THERAPEUTIC COMMUNICATION IN NURSING: DEFINITION, TECHNIQUES AND RESOURCES

Patients who visit a hospital to undergo surgery will receive several types of care. This can include anesthesia before the surgery takes place, the operation itself, as well as recuperation treatment before they leave the hospital. Throughout their stay, patients will receive fundamental and necessary care from trained and qualified nurses. Many of these professionals may rely on a practice known as therapeutic communication in nursing, which can benefit the patient as they recover. All current and aspiring nursing professionals need to know the value of this type of communication and the best ways to provide it.

Therapeutic communication techniques in nursing can be crucial to a patient’s treatment and recovery at a health care institution. Nursing professionals wanting to use this type of communication with their patients will benefit from the following information.

What Is Therapeutic Communication

Communication is a critical component of all successful health care. Practitioners must effectively relay information and instructions to other members of the staff. Doctors and nurses have to effectively communicate diagnoses and treatments to patients. But there is a difference between standard communication and therapeutic communication.

Therapeutic Communication in Nursing

In an article published in the SciFed Nursing & Healthcare Journal, therapeutic communication is defined as “a process in which the nurse consciously influences the patient or helps them in better understanding through verbal and nonverbal communication, while encouraging patients to express their feelings and ideas, which is an important prerequisite for the realization of relation of mutual acceptance and respect.” An example of standard nursing communication is when a nurse providing care to a patient, such as an inoculation or a blood pressure reading, briefly describes the treatment they are providing and then moves on to the next person they must treat. In this example, the nurse explains the treatment, but doesn’t account for the patient’s potential concerns, hesitations or worries. An example of therapeutic nursing communication is when that same nurse also communicates why they are performing the tasks and asks the patient if they have any concerns or questions, speaks in a congenial and welcoming manner, and indicates through body language that the patient’s viewpoints are respected.

Benefits of Therapeutic Communication

The benefits of therapeutic communication techniques extend beyond making a patient feel welcome and at ease during their treatment. According to a nursing book chapter written by Maureen Nokuthula Sibiya titled “Effective Communication in Nursing,” “the quality of communication in interactions between nurses and patients has a major influence on patient outcomes.” For example, effective communication can lead to fewer errors in medical treatment and can ensure that individuals adhere to specific treatment and medication guidelines after consulting with a health care practitioner. Other therapeutic communication benefits can include better assessments of patients and their health and stronger problem-solving abilities when determining what may be impacting a patient. Therapeutic communication in nursing also helps to alleviate anxiety or other negative emotions in patients, such as fear or loneliness, more effectively than standard forms of communication.

Training in Therapeutic Communication

In the “Effective Communication in Nursing” chapter, several guidelines are listed for conducting successful therapeutic communication nursing interactions. These guidelines include maintaining a low-authority profile by using understandable language, tailoring the message to the particular patient and displaying active listening. In a display of therapeutic nursing communication, maintaining a low-authority profile involves engaging on a person-to-person level with the patient rather than solely as a faceless professional. Using understandable language can include providing definitions and examples of hard-to-understand health care terms, such as a specific disease that has a complicated title. Tailoring the message involves confirming patients understand the information given to them. For example, a practitioner may explain to a patient that she has a certain condition. The patient, though, may misunderstand what the practitioner has said and believe that she is afflicted with another condition. This type of miscommunication could have been avoided if the practitioner verified that the patient understood the information. Displaying active listening includes showing nonverbal indicators, such as head nods or having the body positioned to the patient while communicating.

Therapeutic Communication Techniques

There are several therapeutic communication techniques that nurses can use when assessing and treating patients. These techniques can prove to be beneficial both as patients receive care and during their recovery.

Behavioral and Psychological Approaches

When visiting a clinic or a hospital, patients may understandably feel nervous or anxious. They may feel pressured to agree with what the practitioner is stating or claim that they understand, even though they may have reservations about the procedures and treatments being discussed. Because nurses and practitioners can’t read patients’ minds, they can use open-ended questions and remarks to steer the conversation and give patients the ability to communicate more openly. According to “Effective Communication in Nursing,” remarks such as “Tell me more about that” or “You seem to be upset” can indicate to a patient that the practitioner is aware of the patient’s condition and may encourage the patient to share their viewpoints beyond answers to yes and no questions.

Awareness and Empathy

According to an article in NursingPlus Open, “empathy and patient-centered care have been associated with better patient outcomes. Active listening and self-awareness are suggested to be associated with empathy, and, in turn, patient-centered care.” Nurses who can take a step back and empathize with each patient’s unique medical circumstances and condition, as well as how they and their actions may be perceived by that patient, can help to ensure better health outcomes.

Maintaining Relationships

The following appeared in an article published in the Journal of Multidisciplinary Healthcare that reviewed previous studies on the topic of therapeutic interpersonal relationships:

Patients felt emotional comfort when staff displayed ability and confidence in performing tasks; developed relationships through frequent contact and getting to know each other as people; were available and responded quickly to calls for assistance; provided information openly and honestly; used nonverbal interactions such as eye contact, touch, active listening and positioning to enhance communication; and engaged in verbal interactions such as social chitchat and making encouraging comments.

Patients can stay in a hospital for several days or weeks and may be treated by the same nurse during their stay. These instances can include a patient recuperating after surgery, an individual who is attended to by the same professional in a nursing home, or a person who receives periodic medical treatment from a small clinic in their geographic area. Therapeutic nursing communication can establish rapport and build a strong relationship between the practitioner and the individual receiving care, and can enhance the care itself.

Communicating as a Trustworthy Figure

Establishing an open and communicative relationship with a patient while maintaining one’s status as a practitioner who is providing medical advice and direction can be difficult. Projecting oneself as too authoritarian could potentially lead to the patient being less communicative and open about their condition and ailments. Acting too much as a friend or a peer may result in that patient not taking the nurse practitioner or their recommended treatments seriously. In therapeutic communication, nurses can act as trusted figures who are able to forge meaningful connections with their patients. Additionally, because a nurse may spend more time with a patient than a doctor or physician, they can engage in nursing therapeutic communication while also acting as an advocate on that patient and their family’s behalf. “Patient advocacy extends to the patient’s family and support system, who should be included in the patient’s care if done in a positive way with the patient’s consent. Nurse advocates support the patient’s best interests while respecting the family’s important role,” according to an article published in the Nursing2019 Journal. Specific techniques in therapeutic nursing include giving supportive remarks, providing rewards or gestures of approval and offering their presence, according to “Effective Communication in Nursing.”

Tips and Resources for Therapeutic Communication Techniques

Therapeutic communication can be beneficial to nurses and patients alike and is a practice that nurses become more skilled at with repetition. While the previous examples show how effective therapeutic communication in nursing can be achieved, the following resources will help nurses to achieve their communication goals.

Online and Digital Resources for Nurses

There are several mobile apps to assist nurses in their therapeutic communication tasks. For example, Nursing Central is an app that provides nurses with information regarding diseases, disorders and drugs and a dictionary for medical terms. In therapeutic communication, a nurse could use this type of app to provide further information to patients about their conditions or how specific medicines work. The U.S. National Library of Medicine also provides a list of resources for nurses to use in their therapeutic communication efforts. These resources include up-to-date platforms where information about health can be accessed, such as MedlinePlus health information and NIH MedlinePlus Magazine.

Patients with Different Cultural Backgrounds

It some situations, it can be difficult for nurses to practice strong therapeutic communication with individuals of diverse backgrounds. For example, many therapeutic communication techniques are delivered effectively through open conversation. This can be difficult to achieve if there is a language barrier between the patient and the practitioner. In some of these situations, interpreter services may be beneficial. “In-person professional interpretation is the most studied interpretation modality and has been demonstrated to improve satisfaction, processes, and outcomes of care. It allows the interpreter to incorporate visual cues to enhance communication. Professional interpreters report better understanding of patients’ social and cultural backgrounds and greater ease facilitating rapport when interpreting in-person,” according to an article published by the Agency for Healthcare Research and Quality.

There may be patients who hold certain religious or ideological beliefs that can conflict with the care they receive, such as opposition to vaccines. Therapeutic communication can be helpful in navigating these situations by validating the patient’s desires while helping them to receive the best care possible.

Incorporating New Health Care Trends

Nurses who practice therapeutic communication may often break down difficult concepts into more digestible terms for patients to understand, such as what their diagnosis means or what a specific medication will do. This practice can also help explain new health care technology, practices or types of care that are being introduced. For example, a senior patient may not understand the concept of wearable technology, which is being increasingly used in health care treatments. Therapeutic communication can explain how this technology works and its health benefits to the senior population.

Using Therapeutic Communication to Improve Patient Lives

Therapeutic communication is not just a task or process that helps patients have a more welcoming experience when they are receiving health care treatment. It is something that can help improve health outcomes and ensure that patients fully understand their current health care situation. Nurses who understand the benefits of therapeutic communication and how to use it when working with patients can leave a larger impact than those who do not employ these techniques. As patient populations and needs become more complex and diverse in the future, this type of communication will only become more beneficial.