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Therapeutic Communication In Nursing

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Question:

Discuss about the Therapeutic Communication in Nursing.
 
 

Answer:

Therapeutic communication

Therapeutic communication is defined as the process by which a nurse consciously guides the patient or helps them to achieve better understandings by using the verbal or non-verbal communication. The therapeutic communication includes the use of strategies which motivate the patient to share their feelings and ideas. Therapeutic communications consist of two complex words where each of them has a different meaning. Therapeutic means the science and the art of healing or applying a treatment and communication means the social interaction by exchanging messages or ideas among the people.

Therapeutic communication includes the transfer of the information on to different levels that are verbal and nonverbal. Verbal communication includes the use of verbal language and non-verbal communication involves verbal content like eye contact, body language, facial expression and tone of voice. Therapeutic communication includes the communication between the nurses and the patients for the wellbeing of that diseased person. Communication is required to build a good relationship between the nurses and the patients (Sherko, Sotir, & Lika, 2013)

Example 1

A patient who lost a business deal and all of his or her all profits complain about the rising blood pressure. A nurse should clear the situation and asks for additional information by using verbal therapeutic communication.

Example 2

A patient who is semiconscious and not able to speak can be assisted with therapeutic communication to collect the health-related information. In this condition the patient can be asked to move their head, eye or hands to answer the question related to their health condition.

 

Analysis of situations

As mentioned is the case scenario the patient is suffering from type one diabetes mellitus and hypoglycaemia. She also has some medical complications such as nausea and vomiting. In this case, the primary care is provided by the nurses to the patient includes effective therapeutic communications. Types of therapeutic communication techniques can be used in this scenario are expression, clarification, and validation. The expression techniques include use of silence therapeutically, reflective listening, voicing interest, asking questions, acknowledgement and knowledge voicing, repeating the previous words which are used by the diseased person, use of descriptive phrases etc. clarification helps to clarify the observation provided by the patient such as asking for clear uncommon terms and encouraging the comparisons. Validation is helpful to establish a common understanding of what is expressed by the patient such as repeating the messages of the diseased person, ask the pardon to repeat the words and summarizing the whole interaction content (Damasceno, Zanetti, Carvalho, Teixeira, Araújo, & Alencar, 2012).      

Therapeutic communication is also beneficial in case of Hypoglycaemia. According to the American Diabetes Association (2018), hypoglycaemia is the medical condition which occurs when the level of blood glucose decrease from the normal range (3.9 mmol/L). Symptoms of hypoglycemia include headache, blurred vision, confused or disoriented, and unconsciousness in severe cases (National Institute of diabetes and digestive and kidney diseases, 2016). Long-term hypoglycemia is also associated with psychological conditions such as disturbed mood, worrying and fear of hypoglycaemia (Kedia, 2011). In this case, where the patient is suffering from the long-term hypoglycemia may be facing mood. The person can be handled politely and encourage them for taking enough carbohydrate and water. The nurse can use touch and silence when appropriate. Both verbal and nonverbal communication can be used to motivate the patient for their health recovery.  

Pancreatitis is associated with the high intake of alcohol. In this condition, the patient diagnosed with inflammation in the pancreas which caused when the digestive enzymes start affecting the pancreas itself. Pancreatitis is of two types acute and chronic. Acute pancreatitis can be caused by gallstones and usually occurs suddenly and goes away in some days. Symptoms associated with this disorder are the upper abdominal pain, vomiting, and nausea. The chronic form of this disease cannot be healed or improved. With the time it gets worse and results in permanent damage to the organ. Mostly it is caused by heavy alcohol consumption. The other associated risk factors are cystic fibrosis, inherited diseases, high calcium and fat level in blood, autoimmune conditions and some medicines (Medline Plus, 2016).

The person who is suffering from the alcohol addiction problem may be having trust issues with health providers. They think that the health professional may be judging him negatively. In this case, the nurses need to develop trust and believe in a patient. Some of the therapeutic techniques might help in this scenario such as empathy, respect, trust, and openness. These interventions allow the nurses to better understand the person's situation and to change the perception of the addicts about the nurse that he or she is really trying to help him and not to judge him (DARA Thailand, 2018). The patient with pancreatitis may have difficulty to remember the precautions and instructions. The good communication between the patient and the nurse might help the patient with nutritional changes that are required to overcome the situation. Some of the nutrients that can be suggested beneficial in this condition are antioxidants (Forsmark, 2013), vitamins B, iron, and yogurt rich in bacteria (Diethealthclub, 2014)

Pneumonia is the infection of one or both the lungs caused by the bacteria. The symptoms of this disorder include symptoms such as cough, fever, trouble in breathing and chills. The risk factors associated with the pneumonia are age, lung infection and weak immune system. The people older than 60 years kids less than five years old likely to develop this disease (National Heart, lung, and blood institute, 2017). The patients in the given case study have migrated from other country and have limited English. The person who migrated to new places generally has trust issues and lack of knowledge. They may feel hesitation in discussing the condition with unknown people. In this situation the nurses may help the patient by using the good therapeutic communication such as providing information that a patient needs to know, listening to the person carefully and explain everything to them in an easy way as the patient has limited English. The patient is only six years old and might be feeling homesickness so the nurse should behave politely and in a way that the child can trust and cooperate in the treatment. The family of the patient can be involved in the treatment when it is necessary. This may help to improve the trust between nurse and the patient’s family and reduce the negative emotions related to their health.

Strategies

  1. Respect

Respect is the fundamental factor which contributes to the mutual understanding between the nurse and the patient, results and the satisfaction among the patient. Respecting a patient demonstrates that the nurse values every aspect related to the person. Respect can be conveyed by active listening, giving the patient privacy, being honestly related to the length of stay.  

  1. Empathy

Empathy is basically the direct, accurate and clear understanding of the emotions of the patient and expressing the understanding to the person. As a nurse, it is important to understand that the patient needs assistance when feels disconnected and vulnerable. The individual needs to know that the registered nurse really wants to understand about their past experience. The demonstrations of care and understanding may increase the ability of the patient to provide any information. It also encourages commitment and engagement of both the parties in the intervention process.

  1. Developing Trust

The expression of empathy produces the positive emotions that help to develop trust between the patient and a registered nurse. The combination of respect, trust and empathy are the foundations for health goal already set for the patient (Toole, 2016).

 

References

Damasceno, M. M. C., Zanetti, M. L., Carvalho, E. C. D., Teixeira, C. R. D. S., Araújo, M. F. M. D., & Alencar, A. M. P. G. (2012). Therapeutic communication between health workers and patients concerning diabetes mellitus care. Revista Latino-Americana de enfermagem, 20(4), 685-692.

DARA Thailand (2018). Therapeutic relationship. Retrieved from: https://alcoholrehab.com/addiction-recovery/therapeutic-relationships/

Diethealthclub (2014). Chronic Pancreatitis diet plan, restrictions. Retrieved from: https://www.diethealthclub.com/health-issues-and-diet/chronic-pancreatitis/chronic-pancreatitis-diet.html

Forsmark, C. E. (2013). Management of chronic pancreatitis. Gastroenterology, 144(6), 1282-1291.

Kedia, N. (2011). Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach. Diabetes, metabolic syndrome and obesity: targets and therapy, 4, 337.

Medline Plus (2016). Pancreatitis. Retrieved from: https://medlineplus.gov/pancreatitis.html

National Heart, lung, and blood institute (2017). Pneumonia. Retrieved from: https://www.nhlbi.nih.gov/health-topics/pneumonia

National Institute of diabetes and digestive and kidney diseases (2016). Low blood glucose (hypoglycemia) what is hypoglycemia. Retrieved from: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia

Sherko, E., Sotiri, E., & Lika, E. (2013). Therapeutic communication. JAHR, 4(7), 457-466.

 Toole, G. O. (2016). Communication- eBook: core interpersonal skills for health professional. (3rd ed.). Australia: Elsevier Health Sciences.

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