COMMUNICATION

IN NURSING
Arlene D. Ringor, MSN
NCM 103, AY 2021-2022
 COMMUNICATION
is basic component of human relationship and
nurse-client relationships!
TRUST
◦ - is the foundation a a positive nurse-
patient relationship
◦ - client perceives an attitude of
acceptance, understanding and
empathy from the nurse
◦ Client may initially test the nurse’s
confidence such as sharing that he
expects remain confidential
◦ Therapeutic communication
◦ Is fundamental component in all phases of the nursing process
◦ CORE PILLAR:

◦ 1. EGO
– is a way of us experiencing the world. A Transactinal
way of understanding how we relate to ourselves Analysis
and others. Theory
ERIC BERNE
 ◦ CORE PILLAR:

◦2. SROKE - is a ‘UNIT OF Transactinal

Analysis
RECOGNITION” Theory
- Everyone has to have strokes ERIC BERNE

(affection, recognition, praise)

- Strokes may be positive, negative or
mixed, Conditional or unconditional
◦ CORE PILLAR:

◦3.TRANSACTIONAL ANALYSIS PROPER

◦Transaction is an exchange of strokes Transactinal
Analysis
Theory
ERIC BERNE

◦ COMPLEMENTARY TRANSACTION
◦ CROSSED TRANSACTION
◦ ULTERIOR TRANSACTION
◦A. Complementary transaction
Transactinal
Analysis
Theory
ERIC BERNE
B. CROSSED TRANSACTION
Transactinal
Analysis
Theory
ERIC BERNE
C. ULTERIOR TRANSACTION
Transactinal
Analysis
Theory
ERIC BERNE
◦ CORE PILLAR:
◦ 4.TIME STRUCTURING Transactinal
◦ all hate to be bored , desire strokes that we have the Analysis
psychological hunger to structure time
Theory
ERIC BERNE

◦ A. Withdrawal – stay away from others, no risks but no strokes

Central belief of TA is
◦ B. Rituals – acknowledge the presence of others with
that we made the
transactions decision in the first
◦ C. Activities – doing things can get strokes and recognition place so we have the
power to change it.
◦ D. Pastiming – talk about safe subjects that both parties know
the rules about
Adult to Adult
◦ E. Games – sets of ulterior actions transactions tend to
be safe, give and
◦ I. intimacy – open and honest relationship that is game free receive medium level
◦ J. Script - well defined course of action that we decide on strokes while not
making oneself too
vulnerable
 THERAPEUTIC COMMUNICATION
Let your patient know that you’re aware of her
efforts. This recognition acknowledgment is not
Affirm desired “I see you’re wearing the blouse your
1 framed as a compliment because a compliment
behaviors daughter brought yesterday.”
for doing a basic task (like going to the bathroom
by herself) can be perceived as condescending.
You’re not confident you understand your patient
“I’m not sure I got that. What did you mean
2 Ask for clarification correctly due to certain ambiguous words,
by ‘everything is different now?'”
gestures, or body language.
Helps you capture your patient’s thoughts and “Tell me more about that.”
Ask open-ended
3 perceptions while also assessing his attitude,
questions “How do you cope with that?”
awareness, and thinking abilities.
You’ve established trust with your patient, and
“Mr. Jones, you said you wanted to get
now you observe him saying or doing something
back to your family as fast as possible, but
inconsistent with an attitude, belief, or behavior
4 Confront you’ve been in bed all morning. Will you be
he expressed earlier. Gently help him see the
ready to walk the hallway in the next half
contradiction so you can help him align what
hour?”
he’s doing with what the results he wants.
Encourage “What are some steps you think you could
Your patient needs to break a bad habit or
5 formulation of an take to help you limit the number of donuts
create a good habit.
action plan you eat?”
 Your patient is jumping from topic to topic without “You’ve brought up several good
closure on anything. You need her to focus on one points. Let’s get back to what you
6 Focus
key area so you can capture critical details and so said about sometimes forgetting if
she isn’t overwhelmed by everything at once. you took your medicine.”

“After the surgery, you’ll have a

Builds trust, reduces patient anxiety, and improves drainage tube in your neck. You’ll
patient cooperation and safety because she need to change the surrounding
7 Give information
understands what’s happening and why it’s bandage every 6 hours, then come
happening and is therefore more likely to comply. back in three days to have it
removed.”

“What’s on your mind today?”

Gives your patient the freedom to talk about what
Make broad opening
she wants to talk about. She has some control over
remarks
circumstances and is not just a problem to be fixed. “Where should we start?”
8
 Builds trust by demonstrating you care “Is it ok if I sit with you until patient
9 Offer your time and presence
about and are interested in your patient. transport arrives?”
You need to understand what may have
caused specific symptoms, and your “Did you experience the light-
10 Place events in sequence patient should become aware of headedness before or after you got
connections between his actions and his up to leave the theater?”
symptoms.
Your patient asks for advice, and you Patient: “Do you think I should tell my
show respect for her judgment and family physician?”
11 Reflect
encourage self-accountability by asking
the question right back. You: “Do you think you should?”
Patient: “This food tastes like
Assures your patient you heard and cardboard.”
12 Restate / paraphrase
understood what he said.
You: “Not enough flavor for you?”

Shows your patient you are paying “That must have been unpleasant.”
Share thoughts and
13 attention and encourages her to share
observations
more information. “You seem more tired today.”
 You need to convert a patient’s vague or “Does it feel like pins and needles pressing
Suggest
14 abstract experience into something against your fingertips, or more like a pencil
comparisons
understandable. eraser?”
You or your patient provided a lot of
information. You need to confirm a “Ok, so we agreed you’ll press the call button
15 Summarize shared understanding and bring closure next time you either feel that pain in your arm or
to the discussion so you can document feel like it’s more difficult to breathe.”
accurately.

Make and hold eye contact.

Builds trust by showing your patient that

Turn to face your patient.
what she’s saying is important to you.
She knows you are paying attention and Nod in agreement.
16 Use active listening
feels like it’s safe to keep going. It also
contributes to mental and emotional Don’t multitask.
healing.
“Ok, I’m with you.”
“Oh my.”
Retain eye contact.
Your patient needs time to collect and
Continue to face your patient so he knows
17 Use silence organize his thoughts and decide what
you’re ready fo him to continue
to say next.
Allow your patient to speak next
 THERAPEUTIC
COMMUNICATION
SYNTHESIS
ACTIVITY SHEET
Class Activity
 References:
Berman, A. and Kozier, B. (Eds.) (2008) Kozier & Erb's fundamentals of nursing: concepts,
process, and practice Upper Saddle River, N.J. : Pearson Prentice Hall

Peplau, H. (1954). Interpersonal relations in Nursing. New York: G.P. Putnam’s Sons.

Potter, P.A., Perry, A. G., Hall, A., & Stockert, P.A. (2017). Fundamentals of nursing. Ninth
edition. St. Louis, Mo.: Mosby Elsevier.
Photo credits:

1. Circular transactional model - https://slideplayer.com/slide/10931620/

2. Nursing process image - https://nurseslabs.com/nursing-diagnosis/
3.Buddha quote - https://www.india.com/festivals-events/buddha-purnima-2020-best-messages-quotes-facebook-status-whatsapp-wishes-gif-
to-mark-gautama-buddhas-birth-anniversary-4021714/
6. Anthony Robbins quote - https://www.askideas.com/55-most-beautiful-communication-quotes-for-inspiration/to-effectively-communicate-we-
must-realize-that-we-are-all-different-in-the-way-we-perceive-the-world-and-use-this-understanding-anthony-robbins/