Establishing Therapeutic Communication
Nurses serve as patient advocates, maintaining a therapeutic and professional nurse-patient relationship while adhering to appropriate professional role boundaries. Nurses must be able to communicate with patients, other health care providers, correctional staff, and outside providers in order to provide quality health care in correctional settings. Therapeutic communication is defined as face-to-face interaction that focuses on improving a patient’s physical and emotional well-being (Laffan, 2011). Nurses use therapeutic communication techniques to provide patients with support and information. To achieve nursing goals when communicating with a patient, it may be necessary to employ a variety of techniques. Nurses frequently use open-ended statements and questions, repeat information, or use silence to encourage patients to work through problems on their own in therapeutic communication (Engard, 2017).
A triggering event, the behavior itself, and the consequences of the behavior are all components of behavior (Laffan, 2011). The nurse must first define the behavior by describing the action, for example (Laffan, 2011). Next, look for events or other clues that could explain what caused the behavior (Laffan, 2011). Finally, consider the consequences, such as changes in the environment or other people’s behavior (Laffan, 2011). Medication, group or individual therapy sessions, or simply communicating with the person or people involved with the behavior can all be used to manage the behavior. It is critical to set realistic, attainable goals that are tailored to the individual. The nurse may need to be creative in breaking down her plan and goals into small, manageable chunks. Positive reinforcement, setting boundaries and limits, and being honest with the patient are some other behavior management techniques.
Luisa, a 32-year-old woman, has arrived at my outpatient clinic. She is pale and reserved, her hands wringing as she speaks. She refuses to make eye contact. First, I’ll introduce myself and ask her why she’s coming to the clinic today. I’ll give her some space to gather her thoughts and express herself, assuring her that she can take her time. I won’t make eye contact with her unless she initiates it. If she starts by saying her boss told her to come in, I’ll ask her why he thought she needed to be seen today. I’d tell her she’s in a safe place and that anything she says here is strictly confidential between her, the doctor, and myself. I would use a combination of communication skills such as active listening, seeking clarification, placing events in time or sequence, making observations encouraging descriptions of perceptions, encouraging comparisons, summarizing, reflecting, focusing, confronting if necessary, and offering hope or humor to ensure that I understand everything she says and that Luisa is expressing herself the way she wants (Engard, 2017). I would validate her right to have these feelings after learning about her concerns about her husband, her job, and the safety of herself and her children. If she is interested in learning more about them, I would tell her there are many resources available to her. If she wants to use the resources, I will refer her to a mental health counselor by providing a list of reputable therapists in her area. I would also advise her to seek advice from her religious leader, as she is deeply religious. If she decided to leave her husband, I would tell her about local women’s shelters and how to get WIC, food stamps, and housing assistance if necessary. I would also make sure she understands that she does not deserve this treatment, that it is not normal, and that all of the resources listed above will do everything possible to help her.
References
Engard, B. (2017, November 17). 17 Therapeutic Communication Techniques | Rivier Online. Retrieved from https://online.rivier.edu/therapeutic-communication-techniques/
Laffan, S. (2011, Spring). Therapeutic communication and behavioral management. Retrieved from https://www.ncchc.org/cnp-therapeutic-communication
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Question 
1) Introduce and Define the ” Nurse-Patient Relationship” theory to construct a narrative (story) about your experience in clinical or simulation with a patient.
Establishing Therapeutic Communication
2) Explain how this theory applies to your clinical experience with the patient.
3) Must include any 3 of the following when writing about your personal experience:
Demonstration of or lack of:
*leadership
*Interprofessional collaboration
*therapeutic communication
*holistic care (social determinants / cultural considerations)
*safety for the client