Therapeutic Communication

prmenrs, RN · Apr 3, 2005

It's useful @ times, and as you become more experienced, you'll be more comfortable w/it.

When I was a student, we were not allowed to tell pts our 1st names. If a pt was insistent, we were to say: "For what reason do you wish this information?" We couldn't believe it, but most of us had occassion to use that line once or twice.

Try practicing it a few times. Do you have a relative w/whom you find it difficult to communicate? Try it on them. Don't rule it out without trying it in an appropriate situation. I've used it on strangers who have decided to dump their life's problems on me while I'm trapped in an airport or some such. Makes it more interesting.

Long Term Care Columnist / Guide · Apr 3, 2005

What premnrs said. :)

Seriously......therapeutic communication sounds stilted when you're first trying it out, but years from now when you've been faced with angry and/or violent patients a few times and had it literally save your butt, you'll be glad you took the time to learn it. Most, if not all, of the time, people just want to know that someone is listening to them........it's amazing how often you can de-escalate a situation this way.

live4today, RN · Apr 3, 2005

I remember that class quite well! It was fun learning therapeutic communication in class, but it was a little funny sounding practicing it on the geriatric patients in my first clinical rotation. :uhoh3: It is a very beneficial class. It will make more sense to you once you are working with patients on a regular basis. :)

happy&healthy · Apr 3, 2005

I just finished an Intro to Nursing class. It's required to apply for the nursing program. It just seems to me that "Therapeutic Communication" is just repeating what the patient says! I would be immensely irritated if someone talked to me like this... So, on to my question Do any of actually use this in nursing? Am I just being stubborn, and IS it actually worth anything?

Basically, 'therapeutic communication' is generally taught to give the recipient of your communication a sense of you being caring, mentally present/bonding and actively hearing/listening. Initially you can use it to de-escalate, or dissipate, negative/destructive emotions. But you know, that in and of itself, usually leaves the person still "stuck".

Yet, what if you were to consider a neighbor-method of this approach, called "rapporting"... as it can engender a safer sense in another person, superficially. For example, say a person talks livid, enraged, & angry to the max - but yet wanting help with changing to a positive/constructive emotional state.

Were you to approach said person with - (their same words back) *plus* "I can understand how that could be really maddening, or upsetting" - and carefully consider their response.

Next, "And not only that, but if you chose to continue feeling like this - bad - long enough, it could make you sick. And you sure wouldn't want that, right ?" - and carefully consider their response.

Next, "How might you want to feel instead?" - and carefully consider their response. and so on, and so forth. What you are doing here is progressively Pacing... the other person's emotional responses, until shortly they will allow you to help guide (or Lead) them into *choosing feeling much better*. This amounts to a mutually-satisfying and healthy process of communication. I, as well as many "therapists", successfully use similar means to help people shift emotional states, more to their liking.

To further your success, in helping people in this way, there are actually Communication-classes you can participate in (outside of traditional nursing). Have fun with this! :)

trudlebug · Apr 3, 2005

I just finished an Intro to Nursing class. It's required to apply for the nursing program. One of the MAIN focuses of the class was "Therapeutic Communication". This annoyed me...well, it amused me more than it annoyed me . The truth is, I couldn't see how ANYONE can ACTUALLY talk like that. When I did my interview with someone, having to use that, I couldn't bring myself to talk like that. And I explained it to the friend I was interviewing and she said that she would've been annoyed if I had talked that way. It just seems to me that therapeutic communication is just repeating what the patient says! I would be immensely irritated if someone talked to me like this... So, on to my question Do any of actually use this in nursing? Am I just being stubborn, and IS it actually worth anything?

As a fairly recent grad, I can relate to what you are saying! But as the other posters said, it will be useful when you are the nurse. You will get chances while in school/clinicals to use this. Take the time then to practice, it will sound much more realistic when the person you are talking to has a real problem they need help with.

My classmates and I felt the same way, but once we got into clinicals, especially our psych rotation, it was great to have the guidelines to follow to keep up the conversations with the patients. (sometimes they can really get off topic quick, or get agitated easily)

Good luck in school!

Welcome to nursing:)

twinbee25 · Apr 3, 2005

Hi,

I once thought the same also. When I took the communication class (prereq), I couldnt see the point of it and thought "noone talks like this!"

You will (mostly) see the point of it once you have your psych rotation, and also it is tested on throughout the nursing program. So be sure to learn it now, will make it easier later on. ...and as I have found out, people do talk like that. :)

jnette, ASN, EMT-I · Apr 3, 2005

As a fairly recent grad, I can relate to what you are saying! But as the other posters said, it will be useful when you are the nurse. You will get chances while in school/clinicals to use this. Take the time then to practice, it will sound much more realistic when the person you are talking to has a real problem they need help with.
My classmates and I felt the same way, but once we got into clinicals, especially our psych rotation, it was great to have the guidelines to follow to keep up the conversations with the patients. (sometimes they can really get off topic quick, or get agitated easily)
Good luck in school!
Welcome to nursing:)

True enough... while this is not the way you'll find yourself talking 99% of the time, there certainly will be times that you find you'll be glad to have this communication stored in the back of your head. You'll just "know" when the appropriate time is.. so don't freak out over it now. :)

grinnurse, RN · Apr 9, 2005

This area has been one of the funniest for me in NS. We had to include on our prep sheets for clinicals on each patient parts of a TC. For the most part, the majority of the stuff we made up b/c the younger patients think you are an idiot if you talk to them like that and usually just clam up. The older population responds rather well to it though!! I love to practice this on my husband!! and kids........ :chuckle Definately worth learning though and can help out in certain situations esp like they said when trying to diffuse anger and get to the root cause of the persons feelings. In my psych rotation this didn't help at all b/c they didn't have the attention span to listen much less answer. Of course that could have been b/c my patients where all schizophrenic with mania tendencies.

However, the more you practice the better you will become. I am going into oncology and know that it will be beneficial in that arena.

UnewmeB4 · Apr 9, 2005

I just finished an Intro to Nursing class. It's required to apply for the nursing program. One of the MAIN focuses of the class was "Therapeutic Communication". This annoyed me...well, it amused me more than it annoyed me . The truth is, I couldn't see how ANYONE can ACTUALLY talk like that. When I did my interview with someone, having to use that, I couldn't bring myself to talk like that. And I explained it to the friend I was interviewing and she said that she would've been annoyed if I had talked that way. It just seems to me that therapeutic communication is just repeating what the patient says! I would be immensely irritated if someone talked to me like this... So, on to my question Do any of actually use this in nursing? Am I just being stubborn, and IS it actually worth anything?

That is the beauty of it. It gives them the opening some people need to fully explain themselves. It allows them to talk more, and makes you listen more. It is nonjudgemental.

stressgal, RN · Apr 10, 2005

I'm currently in my Psych Nursing rotation, and therapeutic communication is very prevelant. Yesterday during our lunch break a fellow student shared that her boyfriend had just broken up with her. In unison three of us at the table asked "And how are you feeling about that?" Trust me, it does become easier with time and even begins to make sense. Just hang in there

fightthestigma · Apr 16, 2005

I'm a psych nurse. All of my patients are involuntarily committed (they have been deemed by the courts to be a danger to themselves or others) and most have schizophrenia or bipolar disorder-manic episode. With these patients, you have to be especially careful with what you say; an innocent remark can make them aggressive, so TC is the best way to communicate with them until their medication begins to lessen the paranoia, hallucinations, delusions, manic behavior, etc...

TC can help the pt to work through a problem or feeling to come to a solution or better understanding. If a practitioner were to give a solution to the pt, the pt wouldn't learn to resolve problems on their own.