Use therapeutic communication skills in the mental health unit
Use therapeutic communication skills in the mental health unit
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Introduction
Being a fresh graduate nurse in a mental health unit requires the application of the high fidelity simulation introduced in the medical school (Kardong-Edgren, Adamson & Fitzgerald, 2010). It involves student nurses dealing with patients with psychiatric conditions by relating with algorithms (Sleeper & Thompson, 2008). This paper will evaluate the relevant communication skills that a new graduate nurse can apply when administering therapy to a nineteen year boy who has some mental health issues that are as a result of the abuse of cannabis sativa in the past. Some of the observed changes in the boy over the past six months have been mood swings and a drop in his academic performance. While administering therapy to Vinay, a lot of caution must be taken on how one communicates with him due to his mental health issues. Effective therapeutic communication encourages a patient to participate actively in the treatment session to find a solution for his or her problem. This enables the nurse administering therapy to the patient to get all the relevant information from the patient that can be of help in the healing process. This paper therefore aims at shedding light on how application of therapeutic communication skills can aid in building a relationship between a nurse and a psychiatric patient during the admission stage.
Therapeutic communication skills
The first therapeutic communication skill is the use of broad opening statements to initiate a conversation. This allows the patient to take charge of the conversation and determine the direction of the conversation (Ha & Longnecker, 2015). For instance the nurse can address Vinay by using these words: “How are you Vinnay? Is there anything you may want us to talk about?”. The nurse should say these words in a friendly tone while maintaining an eye contact with Vinay. Such broad opening statements would help Vinnay acknowledge that the nurse is interested in the problems he is going through. From the response given by Vinay, the nurse can identify the main issue affecting Vinay which would aid in knowing what techniques should be used in relation to Vinays problems.
The second therapeutic communication skill is the use of general leads during the conversation between the patient and the nurse. This plays quite a similar role as the use of broad opening statements. The aim of using general leads during the conversation is to encourage the patient to speak out all the issues affecting him or her by taking charge of the conversation (Ha & Longnecker, 2015). The nurse can use statements such as “I see”, “… and then?” or “ Yes”. The nurse can also encourage the patient to continue talking by using non-verbal cues to demonstrate that he/she is listening attentively to what the patient is saying. While conversing with Vinay, the nurse may nod or making facial expressions that demonstrate his/her attentiveness. This would help Vinnay acknowledge that the nurse is listening to what he is saying which helps in developing a positive relationship between the Vinay and the nurse.
The third therapeutic communication skill is the use of reflective statements. When listening to Vinay, the nurse may repeat some words said by Vinay to show that he/she is listening and also to get Vinay to explain further what he has just said. For instance, when Vinay says that his thoughts are being controlled by energy waves emitted by the television, the nurse may repeat the statement by saying “television waves?”. This would make Vinay explain the issue further to the nurse so that the nurse can be in a position to identify the root of the problem. Reflective statements also help the patient know that the nurse is paying attention to what he is saying (Ha & Longnecker, 2015). A nurse may use reflective statements to understand a contradicting statement said by the patient. For instance, if Vinay says that he is tired, the nurse may repeat the statement so that Vinay can explain it further. This would help the nurse to know if Vinay is tired, literally or whether he is bored with the conversation.
The forth therapeutic communication skill that a nurse can use to develop a relationship with Vinay during admission is sharing the behaviours that he/she has observed on Vinay (Brunero, Lamont & Coates, 2010). For instance, if the nurse observes Vinay clenching his teeth, he/she would put across a remark such as “Are you upset?” This would help the nurse understand the behaviours based on facts and not assumptions. The nurse would be making true observations, but interpret them wrongly. This skill is therefore essential in administering therapy to a patient with mental health issues as it helps the nurse identify the progress of the therapy sessions. For instance, biting of nails or scratching the head would be a sign of restlessness in the patient. If the nurse shares his/her thoughts about this behaviour with the patient, he/she would be in a position to know if the patient is enjoying the therapy sessions or not depending on the response that the patient gives.
The fifth communication skill that a nurse can apply when administering therapy to Vinay is acknowledging any thoughts or feelings that Vinay expresses (Main, Buchbinder, Porcheret & Foster, 2010). This is very essential in maintaining a positive relationship with the patient. For instance, if Vinay expresses his feelings about disliking the hospital environment whereby he says he would prefer if the therapy was to be administered from home, the nurse can acknowledge this feeling by stating that it must be hard to stay in a place that one dislikes. Not all feelings or thoughts expressed by the patient may be in line with what the nurse feels. However, the nurse must show acknowledgement for these feelings without agreeing or disagreeing with them regardless of his/her own feelings.
Use of silence is also another therapeutic communication skill that can aid in building a relationship between the nurse and the patient (Brunero, Lamont & Coates, 2010). After a long period of verbal communication, a short period of silence would be very effective. The nurse should create an attentive silence whereby he/she can observe the patient and identify any behaviour that can help him/her identify the issues affecting the patient. During the silence the patient is in a position to recollect his thoughts and reflect on the issue facing him. During the silent period, the nurse can also plan on what to tell the patient and the advice he/she can give the patient. The silence can also help the patient identify that the nurse is paying attention to his problem which would be very helpful in developing a positive relationship between the patient and the nurse.
The nurse should also use the therapeutic communication skill of asking for clarification on statements put across by the patient that he/she does not understand. This is because assuming the meaning of some statements can lead to wrong assumptions which in turn would lead to misunderstandings and pre-judgements which are major barriers to effective communication (Main, Buchbinder, Porcheret & Foster, 2010). The nurse should ask for clarification in a polite and friendly tone. He/she can use statements such as, “What do you mean by…?”. This would show the patient that the nurse is paying attention to what he is saying. In the case of Vinay, he would be motivated to go on with the communication and share his thoughts on what may be causing his mood swings. This would help the nurse gets a better understanding of the patients problem. The nurse should avoid using medical jargons as Vinay is still in the preliminary stages of education and he may not be in a position to understand such terms. Asking for clarification helps both the patient and the nurse understand each other better which prevents misunderstandings which would ruin the patient-nurse relationship.
Conclusion
This essay provides an insight on the relevant therapeutic communication skills that a new graduate nurse can apply when administering therapy to Vinay. The therapeutic communication skills discussed are as follows: Use of broad opening statements, general leads, reflective statements, sharing observed behaviours, acknowledging the patients thoughts and feelings, creating silent periods, and asking for clarification where one does not understand the meaning of the other persons statements. A fresh nurse graduate may be tense when administering therapy to Vinay who has developed moods and has been uncommunicative for the past six months (Xu, Shen, Bolstad, Covelli & Torpey, 2010). However, if the nurse applies the above communication skills when administering therapy to Vinay, he/she may be in a position to develop a positive relationship with Vinay which would be useful in making him speak up his problems (Zavertnik, Huff & Munro, 2010). This would help the nurse understand Vinays problem better and therefore offer effective therapy which would aid in helping him recover from his mental health issues.
References
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