Therapeutic Communication in the Nursing Profession

Nursing is a caring profession. It is also a profession that is more and more evidenced based in practice. In as much as the scientific aspects of nursing is increasing due to the complex technological advancement of medicine and the machinery that is used at the patients bedside, the fact remains that the nurse is the first person that the client usually comes in contact with in any emergency or hospital setting.

Having said this, the term, "caring" is an essential emotion that all nurses, for that matter, all individuals in the health profession must possess. With caring comes the trained ability of the nurse to facilitate therapeutic communication. One might ask, what is therapeutic communication? To better answer this question, the term communication should first be defined.

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Communication can be defined as "The Process of transmitting messages and interpreting meaning." (Wilson and others, 1995) With therapeutic communication, the sender, or nurse seeks to illicit a response from the receiver, the patient that is beneficial to the patients mental and physical health. Just as stress has been proven to adversely affect the health of individuals, the therapeutic approach to communication can actually help. In any given situation everyone uses communication.

Therapeutic Communication in the Nursing Profession

Everyone has seen the individual that looks like they are either angry, stressed, feeling ill or maybe sad. These emotions are communicated to others not always by words, but by gestures and facial expressions. A nurse must always be aware of these expressions in clients, for these expressions may be the only way that the nurse can tell if there is something else going on that needs their attention. The term given to this type of non-verbal communication is called, meta-communication. In meta-communication, the client may look at their amputated stump and say that it doesn't really look that bad, while at the same time tears are rolling down from their eyes.

In a case such as this the nurse should stay and further explore how the person actually feels. There are many factors associated with the healing and comforting aspects of therapeutic communication. Circumstances, surroundings, and timing all play a role in the effect of therapeutic communication. If a client is being rushed down for an emergency surgery there might not be time for a bedside conversation, but the holding of a hand could convey much more than words to the client at such a moment.

Ideally, for therapeutic communication to be effective the nurse must be aware of how they appear to the client. If a nurse appears rushed, for example, they are speaking quickly, their countenance looks harried, and they are breathing heavily, their eyes not on the client but perhaps on an intravenous bag on the client in the next bed. In a case like this, there is nothing that this nurse could say to the client in a therapeutic manner that the client would believe. The helping relationship has not been established and therefore therapeutic communication cannot be facilitated. Some of the emotions associated with therapeutic communication include but are not limited to the following: Professionalism, Confidentiality, Courtesy, Trust, Availability, Empathy, and Sympathy. (Potter, Patricia A., Perry, Anne G., Co. 2003, Basic Nursing Essentials for Practice, pg. 123, Mosby)

All of these emotions go into the client nurse relationship, which must be established by the nurse as soon as possible upon first meeting the client. To begin to establish this nurse client relationship, the nurse must assess the overall message that the client is communicating to the nurse, such as fear, pain, sadness, anxiety or apathy. The nurse should be trained in keying into the message that the client is sending. Only then can the nurse determine the best therapeutic approach. Anyone that has to be thrust in to a hospital or emergency room environment has level of anxiety.

This level can go up considerably when the client feels that they have been abandoned or that there is no one there that really cares about how they feel. When a client is the recipient of therapeutic communication from a caring individual, a level of trust is achieved and more than, that the clients entire countenance can change for the better. Their blood pressure, respirations and levels of stress can simultaneously decrease. When this takes place, the management of pain, if any is involved, can be resolved more quickly. The goal for a nurse is to become proficient in the medical

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Therapeutic Communication in the Nursing Profession

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Overcoming Communication Barriers Between People

When you send a message, you intend to communicate meaning, but the message itself doesn't contain meaning. The meaning exists in your mind and in the mind of your receiver. To understand one another, you and your receiver must share similar meanings for words, gestures, tone of voice, and other symbols.

1. Differences in perception

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The world constantly bombards us with information: sights, sounds, scents, and so on. Our minds organize this stream of sensation into a mental map that represents our perception or reality. In no case is the perception of a certain person the same as the world itself, and no two maps are identical. As you view the world, your mind absorbs your experiences in a unique and personal way. Because your perceptions are unique, the ideas you want to express differ from other people's Even when two people have experienced the same event, their mental images of that event will not be identical. As senders, we choose the details that seem important and focus our attention on the most relevant and general, a process known as selective perception. As receivers, we try to fit new details into our existing pattern. If a detail doesn't quite fit, we are inclined to distort the information rather than rearrange the pattern.

2. Incorrect filtering

Filtering is screening out before a message is passed on to someone else. In business, the filters between you and your receiver are many; secretaries, assistants, receptionists, answering machines, etc. Those same gatekeepers may also 'translate' your receiver's ideas and responses before passing them on to you. To overcome filtering barriers, try to establish more than one communication channel, eliminate as many intermediaries as possible, and decrease distortion by condensing message information to the bare essentials.

3. Language problems

When you choose the words for your message, you signal that you are a member of a particular culture or subculture and that you know the code. The nature of your code imposes its own barriers on your message. Barriers also exist because words can be interpreted in more than one way. Language is an arbitrary code that depends on shared definitions, but there's a limit to how completely any of us share the same meaning for a given word. To overcome language barriers, use the most specific and accurate words possible. Always try to use words your audience will understand. Increase the accuracy of your messages by using language that describes rather than evaluates and by presenting observable facts, events, and circumstances.

4. Poor listening

Perhaps the most common barrier to reception is simply a lack of attention on the receiver's part. We all let our minds wander now and then, regardless of how hard we try to concentrate. People are essentially likely to drift off when they are forced to listen to information that is difficult to understand or that has little direct bearing on their own lives. Too few of us simply do not listen well! To overcome barriers, paraphrase what you have understood, try to view the situation through the eyes of other speakers and resist jumping to conclusions. Clarify meaning by asking non-threatening questions, and listen without interrupting.

5. Differing emotional states

Every message contains both a content meaning, which deals with the subject of the message, and a relationship meaning, which suggests the nature of the interaction between sender and receiver. Communication can break down when the receiver reacts negatively to either of these meanings. You may have to deal with people when they are upset or when you are. An upset person tends to ignore or distort what the other person is saying and is often unable to present feelings and ideas effectively. This is not to say that you should avoid all communication when you are emotionally involved, but you should be alert to the greater potential for misunderstanding that accompanies aroused emotions. To overcome emotional barriers, be aware of the feelings that arise in your self and in others as you communicate, and attempt to control them. Most important, be alert to the greater potential for misunderstanding that accompanies emotional messages.

6. Differing backgrounds

Differences in background can be one of the hardest communication barriers to overcome. Age, education, gender, social status, economic position, cultural background, temperament, health, beauty, popularity, religion, political belief, even a passing mood can all separate one person from another and make understanding difficult. To overcome the barriers associated with differing backgrounds, avoid projecting your own background or culture onto others. Clarify your own and understand the background of others, spheres of knowledge, personalities and perceptions and don't assume that certain behaviors mean the same thing to everyone.

If you would like to get custom-made advice about your communication problems, please feel free to email me at martinmim21@hotmail.com All requests will be handled professionally and your communication problem will be handled in strict confidence.

Overcoming Communication Barriers Between People

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