4.4:
Therapeutic Communication
Therapeutic communication is a technique in which the nurse consciously influences a patient or helps them understand better by expressing their feelings through verbal and nonverbal communication.
Nurses use this technique primarily to develop a therapeutic nurse-patient relationship and determine the patient's essential needs.
Therapeutic communication occurs in two forms—verbal and nonverbal.
Verbal communication aims to exchange accurate, concise, and complete information using spoken or written words in a mutually understood common language.
In verbal conversation, the speaker must be mindful of their vocabulary, tone, pace, clarity, conciseness, timeliness, and relevancy.
In the healthcare setting, verbal communication occurs in two ways. It can be in oral form, such as two nurses sharing patient information, or in written form, such as emails.
In contrast, nonverbal communication is exchanging information through body language or expressions rather than words.
Various forms of non-verbal communication include eye contact, facial expression, gestures, sound, and posture.
For instance, a nurse may pat the patient's shoulder to reassure them. In this situation, the nurse communicates nonverbally through touch.
4.4:
Therapeutic Communication
Communication is a lifelong learning process. Through therapeutic communication, nurses can collect relevant assessment data, provide education and counseling, and interact during nursing interventions. Sending and receiving messages occur through verbal and nonverbal communication techniques and can happen separately or simultaneously.
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal communication are as follows:
- • Vocabulary refers to all the words that a person or group understands. For example, the technical language healthcare professionals use sounds strange to patients unfamiliar with the healthcare environment.
- • In pacing, the nurse attempts to structure the conversation at an appropriate speed or pace so communication will be more successful. Talking rapidly, pausing awkwardly, or deliberately speaking at a slow speed conveys the wrong message. Therefore, it is crucial to communicate clearly and at a moderate speed.
- • Intonation is a variation in the tone of voice that conveys the speaker's attitudes and feelings. The style of voice greatly influences the meaning of a message. Even a straightforward question or statement can elicit various emotions, depending on intonation.
- • In clarity and brevity, effective communication is simple, brief, and direct. For elderly populations, phrases such as "you know" or "OK?" at the end of every sentence detract from clarity. Direct sentences such as: "Where is your pain?" is beneficial.
- • In communication, relevance and timing are crucial. A clear message may only be compelling if delivered at the right time. For instance, when a patient is facing emergency surgery, discussing the risks of smoking is less relevant than explaining pre-surgical procedures.
Nonverbal cues in communication, like body posture, eye contact, and voice intonation, are as important as verbal messages. The essential elements of nonverbal communication include the following:
- • Personal appearance includes physical characteristics, facial expressions, and the manner of dress and grooming.
- • Posture and pattern of walking can be forms of self-expression. For instance, how people sit, stand, and walk reflects attitudes, emotions, self-concept, and health status.
- • Facial expressions convey surprise, fear, anger, happiness, and sadness. Some people have an expressionless face or flat affect, which communicates concern to others about their thoughts or feelings.
- • Maintaining eye contact throughout a conversation shows a desire to listen and shows respect. Lack of eye contact may communicate anxiety, defensiveness, discomfort, or lack of confidence.
- • The spoken word is emphasized, punctuated, and clarified through gestures. When combined with other communication cues, gestures can convey specific messages.
- • Sounds such as sighs, moans, groans, or sobs communicate feelings and thoughts. Combined with other nonverbal communication, sounds help send clear messages.