Initiate the nurse-patient relationship using therapeutic communication techniques.

INTRODUCTION

Communication is an essential component of the nurse-patient relationship. It impacts the nurse’s ability to positively influence the therapeutic relationship, moving patients towards an exploration of their feelings and attainment of their treatment goals. The process recording is a written record and analysis of the therapeutic communication (both verbal and nonverbal) between the nurse and patient. This exercise affords the student nurse an opportunity to analyze communication in an objective manner and examine the content and the process of the nurse-patient interaction. Benefits include: learning to pay attention to the communication process; reflecting on the significance of nonverbal behaviors, and becoming comfortable using a variety of therapeutic communication techniques; becoming more self-aware by reconstructing and analyzing both your responses and those of your patients; and developing the ability to purposefully guide the process of the nurse-patient relationship.

OBJECTIVES

· Initiate the nurse-patient relationship using therapeutic communication techniques.

· Identify and describe both verbal and nonverbal data.

· Identify and describe therapeutic communication techniques used and rationale for use.

· Examples of revisions and alternatives to therapeutic communication techniques.

· Identify and analyze the nurse’s thoughts and emotions.

Purpose for Interaction with Patient: With the purpose of examining and analyzing your communication skills, thoughtfully facilitating the encounter through therapeutic use of self and evaluating the patient’s and nurse’s behaviors and approaches in the therapeutic relationship.

Introduction: Identify any pertinent information regarding your patient as well as your goals for the therapeutic encounter.

Nurse and Patient Interactions: FOR EACH EXCHANGE, write down and analyze the words spoken by you and your patient verbatim from memory. ( Also, observe and record nonverbal cues for both the nurse and the patient such as body posture, quality of eye contact, tone of voice, rate of speech, affect, mood and changes in facial expressions). Every communication (Student nurse said-patient said) will be referred to as “an exchange.” Analyze a minimum of a flow of 10 (ten) exchanges.

Analysis: FOR EACH EXCHANGE, identify the therapeutic communication techniques utilized and rationale for use in each of the exchanges between you and your patient. Identify whether the exchange was therapeutic or nontherapeutic and if nontherapeutic identify what you might have said and done differently to elicit communication at a feelings level (write in direct quotes what should have been said to change this from a non-therapeutic to therapeutic communication) and further the therapeutic communication process. Reflect after each exchange and identify your thoughts and your emotions (distinguishing between the 2) that occurred during that exchange.

Summary: Summarize your overall impressions of the therapeutic encounter, and assess the role that the setting played in the communication process. Critically evaluate the effectiveness and therapeutic value of your exchanges and how you managed termination of the therapeutic encounter. Discuss therapeutic communication techniques that were most useful and lessons learned from this interaction.

The Process Recording is a learning tool and is supposed to be a critical analysis of your encounter. It does not have to be perfect; it is evaluated according to whether you thoughtfully and critically analyzed the interaction, correctly and comprehensively recorded all information, made corrections when there were actual or potential blocks (nontherapeutic), identified therapeutic techniques used and appropriate rationales, and identified your references.

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