This document discusses communication techniques for nurses. It describes therapeutic communication as using techniques that prioritize the patient's well-being, such as active listening, acceptance, and reflection. Non-therapeutic techniques are discussed as those that make patients uncomfortable like overloading them, making judgments, or changing the subject inappropriately. Effective communication requires being clear, accurate, relevant and applying techniques like paraphrasing, clarifying, and focusing to understand patients fully.

1. NURSE –PATIENT
RELATIONSHIP
THERAPEUTIC COMMUNICATION AND NON-THERAPEUTIC COMMUNICATION
TECHNIQUES
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COMMUNICATION
 Communication is central to successful
caring relationships and to effectiveteam
working.
 It is essential for ‘No decision without me
’
.
 Communication is the key to a good
workplace with benefits for those in our
care and staff alike
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 sharing information
 generating and transmitting meanings
 foundation of our way of life
 requirement for a person’s well being
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2. The Communication Process
SENDER
(encodes)
RECEIVER
(decodes)
Barrier
Barrier
Medium
Feedback/Response
Interpersonal
Variables
Referent Referent
Channel
Sender
Sender MESSAGE
FEEDBACK
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Verbal
communication
Non – verbal
communication
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What are the most common ways
we communicate?
Written Word

3. Characteristics of effective
communications
Effective communication requiresthe
message to be:
 Clear and concise
 Accurate
 Relevantto the needs of the receiver
 Timely
 Meaningful
 Applicable to the situation
Characteristics of effective
communications
Effective communication requires the
sender to:
 Know the subject well
 Be interested in the subject
 Know the audience members and establish a rapport
with them
 Speak at the level of thereceiver
 Choose an appropriate communicationchannel
Characteristics of effective
communications
The channel shouldbe:
 Appropriate
 Affordable
 Appealing
Characteristics of effective
communications
The receiver should:
 Be aware, interested, and willing to accept the message
 Listen attentively
 Understand the value of themessage
 Provide feedback

4. Characteristics of effective
communicator
An effectiveverbal
communicator:
 Clarifies
 Listens
 Encourages
empathically
 Acknowledges
 Restates/repeats
An effective
nonverbal
communicator:
 Relaxes
 Opens up
 Leans toward the oth
er
person
 Establishes eye contact
 Shows appropriate facial
expressions
Barriers to communication
• Language
• Values and beliefs
• Sex/gender and age
• Economic status
• Educationallevel
• Physical barriers
• Attitude
• Timing
• Understanding of message
• Trust
Dysfunctions of Communication
 Selective perception
 Receiver filters a message and then gives meaning toi
t
 Block out information a receiverdoes not want to hear
 Semantic problems
 Different people have different meanings forwords
 “Good,” “average,” “Do your best”
 Jargon: “burden”, “metrology”
Dysfunctions of Communication(Cont.)
 Distortion of messages: different frames of reference
because of background
 Filter messages
 Intentional: sender is concerned about receiver’s reaction
 Unintentional: sender does not fully know what she or he wants t
o
say

5. Dysfunctions of Communication(Cont.)
 Information overload
 Too much information to process accurately
 Related to time available
 Message timing
 Too short oftime
 Too early
 To gather data, information
and knowledge
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Types
Of
Interview
Informational Interpretative Emotional
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Planningyour
interview
Research the
background
Identify your
goals
Select a
good location
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6. Two types
of
Interview
Question
Close ended Open ended
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Phases of interview
Orientation
Termination
Phase
Working
Phase
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Orientation Phase
 “getting to know you” phase
 setting the tone
 making introductions
 establishing roles
 reaching agreement on goals
 developing trust
Working Phase
 “problem solving” phase
 attending to client’s needs
 Nurse in role of teacher/counselor
 encouraging active participation byclient
 gathering further data
 assisting client in decisionmaking
 facilitating change
 Evaluate problems & goals

7. Termination Phase
 reviewing & summarizing goals met and progress ma
d
e
 acknowledge feelings of loss
 reassuring clients with issues such a
s
,
“How will this problem/disease affect
my life ?” or
“What do I need to change?”
Interview
Start withan
Icebreaker
Be
observant
Ask questions
in
non
threatening
way
Let it
flow naturally
Obtain
cues
Control the
interview
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THERAPEUTICCOMMUNICATION
Therapeutic communication is a collection of techniquesthat
prioritize the physical, mental, and emotional well-being of
patient
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https://www.rivier.edu/academics/blog-posts/17-
therapeutic-communication-techniques/
Therapeutic Communication Techniques
 Using Silence
 Accepting
 Giving recognition
 Offering Self
 Giving Broad Openings
 Active Listening
 Seeking Clarification
 Placing Events in time o
r
sequence
 Making Observations
 Encouraging Descriptions
of Perceptions

8.  Encouraging comparisons
 Summarizing
 Reflecting
 Focusing
 Confronting
 Voicing doubt
 Offering hope and humor
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Commoncommunicationstrategies
Using
Silence
 Promotes observation
 Client’s can organize
thoughts
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Commoncommunicationstrategies
A ttentive
Listening
 Facilitates e
y
e
contact
 Communicates
interest in the client’s
needs
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Commoncommunicationstrategies
Conveying
A cceptance
 Non – judgmental
attitude
“Yes.” “okay.”
Nodding Smiling I
understand
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9. Sample question:
Which of the following statements or
response uses conveying acceptance as a
communication strategy?
A. (Nodding) “I hear what you’re saying.”
B. “Where would you like to begin?”
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Commoncommunicationstrategies
Providing
General
Leads
 Encourage the client to verbalize
 Choose a topic
 Facilitate continued verbalization
“Go on…”
“Talk more about”
“Then what?”
“please go on.”
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Commoncommunicationstrategies
Paraphrasing
or
Restating
 Repeating those thoughts
or feelings
 Validate information
Client: “I couldn’t manage to
eat any dinner last night.”
Nurse: “You had difficulty
eating yesterday.”
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Sample question:
Which of the following statementsor
response uses restating as a
communication strategy?
A. Client: “I’m down.”
Nurse: “Would you please say thatagain?”
B. Client: “I’m down.”
Nurse: “You feel depressed?”
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10. Commoncommunicationstrategies
Clarifying/
SeekingClarification
 Facilitates correct
communication
(restate)
“Would you please say
that again?”
“I’m not sure I
understand that.”
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Commoncommunicationstrategies
Focusing
 Expand on and develop a t
o
p
i
c
of importance
 Eliminates vagueness
in communication
“Let’s look at this more closely.”
“You said you hate all your
brothers. Tell me about Carlo
first.”
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Sample question:
Which of the following statementsor
response uses focusing as a
communication strategy?
A. “Please go on.”
B. “Let’s return to the last point you made and
talk more about that.”
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Commoncommunicationstrategies
Stating
Observation
 Provides feedback
“You seem to be
shaking.”
“You appear anxious.”
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11. Commoncommunicationstrategies
Offeringinformation/
Educating
 providing information
that the client may or
may not ask.
“Your next consultation in
the health center is
on…”
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Commoncommunicationstrategies
 Directing ideas b
a
c
k
to clients
Reflecting
Client: “What can I do?”
Nurse: “What do you think
would be helpful?”
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Commoncommunicationstrategies
 giving
recognition
Acknowledging
“You walked twice as
far today with your
walker.”
“It’s good that you have
decided to….”
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Commoncommunicationstrategies
Summarizing
 stating the main p
oi
nt
s
 review
 condenses data
to further validate
“During the past half hour,
we have talked
about….”
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12. Non TherapeuticCommunications
 Nontherapeutic communication includes words,
phrases, actions, and tones that make a patient feel
uncomfortable, increase their stress, and worsen their
mental and even physical wellbeing

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 1. Overloading
• talking rapidly, changingsubjectstoo often, and asking for
more information than can be absorbedat one time.
“What’s your name? I see you like sports. Wheredo you live?”
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 2. Value Judgments
• giving one’s own opinion,evaluating,moralizing or implying
one’s values by using words such as “nice”, “bad”, “right”,
“wrong”, “should”and “ought”.
“You shouldn’t do that, its wrong”.
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 3. Incongruence
• sendingverbal and non-verbalmessagesthat contradict one
another.
The nurse tells the patient “I’d like to spend time with you” and
then walksaway.
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13.  4. Underloading
• remainingsilent and unresponsive,not picking up cues, and
failing togive feedback.
The patient ask the nurse, simply walks away.
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 5. False reassurance/ agreement
• Usingcliché to reassure client.
“It’s going to be alright”.
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 6. Invalidation
• Ignoring or denying another’s presence, thought’s or feelings.
Client: How areyou?
Nurse responds:I can’t talk now. I’m too busy.
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 7. Focusing on s
e
l
f
• respondingin a way that focuses attention to the nurse
instead of the client.
“This sunshineis good for my roses. I have beautifulrose
garden”.
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14.  8. Changing the subject
• introducing newtopic
• inappropriately,a pattern that may indicate anxiety.
The client is crying, when the nurse asks “How many childrendo
you have?”
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 9. Giving advice
• telling the client what to do, giving opinions or making
decisionsfor the client, implies client cannot handle his or her
own life decisions and that the nurse is accepting
responsibility.
• “If I were you… Or it would be better if you do it this way…”
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 10. Internal validation
• makingan assumptionabout the meaningof someoneelse’s
behavior that is not validated by the other person (jumping
into conclusion).
The nurse sees a suicidalclients smiling and tells another nurse
the patient is in goodmood.
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Therapeutic Versus
Nontherapeutic Communication
 THERAPEUTIC
- Facilitates transformationof
working nurse-patient
relationship
- Relationship allows for
adequate& accurate data
collection & assessment
- Performed with & notfor
patient

15. B a r r i e r s t o
e f f e c t i v e c o m m u n i c a t i o n
 Giving opinion
 Offering false reassurance
 Being defensive
 Showing approval or disapproval
 stereotyping
 asking why
 changing the subject inappropriately
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Gracias!!!
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Date:
Name:
Section:
Nurse – Patient
Interaction:
Communication
Strategiesused:
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