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Explore communication skills and abilities, including general and special abilities in a nursing context. Learn about managing therapeutic impasses such as resistance, transference, counter-transference, and boundary violations.
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Therapeutic communication: Communicationskills & abilities NISSI ANGEL BABY
LEARNING OBJECTIVES • Describe Communication skills & abilities • Explain the Therapeutic impasses and its management.
INTRODUCTION • Skill- ability to use the knowledge effectively and readily • Ability-competency in doing or acquiring proficiency
Communication skills & abilities General abilities - ability to ; • Read • Express oneself by writing • Speak • Listen and interpet
Communication skills & abilities Special abilities – ability to; • Observe and interpret • Guide NPI to accomplish goals • Ascertain if communication is taking place between the nurse and the patient • recognize when to speak & be silent • Wait to proceed at patient’s pace • Evaluate participation of pt. in NPR
Ethics and Responsibility: • The Code for Nurses reflects common values regarding nurse-patient relationships and responsibilities and serves as a frame of reference for all nurses in their judgments about patient welfare and social responsibility. • Responsible ethical choice involves accountability, risk, commitment, and justice.
1. Resistance • patient's reluctance or avoidance of verbalizing or experiencing troubling aspects of oneself. • often caused by the patient's unwillingness to change when the need for change is recognized.
2. Transference • an unconscious response - patients experience feelings and attitudes toward the nurse • reduces self-awareness • The first is the hostile transference. If the patient internalizes anger and hostility, this resistance may be expressed as depression and discouragement.
A second difficult type of transference is the dependent reaction transference. This resistance is characterized by patients who are submissive, and subordinate, and regard the nurse as a godlike figure.
3. Counter transference • created by the nurse's specific emotional response to the qualities of the patient. • Counter transference reactions are of the 3types: • Reactions of intense love or caring • Reactions of intense disgust or hostility • Reactions of intense anxiety, often in response to resistance by the patient.
4. Boundary violations • Which occur when a nurse goes outside the boundaries of the therapeutic relationship and establishes a social, economic, or personal relationship with a patient.
Possible boundary violations related to psychiatric nurses • The patient takes the nurse out to lunch or dinner. • The professional relationship turns into a social relationship. • The nurse attends a party at a patient's invitation. • The nurse regularly reveals personal information to the patient. • The patient introduces the nurse to family members, such as a son or daughter, for the purpose of social relationship. • The nurse accepts free gifts from the patient's business. • The nurse agrees to meet the patient for treatment outside the usual setting without therapeutic justification. • The nurse attends social functions that include the patient • The patient gives the nurse an expensive gift. • The nurse routinely hugs or has physical contact with the patient • The nurse does business with or purchases services from the patient.
SUMMARY • We have discussed about Communication skills, abilities&Therapeutic impasses and its management
EVALUATION • What are the Therapeutic impasses?
REFENCEE • Kaplan & Sadock’s Synopsis of Psychiatry, (2007). Behavioral Sciences/Clinical Psychiatry, 10th Edition • american nurses association. Scope and Standards of Psychiatric-Mental Health Nursing Practice (2000). • Balzer Riley, J. w. Communications in nursing: Communicating assertively and responsibly in nursing (2000). • van Servellen, g. Communication skills for the health care professional: Concepts and techniques. (1997).
