Developing quality nurse communication skills is essential to creating a positive patient to patient care, it can also detract from nurse-patient relationships. The nurse–client relationship is an interaction aimed to enhance the well-being of a "client," . eye contact, R-relax. These behaviours are effective for communication skills, and are useful for thinking about how to listen to another person. . The relationship that developed depended on the nurse's personality and attitude. Keywords: Communication, Jargon, Nurse-patient relationship Making meaningful use of 'communication skills' demands appreciation of the.
This article has been cited by other articles in PMC. Abstract Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician—patient experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes.
Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships.
The concept is also interrelated with that of patient-centered care. Patient-centered care also known as person-centered or patient- and family-centered care describes a standard of care that ensures the patient and their family are at the center of care delivery. Therefore, the aim of this review is to identify strategies to enhance therapeutic interpersonal relationships between patients and health care professionals in the acute care setting.
Methods Integrative review process An integrative review is a research strategy involving the review, synthesis, and critique of extant literature. In addition, the reference lists of potential papers retrieved were examined to identify any further material that met the inclusion criteria. Both versions of British and American spellings were used to construct the search strategy as to reflect a systematic and comprehensive approach.
Use Body Language Despite the words you use, the majority of human communication is through the body language in your face, hands, posture etc. Be conscious of what your body is saying and whether it is in agreement with your words.
Do not send conflicting messages. Know Your Communication Roadblock If you have ever stumbled on a word or found yourself frustrated trying to communicate an idea, then you know your roadblocks. Everyone has a few of them. Knowing yours can help you to find ways around them. For instance, if you know that a person crying will effectively make your communication skills disintegrate then try to actively practice ways to manage these situations better.
Consider Learning a Foreign Language It might sound strange, but learning a new language puts you in better touch with your native tongue and can open your eyes to the way you use the words you already know. SECTION 2 Communicating with Patients Set the Scene Choose an appropriate time to speak with the person that is, avoid approaching them during a favourite television program, when leaving for work, when stressed about an unrelated issue, and so on or negotiate a time.
Do not try to speak about important issues if one or both of the parties are intoxicated. For teenagers, talking in the car or using issues on a contemporary television show might provide a good springboard. I know you have been busy but when could we catch up properly? Think about small, less emotionally charged topics as a way of opening the door to more significant conversations.
Sometimes, if you talk about what you think and feel, others will slowly follow. Use questions beginning with why, what, when, where and how. Limit the Expressing of Assumptions and Opinions for a Time Reverting to old patterns of communication can block new ones.
People who have known each other for many years, if not all of their life, will feel as if some albeit important discussions are no longer worth having as they always seem to end in the same way. Not responding in the same way they always have can help others to be more tolerant and to try to reach new ground. For those that have avoided communicating so far, this is confronting and enormously challenging.
Communication about difficult issues is much easier if the small steps have been taken first. Try to use the valuable time you have now to open discussion slowly. Be Assertive When You Need to. I feel pretty tired most days. I want you to help around at home by making your own lunches. Communication evolves and there are nearly always other opportunities to talk.
Be realistic in your expectations — set realistic goals for communication and be patient, yet motivated, to create even small changes.
Communicate Without Words Loving and supportive communication does not need to revolve around words. Simply being there, holding hands, smiling, sharing meaningful eye contact and showing physical affection are all meaningful ways of demonstrating respect, concern and support.
Large families, though, pose a problem as there may be a number of next of kin. It is simple and easy to turn someone down under those circumstances. That number can very easily be disseminated to numerous people, and this means the nurse has to spend a great deal of time explaining the same information to ten or twelve different people.
It takes time to make non-medical persons understand the situation, and the problem can get quickly out of hand. Managing Large Families In large family situations, someone should be appointed the main contact. This way, the nurse only has to explain the situation once. Ideally, it should be the next of kin; but some families may want a member with a medical background to handle updates and check-ins.
Another possible management tool is to tell the next of kin to guard the privacy number closely. Explain to them that it takes away from the care of their family member to have several people with the privacy number. Even though you are not in charge of the family, you will have to step in and make suggestions that they may or may not comply with.
However, even in the best of situations, it may be difficult to get the amount of contacts down to one. Case Study Mrs Jones is an year-old woman who has come into the intensive care unit with an acute stroke. She is the proud mother of five children, all of whom are married, and a grandmother of ten. Some of these grandchildren are old enough to have spouses of their own.
The relationship between Lisa and her siblings is complicated, and all of them have insisted on obtaining the security code for themselves. Lisa, not wanting to start an argument, has given it to her brothers and sisters, who in turn, gave it to a few grandchildren. Although the nurse tries to be concise, often these conversations can take up to twenty minutes.
It is decided that all information will flow through Lisa, although this does not make everyone happy. Juggling Bad Feelings In the end, you will inevitably engender bad feelings, even in small families.
Even those without the privacy code may try to bully you into telling them something, and your assertiveness as a nurse has to override that impulse to please. There are no easy answers in cases like this, and the nurse has to make a judgment on a case-by-case basis. You can help minimise bad feelings by actively listening, keeping your cool and assuring callers that you understand they are concerned about the patient.
If you have someone who is angry with you, that may be necessary for the good of the patient. If that person goes to your manager, be sure to back up your actions so that you can prove you are merely respecting privacy laws and protecting your ability to care for the patient. What to Do When Things Escalate Sometimes, despite our best intentions, things can get a little out of hand and patients may demand to speak to a higher authority — your nurse manager for example.
Crisis Management Families in crisis may react in ways that they normally would not. The stress and worry over a patient in danger can cause them to say and do things that are offensive, violent, loud, and intimidating.
A great deal of the attention will be focused on you because you are at the bedside, caring for their family member. As in most communication situations, it is important to remain calm in the face of whatever the family may present. In that case, you need to work on calming the relative.
Once you have established that they are privy to the details, tell them the truth about what is going on with their loved one. Be prepared for a wide range of reactions. Some will react with anger, but most will react with neutrality or sadness. In some cases, this can be more difficult to deal with than hostility. Offer yourself as a sounding board for the relative. Make it a point to be there for them, a presence of peace and understanding. Comfort them and do not betray their trust in you.
Patient Rights v Family Rights Patients have the right to competent care, protection from reasonable risks, and advocacy from their nurse. If the relatives are disturbing the patient, working them up, or causing more stress, the nurse has to step in and remove the family. It is a difficult situation to be put in because no one wants to separate a family from their loved one.
Nurse–client relationship - Wikipedia
Is this helping them or hurting them? Most families will not cause stress, but sometimes even the most laid back family may cry, focus only on the negative, or in other ways upset the patient. In these cases, it is important to talk to the patient and the family member. Ask the patient if they are comfortable with their family and if they would like the family to have restricted access to them.
Most will decline, but at least you are offering the opportunity to the patient. Next, talk with the family. Explain that their behaviours are upsetting the patient and that a different approach is needed. There is no reason to be falsely happy, but tell them to simply be with the patient instead of focussing on the negative. In the end, talking to a patient may be easier than talking to their family. Patients may not understand what is going on with them, and their relatives are basically in the same position.
However, they also have the added stress of not knowing if their loved one will make it through. Acknowledge the fear they are feeling and offer them the same compassion you would offer your patients. This makes sense, because as a person ages they may require more frequent care. Communicating with patients is a skill that you need to practice. Memory and cognitive disturbances can also make talking to this population challenging.
It is hard to dedicate the time necessary to talk properly to an older person, but this is the way to open the communication channel. It is only over time that you get the whole story. This is especially true of doctors, but they may feel the same reticence when talking to nurses. If you are there and available for their concerns, they may be more willing to talk to you than to the doctor who might only spend five minutes in the room.
You may find out something that is vital to the care and comfort of that patient just by spending an extra few minutes with them. Yes, nurses are busy, but older people need time to express their pain, fear, and questions, and you need to allow for that in your schedule.
Explain Things Simply As with children, it is best to avoid medical jargon when speaking with older people. It is a fine line to walk, and you need to base your language on the questions and cognitive ability of the patient you are speaking with. Click To Tweet Try to use language that is simple, clear, and non-threatening. You should also strive to be as honest as possible. Some older patients need to write down what you are telling them so that they will remember it. Be prepared to repeat yourself and express concepts in different ways so that your patient can grasp what you are trying to say.
One of the most important parts of helping your elderly patients is acting as a kind of interpreter for the doctor. Try to be on hand when the doctor talks to the patient so you can explain later what they said. They will wait and ask you later to get a better understanding. Although she is forgetful, she is still able to live a relatively independent life. She experienced an episode of fainting that was witnessed by several people at church, and she was taken to her primary care physician.
It took a great deal of talking to her to help her understand that the fainting spell was, in fact, a major problem that needed to be investigated. In addition to restricting her driving privileges, Carolyn needed several tests to rule out different probable causes of her fainting spell. Each test needed to be carefully explained to Carolyn and the information repeated so that she could grasp what each one required.
She wrote down all the key information in a system that she had developed to keep herself from forgetting important points. It takes careful reminding to keep her from driving her car or performing other actions that may put her in danger. Include Family in the Conversation Finally, including family is a big part of communicating with older people. You should always try to keep your older patient in the conversation, although not much of it may be understood.
Often children, spouses and family friends can help the older person understand what is needed from them. Family and friends can help you to communicate with an older patient because they know how that person thinks.
It may help to have a three-way conversation between the patient, their caregiver, and yourself. When everyone works together to help the patient understand, you stand a much better chance of putting him or her at ease with all that is happening around them. Not only are you trying to explain a difficult situation to a child, but you are trying to include the parents in the conversation as well.
It is natural for a child to be scared, unreasonable and resistant to medical treatment, and it takes a skilled nurse to work through these roadblocks to achieve understanding.
As with most communication, listening and allowing the patient to be heard will serve you well in talking to children. Communicating with Children When talking to children you want to avoid medical jargon. For very young children, you have to use words that are as simple as possible.
Even then, you may not get them to understand because their fear response is overriding everything else. However, you have to use care when talking to older children. You have to make a mental note of the age of the patient and their level of understanding, and tailor your speech to meet their needs. You need to moderate your language, get down on the level of the child, and use a soft tone of voice.
Sometimes, though, you need to do something that will cause them discomfort, and you must explain this with honesty and using straightforward language. Talking to Parents Part of communicating with children is communicating with their parents. Again, you are likely to be dealing with someone who is in a great deal of distress and fear. It is helpful to try to allay their fears, answering all their questions as honestly as possible. Some parents may get emotional and you need to be aware of possible outbursts of anger or sorrow.
Either of these can upset your patient and that can go against what you are trying to accomplish. Try talking to parents away from the child and use active listening techniques, as you would for any other patient, family and relatives.
Case Study Daniel was a two-year-old heart patient who was preparing for his second open-heart surgery. Already, starting the IV line had been a traumatic event. Then one of the nurses from the OR came into the room the night before the operation with a bag of items. She got down on her knees with Daniel and showed him the hairnet he would wear, the tubes that would come out of him, and the mask that would be placed over his face.
Instead of being afraid, Daniel was fascinated with the new toys in front of him and played with them all.
Communication Skills for Nurses
During this time, the nurse took the time to talk to the parents about their concerns. She helped them to understand what would happen, explaining the procedure, the heart-lung machine, and the estimated time of the surgery.
When the nurse prepared to leave after half an hour of talking, both Daniel and his parents were much more at ease. Although all of them were still afraid of the surgery, it helped to know a little bit about what would happen so not everything would come as a shock.
Click To Tweet Including the Child Finally, it is important to include the child when talking about procedures or their health.