This document discusses the importance of communication and the nurse-patient relationship. It defines the therapeutic relationship as an interpersonal helping process based on theory. There are three phases to the nurse-patient relationship: the initial phase where the nurse prepares to meet the patient, the orientation phase where roles and goals are established, and the working phase where progress towards goals is assessed. Termination of the relationship involves evaluating achievements, reducing contact, and encouraging independence. Respect, genuineness, hope and empathy are important factors for an effective therapeutic relationship.

1. PRESENTED BY
MRS.TEJESHWARI.B.V
Ph.D Scholar, HOD & Associate
Professor, Dept Of Community
Health Nursing,
RajaRajeswari College of
Nursing, Bangalore, Karnataka

3. IMPORTANCE
COMMUNICATION

4. IMPORTANCE
• Foundation for sound management
• Planning, Organising, Directing and
Controlling depend on communication
• Each of these functions involve
interaction with people
• Communication aims at developing an
understanding

5. 90% of time we are
Communicating
Listening
41%
Reading
15%
Others
9% Writing
8%
Talking
27%

14. CAUSES OF
COMMUNICATION
• STUDIES TELL 70% OF
MISTAKES IS THE
WORKPLACE ARE A DIRECT
RESULT OF POOR
COMMUNICATION

15. CASUSES OF
COMMUNICATION
DIFFICULTIES
• LACK OF INFORMATION AND
KNOWLEDGE
• NOT EXPLAINING PRIORITIES
OR GOALS PROPERLY
• NOT LISTENING
• NOT UNDERSTANDING FULLY
• FAIL TO ASK QUESTIONS

16. • MIND MADE UP,
PRECONCEIVED IDEAS
• NOT THINKING CLEARLY,
JUMPING TO CONCLUSIONS
• BAD MOOD
• FAILURE TO EXPLORE
ALTERNATIVES
• POOR COORDINATION &
COOPERATION

22. Tips for good verbal
communication
• Do ABC analysis
– A - Accuracy,
– B – Brevity
(short duration)
– C - Clarity
• KISS your words
– K - KEEP
– I - IT
– S - SHORT
– S - SIMPLE

23. Some KISS Tips
Big words KISS words
• Along the lines of... Like
• In the majority of instances... Usually
• Give consideration to... Consider
• A large no. of … Many
• In spite of the fact that … Although
• During the period that … While
• It would seem reasonable
to believe … I believe
• Rectangular in shape… Rectangular
• The month of December… December
• In order to … To
• Recur again … Recur
• Entirely completed… Completed
• On the part of … by
• In the not too distant future… Soon

26. Communication skills
and the Eight Active Listening
Secrets

28. “I like to listen. I have learned a
great deal from listening carefully.
Most people
never listen.”

29. Why Listen?
•People prefer talking to
listening
•Listening complement
somebody –shows you care
•Listening builds trust
•By simply listening, prospects
will tell you everything
•Good listening will increase
your success

31. Listening – 3 steps
• Hearing
• Understanding
• Judging-pass
judgment

32. Listening as an active activity
• Avoid distraction
• Suspend all unrelated thoughts-Start with
a blank canvas
• Listening is a skill -
Learned and Practiced

33. Listening as an active activity
• 4-to-1 Ratio between Thoughts & Speech
• Good listeners lead with their faces

34. How to listen
• Active listening-facial expression,
feedback
• Listen with your body
• Change body position when
drifting
• Maintain eye contact

35. Active Secrets
1. Repeat what is said back in slightly
different way
2. Don’t plan in your head what
you’ll say next
3. Keep an open mind.

36. Active Secrets
4. Completely understand what is
conveyed before responding.
5. Respond-Don’t react. Respond using the
facts and your feelings to
add to the conversation.
6. Pay attention- participate

37. Active Secrets
7.Restate what you think you just heard
to clarify
8.Make notes if you are
listening on the phone.
Not having the eye contact and
maybe other distractions may
affect how well you listen.

38. Listening tips
• Do not finish sentence of others
• Do not answer questions with questions
• Let others talk
• Do not react to personally-emotive words
• Don’t dream while others talk
• Take brief notes.
• Observe eyes, hands and legs of the
speaker without being conscious.

39. Listening
is a valuable communication skill.
REMEMBER
YOU CAN’T LEARN
ANYTHING NEW
WHILE YOU ARE
TALKING!

42. PPT ON PATIENT
TEACHING

63. Objective:
At the end of this part the student will be able to:
1)Define The Nurse-patient relationship.
2)State the type of relationship.
3)Differentiate between social and professional relation ship.
4)Describe the 3 phases of the relationship.
5)Discuss the factor leading to effective of therapeutic relationship
Outline:
1)Definition of nurse patient relationship.
2)Type of relationship.
3)Characteristics of therapeutic and social relationship.
4)Phases of nurse patient relationship.
5)Factor leading to effective of therapeutic relationship.
6)Empathy

64. The nurse's therapeutic relationship with a client is
an interpersonal helping process based on theory:
A)It is interpersonal :
Because the nurse reaches out as one human being
to another to enable the client to experience
being listened to and having his personal worth
affirmed.

65. B)It is helping :
Because it is focused towards the
client's care, well being, learning &
growth.
C)It is theory based:
Because it requires knowledge and
skill

66. 1)Therapeutic relationship(helping)
2)Professional relationship(at work)
3)Social relationship(friends)

67. Social
Therapeutic
*Interaction is primarily for reason of
pleasure or companion-ship.
*Concerned with helping the patients
(regardless their
sex,religion,race…etc.)
*No person is in the position of
responsibility of helping the other.
*Require the help of person with
scientific knowledge and special
skills(the nurse).
*There is no this intention.
*There is intention of dealing with
other's problem.
*The goal is more or less social
*The relation ship is purposeful
directed toward a therapeutic.
*It is up to the partners to share their
personal affairs.
*The relationship should not entail
the nurse's personal matters or
problems.
*Unlimited.
*Time limited.

68. I.Initial Phase:
or pre-interaction phase : the
Nurse should prepare to meet
with a particular patient .

69. II.Orientation Phase
1)The nurse meets the patient and gathers necessary data.
2)Nurses use skills of observation and communication to
formulate a nursing diagnosis
3)Clarify with the patient goals of the relationship and the
process for attaining them.
4)Develop the treatment contract which includes:
-Frequency
-Length
-Place of sessions
-How termination will be decided

70. 5)Mutual roles and responsibilities are defined in
part through discussion
6)Summarize discussion of roles by specifying
time,place and frequency of treatment
sessions
7)Communicate to patient's hopes and that the
assistance is useful to him

71. III.Working Phase:
By working phase, the patient has an increased
commitment to the work of relationship and is less
guarded .This phase calls for maintenance of
therapeutic alliance as a context for pursuing the
agreed goals through:
1)The nurse encourages discussion of current
relationships and issues that are problematic for
the client.
2)Help the patient to describe experiences in
concrete specific way.

72. 3)Observe patient's patterns of interaction as
an indication of behaviors that create
problem for the patient in other
relationships.
4)Assess patient's level of anxiety about the
topics discussed.
5)Accept low levels of anxiety to enhance
learning.
6)Avoid high levels of anxiety to therapeutic
alliance.
7)Assess patient's progress towards goals.

73. IV.Termination phase:
Preparation for this phase starts at the beginning of
the relationship with clarification of how long the
relationship will continue.
The termination phase may be due to:
1)Achieving goals set by the nurse and the patient.
2)Patient's discharge from the hospital.
3)Nurse has finished work in this section.

74. To achieve this termination phase, the nurse
should:
1)Acknowledge the fourth coming termination.
2)Evaluate what has been achieved and learned
during the relationship.
3)Gradually reduce the frequency and intensity of
the session.
4)Encourage the client to participate in other
relationships.
5)The nurse can share the genuine reactions to
termination in an appropriate way.

75. Respect:
The nurse respect the patient through:
1)Recognize the client's feeling,beliefs and
experiences.
2)Actively listen to the patient.

76. Genuineness;
Genuineness in a relationship means real, i.e.:the
nurse believes or feels what is expressed.
This is congruence and is basic to establishment of
interpersonal trust.

77. The nurse's genuineness encourages the patient
to:
1)Self disclose.
2)Communicate information or emotions.
3)Differntiate between social relationship and
authentic therapeutic relationship

78. Hope:
When people face the repeated negative experiences
and have thus lost respect for themselves,trust in
their abilities and faith in their potentials,so the
nurse should help the patient to:
1)Recognize her beliefs in these potentials.
2)Realize that he should continue taking the
medication.

79. 3)Convey to the patient any small changes and
success and communicate them to the patient .
4)Assist the patient in seeing the self as
confronting problems.
5)Help the patient to make changes that he
wishes to make and are right for him

80. Empathy is significant in the nurse-client
relationship.
Empathy means: that the nurse comprehend what
the client is experiencing,the nurse will undergo
this through:
1)Observe the patient's physical demands and
listening to content and the style of what is said.
2)Develop spontaneous,emotional awareness of the
patient.

81. 3)Develop the ability to alternate between
effectively participating with the patients and
intellectually observing the patient.
4)Differentiate between sympathy and empathy.
Sympathy means that the nurse feels sorry for the
patient.

83. THANK YOU FOR YOUR
LISTENING