10 Techniques for Therapeutic Communication in Nursing
Did you know that therapeutic communication in nursing was originally designed to help patients overcome emotional or psychological distress? Florence Nightingale was one of the first to emphasize the importance of communication and trust building with patients in the 1800s.
You’ve likely heard of this term and even studied it during nursing school. Therapeutic communication in nursing is as important as your assessment skills. So it’s no wonder why so many nursing exams will include a few questions on this topic.
What Is Therapeutic Communication in Nursing?
Therapeutic communication is a method of communicating between nurses and patients that allows patients to freely express themselves, enhances trust and respect, and helps them better understand their condition. It involves both verbal and nonverbal cues.
There are many benefits to implementing therapeutic communication nursing. These include:
- Improved success following a treatment plan
- More accurate diagnoses
- Collaborative decision-making
- More effective identification of barriers to maintenance and treatment of a condition
- Better patient outcomes
- Inclusion of the patient’s perspective on their diagnosis
- Improved patient and provider satisfaction
- Reduced provider burnout
How to Use Therapeutic Communication Techniques
You have a myriad of options when it comes to therapeutic communication in nursing. Use your best judgment to determine which technique is best at which time and for which patient. This is where your skills in the art of nursing will shine.
- Use silence.
- Restate what is said to you.
- Ask open-ended questions.
- Use active listening.
- Make observations.
- Summarize conversations.
- Clarify what you hear.
- Reflect questions.
- Focus on important statements.
- Be physically present.
1. Use Silence
Silence allows patients to process through their thoughts and emotions. Silence can work much like open-ended questions, allowing the patient to explain themselves in their own words.
There is no hard rule for when to use intentional silence. You need to be attune to your patient — do they need space to talk and vent? If you aren’t sure, ask.
2. Restate What Is Said to You
Repeat back to the patient what you heard them say. Sometimes you can do this word for word.
For example, your patient described feeling frustrated they only had a few minutes to speak to the doctor and did not get their questions answered. You can say, “You are feeling frustrated you only had a few minutes to speak to the doctor. You are upset you did not get your questions answered.”
This allows space for the patient to expand on a thought, as well as provides an opportunity to clarify any misunderstanding.
3. Ask Open-Ended Questions
There’s a big difference between asking, “Do you have pain?” and “How are you feeling?” One will extract either a yes or no response. The latter will extract a variety of inputs.
Using open-ended questions allows for a free flow of communication. It provides space for patients to express what is on their minds. They may even share something you wouldn’t have thought to ask about, which may not have been communicated if you only asked yes or no questions.
Other examples include:
- “What concerns you?”
- “What is your understanding of your diagnosis?”
- “How was physical therapy?”
- “How are you feeling after your medication?”
4. Use Active Listening
Active listening is a way of demonstrating listening and careful attention when someone is talking. It includes both nonverbal and verbal cues.
Nonverbal cues: Arms uncrossed, leaning forward, making eye contact, nodding your head, having an open posture, or a smile.
Verbal cues: Saying things like, “Right,” “Mmhmm,” “Sure,” “I understand that”, “Yes,” and “Go on.”
Practicing active listening can encourage patients to express their thoughts and feelings. It also builds trust, showing patients that you care and respect them.
5. Make Observations
State what you see. This avoids making any assumptions and opens the doors for open communication to take place. Say something like, “I noticed you didn’t eat your lunch today.”
Part of your nursing assessment involves noting how a patient’s mood and behavior changes, not just their vital signs. It’s important to discuss these changes with patients so they can share what is going on for them.
6. Summarize Conversations
Provide a brief and concise summary of your conversation or care plan. This can help break down complex information into bite-sized, digestible amounts.
You can also summarize what you heard after a patient has spoken. This tells them you were listening, and gives them the chance to correct anything that was miscommunicated.
End your summary with, “Did I get that right?” or “Does that sound correct?” This short and simple statement gives the patient permission to add any other details. It also makes them feel heard.
7. Clarify What You Hear
Ask clarifying questions to avoid misunderstanding. If your patient says, “I feel worse today,” do not assume what they mean by “worse.” Instead, ask. Say, “What symptoms have changed and how?” or “What has changed?”
This is a direct but open-ended question that uses assertive communication and will allow that patient to expand on exactly what they meant.
8. Reflect Questions
Sometimes patients may ask you for advice or guidance. While it is your job as the nurse to provide nursing education, the final decision lies with the patient.
If your patients says, “What should I do? Should I tell the doctor?” you can reflect the question, and reply, “What do you think you should do?”
Of course, read the room. If there’s a chance this can be received as passing the buck or dismissive, choose an alternative communication technique.
You can always combine techniques, and first make an observation and then reflect. Try saying, “You sound unsure about what you should do. What do you think you should do?”
9. Focus on Important Statements
When a patient mentions something very important, call it out. Focus on their statement or comment and prompt the patient to expand on it. This allows you to assess this concern or symptom in detail. It shows the patient that you’re actively listening to them and care for them.
Say:
- “That sounds important. Can you tell me more?”
- “That seems to be important to you. Tell me more about that.”
- “You mentioned something a minute ago I want to go back to.”
10. Be Physically Present
Simply being in proximity to a patient can be a form of therapeutic communication. Your presence may be reassuring in times of stress or loneliness. Offer to sit with your patient for a bit and give them your attention. It can make them feel like they’re worthy of your time.
Start Practicing What You Learned
As you’ve learned, therapeutic communication in nursing is an essential part of your nursing practice. Start implementing these techniques into your own practice, either in your clinical rotations or current job.
If you’re looking for a new job, and just can’t wait to get started using these amazing communication techniques, IntelyCare can help. Want access to more career opportunities? Discover how IntelyCare can connect you with specialty nursing jobs in a range of areas.