Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide • Clarifying is the technique of asking the patient to repeat information when the nurseis not sure of the meaning. "Do youmean...?" • Paraphrasing is the technique of repeating the patient's thoughts in the nurse's own words. "Here's what I think you are saying..." • Silence is the technique of saying nothing. This may encourage patients to expand on thoughts they are having. • Reflection is the technique of repeating all or part of a message back to the patient. This technique helps the nurse understand the message and allows the patient to hear whathis message was to the nurse. Reflection can also be used to reflect a patient's non-verbal communication. "You look sad." • Summarization is the technique of highlighting the main points the patient and nurse have discussed. Summarizing a conversation can ensure that the patient's message has been heard and may provide an opportunity to expand on certain misunderstood messages. Communication Barriers Communication can also be non-therapeutic when either the sender or receiver uses techniques that block the communication process. These barriers include: • The constant use of closed questions, requiring only a one word or yes/no response. Although occasionally useful, the constant use of closed-ended questions tends to end communication. • False reassurance is typified by giving reassurance not based on reality. When the nurse tells a patient with cancer that, "everything will be fine,” the patient eventually begins to distrust the nurse as everything else in the patient's situation tells him that things are not fine. • Using clichés and overused phrases will tend to give the impression that the nurse is not listening, but is instead, resorting to tried-and-true phrases that are meaningless. • Defending positions or treatments may result in the patient feeling that it is not permissible to criticize. • Stereotyping, or categorizing a patient based on race, religion, gender, occupation, or any other attribute of the patient, may imply to the patient that the nurse does not really care about her as an individual. While patient attributes are important to the nurse,those attributes should not determine how the patient should be treated until verified with the patient or family. • Giving advice should be avoided, because the patient may infer that the nurse thinks the patient is not able to make decisions resulting in greater dependence on the healthcare team. Giving advice may otherwise end a therapeutic communication session. • Judgmental responses based on the nurse's personal beliefs or values will imply rightor wrong and typically will result in the patient ending the conversation if their family or personal beliefs conflict. • Asking a patient why she feels a certain way can be intimidating. Instead, the astute nurse will use open-ended questions to explore the patient's thoughts and feelings.

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