Medical knowledge and clinical skill are very important to becoming a successful nurse. Communicating with patients can often be a challenge but is also an important skill in developing relationships with patients. From admission to discharge, nurses must communicate well to provide comprehensive care in which a patient can fully understand. This paper will discuss the history of communication along with considerations and thought processes that can be used to enhance patient care and establish good relationships with patients.
Therapeutic Communication
As the old saying goes, “You never get a second chance to make a first impression’. Therapeutic communication is a technique used in professional nursing practice to enhance patient care and make those first impressions matter.
It can be used in various situations and can impact a patient’s total healthcare experience. Hospitals and clinics want patients, clients, and visitors to return to their establishments after they have visited or had a stay. How that patient is cared for is a crucial role in maintaining a thriving business and is considered important when it comes to the nursing care of patients.
Therapeutic communication is a significant tool used daily to establish trust between caregiver and patient. It is a learned process that depends on the individual’s attitude, the sociocultural background, the context, past experiences, and the capacity to relate to others (Achury DM, Pinilla, M, Alvarado, H, 2015). A nurse who displays kindness, courtesy and respect are generally able to establish a good rapport with patients, family members, or caregivers.
Experience can play a big role in establishing a good rapport. Nurses with several years of experience under their belt have probably had a few trials and errors about the best ways to communicate. Good communication can also be used to de-escalate threatening situations or dispel negative emotions. Not everyone is a natural communicator. Nurses can benefit from additional training to learn how to react in different situations instead of avoiding them.
Patients come from all walks of life. They have different backgrounds and capacities in how they communicate with others. Each patient must be approached differently. How an individual communicates is important to consider with an assessment of a patient. A patient may be hearing or speech impaired and a nurse needs to find the best way an individual relates.
For example, strategies for patients with hearing loss can use tools to communicate such as a simple board picture. If a sign language interpreter is present, nurses need to make sure they always face the patient and address questions to the patient, not the interpreter. Some patients may have hearing loss in one ear and the nurse should stand on the unaffected ear.
Gender is sometimes an issue in communication as well. A female may not want a male nurse which could be based on religion or culture. A male may not want female nurses involved in his care for fear exposure to the opposite sex. Nurses need to understand their patients, not make assumptions. Nurses need to speak slowly and clearly. Avoid using slang. Use reflection to make sure the patient understands what is being communicated.
We all have different values. Therapeutic communication is a process that starts with conscious awareness about one’s own beliefs (Rasheed, S, 2015). Nurses need to understand how they feel about certain situations in which they may find themselves. How a nurse was raised can also have an impact on how one relates to others. Self-awareness can be considered the most important aspect of providing high-quality patient care.
Nurses are better equipped when they know their strength and limitations, which battles are important and which ones to leave alone. Nurses can sometimes unknowingly bring their personal stress to their patients which can hinder the effectiveness of a nurse-patient relationship. A therapeutic relationship is defined as ‘one in which the patient feels comfortable being open and honest with the nurse” (Doherty, M; Thompson, H, 2014).
From the early 1900s, nursing care was based on hands-on work and service to patients. It wasn’t until the 1950s that there was a change in nursing care that centered on the patient-nurse relationship. It was recognized there was a need for individual patient assessment and care. Identifying the nurse-patient relationship was initiated by Hildegard Peplau, often known as the mother of psychiatric nursing. Ms. Peplau considered that all patients, regardless of the situation, could benefit from a term called “interpersonal care”. It was understood by considering a patient’s viewpoint that a nurse could truly be effective in providing better nursing care.
Therapeutic communication is a part of nursing practice today because both actions and words are important to establishing a good rapport with patients. A nurse needs to watch body language and listen for verbal cues. Most people have some form a facial communication in which expressions can indicate confusion or frustration. A few examples are puzzled looks, eye rolling, grimacing or smiling. A patient may be nervous, upset, or uncertain about their care.
A nurse must allow enough time for patient interaction. A nurse who rushes through an assessment or teaching will find that patients may consider their caregiver rude even though the nurse may have felt they spent enough time with them. Though any nurse, in all reality, is probably in a rush, he or she needs to slow down and give a patient your complete attention.
Privacy is a big issue in health care. Nurses must consider where teaching occurs and who is involved in the patient’s care. Everyone in a patient’s room may or may not be aware of what is going on with the patient. Discussion of a patient’s health should not occur in a public waiting room or within hearing range of strangers. HIPPA always plays a role in that as well which protects a patient’s right to privacy.
Conclusion
Nurses are at the center of a patient’s health. They are the patient’s advocate who relays information between physicians, caregivers, and family members. Nursing has become a task-oriented profession which, in turn, limits the time a nurse can spend with a patient. A large portion of effective communication involving a patient’s health falls on nurses to ensure the needs of patients and plays an important role through a patient’s entire healthcare experience. Additional training on effective communication may be needed to better meet the needs of patients in an empathetic manner.
