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T/NT Communication
NRN101 Theraputic & Non-Theraputic Communication
| Question | Answer |
|---|---|
| Using Silence | Accepting pauses or silences that may last several seconds or minutes without any verbal response. |
| Sitting quietly (or walking with the client) and waiting attentively until client is able to put thoughts and fments or questions that (a) encourage the client to verbalize, (b) choose a topic of conversation, and feelings into words | Using Silence (example) |
| Providing general leads | Using statemens or questions that (a) encourage the client to verbalize, (b) choose a topic of conversation, and facilitate continued verbalization. |
| "Perhaps you would like to talk about..." ; "would it help to discuss your feelings?"; "and then...."; "I know what you are saying" | Providing General leads (example) |
| Using specific and tentative | making statements that are specific rather than general, tentative rather than absolute |
| "You scratched my arm" instead of "you are clumsy as an ox" OR "you seem concerned about mary" rather than "you don't care about mary" | Specific & Tentative (examples) |
| Open-ended question | ASKING BROAD QUESTIONS that lead or invite the client to explore, elaborate, clarify, define, and describe thoughts or feelings. Client's answers are longer than 1 or 2 words |
| "I'd like to hear more about that"; "What brought you to the hospital today?"; "you said you were frightened yesterday, how are you feeling today?" | Open-ended question (example) |
| Using Touch | Providing appropriate forms of touch to reinforce caring feelings. |
| Putting arm over client's shoulder OR placing hand over client's hand | Using touch (example) |
| Restating | using the same words as the client |
| Client: "I couldn't manage to eat any dinner last night- not even dessert" Nursing- "you couldn't manage to eat any dinner last night- not even dessert?" | Restating (example) |
| Paraphrasing | Restating in different form with implied feeling or observation |
| Client: " I have trouble talking to strangers" Nurse "You find it difficult talking to people you don't know" | Paraphrasing (example) |
| Seeking clarification | Making the clients overall meaning of the message more understandable. It is used when paraphrasing is difficult or when communication is rambling or garbled. To clarify, the nurse may restate the message or confess confusion and ask the client to repeat |
| Nurse: "I'm puzzled" Nurse: "I'm not sure what you mean by ___ Would you please repeat that again?" | Seeking Clarification (example) |
| Perception Checking/ Consensual Validation | A method similar to clarifying that verifies the meaning of specific words rather than the overall message |
| C: "it just won't stop" N: "I'm not sure what you mean - it won't stop" OR C: "my husband never gives me presents" N: "He never gives you gifts for your birthday or christmas?" C: "well, ok, he gives me gifts then, but not for no reason" | Perception Checking/ Consensual Validation (example) |
| Offering Self | Suggesting ones' presence, interest, or wish to understand the client without making any depands or attaching conditions that the client must comply with to receive nurse's attention |
| "I'll stay with you till your daughter arrives"; "we can sit here quietly for awhile, we don't need to talk unless you would like to" | Offering Self (example) |
| Giving Information | Providing, in simple and direct manner, specific factual information the client may or may not request. When information is not known, the nurse states this and indicates how the nurse will obtain the information. |
| "Your surgery is scheduled for 11am tomorrow"; I don't know the answer to that, but I'll find out from the unit manager, when she comes in" | Giving information (example) |
| Acknowledging | Giving recognition, in nonjudgemental way, of change in behavior. |
| "You trimmed your beard and mustache" OR "you walked twice as far today with your walker" | Acknowledging (example) |
| Clarifying time or sequence | Helping the client clarify and event, situation, or happening in relationship to time |
| C: "I puked this morning" N: "before or after breakfast?" | Clarifying time or sequence(example) |
| Presenting reality | Helping the client differentiate the real from the unreal |
| "The telephone ring came from the TV"; "That's not a dead mouse in the corner, it's a used washcloth" | Presenting reality(example) |
| Focusing | Helping the client expand on and develop a topic of importance. The focus may be an idea or feeling, however, the nurse often emphasizes a feeling to help the client recognize and emotion disguised behind words |
| C: "My wife says she will look after me but I don't think she can, what with the children to take care of..." N: "you're worried about how she can manage" | Focusing (example) |
| Reflecting | Directing ideas, feelings, questions or content back to enable them to explore their own ideas and feelings about a situation. |
| C: "what can I do?" N: "what do you think would be helpful?" C: "do you think I should tell my husband" N"You seem unsure about telling your husband" | Reflecting (example) |
| Summarizing and planning | Stating the main points of a discussion to clarify the relevant points. This is useful at an end of an interaction. Often acts as an introduction to care planning |
| "During the past half hour we've talked about.."; "Tomorrow afternoong we may explore this further"; "in a few days we'll review what you've learned about insulin" | Summarizing and Planning (example) |
| Closed Questions | require only one or two word answers. A Closed question may be used to open up a discussion. Using too many is a barrier to communication |
| "When did you have your accident?" ; "Did you....?" | Closed questions (example) |
| Stereotyping (NT) | Offering generalized or oversimplified beliefs about a group that is based on experiences too limited to be valid. These categorize clietns and negate tehir uniiqueness as individuals. |
| "Women are complainers"; "Men don't cry" ; "Most people don't have any pain after this type of surgery" | Stereotyping (NT example) |
| Agreeing and disagreeing (NT) | Similar to judgemental responses. Agreeing and disagreeing imply that the client is either right or wrong and that the nurse is in a position to judge this.These deter the client from thinking through their position and may cause the client to be defensi |
| C: "I don't think Dr R is a very good doctor" N: "Dr R is the head of the department of surgery and is an excellent surgeon" | Agreeing or Disagreeing (NT example) |
| Being Defensive (NT) | Attempting to protect a person or health care service from negative comments. These prevent the client from expressing true concerns. Also prevent the nurse from admitting a true weakness. |
| "Those night nurses must just sit around and talk all night" N:" I'll have you know we literally run around on nights. You're not the only client you know" | Being Defensive (NT example) |
| Challenging (NT) | Giving a response that makes clients prove their statement or point of view. These responses indicate that the nurse is failing to consider the client's feelings, making the client feel it necessary to defend a position |
| C: "I feel like I'm dying" N: "how can you feel that way when your pulse is 60".... C: "I feel my husband doesn't love me" N: "ho can you say that when he visits you everyday?" | Challenging (NT example) |
| Probing (NT) | Asking for information chiefly out of curiosity rather than with the intent to assist the client. Considered Prying. Often include "why". |
| C: "I was speeding and didn't see the stop sign" N "Why were you speeding?".... C: "I didn't ask the doctor" N:" Why didn't you ask him when he was here?" | Probing (NT example) |
| Testing (NT) | Asking questions that make the client admit to something. These responses permit the client only limited answers and often meet the nurse's needs rather than the client's. |
| "Do you think I'm not busy?" (forces client to admit the nurse reallyis busy. | Testing (NT example) |
| Rejecting (NT) | Refusing to discuss certain topics with the client.. These responses often make clients feel the nurse is rejecting the client in addition to the conversation. |
| "I don't want to discuss that, let's talk about....." or "I can't talk now I'm on the way too my coffee break" | Rejecting (NT example) |
| Changing Topic(NT) | Directing the communication into areas of self-interest rather than considering the client's concerns. Often a self-protecting response to the topic that causes the nurse to experience anxiety. |
| C: "I'm separated from my wife. Do you think I should have sex with other women?" N: "What caused your separation?" | Changing Topic (NT example) |
| Unwarranted Reassurance (NT) | Using cliches or comforting statements of advice as a means to reassure the client. These responses block the fears, feelings, and thoughts of the client |
| "You'll feel better soon"; "I'm sure everything will turn out alright"; "Don't worry" | Unwarranted Reassurance (NT example) |
| Passing Judgement (NT) | Giving opinions and approving or disapproving responses. Moralizing or implying one's own values. These responses imply the client must think as the nurse thinks. |
| "That's good"; "That's bad"; "You shouldn't do that"; "What you did was wrong(right)" | Passing Judgement (NT example) |
| Giving Advice (NT) | Telling the client what to do. These responses deny the client's right to be an equal partner. HOWEVER, giving expert advice is considered to be theraputic. |
| C: "Should I move from my home to a nursing home?" N:" If I were you, I'd go to a nursing home where you'll get your meals cooked for you" | Giving Advice (NT example) |
Created by:
aprilbob6
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