Well therapeutic conversation is a bust

[LCinTraining]

We had a seminar on therapeutic communication. Just a basic intro saying this is what you will learn during the communication unit. I've had some particularly high acuity patients at work and a lot of nervous, and anxious patients. I caught myself repeatedly responding non therapeutically. Telling the patient who kept saying he was nothing more than a vegetable not to say that because it thought he was a great man. Staying silent like we were taught when we just don't know what to say and allowing them to talk, had my other patient looking at me asking me directly "what do you think?" And honestly I didn't know what to think. The situation was sad, but focusing on the sad upset him further. Hopefully I figure out this therapeutic conversation thing. I'm pain stakingly aware of my short comings today.

[Hygiene Queen]

It's one of those things you learn by trial and error.

Soon enough, you will have enough patient experiences that you will be able to draw from and tweak for each individual patient.

But know that even after 20 years of patient experience, I sometimes find that shoelaces are chewy and rubber soles leave a bad taste in my mouth.

Hang in there!

[Tarabara]

I thought it was the cheesiest thing when I learned it but it really works. Repeat back to them what they've said. Pt says "I feels so frustrated because something something." You say something along the lines of "it sounds like you're frustrated". Most of the time they'll say "yes! i'm so frustrated because blank!" and they'll keep talking on their own. It can be hard though because sometimes there's just really nothing good you can say to make them feel better. In those cases I will usually just ask them if there's anything I can do for them or if they'd like to be left alone for a bit and remind them I'm there if there's anything they need. You can also offer to ask for a chaplain to talk with them if they'd like. For patients that are nervous/anxious about a procedure or something like that I will remind them that they have the right to refuse anything and to ask as many questions as they need to feel comfortable. Its good practice to always explain what you're doing as you're doing it anyway, but its especially important for nervous patients.

[LCinTraining]

We don't have psych in staff or a chaplain. A catholic priest comes in occasionally voluntarily to do mass. It's something our doctors are trying to rectify. In the mean time, I feel helpless at times.

[Esme12, ASN, BSN, RN]

"Telling the patient who kept saying he was nothing more than a vegetable not to say that because it thought he was a great man"

Even the cheesy....."You feel that you are a vegetable?" "What makes you feel that you are nothing more that a vegetable?" You can ask if there is anyone they want to talk to or call. Sometimes just sitting and listening helps. You can offer to call clergy or you can ask for a social service/psych eval..

When patients ask what I think........it depends on the patient. Sometimes I will break the ice and tell them I'm not paid to think....but I am paid to listen, what are your thoughts. Sometimes, patients just want to know someone is listening.....tell them you hear what they are saying.

Like everything in nursing it just takes time. You just started your program.....awkward moments are a given. Give yourself a break.:)

[classicdame, MSN, EdD]

I remember feeling so inept when I was learning this concept of nursing care!! It does take practice. Read about what others suggest in texts or online and maybe you will get some ideas. The good news is, being there for the patient and allowing them to talk really does help. Words are only words.

[LCinTraining]

Thanks guys. I'm figuring recognizing it is half the battle. I thought I was pretty good at active listening, but apparently all those psych classes I took when I did TSS (basically behavior therapy implementation) either didn't do much or I completely forgot them all.