Therapeutic Communication

I got most of the scenarios on my paper but there are a few I was unsure on and I wanted to see what you guys think of my responses or if there is something better.

1.)"I could not sleep at all last night because the lady next door was moaning."

Im very sry to hear about your rough night, if its possable try to take a nap as soon as you can to help reengerize your body,

2.)"You are the best nurse working here. No one else seems to care as much."

"o" well thank you so much thats means a lot to me, but im sure every one here cares about you as much as i do. Every one just has a differnt way of showing it

3.) The people in physical therapy are very mean!"

Im sry you feel that way, what about pt makes you feel that there mean to you..Then id go from there

I got most of the scenarios on my paper but there are a few I was unsure on and I wanted to see what you guys think of my responses or if there is something better.

1.)"I could not sleep at all last night because the lady next door was moaning."

My response would be It must have been a rough night, maybe you can take a nap this afternoon

2.)"You are the best nurse working here. No one else seems to care as much."

My response would be. What makes you think that none of the other nurses seem to care?

3.) The people in physical therapy are very mean!"

My response would be What makes you think that they are mean?

I just read about this, and did some of the homework. I had a hard time thinking about it.. But I *think* I may have figured it out.. Try to use open-ended questions, acknowledge the patients fears/concerns/feelings, etc., and basically always make it where there is something else left to say, like making it where the patient opens up and lets it out. You are acknowledging their problem but helping them work through it on their own. It's also comforting to them.

Someone correct if I'm wrong. Im sure i am. I haven't even started class yet. It's just what I did yesterday. I'd like to know, too. I hope my response made sense.

I think your responses are on the right track. However, I would not open up an invitation for the patient to complain about the staff because it can be a way for them to "split" staff. This is especially a problem for those on psych floors.

Here is what I would say:

1. I can see how excessive noise may interrupt your sleep. Let us know when you'd like to take a nap today and we can schedule around it. What are some ways we could assist you to sleep better tonight?

2. All of the nurses here care about their patients. What traits do you think make a good nurse? (takes the focus off of the personal and onto the general)

3. What makes physical therapy difficult for you? If they say it's painful, which is probably the case, then you can inquire about pain medication beforehand, time of day that's best for them, etc. If they complain about the staff pushing them too hard, you can say, "I understand it can feel that way, but the ultimate goal is to get you fully-functioning again. What are some of your goals for physical therapy?...How would you like to work on it?"

Therapeutic communication is about being a neutral third party who validates the patient's feelings and guides them toward problem-solving on their own.

Thank you for your responses. Since I see that I was sort of on track but not completely could you just check my other answers for other questions, that would be great. I appreciate all your help.

1.)"I am so mad at the night nurse because she told me that I wasn't trying hard enough to help myself get out of bed."

My response The Nurse upset you because she said you weren't trying hard enough.

2.) "I am so worried my insurance will not cover the extra day I am spending here."

My response: You are concerned about not having the money to stay.

3.) "The pain Medications are just not working and no one is listening to me."

My response: How often are you taking the pain medications?

4.) "The doctor just left and told me I have to start heparin. I don't have any idea what that is! He didn't even explain it!"

My response: You sound angry. Lets sit down and talk about this.

5.) The client has just gotten devastating news about the recurrence of her breast cancer. She is alone in her dark room and sobbing. You enter the room.

My response: Good Afternoon Ms. Jones. I can tell you are upset, would you like to talk about anything?

I think your responses are on the right track. However, I would not open up an invitation for the patient to complain about the staff because it can be a way for them to "split" staff. This is especially a problem for those on psych floors.

Here is what I would say:

1. I can see how excessive noise may interrupt your sleep. Let us know when you'd like to take a nap today and we can schedule around it. What are some ways we could assist you to sleep better tonight?

2. All of the nurses here care about their patients. What traits do you think make a good nurse? (takes the focus off of the personal and onto the general)

3. What makes physical therapy difficult for you? If they say it's painful, which is probably the case, then you can inquire about pain medication beforehand, time of day that's best for them, etc. If they complain about the staff pushing them too hard, you can say, "I understand it can feel that way, but the ultimate goal is to get you fully-functioning again. What are some of your goals for physical therapy?...How would you like to work on it?"

Therapeutic communication is about being a neutral third party who validates the patient's feelings and guides them toward problem-solving on their own.

This was very helpful and thank you so much. I would really appreciate it if you could look over a few more of mine since I wasn't quite right before with those three questions.

Okay so I posted questions about Therapeutic Communication on Scenarios that I have and it helped tremendously and I decided I wanted to check my other answers since mine before were not fully correct. I will post the scenario and then my response and if someone has anything better please let me know or if you have any feed back that would be great.

1.) "I am so mad at the night nurse because she told me that I wasn't trying hard enough to help myself get out of bed."

My response The Nurse upset you because she said you weren't trying hard enough.

2.) "I am so worried my insurance will not cover the extra day I am spending here."

My response: You are concerned about not having the money to stay.

3.) "The pain Medications are just not working and no one is listening to me."

My response: How often are you taking the pain medications?

4.) "The doctor just left and told me I have to start heparin. I don't have any idea what that is! He didn't even explain it!"

My response: You sound angry. Lets sit down and talk about this.

5.) The client has just gotten devastating news about the recurrence of her breast cancer. She is alone in her dark room and sobbing. You enter the room.

My response: Good Afternoon Ms. Jones. I can tell you are upset, would you like to talk about anything?

I wouldn't say that your answers are bad because they're not. They're perfectly fine and acceptable. Let me caution you about the "parrot" response. Restatement is good when you're helping a patient to recognize their own feelings, but you don't want to repeat exactly what they said and leave it at that. An example would be: Patient states, "My dad has barely spoken to me or my brother since my parents' divorce. He just left my mom one night last year without warning. I don't understand why he hasn't come to see me in the hospital." Nurse responds, "It sounds like you miss your father and are upset about him not being here for you." It's a subtle difference.

1.)"I am so mad at the night nurse because she told me that I wasn't trying hard enough to help myself get out of bed."

My response The Nurse upset you because she said you weren't trying hard enough.

I understand how that could be upsetting if you were trying your best. What is making getting out of bed difficult for you?...How could I assist in helping you get out of bed today?

Again, you don't need to place blame on the other nurse. Refocus the patient on themselves and solving their issue.

2.) "I am so worried my insurance will not cover the extra day I am spending here."

My response: You are concerned about not having the money to stay.

This is a little harder to pick the right response because there is no context. If the patient had no choice in staying there an extra day, then I would use what you said and then say something to the extent of, "Would you like to see the social worker? They can help you figure out a plan for payment with the hospital if insurance will not cover the extra day." If there was more leeway in the leaving time, I would again preface it with your statement and then add, "Let me speak with the doctor and see if we can discharge you earlier." Then return to the first response to finish it out. Collaboration is a great thing!

3.) "The pain Medications are just not working and no one is listening to me."

My response: How often are you taking the pain medications?

"I'm sure it is frustrating for you to still be in pain. I want to help you to manage your pain better and work with the doctor to find a regimen that works for you. Could you describe the pain you are currently experiencing for me?"

4.) "The doctor just left and told me I have to start heparin. I don't have any idea what that is! He didn't even explain it!"

My response: You sound angry. Lets sit down and talk about this.

"I can see that you are frustrated with the lack of information about heparin. Heparin is called an anti-coagulant and is used to prevent blood clots. Would you like me to print out some information on heparin for you? I will also contact the doctor and let him know you would like to discuss the reason for starting this medication."

5.) The client has just gotten devastating news about the recurrence of her breast cancer. She is alone in her dark room and sobbing. You enter the room.

My response: Good Afternoon Ms. Jones. I can tell you are upset, would you like to talk about anything?

Sit down next to the patient on a chair. "I understand you received bad news this morning about your breast cancer returning. I am here for you." Let the patient vent/cry/whatever and use silence while she speaks. Afterward, add, "Are there family or friends I can call for you this morning? We also have a chaplain I can contact to come see you if you'd like."