one of the early lessons i had in nursing school was "don't be judgmental". it will never steer you wrong. you know, the doctor can come in and only be with the patient for a few moments. we nurses are with them for 8 or 12 hours shifts. tell someone, or give them the impression, i think they are faking their symptoms and any trust that might have been built between me and that patient and hope for cooperation from them in their care is gone out the window. we can think it, but i don't have to force the patient to admit that i suspect it.
early in my career i worked on a medical unit that got alcohol detox patients. that somehow translated to every nut job being admitted to our unit. we got patients who were real whackos from faking seizures to one goofball who was actually punching herself until she got bruises. she had the docs baffled for days doing all kinds of tests looking for some kind of bleeding problem. the last thing we did with our detoxing alcoholics was to tell them that they shouldn't be drinking--unless they brought it up first. and, even then, we were instructed by the psychiatric nurse practitioner to just listen sympathetically and not impose or reinforce any judgments.
therapeutic intervention is best left to nurses who specialized in counseling and treating that; not med/surg nurses on med/surg units. and, that's my view on it. it requires some specialized training in how to intervene with them and a basic nursing program just doesn't give you that training. what it does give you, however, is the basics in therapeutic communication skills. i can always converse with these people and give them the impression that i am in no way making any kind of judgment about what they are doing. i am sympathetic to their plight. any complaints or personal judgments i have about them are going to be said to my cats who won't repeat them to anyone else. above all else, be kind to people. that is what they will almost always remember most about the nurses who cared for them. confrontation of any type almost always is interpreted as an unwarranted attack, unkind, unasked for and will never be forgotten.
- a really nice slide show on therapeutic communication. includes techniques, scenarios and blocks to communication.
- therapeutic communication. a discussion about therapeutic communication that includes a nice listing of examples of appropriate open-ended responses to make to patients to get them to talk.
- a slide show on therapeutic communication. talks about the components, goals, therapeutic and non-therapeutic techniques.
- communication. a slide show (18 slides)
- therapeutic communication skills tutorial - page of links to subjects covered
- therapeutic communication. some online information and practice modules from the university of north carolina chapel hill school of nursing. click on the links on the left side of the page to access activities.
- a lecture series on therapeutic communication and the nursing process on cds that you can access at this website from education resources, inc. you need a real player to view the video.