TRINITY VALLEY COMMUNITY COLLEGE
TRINITY VALLEY COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM
COMMUNICATION TECHNIQUES
Techniques for Facilitating Effective Communication
|Technique | |Example |
|Therapeutic Techniques for Obtaining Relevant Information/Questioning |
|Giving Broad Openings – Allowing patient to introduce the topic. | |Let’s talk about how you’re feeling. |
| | |How are you feeling? |
|Open – Ended Questions – Nurse chooses subject but allows for | | |
|patient directions. | |How have you been? |
| | |How do you feel about...? |
|Indirect Statements – Similar to open ended questions. | | |
| | | |
|Exploring – Delving further into a subject or idea. | |I’d like to hear about... |
| | | |
| | | |
| | |Tell me more about that. Describe how you feel more fully.|
|Techniques for Responding |
|Restating or paraphrasing – Repeating main idea expressed in own | |Pt. “I can’t sleep. I stay awake all night worrying.” |
|words. | |Ns. Worrying keeps you awake at night. |
| | | |
| | |Pt. “My brother spends all my money and then has the nerve|
| | |to ask for more.” |
|Reflecting – Verbally giving back the feeling part of the | |Ns. “This causes you to feel angry.” |
|patient’s message. | | |
| | |You appear tense. |
| | |You are uncomfortable when you... |
| | |I notice that you’re biting your lips. |
|Making Observation – Verbalizing what is perceived. | |It makes me uncomfortable when you... |
| | | |
| | |I’m not sure that I follow you. Could you say it another |
| | |way? |
|Seeking Clarification – Trying to make clear what you do not | | |
|understand. | |Go on. |
| | |And then? |
|Offering General Leads – Giving encouragement to continue. | |Tell me about it. |
| | | |
| | | |
| | |Uh hum. |
|Accepting – Giving encouragement to continue. | |I follow what you said. |
| | |Nodding. |
|Giving Information – Giving facts to patient – (may be used to | |My name is.................................. |
|open or close a conversation, but does not elicit feelings). | |Visiting hours are........................ |
| | |My purpose in being here is........ |
|Reassurance – Truthful reassurance that patient is being listened| |I’m taking you to the................... |
|to and that we understand what they say. | | |
| | |I am here. I care. |
|Using Silence – Utilizing the absence of verbal communication to | |I hear what you’re saying. |
|allow Patient to collect thoughts or control emotions. | | |
| | | |
|Summarizing – Organizing and summing up what has been said. | | |
| | | |
| | | |
| | | |
| | |Have I got this straight? |
| | |You’ve said that.............................. |
| | |During the past hour you and I have |
| | |discussed.......................................... |
|General Techniques – Used to develop rapport, so therapeutic conversation can develop. |
|Giving Recognition/Focusing on Patient – Acknowledging, | |Good morning, Mrs. X. |
|indicating awareness. | |You’ve tooled a leather wallet. |
| | |I noticed that you’ve combed your hair. |
| | |Tell me about yourself. |
|Offering Self – Making oneself available. | | |
| | |I’ll sit with you for a while. |
| | |I’ll stay here with you. |
|Techniques Which Inhibit Effective Communication |
| |
|Non-therapeutic Techniques for Obtaining Relevant Information/Questioning |
|Requesting an Explanation or Probing – Asking for reasons. | |Why do you think that? |
| | |Why do you feel this way? |
| | |Why do you do that? |
|Multiple Questions | | |
| | |Did you sleep well, enjoy your breakfast, and have a good |
| | |morning? |
|Overuse of Closed Questions – Inhibits Patient; | | |
|disrupts flow or communication. | |Are you in pain? |
|Non-therapeutic Techniques for Responding |
|Advising – Telling patient what to do; giving own opinion. | |I think you should...................... |
| | |Why don’t you....................... |
|Giving Approval or Disapproval – Saying Patient has or has not | | |
|measured up to nurse’s standards. | |That’s good. |
| | |I’m glad that you....................... |
|Agreeing/Disagreeing – Nurse’s judgment that patient is right or | |I’d rather you wouldn’t............. |
|wrong. | | |
| | |That’s wrong. |
| | |I don’t believe that. |
|Blaming/Moralizing – Being judgmental. | |I agree. |
| | | |
| | |Don’t’ you know that smoking is bad? |
| | |What have you done to your child? |
|Patronizing The Patient – Talking down Patient. | |You shouldn’t feel angry. |
| | | |
| | | |
|Belittling Feelings Expressed – Telling patient his problems are | |It’s time for our bath. |
|not important. | | |
| | | |
| | | |
| | |Pt. “I have nothing to live for...I wish I were dead.” |
| | |Ns. “Everybody gets down in the dumps. I’ve felt that way |
|False Reassurance – Indicating there is no cause for anxiety. | |sometimes.” |
| | | |
| | |I wouldn’t worry about.................. |
|Making Stereotyped Comments – Offering meaningless cliches. | |Everything will be all right. You’re coming along fine. |
| | | |
| | |Fine weather we are having. I’m fine, how are you? It’s |
| | |for your own good. Keep your chin up. |
| | | |
|Defending – Attempting to protect someone from verbal attack. | | |
| | | |
| | |This hospital has a fine reputation. |
|Changing The Subject | |No one here would lie to you. |
| | |But, Dr. B. is a very able psychiatrist. |
| | | |
| | |Pt. “I’d like to die.” |
|Stumped Silence – Silence due to confusion. | |Ns. “did you have visitors this weekend?” |
TRINITY VALLEY COMMUNITY COLLEGE
ASSOCIATE DEGREE NURSING PROGRAM
COMMUNICATION EXERCISE
THERAPEUTIC COMMUNICATION TECHNIQUES
The following therapeutic communication techniques are used in the following conversation. N is the nurse and P is the Patient. Read each interaction and identify the technique the nurse utilizes. Use each technique only once.
Exploring Reflecting
Restating Giving Information
General Lead Seeking Clarification
Accepting Focusing on Patient
Offering Self
|N “My name is Mr. Jones and I am your student nurse today.” | |Giving information |
|P “A male nursing student! I don’t know how I feel about a man | | |
|taking care of me.” | | |
| | | |
|N “You sound unsure about having a male taking care of you.” | | |
|P “I am unsure about both your being a male and a student.” | | |
| | |____________________________ |
|N “Go on.” | | |
|P “Now that I think about it, I don’t guess it really matters | | |
|whether you are a male or a student, as long as you know what you| | |
|are doing.” | | |
| | |____________________________ |
|N “I think I do. I have worked as a nursing tech before I | | |
|started nursing school last year.” | | |
|P “You are in your second year of nursing school?” | | |
| | | |
|N “Yes, ma’am. I graduate in May. You’re still uneasy about | | |
|having a student today.” | |____________________________ |
|P “Not so much. You seem to know what you are doing. Will my | | |
|doctor be by this morning? | | |
| | | |
|N “I don’t know, but I can check.” | | |
|P “If you don’t mind. There are some test results that should be| | |
|back soon that I want to know about.” | |____________________________ |
| | | |
|N “Your concerned about some test results.” | | |
|P “Yes. I hope they are alright.” | | |
| | | |
|N “Uh hum.” | | |
|P “I have been having these dizzy spells. They ran one of those | | |
|CAT scans to see if I had a stroke.” | |6. _____________________________ |
| | | |
|N “Tell me more about your concern.” | | |
|C “I’m just a little worried. My sister died of a stroke when | | |
|she was real young.” | | |
| | |7. _____________________________ |
|N “You feel anxious.” | | |
|P “Yes, it seems like it is taking forever for those tests to | | |
|come back.” | | |
| | |8. _____________________________ |
| | | |
| | | |
| | | |
| | | |
| | |9. _____________________________ |
| | | |
| | | |
| | | |
| | |10. ____________________________ |
| | | |
NONTHERAPEUTIC COMMUNICATION TECHNIQUES
The following therapeutic communication techniques are used in the following conversation. N is the nurse and P is the Patient. Read each interaction and identify the technique the nurse utilizes. Use each technique only once.
Requesting an explanation Multiple Questions
Closed Ended Questions Advising
Agreeing/Disagreeing Blaming/Moralizing
Patronizing Belittling Feelings
False Reassurance Stereotypes Comments
Defending Changing the Subject
|N “Hi, honey! My name is Mr. Jones and we will be taking care of| |____________________________ |
|you today.” | | |
|P “A male nursing student! Will there be more than one of you? | | |
|I don’t know how I feel about men taking care of me.” | | |
| | | |
|N “Why don’t you want me to take care of you today? | | |
|P “I’m not sure. I’ve never had a male nurse before.” | | |
| | |____________________________ |
|N “My instructor wouldn’t let me take care of you if I wasn’t a | | |
|good nurse.” | | |
|P “Now that I think about it, I don’t guess it really matters, | | |
|that you are a male.” | | |
| | |____________________________ |
|N “There is no reason for you to feel uncomfortable with me | | |
|taking care of you.” | | |
|P Silence. | | |
|N “Are you uncomfortable because I am a male? Do you not like it| | |
|because I am a student? Do you just not like me at all? | |____________________________ |
|P “I am just worried about something. Will my doctor be in | | |
|sometime this morning?” | | |
| | | |
|N “I do not know. It sure is warm in here.” | |____________________________ |
|P “Yes, but do you know about my tests?” | | |
| | | |
|N “I’m sure your doctor knows what he is doing!” | | |
|P “Yes. I hope you are right.” | | |
| | | |
|N “You shouldn’t worry so much or you will get an ulcer.” | | |
|P “I have been having these dizzy spells. They ran one of those | | |
|CAT scans to see if I had a stroke.” | |____________________________ |
| | | |
|N “That sounds nice.” | | |
|P “I’m just a little worried. My sister died of a stroke when | |____________________________ |
|she was real young.” | | |
| | | |
|N “Keep your chin up. It will be alright.” | | |
|P “Are you sure?” | |____________________________ |
| | | |
|N “Well if I were you, I’d get a second opinion.” | | |
|P “Is there something I should know about?” | | |
| | | |
|N “Did you ask your doctor?” | | |
|P “No. That’s what I have been trying to tell you. I haven’t | |____________________________ |
|seen him yet!” | | |
| | | |
| | | |
| | |____________________________ |
| | | |
| | | |
| | |____________________________ |
| | | |
| | | |
| | | |
| | | |
| | |____________________________ |
| | | |
THERAPEUTIC AND NONTHERAPEUTIC COMMUNICATION TECHNIQUES
The following communication techniques are used in the following conversation. N is the nurse and P is the Patient. Read each interaction and identify the technique the nurse utilizes.
Change Subject Patronizing
Belittling Feelings Stereotypes Comments
Requesting Explanation Open Ended
Giving Information Summarizing x 2
Seeks Clarification Reflecting
General Lead Offering Self
Broad Opening Restating
|N “My name is John and I am your nurse today.” | |____________________________ |
|P “My. I’ve never had a male nurse before.” | | |
| | | |
|N “You seem unsure about having a male nurse.” | | |
|P “I’ve just never had one and never really thought about it | | |
|before.” | |____________________________ |
| | | |
|N “How are you feeling this morning?” | | |
|P “I’ve been a little worried about the tests I had done | | |
|yesterday.” | | |
| | |____________________________ |
|N “Why are you worried?” | | |
|P “I don’t know how they turned out.” | | |
| | | |
|N “What kind of tests did you have run?” | |____________________________ |
|P “Several. They did lab work, some kind of x-ray scan, and a | | |
|heart test.” | | |
| | |____________________________ |
|N “What kind of problems have you been having?” | | |
|P “I have felt weak and dizzy here lately.” | | |
| | | |
|N “This concerns you.” | |____________________________ |
|P “Yes. Wouldn’t it you?” | | |
| | | |
|N “No news is good news so they say.” | | |
|P “Do you really think so?” | |____________________________ |
| | | |
|N “We’ll just have to see, won’t we?” | | |
|P “Will you see if my doctor is coming to see me this morning?” | |____________________________ |
| | | |
|N “Yes. I’ll check on that for you.” | | |
|P “I hope he has those test results.” | |____________________________ |
| | | |
|N “You sound nervous.” | | |
|P “I have been having these dizzy spells.” | | |
| | |____________________________ |
|N “Go on.” | | |
|P “My sister died of a stroke when she was young.” | | |
| | |____________________________ |
|N “You seem afraid of dying.” | | |
|P “I’m not so afraid of dying as I am afraid of getting to where | | |
|I cannot take care of myself.” | |____________________________ |
| | | |
| | | |
|N “You are afraid of becoming dependent.” | | |
|P “It is just so undignified to have to rely on someone else to | |____________________________ |
|take care of your bodily functions.” | | |
| | | |
|N “You shouldn’t feel that way.” | | |
|P Silence | | |
| | | |
| | |___________________________ |
| | | |
| | | |
| | | |
| | |___________________________ |
| | | |
N\ Syllabus/Fresh/Fall/RNSG 1523\ Communication Techniques & Exercises Reviewed 06/11
Reviewed 06/12
Reviewed 06/13
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