are you talking to me?
going to nursing school was not a breeze. but i liked it.
what i really like about it is the fact that they teach you something that you can actually use/apply when you are in the real world, working.
where i went, we had to practice giving bedbaths, enemas and shots with our classmates, for us to get the real feel of how it is to be on the patient’s shoes.
don’t ask me about the enema. we only had one restroom, and there were 6 pairs of nursing students doing the whole thing at the same time. be creative and imagine how priceless the sight is. students very eager to learn and master the craft of pushing a tube through the rectum, and finding out after a few seconds, that the stuff DOES make you want to push your gut out. knocking at the restroom door with your other hand holding your behind, (hoping that would stop the inevitable), is a mastercard moment too. priceless.
anyway, i’m digressing.
at the nursing school, they taught us stuff.
THERAPEUTIC/EFFECTIVE COMMUNICATION TECHNIQUES
the idea is to communicate to the patients, their family, in such a way that will foster a better relationship.
“how are you tonight mrs. C?” (open ended question)
“not fine. leave me alone.”
“not fine?” (clarifying)
“not feeling well. just leave me alone.”
(silence/listening)
“what the h#% are you still doing here?”
“oh, just in case you need anything, just let me know.” (offering assistance)
“i won’t need anything, just leave me alone. i don’t want to be disturbed.”
i guess i got this whole effective communication process thing all mixed up huh.
“yes, i am mrs.C’s nurse, my name is May” (giving information)
“okay, listen May. this is the 6th time i called today. and everytime i call, nurses tell me my mom is asleep.she cannot be asleep the whole day if you didn’t drug her, can she?”
“R, i know it is frustrating that you have not talked to your mom…” (clarifying/validating)
“no no no no no, don’t start me on that one. tell me right now. what is wrong with my mother, why is she asleep the whole day? what is going on?”
“uhm your mother was…(ABOUT to provide feedback and information)
“don’t interrupt me when i’m talking. you have to let me finish first! now…..
(silence/respecting the person’s feeling/encouraging formulation of plan of action)
“go there and get her on the phone now. i don’t care if you had to wake her up, i want to talk to my mother.”
awww. i definitely was not paying attention when this whole effective communication thing was being discussed. how can i mess it up big time if i was paying attention?
if i didn’t know about effective/therapeutic communication, was there a possibility of a happy ending?
“i’ll leave you alone now.” mrs. C would have been a lot happier if i said that. and when R, her daughter called, i could have just shaken mrs. C out of her deep deep sleep and pressed the phone to her ear, ever so gently. then, they can talk nicely about the nurse, and bitch against each other peacefully. end of story. everybody happy.
could be that, or i need to review these so called effective communication techniques. has it been working out for you?


Oh my god! That’s entirely too funny! I kill people with kindness. It tends to wear them down after a while. The families are usually worse than the patients.
Comment by Nurse Practitioners Save Lives — July 31, 2005 @ 9:27 pm
Laughing out loud! My husband is listening to a boring radio show and wondering whats up with me and why I’m laughing!
Strangely, I just finished posting something about therapeutic communication myself. We must be thinking along the same lines today!
Did you do the same thing I did when we were going over that stuff and go home and practice on your family? My hubby got all sorts of communication when he got home form work! ;D
Comment by HypnoKitten — July 31, 2005 @ 11:49 pm
I. HATED. THERAPEUTIC. COMMUNICATION.
They had us practice scenarios while being videotaped…which immediately makes me freeze in self-consciousness!
Not to mention the lengthy evaluations with our real-life patients…it was horrible!
Comment by Sandy — August 1, 2005 @ 4:18 pm
Therapeutic communication is NOT my strong point. Oh, Lord, no. You don’t even want to ask me about that. No, no, no.
Strangely, as untherapeutic as I am, the most difficult patients still seem to love me. Maybe this is part of that “boundary setting” thing I vaguely remember?
Comment by Jo — August 1, 2005 @ 5:13 pm
Here are my observations during my decade-long stint in the medical field….
The Chronically Sick are always depressed. They want to sleep and be left alone most of the time. More often than not, they have problems about trust and love.
On the other hand, the relatives of the Chronically Sick always want information about their patient either because they’re really worried or feel guilty about something.
Great post, May. Just like in medschool, I think our teachers supplied us with facts and details of our respective crafts, but forgot about dealing with emotional problems. We should have spent more time being taught strategies on how to heal them and yet not get on their nerves. As it is, we now learn everything as they come.
Comment by Dr. Emer — August 1, 2005 @ 5:54 pm
Teee Heee…. Therapeutic Communication used by one of my fellow nurses today to a mom, “Ms. X, I’m going to bop you in the nose!” And she said it with such a smile and such a pleasant voice that the patient laughed instead of taking offense!
Comment by mamalife — August 1, 2005 @ 6:36 pm
I have several long term patients with whom trying to communicate can be like pulling teeth (and lots of the time I think that might be more fun!!!). I think that I have my best therapeutic interactions w/pts when I’m NOT trying (you all know what I mean). But it’s so fantastic when I get some one to trust me enough so that they’ll open up, even a little, or so that they’ll feel enough trust to ask me to do something. I find that I can then say very blunt things, along the lines of “If you don’t do X then you will die.”, and still not shut everything down (OK, I know that sounds mean, but it was the right thing to say at that time.) And yes, I’m mostly talking about one pt here.
I think that I also just like to talk, and to find out about people. My attending and I have a running thing going about who can find out more about our pts. I love it when he thinks that I don’t know something and then I do.
OK, I’ll shut up now.
-Abby, FNP
(BTW, anybody want to talk about therapeutic communication with children? My youngest pt is 4! And I though adults were hard!)
Comment by Anonymous — August 1, 2005 @ 7:39 pm
LOL! I’m not sure if anyone gets to be really good at therapeutic communication. By the time I finish with using therapeutic communication with a patient, I’m the one who needs therapy!
Comment by marj — August 2, 2005 @ 1:58 pm
nice post, i needed that at the end of the day!
Comment by Dr. Charles — August 2, 2005 @ 2:52 pm