Therapeutic Communication free essay sample

University of Makati College of Allied Health Study Title2: Relationship of therapeutic communication of nurses as a contributing factor to patient’s satisfaction in Ospital ng Makati: A basis for tips on effective use of therapeutic communication †¢ Related Literatures †¢ Background of the study †¢ Statement of Problems †¢ Hypotheses †¢ Significance of the study †¢ Scope and limitations Submitted by: Marinay, Jane Paula P. Pesebre, Johnette P. Related Literatures: 1. Cheermith Villarosa: Some of the nurses don’t understand the feelings of the patients, but some people understand it. But I’m just curious of one thing. Why some of the patients are getting well if theyre nurses is talking to them? I’m just curious of how did nurses do that? It is really amazing for me! So I search one of the hospitals in here in my country Philippines to ask the nurses about this topic. When I ask some nurses there I was so surprise when she answers my question. We will write a custom essay sample on Therapeutic Communication or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page My question goes like this, â€Å"are you having a conversation with your patients? † She answers it like this, â€Å"I always have a conversation with my patients because every time I do talk to them that will be the only way your patient will trust you and you’re too lucky if your patients trust you. And every time you medicate your patient they will not ask you â€Å"what is that? † all that they know is that the medicine that you will gave them is the only way that they will recover and having a conversation to your patients is a proper way of being a nurse. Not just the talk but the way you took care to them also. † 2. Barbara Bryant: Nurses spend more time with and often get to know patients better than physicians do, especially in the hospital setting. As a result, they need to interact with patients on many different levels to assess their moods and perspectives to help them prepare for and undergo treatment. Nurses need to develop relationships with patients and make them feel at ease in the clinical setting, but also maintain a professional relationship with them at a time when they may be emotionally vulnerable. o Balance of Power Nurses have knowledge, skills and authority that patients count on, which makes patients dependent on them, the British Columbia College of Registered Nurses website points out. This can make patients feel vulnerable and, perhaps at times, defensive. Gentle, nonjudgmental interactions with patients are key to earning their trust and willingness to communicate. Rapport Open communication between nurses and patients is important because nurses may need to recognize subtle cues from reticent patients to understand what theyre thinking and feeling if they are feeling afraid or defensive. This is especially if theyve been admitted on short notice, after an accident, or due to a sudden health problem or abuse. They may be disoriented or unwilling at first to explai n the circumstances surrounding their admission if they suddenly find themselves in the hospital. In any case, introducing your name, using the patients name in conversation and maintaining eye contact with the patient helps to form a therapeutic bond, according to the Nursing Made Easy website. Listening carefully to what the patient says and rephrasing the concerns he expresses indicates your understanding of their concerns. o Visual Cues Nurses need to read the physical cues patients send out during interactions. Some patients like to be touched frequently as a gesture of reassurance or solidarity. Others may not wish to be touched due to cultural influences, the Nursing Made Easy website states. The desire to maintain distance could also be caused by psychological trauma. For example, a woman who has been physically assaulted by a male may not want to be touched soon thereafter by a male physician or nurse. This is a subtle form of communication nurses should pick up on. 3. Wanda Lockwood: Therapeutic communication begins with the nurse showing respect for the patient and family members and recognizing that communication includes not only verbal responses but also nonverbal expressions, such as tone of voice, body language and facial expression. The nurse must listen and observe carefully and use communication techniques that promote better communication in order to understand the needs and feelings of the patient. o Use names Mrs. Markson, I am John Stevens, your nurse. Using a persons name makes her feel more valued, and introducing yourself is a basic step in establishing a therapeutic interaction. o Show empathy You should be honest with the patient and acknowledge his concerns and feelings, answering questions as completely as possible. Sometimes the patients nonverbal behavior can communicate more than words. Making observations about what you see can encourage communication: Mr. Brown, your hands are shaking. You seem upset. o Provide encouragement Patients often want to talk about their concerns but are reluctant to impose on your time or feel intimidated. Open-ended questioning may facilitate communication: Miss Jacobson, do you have concerns youd like to talk about? Dont be afraid to allow periods of silence and encourage the patient by brief acknowledgments, such as Yes or I see. Use your own body language, leaning forward and nodding your head, to promote communication. Listen for the implied meanings and encourage people to express them. o Help to orient Illness and hospitalization can be very disorienting for patients, especially the elderly. You should tell the patient what is real without challenging her. If the patient insists someone is crying, respond with what is true. o Include the patient You must remember that patient care should be collaborative and include the patient in decision making whenever possible. The patient often feels at the mercy of the system, but you can help him find ways to feel in control: How can we make these dressing changes more comfortable for you? Asking the patient is more effective than making assumptions: Have the physical therapy treatments helped you to walk better? o Recognize limits You should never try to force the patient to talk or express feelings until he is ready. If the patient doesnt answer a question or chooses not to discuss feelings, back off. Respect the patients right to silence. You can indicate an openness to talk: Im happy to talk with you about your treatments when you like. 4. Lani Thompson: Therapeutic communication is a technique nurses use to promote and enhance the physical and emotional well-being of their patients. Its purpose is three-fold: to collect information, assess and change behavior, and to educate. Nursing schools teach a number of techniques to help nurses communicate with their patients in a supportive and therapeutic manner. o Silence Moments of silence give the nurse and patient time to sort their feelings and think about whats already been communicated. The nurse should let the patient break the silence. o Sharing Nurses can share in a number of ways. Sharing observations such as you look tired can encourage a patient to talk, reported a writer in the article Therapeutic Communication Techniques on the Napa Valley College website. Sharing empathy communicates understanding, while sharing humor gives a feeling of togetherness and friendliness. Finally, when a nurse shares hope, she gives her patient a sense that something can be done. o Using Touch Touching is a powerful way to communicate. It can relax or comfort a patient. Nurses need to be sensitive to patients and ascertain whether touching is acceptable, since some patients may feel threatened by it. o Asking Questions Asking relevant questions allows the nurse to gather important information. A nurse should ask only one open-ended question at a time. An example is What is your biggest problem right now References: †¢ Therapeutic Communication Techniques for Nursing | eHow. com http://www. ehow. com/about_5098131_therapeutic-communication-techniques-nursing. html#ixzz1S6I8xOfh †¢ Communication Therapeutic Nurse-Client Relationship | eHow. om http://www. ehow. com/about_6602331_communication-therapeutic-nurse_client-relationship. html#ixzz1S6GSkFxp †¢ Nursing Therapeutic Communication | eHow. com http://www. ehow. com/facts_7194657_nursing-therapeutic-communication. html#ixzz1S6LTVNvV 1 . Gray Pilgrim Therapeutic communication is healing and bringing about positive change through open communication in a patient who is suffering from problems. In this article, I share an overview different types of communication techniques that are used by psychotherapists and psychiatric nurses to help their patients. The problems and the maladies of the body are sometimes easily curable, but the problems of a mind are not that easily solved. To put together the pieces of a fragmented and shattered mind and help it heal itself requires therapeutic communication techniques. A person can only get better and gain his confidence back when he strives to do so, on his own. The role of the therapist and therapeutic communication is to guide them back and help them open up and face their fears and challenges with confidence. Here I discuss some of the therapeutic communication techniques in psychiatric nursing and psychotherapy, that are known to be effective. What is Therapeutic Communication? The term Therapeutic Communication is well chosen. It directly identifies what therapeutic communication techniques mean. It is caring and healing through communication. To slowly guide a patient through the messed up situation he/she is in and help him/her overcome it. The job of psychiatric nursing and psychotherapy is increasingly vital as people are increasingly falling prey to depression and hollowness inside even though they live a life of material abundance and have opportunities like never before. The job of a therapist is to help a patient get to the root cause of his problems through a process of introspection, guided by the therapist. That is why, a therapist needs to be non-judgmental and create an atmosphere where, the patient lets down his guards and communicates openly due to the trust he develops in the therapist. Therapeutic communication techniques are one of the most important part of psychotherapy. Therapists need to have a range of therapeutic communication techniques which help them in dealing with patients with myriad personalities and problem patterns. One of the most important things is that a therapist needs to be sincere and take genuine interest in the person he is trying to help. He needs to walk a thin line of empathy for the patient while still not letting that affect his objective thinking and analysis of the patients problems. Studying transcripts or therapeutic communication techniques examples can help in gaining insight into how the art of reaching through the defenses of a patient is practiced. Case study of similar cases is very important as it can give extra clues for a solution. Therapeutic communication techniques in health care and nursing are also very important. A patient recovering from a debilitating illness needs encouragement and a lot of care from the nursing staff. Positive body language like a smile and demeanor which makes the patient feel cared, can bolster the healing process of a patient. Therapeutic communication techniques in nursing are aimed at healing the mind while medicines can only cure the body. In the next section let us see some of the types of therapeutic communication techniques that are used by therapists. Types of Therapeutic Communication Techniques Here are the major types of therapeutic communication techniques that make it easier for the patient to open up and the therapist to gain insight into what is the source of a patients problems. Undivided Attention Listening Giving your undivided attention to a patient when he talks is very important. Listening intently to what he says and being sympathetic and encouraging through eye contact and body language helps a lot. He should feel that you want to listen to him and are genuinely trying to understand his problems. These non verbal cues are crucial in the initial phase of therapy in creating an encouraging atmosphere. Reflecting Thoughts One way of therapeutic communication and one of the subtlest techniques is reflecting. A patients statement is redirected towards him through similar wording which makes him think about it again from another perspective. Sharing Encouraging Interaction One way of helping and connecting with a patient is to share your own personal experiences with him. This will encourage him to share his own experiences and problems more easily. Direct Questioning and Problem Solving This is the straightforward process where based on the facts and information, gained through questions about problems of patient, the therapist makes concrete suggestions about possible suggestions. This approach can work in case of only certain specific kinds of problems. Identifying Inconsistencies and Contradictions Through the way of conversation the therapist must identify the inconsistencies and contradictions in the thinking of the patient. He must also subtly point out behavioral patterns and habits that are wrong and causing harm. One needs to quietly go on emphasizing the importance of a behavioral change and bring the patient to the point where he acknowledges that he needs to change to get better. These were some of the therapeutic communication techniques employed by therapists. There is no one perfect communication technique of therapy. Every person is different and a therapist needs to explore various ways of reaching out to the person. Children are some of the toughest people to reach out and so are some grownups. All you need is empathy and a non-judgmental caring attitude, backed by sincere concern. 2. Nancy Lydia Kimmel R. N. , Ph. D. , C. H. M. M. Nursing is a caring profession. It is also a profession that is more and more evidenced based in practice. In as much as the scientific aspects of nursing is increasing due to the complex technological advancement of medicine and the machinery that is used at the patients bedside, the fact remains that the nurse is the first person that the client usually comes in contact with in any emergency or hospital setting. Having said this, the term, caring is an essential emotion that all nurses, for that matter, all individuals in the health profession must possess. With caring comes the trained ability of the nurse to facilitate therapeutic communication. One might ask, what is therapeutic communication? To better answer this question, the term communication should first be defined. Communication can be defined as The Process of transmitting messages and interpreting meaning. (Wilson and others, 1995) With therapeutic communication, the sender, or nurse seeks to illicit a response from the receiver, the patient that is beneficial to the patients mental and physical health. Just as stress has been proven to adversely affect the health of individuals, the therapeutic approach to communication can actually help. In any given situation everyone uses communication. Everyone has seen the individual that looks like they are either angry, stressed, feeling ill or maybe sad. These emotions are communicated to others not always by words, but by gestures and facial expressions. A nurse must always be aware of these expressions in clients, for these expressions may be the only way that the nurse can tell if there is something else going on that needs their attention. The term given to this type of non-verbal communication is called, meta-communication. In meta-communication, the client may look at their amputated stump and say that it doesnt really look that bad, while at the same time tears are rolling down from their eyes. In a case such as this the nurse should stay and further explore how the person actually feels. There are many factors associated with the healing and comforting aspects of therapeutic communication. Circumstances, surroundings, and timing all play a role in the effect of therapeutic communication. If a client is being rushed down for an emergency surgery there might not be time for a bedside conversation, but the holding of a hand could convey much more than words to the client at such a moment. Ideally, for therapeutic communication to be effective the nurse must be aware of how they appear to the client. If a nurse appears rushed, for example, they are speaking quickly, their countenance looks harried, and they are breathing heavily, their eyes not on the client but perhaps on an intravenous bag on the client in the next bed. In a case like this, there is nothing that this nurse could say to the client in a therapeutic manner that the client would believe. The helping relationship has not been established and therefore therapeutic communication cannot be facilitated. Some of the emotions associated with therapeutic communication include but are not limited to the following: Professionalism, Confidentiality, Courtesy, Trust, Availability, Empathy, and Sympathy. (Potter, Patricia A. , Perry, Anne G. , Co. 2003, Basic Nursing Essentials for Practice, pg. 123, Mosby) All of these emotions go into the client nurse relationship, which must be established by the nurse as soon as possible upon first meeting the client. To begin to establish this nurse client relationship, the nurse must assess the overall message that the client is communicating to the nurse, such as fear, pain, sadness, anxiety or apathy. The nurse should be trained in keying into the message that the client is sending. Only then can the nurse determine the best therapeutic approach. Anyone that has to be thrust in to a hospital or emergency room environment has level of anxiety. This level can go up considerably when the client feels that they have been abandoned or that there is no one there that really cares about how they feel. When a client is the recipient of therapeutic communication from a caring individual, a level of trust is achieved and more than, that the clients entire countenance can change for the better. Their blood pressure, respirations and levels of stress can simultaneously decrease. When this takes place, the management of pain, if any is involved, can be resolved more quickly. The goal for a nurse is to become proficient in the medical art of therapeutic communication to facilitate the healing process, both mentally and physically. 3. Constance Kenya Despite the fact that doctors almost always get all of the credit, nurses have long been the unsung heroes of the medical profession. One of the reasons that nurses are so essential to the medical profession and to the successful healing of patients is that they naturally practice therapeutic communication. Therapeutic communication means gauging how well someone is doing by paying attention to how the person communicates, both verbally and non verbally. Good nurses develop this talent with time and experience and a healthy sense of empathy and compassion. They learn how to hone this talent and use it to take better care of their patients and sometimes even to help save lives. When a nurse comes into a room to do a post-operative check on a patient, she will do some routine things such as check the patients blood pressure, pulse, temperature, and stitches. These things are all indicators of how the patient is faring. If the patient is awake she may ask him some general questions about how he is feeling. When the patient answers the questions, the nurse not only listens to the answers, but watches the patients body language and facial expressions for signs of distress or discomfort. A patient may smile and say that he feels fine and can go home earlier than was scheduled, but his watering eyes and slightly trembling hand may say differently. Therapeutic communication not only helps with diagnosis, it also can help with healing. When a patient is concerned about his health or does not understand something that is going on with his body, the stress can be detrimental. When a nurse or doctor listens intently to the patients concerns and then addresses them calmly, the patient will often relax, and his body will be in a better state to work toward healing. Telling a post-operative patient that his pain is normal and then walking away does not alleviate much of his stress. Telling him why he is feeling the pain, how the pain medication will help, how quickly the pain will begin to subside, how well he is doing and how much better he will feel tomorrow will give him something to look forward to. The patient will relax a bit more, the pain medication will work better, and his stay in the hospital may even be a day shorter. Therapeutic communication is important for patient health, and nurses can be an essential part of making sure that it always comes into play when treating every patient. References: †¢ Therapeutic Communication A Nurses Tool http://www. articleclick. com/Article/Therapeutic-Communication-A-Nurse-s-Tool/1043905 †¢ Therapeutic Communication In The Nursing Profession http://www. nurseslearningcenter. com/articles/therapeutic_communication_in_the_nursing_profession. tml †¢ Therapeutic Communication Techniques http://www. buzzle. com/articles/therapeutic-communication-techniques. html Background of the Study Nursing is a profession that entails a caring personality. In the hospital setting, it is very hard to miss the nurses there—nurses are probably the first and last persons one might meet while in the hospital. They are also the first p erson a client usually comes in contact with in the health institution. Thus, the interaction between the nurse and patient is inevitable. It becomes a must for the nurse to communicate with the patient to give care and assistance during the patient’s stay. This is where Therapeutic Communication takes place. Therapeutic communication means that nurses use their communication skills in such a way that it will be of benefit to their patients. It means taking into account how well someone is doing by paying attention to how the person communicates, both verbally and non verbally. It makes the nurse appear more humane to a patient. Its primary goal is to make the patient feel and realize that he or she is being cared and that their pain, anxiety or emotions are well understood and adequately addressed through support, care and management. Being aware to the needs of a patient and their turmoil is very important. A lot of nurses do not recognize this and do not know how to deal efficiently with a patient as a result. Circumstances, surroundings, and timing all play a role in the effect of therapeutic communication. Ideally, for therapeutic communication to be effective the nurse must be aware of how they appear to the client. If a nurse appears rushed, for example, they are speaking quickly, their countenance looks harried, and they are breathing heavily, their eyes not on the client but perhaps on an intravenous bag on the client in the next bed. In a case like this, the helping relationship has not been established and therefore therapeutic communication cannot be facilitated. Some of the emotions associated with therapeutic communication include but are not limited to the following: Professionalism, Confidentiality, Courtesy, Trust, Availability, Empathy, and Sympathy. (Potter, Patricia A. , Perry, Anne G. , Co. 2003, Basic Nursing Essentials for Practice, pg. 123, Mosby) The international standard for the ideal ratio of nurses to patients in hospitals is 1:4. But even at the premier state hospital in the country, the Philippine General Hospital (PGH), said Dr. Jaime Galvez Tan, former Vice Chancellor for Research of the University of the Philippines-Manila and executive director of the National Institutes of Health-Philippines, the ratio of nurses to patients averages from 1:15 up to 1:25. (Bulatlat, 2005) This may be a factor why nurses here in the Philippines can no longer give sufficient therapeutic communication to their patients. The time that should be allotted for it is consumed for they still have to think about their other patient’s need as well. But, this is not enough reason for nurses to lessen the therapeutic communication that they could provide to their clients. This study will be a significant endeavor in promoting and adding knowledge to student nurses for effectiveness of their therapeutic communication. This study will also be beneficial to clinical instructors, registered nurses, and other healthcare givers who use therapeutic communication for the patient’s satisfaction. By understanding the topic and benefits of quality education, these soon-to-be healthcare providers and those who are already healthcare givers are assured of a competitive advantage. Moreover, this research will provide recommendations on how to improve the study. Statement of the Problem (Behavior Modification: relationship of patient to nurse) The study intends to determine the â€Å"Relationship of therapeutic communication of nurses as a contributing factor to patient’s satisfaction in Ospital ng Makati: A basis for tips on effective use of therapeutic communication†. Specifically, this study aims to seek the answers to the following questions: 1. What is the profile of the respondents in terms of: (profile of the patient dw dpat so di ksma ung physical app at comm. skills ng nurse) A. Age B. Gender C. Type of hospital service 2. How does the effectiveness of therapeutic communication of nurses in Medicine ward, Surgery ward and General Ward of Osital ng Makati affect the satisfaction of the patients towards their care? (kaya ko tntnong wat ward kc ksma s tanong dto. , blank kc ung wards ng OSmak sa question sa paper n chineck ni mam) _________________1,3,5 _________________6,4,8 _________________ (eto may line n gnito c maam)2,7,9 3. What is the relationship between the perspective of patient about spending time with them of the nurses and their satisfaction? 4. Based on the findings of the study, what possible guidelines can be proposed? . List of recommendations (tips) on how therapeutic communication can be used effectively in order to ensure better therapeutic communication between the patient and the nurse. (*naitama ko n ung mga questions, yung no. 2 lang di malinaw. ) HYPOTHESES: At 0. 05 level of significance, the following hypothesis will be tested: A. There’s positive effect that can actuall y help patients if communication is approached therapeutically. B. The perspective of the patient to nurses is an aid to determine the effectiveness of therapeutic communication in patient’s satisfaction. C. The patient’s satisfaction is ensured if therapeutic communication is frequently used by the nurses. SIGNIFICANCE OF THE STUDY The researchers believe that this study will strengthen the importance of therapeutic communication as an essential component of quality nursing care and will aid in the improvement of such. This study will be beneficial to the patients, as they are the primary subjects in this study. This will give them an opportunity to minimize their anxiety that can lead them to fast recovery and a higher patient’s satisfaction. In line with this, the patients can be certain that they are listened to and that their needs are being taken into account. Also, the study would be beneficial to the registered nurses who are continuously handling patients every day. This will make them value the importance of therapeutic communication for the patients, hence, *promoting better relationship could increase the satisfaction of patients. (Tama ba sentence? ) This would also make them prioritize visiting their patients in their daily activities for effective communication to occur. This study can also benefit other health care providers such as physicians. This study can aid them in formulating the plan of care of their patients. This can help them further assess the needs of the client that they do not complain about. This study will also benefit clinical instructors as to how they could teach their students to improve therapeutic communication with clients in the area. They would be able to equip their students to the life as a nurse and to give them a competitive advantage in handling their patients in the area. The study will benefit nursing students by promoting and adding knowledge on how they handle therapeutic communication with their clients. As a result of sufficient knowledge, this study could also boost the confidence of students in communicating and handling their patients during their Related Learning Experience (RLE) rotations in different areas. This can also train them to being an effective nurse in the future. Lastly, this study can also aid the future researchers. This may serve as a reference material to their research study as well. It may be able to use the result of the study in farther research similar to what the study is. SCOPE AND LIMITATIONS The problem under investigation was to establish how therapeutic communication influenced the recovery of the patient. This seeks to describe the effectiveness of the use of therapeutic communication of staff nurses as a nursing function to fasten recovery of the patients. This research is designed to present the concept of therapeutic communication to influence staff nurses function with regards to interaction to help in modifying the illness and providing health education to patient under recovery stage. In line with the focus of this study, the respondents are limited to patients who are admitted in Ospital ng Makati in Surgery Ward, Medicine Ward and General Ward particularly patients who are in recovery stage that has been staying for more than 1 week. Patients who are just in one hospital would be more possible to survey than to have different other hospitals. The method of data collection would be a survey-questionnaire formulated by the members of the group that would describe the effectiveness of the use of therapeutic communication. This method was chosen because it would be easier to tally than other methods. Patients are limited to 100 persons, age of 20-60, a Filipino, either male or female. Gathered data will contribute to answer questions how therapeutic communication influenced the satisfaction of the patient. This research would only serve as a study to establish how therapeutic communication influences the satisfaction of patients. This research will aim to try and formulate list of recommendations (tips) on how therapeutic communication can be used effectively in order to ensure better therapeutic