Therapeutic Communication Analysis

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Table of Contents

Introduction
Establishing Nurse-client Relationship
Relationship between the Environment and the Interaction
Zones of Personal Space
Non-verbal Communication and the Patient’s Special Needs
Dialogue
Conclusion
References

Introduction

Patients who are anxious, depressed, or angry due to life-altering health conditions challenge receiving adequate care. This paper aims to establish effective therapeutic communication between the student nurse and their patients through the various therapeutic communication techniques for better patient care. Therefore, student nurses should be assisted in engaging with patients by cognitive and social strategies and specialized instructional knowledge on understanding patient obstacles to care.

In developing the therapeutic communication, the conversation discussed later in the paper involves a 43 years old male client diagnosed with Acute Lymphoblastic Leukemia (ALL). ALL is a rare type of cancer that targets the bone marrow’s white blood cells (Senft & Jeremias, 2019). Because the condition commences with young cells and advances swiftly, the label includes the term acute. While there is no conclusive reason for abnormalities, documented risk factors include obesity, smoking, having a weakened immune system, and having previously received chemotherapy.

Establishing Nurse-client Relationship

In establishing an effective nurse-patient relationship, the paper explores the four phases of relationship development and how the student nurse facilitated each step for efficient nurse-client communication and satisfactory patient satisfaction and experience. Reynolds (2021) enumerates the following four phases of relationship development as essential in effective nurse-client therapeutic communication. First, the phase preceding contact is the only stage of the therapeutic nurse-client engagement in which the patient is not engaged directly. Throughout this phase, the physician organizes for the patient encounter by acquiring pertinent customer data and addressing client issues before the meeting. In ensuring that the communication was effective, I checked the patient’s past medical history to ascertain whether the condition was acquired or hereditary. Additionally, I was mindful of the possible client problems before contacting the patient.

Second, the orientation phase describes the component’s objective, responsibilities, norms, and a methodology for identifying the client’s needs. As the physician attempts to build credibility with the patient, they provide the individual with background knowledge such as their name, professional position, and details about the relationship’s goal. Additionally, I provide my name and professional status to the patient. The nurse-client interaction protects each client’s integrity, freedom, and confidentiality (Reynolds, 2021). Therefore, as a nurse, I provided the client with the required information to set the framework for care.

Third, the working stage is the relationship’s problem-solving phase compared to the nursing component’s planning and execution stages. Before entering the operational phase, medical strategies and patient activities are appraised with the therapeutic objectives that direct nursing treatments and client activities. Clients can go into greater detail about their problems. I encouraged the patient to establish appropriate dietary patterns that prohibit raw fruits and vegetables and require all meals to be processed, thus inhibiting them from consuming raw fruits.

Lastly, the self-disclosure phase allows patients to articulate their sentiments concerning the physician’s communication; therefore, limiting one’s self-disclosure may be suitable. Giving a client access to my personal information helped build a stronger relationship. The following tactic helped me maintain self-disclosure on a therapeutic level while yet facilitating communication: I talked about my considerable experience with ALL individuals and how I understood what he was going through at the time.

Relationship between the Environment and the Interaction

In interactions between patients and clinicians, effective communication is essential for client-centered care, collaborative decision making, and healthcare-related adverse occurrences that can be avoided. Environmental relations can have a variety of implications on interpersonal interactions, both beneficial and unfavorable. Timing, distraction, location, weather, inadequate illumination, long-distance hurdles, and visual noise are just a few of the challenges to efficient communication. In my interaction with the patient, the environmental concern was the frequency and intensity of medical alarms within the medical facility. To improve this condition for effective nurse-client communication, I took the patient outside to the hospital’s open air space garden, free from any noise and air refreshing.

Zones of Personal Space

Personal space refers to the area around an individual that they view as psychologically theirs. Most people cherish their personal space and experience irritation, rage, or panic when it is violated. Broadly, there exists four distinct zones of personal space: public, social, personal, and intimate zones. The intimate zone is characterized by a social distance of 0-8 inches, the personal zone has a length of 18 inches, social-consultative has a distance of 9-12 feet between the nurse and the patient, and the public zone has a distance of 12 or more feet between the individuals. Therefore, the type of personal zone used was the personal space preferably because, according to Holmes et al. (2020), personal space is most effective for the therapeutic communication. It establishes a strong emotional bond with the nursing student, reducing patient worry and tension and enhancing safety and quality of care.

Non-verbal Communication and the Patient’s Special Needs

Facial features, eye contact, and stance all constitute non-verbal interaction. Gestures can either increase or hinder patient interactions. Monitoring clients’ body gestures can reveal critical information about their emotional state. During the exchange, I maintained eye contact with the patient. Maintaining eye contact throughout a conversation demonstrates respect for the other person and a willingness to understand. As a result, there was a trust created between us, culminating in desired health outcomes. On the other hand, the patient eye contact showed that he was attentively listening and following what I was saying throughout the conversation.

Because of the severity of the disease, the patient was sad at most times. Additionally, his age was a factor to consider since it allows for longer hours of activity and concentration. Showing compassion and bringing up funny stories during the conversation made his moods swift to happiness at times. Furthermore, in between the conversation were resting periods where we would take a break and let him rest since the chemotherapies he took could not allow him to have a long attention span.

Dialogue

The table below summarizes both the verbal and non-verbal communication that I had with my client during the session we spent together at the hospital. The dialogue encompasses the various issues about Acute Lymphoblastic Leukemia (ALL) and how the patient generally feels about his condition. Additionally, as a student nurse, it provides insight into how to deal and create an effective, long-lasting relationship with the patient bound with trust.

Student (S) and patient (P) verbal and non-verbal communication	Analysis of student communication and impact of pt. verbal and non-verbal responses
S: It really must be difficult to live with that daily. Have you talked to anyone else in the same situation? Non-v: making gentle eye contact	To let the patient know that I recognize it has not been easy for him Sharing empathy (Potter et al., 2021)
P: Yea, it is, but no, I have never talked to anyone in my situation. Non-v: nodding head, then shaking head no, then shrugging shoulders and looking up at me.	I am thinking that maybe joining a support group might help the patient. Wondering how to follow up on this issue.
S: I can try to find out if there is someone else for you to talk to. Non-v: smile and raise eyebrows	Suggesting a plan of action, phrased as a question to invite the patient’s opinion and collaborate. Asking a relevant question (Potter et al., 2021)
P: I am not certain, but I am willing to try Non-v: makes eye contact and smiles	Looks like my invitation was effective
S: What crossed your mind at the moment of the diagnosis? Non-v: making gentle eye contact P:I’m not sure; too many thoughts passed through my mind. ‘Why me?’ was my initial thinking. ‘How come now?’ Non-v: looking up at me, nodding head, and then rubbing his eyes. S: What is the treatment like? I mean, the chemotherapies? Non-v: making gentle eye contact P: Well, the chemotherapies are not that bad except that they hurt a little. Non-v: raises eyebrows and maintains eye contact. S: Do you love football, because I do Non-v: making eye contact and smiling P: Yeah, I do. During my youthful days, I played the sport. Non-v: making eye contact S: That is great; you be a loyal fan, and what is that beautiful armband? Non-v: touching and staring at his armband. P: This is Inter Miami’s armband; I am a great fan of the football club. Non-v: smiling while staring at his armband S: How much do you know about your condition? Non-v: making eye contact P: Not much, apart from it is cancer. Non-v: nodding his head in dissatisfaction. S: Would you love to know? Non-v: making eye contact P: Yes, I think it would serve some meaning. Non-v: making eye contact S: I will leave you with this leaflet that contains all the information about Acute Lymphoblastic Leukemia (ALL) and, most importantly, read through the dietary patterns. Non-v: handing him the leaflet. P: Thank you for the leaflet. Non-v: taking the leaflet, smiling, and making eye contact. S: How does the hospital environment make you feel? Non-v: making eye contact P: I must say that the very first few days were not easy. I thought I would rarely be coming here, but I am now used to it since I was hospitalized. Non-v: sighing and making eye contact. S: Besides the chemotherapies, do you take your medication promptly? Non-v: making eye contact P: Eer.. Not promptly. Non-v: sobbing and avoids eye contact S: Are you aware of the side effects of skipping medication? Non-v: making eye contact, holding his hands P: Unresponsive Non-v: making eye contact. S: Thanks for your time and opinions, and I hope you will remain positive and continue with your daily medication. Perhaps one of these fine days I will accompany you to an Inter Miami football match. Non-v: making eye contact and smiling. P: You are welcome and looking forward to that day. Non-v: smiling	Asking a relevant question (Potter et al., 2021) I am thinking about how difficult and stressful it must be for him and the people in his condition. Sharing empathy (Cooper, 2001) Asking a relevant question (Potter et al., 2021) Trying to find out whether the patient agrees to chemotherapies or should instead take cancer drugs. Changing the subject (non-therapeutic communication) (Capriotti & Frizzell, 2020). Seemingly my invitation was compelling. Suggested this because I saw him putting on the Inter Miami armband. Showing concern and togetherness in what we both love and collaborate. Providing information (Cooper, 2001) Maybe knowing would be critical in ensuring he avoids associating with risk factors like children with contagious diseases. Providing information (Cooper, 2001) Looks like my question was compelling. Providing information (Cooper, 2001) My course of action was practical. Asking a relevant question (Ignatavicius & Workman, 2020) I am enquiring how the hospital environment makes him feel. Seeking clarification (Ignatavicius & Workman, 2020) Requesting on whether the patient understands the ramifications of skipping medication. Confronting Suggesting a plan of action to encourage the patient to maintain a regular medication. Summarizing (Cooper, 2001) Reviewing essential items of the interaction for the satisfaction of patient interaction and closure.

Conclusion

In conclusion, the vital role that communication plays in the nurse-patient relationship cannot be underestimated. Communication brings about effective and satisfactory clinical outcomes, and, therefore, its absence could be detrimental to any healthcare institution. Additionally, therapeutic nurse-patient interaction is essential to delivering medical care that is secure, effective, empathetic, and conscientious. The nursing profession is theory-driven and scientific proof when it is provided through the therapeutic patient-nurse interaction. Therefore, medical professionals should strive to maintain and create an effective therapeutic communication relationship with their patients for effective health outcomes.

References

Capriotti, T., & Frizzell, J. P. (2020). Pathophysiology: Introductory Concepts and Clinical Perspectives. (2^nd ed) Philadelphia: F.A. Davis Company.

Cooper, C. (2001). The Art of Nursing: A Practical Introduction. Philadelphia, PA: W.B. Saunders.

Holmes, S., Baumhover, M., & Lockwood, J. (2020). Safety Unseen: Leveraging Design to Improve Inpatient Mental Health-Care Practices.Creative Nursing, 26(3), e48-e55. Web.

Ignatavicius, D. D., & Workman, M. L. (2020). Medical-surgical Nursing: Patient-centered Collaborative Care (10th ed.). St. Louis, MO: Elsevier.

Potter, P., Perry, A., Stockert, P. & Hall, A. (2021). Fundamentals of Nursing (10th ed.). St. Louis, MO: Elsevier.

Reynolds, W. (2021). Empathy: The core of the nurse-client relationship. In From Therapeutic Relationships to Transitional Care. Routledge.

Senft, D., & Jeremias, I. (2019). A rare subgroup of leukemia stem cells harbors relapse-inducing potential in acute lymphoblastic leukemia.Experimental Hematology, 69, 1-10. Web.

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