Communication

when explaining dx to a p/t, what are good guidelines to follow?

-Complex scientific or medical terminology should be avoided -Go for most basic explanation

Whats therapeutic communication?

-client centered -goal directed -strengthens therapeutic relationship (which is centered around helping the p/t)

Whats sympathy?

Feeling bad about what someone else is going through

should one challenge a p/t's statement?

No

Public speaking

a unique way of talking to the group were the speaker addresses the group

Role of self serving group member?

advances the needs of individual member at groups expense

interpersonal communication

communicating between two or more people

name therapeutic communication techniques

listening, maintaining silence, maintaining neutral responses, using broad openings and open-ended questions, focusing and refocusing, restating, clarifying and validating, sharing perceptions, reflecting, providing acknowledgment and feedback, giving information, presenting reality, encouraging formulation of a plan of action, providing nonverbal encouragement, and summarizing

name some open ended words

may, usually, normally, commonly, or generally

what are the five elements of communication?

message, sender, channel, receiver, and feedback

What would be a good response to a p/t that states "Those aren't real police outside the door, they're here to make sure I don't escape so that they can take me away to their boss and I can be punished once ya'll are done with me."

"Do you feel afraid that people are trying to hurt you?" -focus on feelings of p/t be -don't feed the delusion

A P/T's spouse brings her husband into the ER because he's going through opiate withdrawals. She says "I want out of this relationship. I should leave him right?" whats the most therapeutic response?

"What do you find most difficult with this situation?" -do not offer opinions - -let others learn how to handle their lives (THEY KNOW THEMSELVES, THEIR RELATIONSHIPS AND THEIR LIVES THE BEST)-

If a client says something like "my family would be better off without me". What would be an appropriate response?

"you sound upset; Are you thinking of hurting yourself?" -always explore if someone seems at risk for hurting themselves or others

If a p/t is being discharged (from the hospital) and has to self administer IM/IQ (or whatever injection) but says something like "I feel as if I shouldn't be going home yet if I have to give myself injections?" what would be an appropriate response? -"Are you not happy about going home?" -"You should talk to your doctor." -"Do you think you should stay here longer -"Research has shown that self administering this medication is better for patients rather than staying in the hospital."

-"Research has shown that self administering this medication is better for patients rather than staying in the hospital." -always use an opportunity to educate the p/t if it helps them adapt/cope to change

Goals of termination phase

-Examine goals of helping relationship for attainment. -Make suggestions for future efforts, if necessary. -Encourage patient to express emotions about the termination. If appropriate, help the patient establish a helping relationship with another nurse. Assist the patient transferring from one agency to another or from one unit in an agency to another.

What are the characteristics of a therapeutic relationship?

-dynamic -purposeful and time limited -person providing assistance is professionally accountable for the outcomes

Goals of orientation phase

-establish tone/guidelines for relationship -Use one another names -clarify role of each person -establish agreement about relationship -orient p/t to healthcare system, hospital room, hospital bed, how to call the nurse and etc.

What are some therapeutic communication barriers?

-failing to explore issues in detail -offering advice -failure to listen -expressing approval or disapproval -changing the subject abruptly -using question containing "why" and "how" -using questions that probe for information

Goals of Preinteraction phase

-get health history -find out as much info about p/t -learn about family dynamics

Goals of working phase

-give and receive help from medical personnel to meet p/t needs. -provide teaching and counseling

if a question asks you for a response and there aren't any therapeutic questions available to use, whats a strategy to pick a response?

-restate the p/t concerns (shows that you were listening) -pick a response that also encourages communication

What are components of communication?

-subject matter -words -gestures -substance of the message -open to interpretation (how the message is perceived)

When a p/t refuses to take a medication, the best response will be?

-the one that respects the p/t's rights -As nurses, we are patients rights ADVOCATEs

if they might hurt themselffs....

...alarm yo selffss

The nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and is making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make to this client? 1."You need to stop that behavior now." 2"You will need to be placed in seclusion." 3"You seem restless; tell me what is happening." 4."You will need to be restrained if you do not change your behavior."

3. "You seem restless; tell me what is happening." strategic words in the question are "most appropriate"

A client is experiencing impotence after taking guanfacine. The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse? 1. "I can understand completely." 2. "You wouldn't really want to have a stroke." 3. "You are concerned about the effects of your medication." 4. "The health care provider should change your prescription."

3. "you are concerned about the effects of your medication." -restates p/t concern -encourages further communication

dysfunctional affect

Display of emotions that are unsuited to the situation; a symptom of schizophrenia. example: A p/t laughing about being sexually abused as a child.

If a p/t hears another p/t screaming, crying, and etc. and asks "Whats wrong with them? Why are they crying? I hope they're alright." is acknowledging there's a p/t a violation of HIPA?

Its only a violation if YOU give information about the client's care. If a p/t finds out on their own, no one broke the rule.

Is it ever ok to reinforce a mentally ill p/t's delusions?

No

should one tell someone in an abusive relationship to "get out of that relationship"?

No, don't offer advice in a clinical setting Not a therapeutic response

clarifying questions

Open-ended questions that ask the customer to elaborate on information already received.

RPFTR

Restating Patients Feelings for a Therapeutic Response

ripple pipple fibble tree roo

Restating Patients Feelings for a Therapeutic Response

clarification

Restating what the client has said makes the client feel as though you are listening and can allow you to make clear how a p/t's feelings relate to their actions examp. Patient: "I don't have any food in the house and the only person that I can ask for help is my brother, but I don't want to worry him." Nurse: "If your brother was having trouble with keeping food in the house, wouldn't you want him to tell you so that you could help him?" (n.) the act of making clear or understandable, an explanation

Whats the first thing one should focus on asking when coming up with a therapeutic response?

The p/t's feelings.... focus on them.... ....their feelings..... focus on them.....some more.

Whats a good goal to have in mind when trying to think of therapeutic responses?

To try get the client respond therapeutically not socially.

Whats the point of trying to get a therapeutic response?

To try to get the patient to respond therapeutically (talk about their feelings)

Whats empathy?

Understanding and sharing what someones going though

Should you address the clients concerns?

Yes always, as long as its not irrational (like with p/t's with certain mental illnesses)

flat affect

a lack of emotional responsiveness

name some close ended words

all, always, every, must, none, never, and only -(close ended) "absolute" words are not part of therapeutic responses - -if you see these words in a "response" question, you can eliminate them -

Group communication

communicating with the all of the group at the same time

What is compassion?

empathizing with how someone feels AND doing something to ease the suffering

what aspect of the client should one be thinking about when coming up with a therapeutic response?

focus on the clients feelings (a restatement of their perception/feelings)

Task oriented group member?

focuses on work that needs to be done

aphasia

impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

when a mental health p/t is being disruptive, what is important to do?

its important to set boundaries as to make sure the client realizes that the way they're acting is inappropriate. If you want to be treated with respect, you have to give it as well. Establish Mutual Respect

intrapersonal communication

self-talk (can be negative or positive)

validating question

serves to validate what the nurse believes he or she has heard or observed

imposition

something that is a burden to someone else; to put your needs above someone else's to the point that it's a burden for others like ethnocentrism which is r/t cultural imposition

transmission

the action or process of transmitting something (like a pathogen)

Role of group builder/maintenance?

the focus of the well being of the people doing work

What word is never a therapeutic response?

why? NEVER THERAPEUTIC