I had my first day of clinical last week and it involved therapeutic/non-therapeutic conversation. I was dreading this since day 1. I am a little shy and sometimes have trouble starting conversations. So this is going to be the hardest part of nursing school for me. Once a conversation starts going and flowing I am fine, but just starting the conversation is the worst part for me. It was so hard trying to start a conversation and ask patients questions, while not trying to sound like I am interviewing them and trying not to add anything in about myself since this is a conversation about them. I ended up with an adorable little old lady who was not very talkative because she had just spent he past 4 hours in the gym and was tired. I tried using all my techniques I learned and she did give me a little information, but not much. She was just really not talkative and I got extremely nervous and at the end of the conversation I ended up just telling her today was my first day of clinical so i'm a little rusty, she said she was sure it will get better for me and I will be as amazing as all the nurses who have been taking care of her so that was a little reassuring.
I am so nervous now for next week. I know everyone else said their patients were alot more talkative than mine, but I am still nervous. I really am a people person and I work in customer service now and have small talk with customers all day long, but when it came to the patient I kind of froze up and got nervous cause it was so different and I was trying to remember so many things at once. My aunt is a nurse and she told me in time it will get better I am still new and being good with talking to patients takes time for some people.
I think I may go talk to my instructor and ask her for some tips. I really do love nursing so far and cannot imagine myself doing anything else, I just need to get talking to patients down.
Sep 27, '13
You'll get there, don't worry. I work as a waitress and like you, have no problem chatting away if people are friendly. The thing that made me nervous at first with clinicals is being so out of my element. You have no problem taking to people at your customer service job because you're probably good at your job and comfortable there. It's human nature.
Sometimes you'll have lovely, talkative patients that are amazing people to be around. Other times you'll have grouchy patients, or a patient with an overbearing family, or one with altered mental status. If you're polite, professional, caring, and relatively friendly, then you'll be fine. You don't have to get to know everything about your patient, particularly if they'd rather be left alone. We all handle illness differently. Even when I'm 100% healthy, it's a coin toss as to whether I'm going to talk your ear off or be silent. It's not something to take personally, just feel their vibe and give it a shot.
Sep 27, '13
Practice makes perfect. It is hard to talk to people you don't know. Try not to make it so hard . I know they expect nursing school talk but you can do that without being formal. It will get easier and done patients won't talk but then there are some you might need to be saved!
Sep 28, '13
It will get easier, I promise! I am in my last year, but I still remember that first day of clinicals. I was a fumbling, nervous mess. I can now handle most personality types as patients.
Sep 28, '13
Ah, therapeutic conversation. I remember in one of my early clinical rotations I had had some pretty extensive dental work done at the front of my jaw and had some pretty nifty bruising there to show for it. My patient, as luck would have it, had had multiple extractions in the same area, and we looked like twins who had both been bopped by the same right cross. We blinked in amusement when we saw each other, mumbled a little bit to each other, decided not to talk unless we had to, smiled as best we could, and I started her bath. Unbeknownst to me that's when my instructor came to lurk outside the door to see how I spoke to patients, and she pinned me for being silent when I came out later. I explained, though, and invited her to speak to the patient.
However. One thing that's hard for nursing students to integrate into their patient relations early on is the idea that it's not about them, it's about their patients. I know what they teach you about therapeutic use of self, but that doesn't mean that you get to turn the conversation to you and your feelings and seek reassurance in their words. In the OP's example, what might have happened if she had said, "I'm guessing you must be pretty tired after four hours in therapy. Could you tell me just a little bit about how that's going, and then I'll just sit here quietly?"
Sep 28, '13
Like GrnTea I usually try to make explanations for things. "I'm so sorry to wake you tonight but I have to ask you a few questions." "Paperwork, you know?" "I need to take your vital signs so I know you're okay and then I will let you get back to sleep."
When you work nights you have to wake people all the time so I try and put on a cheery face and speak softly. Moving quick helps too.
If someone isn't talkative note that in your assessment.
Must Read Topics