tell me if you’ve been feel ashamed on
thinking about myself and that’s
harming yourself? the time I wanted
to end my life.

Did you tell someone ● In face to face How am I able to ● Crying ● Exploring
or anyone about what position to the client face someone? I ● Exploring can help them
examine the issue more fully and
you feel? am afraid of in depth.
criticisms. I feel
like my world
will abandon me
for I am so filthy.

So it must be really ● In face to face I wanted to end ● Stares at the ●Restating & Seeking clarification ●This encourages the client to
taking over your life. position to the client everything. How nurse continue sharing her thoughts.
long I’ll be this ● Teary-eyed
miserable? It feels
like it will last
forever.

● Telling the patient’s do’s and

● In face to face We cannot do ● Stares at the ● Informing
That’s why we’re don’t’s will bring him more
here…we are doing position to the client anything. It’s nurse
already done. ● Teary-eyed knowledge and information
this one-on-one about his health.
session so we can do
something about it.

● In face to face No response ● Stares at the ● Giving ideas to the patient

Yes, we can’t undo position to the client nurse ● Encouraging and informing what to expect from the student
what’s happened but ● Encouraging voice ● Looks down the client nurse will allow the patient to
what we can do prepare, gain knowledge and to
together is to
be aware to the nursing
minimize the impact
on the way you interventions that will be done.
function. Sofia, we
can work together for
you to overcome this.
 Sofia’s cooperate with her psychiatric nurse and attend all her sessions. She is now better and confident with herself.

TERMINATION PHASE

OBJECTIVES
During this phase, the student nurse will be able to:
● to evaluates goal achievement with the client
● student nurse and client express thoughts and feelings about termination
● observe client – high level of anxiety during this phase

NURSE PATIENT THERAPEUTIC RATIONALE

COMMUNICATION
TECHNIQUE

This will be our last ● In face to face Thank you so ● Smiling ●Giving recognition ●Indicates awareness or noting
session, Sofia. I am so position to the client much, nurse ● Looks at the the efforts the client has made.
proud of you. ● Encouraging voice Abigail. I am now nurse Showing of appreciation and
free respect.

● In face to face I couldn’t be here ● Smiling

I knew you could do ●Summarizing ●It seeks to bring out the
position to the client without your help ● Looks at the
it since our first important points of the discussion
encounter. You did ● Encouraging voice and effort. Thank nurse
and to increase the awareness and
great in all our ● Smiling you for listening
understanding of both
sessions. nurse Abigail. participants.

● In face to face Goodbye, nurse ● Smiling ● Terminating the conversation

You’re welcome, Abigail! ● Looks at the ● Giving Recognition
position to the client for today nicely and
Sofia. Seize the day!
● Encouraging voice nurse acknowledging her
God bless you!
● Smiling thankfulness.

END