Theraputic communication

[mycatmax]

I am a very new RN. 2 weeks in my position.

I used to always get these questions right in school (which is the most theraputic response)...joke...kinda... BUT I feel very awkward when i am in a situation where I need to use that type of communication.

My preceptor always seems to have the right things to say to a patient when they are sad about something, scared, anxious, etc.... I just stumble around with my words and feel like a big doof!

Is this something that is going to get better with time? With experience will I also have all of the right things to say like my preceptor does?

[mycatmax]

I know i don't always have to say something.... I know that a lot of times patients just need someone to listen to them. But what about those times where u do kinda have to say something back?

[Indy, LPN, LVN]

It comes with experience. You do have to start somewhere, though. Being brave enough to just open your mouth occasionally will result in two things: experience with comforting people and sticking your foot in your mouth.

"I'm sorry" goes a long way, as does "that must be tough." One cancer patient that I had was asking about pain management and all I had were anecdotes of a couple of patients I'd had, and for some reason that was exactly what she needed. She thanked me for the stories, her affect improved, etc. I have no idea what was so meaningful to her in what I said.

I don't think we have a way to judge exactly what patients appreciate in our communication as it's an individual thing. Keep your intentions honest and sincere if at all possible. That'll go a long way.

[sharann, BSN, RN]

Just be sincere and LISTEN to what they say. That is the theraputic part, the feeling listened to and the empathy. You will get better(and your preceptor does not always say the right thing, just ask)

[rn/writer, RN]

When nurses start out, they're usually so afraid of saying the wrong thing or not having anything helpful to offer that more of their attention ends up focused on themselves instead of their patients. That's normal. It's also uncomfortable.

Eventually, you begin to feel more at ease, less responsible for saving the world, and better able to understand how to just "be there" for your patient. Your focus shifts to that person lying on the bed and you forget your self-consciousness and your fear. You learn how to put yourself in the patient's place--the definition of empathy.

This is a process that takes time, experience, and practice. You come in as a new nurse with knowledge. You grow into wisdom.

Here are some phrases to help you in the meantime:

I'm so sorry.

Tell me what's on your mind.

How can I help you?

What do you need?

Is there something that would help you to feel better?

I'm listening.

I can only imagine what you're going through.

Please, help me to understand.

What are you feeling?

It's okay for you to feel that way.

May I hold your hand?

What is it that you want?

Most of all, just be there. Be willing to endure with them when there are things that can't be fixed. We're used to addressing problems and making changes. But there are times when there are no easy answers. It is then that many "take charge" kind of people split. The inability to fix things makes them too uncomfortable to stick around. Stay with your patient. Offer what comfort you can and be willing to listen. Sometimes it's what you don't say that matters most.

[al7139, ASN, RN]

I don't know if this will help you, but I am a new nurse on a floor where we see our share of deaths and terminal patients. I do not always know what to say, but I try to remember that the most important thing is to show in some way that I care, even if it's just holding their hand, or straightening their bed. I try to be receptive to their needs, even if they are difficult patients. It's amazing what that extra minute in the room does for them.

Amy

[ramonmalino]

If you're hospital has a psych unit, see if you can float over there. Those nurses are the closest things to experts in TC that you'll find. Other than that it's something that will come in time. I've been working on our 3 psych floors all summer and I'm only marginally better at TC, if that!

[neyney1979]

I know what you mean about the awkwardness of trying to use therapeutic communication. I sometimes feel the same way as you do. I think that there is some really good advice below though. I am going to also take advantage of that info for my use. Hope that things get easier for both of us.

[Joe NightingMale, MSN, RN]

I had some suggestions, but all the responses have been so good that I really don't have anything to say.

If you want more resources you could look up articles and books on "active listening"; I learned this working at a crisis hotline and it's a great way to communicate with people in difficult situations.