therapeutic-communication

I work in the Therapeutic Recreation department in a nursing home facility in Minneapolis. I consider it my job to show people that just because you’re getting older, that doesn’t mean you stop@ discovering, learning new things, and having fun.

I interact and do programs with my folks constantly, and they like to get to know me. I gave them a presentation one day on aquatic plants and aquariums to teach them about what I do when I’m not at work. I brought in samples of many different types of plants, let them touch and hold them. They asked tons of questions about the process of plant-keeping. One lady even asked if having her hands in the water tending plants would help her arthritis. Another lady said she was going to start a little tank. She couldn’t garden after becoming wheelchair-bound, and she said this is the next best thing. They all seemed especially curious about my marimo.

I decided to do a planting/crafting group. I got 40 balls of half-inch marimo, corked glass phials from Michael’s, and 5 pounds of pebbles. They each assembled their own marimo habitat, and each got to take home a three baby marimo. I gave a little lecture about marimo and proper care, and and off they went with their new pets.

They are so excited to come to me every week and tell me about their water changes. One lady tells me every week, “You have to help me divide them soon!”, and every week I tell her to wait a few more months.

It’s so satisfying inspiring a new generation of aquatic gardeners—even even if they’re a generation of octegenarians.

Motivational Interviewing

I just watched an excellent video that summarizes the various techniques used in motivational interviewing. According to Rollnick, Miller, and Butler (authors of the book Motivational Interviewing in Health Care: Helping Patients Change Behavior), motivational interviewing is…

"…a skillful clinical style for eliciting from patients their own good motivations for making behavior changes in the interest of their health."

In essence, health care practitioners are guiding patients to change behaviors (i.e. smoking, drinking, overeating) upon the patients’ own motivations rather than simply telling patients what to do.

I finished reading the book by Rollnick, Miller, and Butler about a month ago.

It’s an easy, educational, and entertaining read! It explains all the components of “MI” and provides case studies, resources, and additional learning tools to aid practitioners. 

The video I just mentioned (posted below) is basically a 5-minute summary of the book. Of course, not all techniques are disclosed in the video, but it does a great job of demonstrating the most crucial techniques used in MI!


Helpful resource:
http://www.motivationalinterview.org/

Step 10: Therapeutic Communication

DON’T EVER choose these types of answers:
1- “It’s going to be OK!” [don’t worry]
2- “Don’t worry; your doctors will do everything necessary for your care.” [don’t worry]
3- “Let’s talk about why you didn’t take your medication.” [let’s explore]
4- “Tell me why you really injured yourself.” [let’s explore]
5- “What makes you think that?” [why questions]
6- “Why do you feel this way?” [why questions]
7- Don’t insist that the client follow unit rules. [authoritarian answers]
8- Don’t insist that the client do what you command immediately. [authoritarian answers]
9- “That happened to me once.” [nurse focused]
10- “I know from experience this is hard for you.” [nurse focused]
11- “Are you feeling guilty about what happened? [close ended]
12- “How many children do you have?” [close ended]


Do choose these types of answers:
1- “You are experiencing alcohol withdrawal; you may see and feel things that aren’t real.”
2- “There are many reasons for memory loss; tell me more about what you have noticed.”
3- “I can see that you are frightened about being here.”
4- “You seem very upset. Tell me how you are feeling.”

A patient asks about taking potassium supplements while taking spironolactone (Aldactone). What is the nurse’s best response? a) “You are correct about your concern. I will make sure that you get some right away.” b) “I will call your doctor and let him know of your concern.” c) “Potassium supplements are usually not necessary with this type of diuretic.” d)  “You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”

Keep reading

5 Principles in Answering Therapeutic Communication Questions

5 easy tips on how to answer Therapeutic Communication questions. #NCLEX #NLE #Nursing

Getting the client’s response or the way you communicate with them are mainstay of the local boards, be it the NCLEX or the NLE. The psychosocial focus has been a central thread throughout all of the clinical areas: medical-surgical nursing, maternity and pediatric nursing, and most especially psychiatric nursing. It just shows that effective communicationis key in establishing therapeutic…

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This or That

Pop quiz:  If a patient calls the physician’s office you work for (after hours) and describes symptoms such as fatigue, SOB, and mild headache and asks you if that could be a side effect of her coumadin do you tell her

A) Well, anything can be a side affect of medication. If your symptoms worsen or you feel very concerned, go to the ER to be evaluated.

or

B) That could be a brain bleed! If it gets any worse, go to the ER! 

*facepalm*

People, please think before you speak.  You FREAK PEOPLE THE FUCK OUT WHEN YOU SAY BRAIN BLEED and then they call me crying hysterically. It’s called therapeutic communication, invest in some.  

(BTW option B is a verbatim answer from the call line nurse, in case you’re interested.)

youtube

The content of this program will focus on interpersonal communication as a process of human expression and influence. Initially, focus will be placed upon basic communications concepts. Students will then examine therapeutic communication skills, core dimensions and strategic implementation of key therapeutic communication concepts.

-Therapeutic Communication via http://work911.com/communication/video/therapeutic.htm

Nurses' therapeutic communication.

Bilang isang nurse, first year palang, tinuturo na yung mga therapeutic at non-therapeutic communications sa’tin. At isa sa mga non-therapeutic na pinakainiiwasan ko ay yung mabe-belittle ko ang nararamdaman ng isang taong may sakit.

Tandaan: Everything is not what it seems.

Hindi lahat ng nakikita ng mata mo, yun lang ang basehan mo ng nararamdaman ng isang tao. Kasi one time, may duty kami sa Manila. Fourth year na ako nito. January 2012, may sakit ako. Viral infection. May blisters ako sa right side ng balakang ko. One-sided lang naman siya tapos, hindi sila nagccross sa other side. Kumbaga, kung hanggang saan ang midline ng spine ko, hanggang dun lang silang lahat. Madami tapos sobrang sakit.

Kala ko nun, taghiyawat na naligaw na masakit at konti-konting dumadami lang. Hahaha. Tapos, nung nagpaconsult ako, umiyak talaga ako nung nalaman ko na may Herpes Zoster ako. Shingles na lang para medyo cute ang term. Hahaha. Paano nagkakaroon nun? Ganito kasi yun.

Konting pathophysiology lang: Nung bata ka, nagkachicken pox ka - varicella virus ang nagccause nun. Kapag naresolve ang chicken pox mo, hindi totally eliminated ang virus na yun sa system mo. Parang, nadeactivated lang. Nandun lang siya sa katawan mo, natutulog lang (let’s put it that way).

Ngayon, sa middle-age years mo, nakaencounter ka ng someone na may active chicken pox. May chance na yung varicella virus sa katawan mo ay mareactivate. Kapag nareactivate siya, hindi na chicken pox ang tawag dun. Herpes Zoster na, or Shingles. Iba na din ang signs and smptoms nun sa chicken pox.

Kaya hindi porket nagkachicken pox ka ay safe ka na. ;> Ingat-ingat kasi mas matindi at mas masakit ang Shingles, promise. -.-” xD.

Anyway. So ayun, duty kami sa Manila. May Shingles ako. Kailangan kong umuwi na dito sa Batangas kasi baka makahawa ako. Nasa dorm kami nun and before ako makaalis, I have to talk muna sa level coordinator namin about my condition and I was advised to go home.

May lalaki dun sa counter, yung nasa front desk ng dorm na nagwwelcome ng guests. Connected din siya sa mga CI’s namin, may number kasi sila. Nung una, nagtatanong siya kung bakit ako uuwi. Para kasing ayaw niya akong payagang umalis. Sabi ko, may sakit ako. Ganito yung usapan namin.

Siya: Anong sakit?

Me: (nung una, nahihiya akong sabihin.. kasi bakit ko naman isspoil ang medical diagnosis ko; pero anyway, for the sake of it..) Shingles po.

Siya: Ahh. Yung sa Herpes? Talaga?

Me: Opo. Akala ko po kasi ay wala lang kaya pumasok pa din ako. Tapos, sobrang sakit po ng blisters ko kaya-

Siya: Oo. Alam ko naman yun. Nurse din naman ako. May nireseta sa’yong gamot?

Me: Opo. *Pinakita ko sa kanya. Tanda ko nun, may Acyclovir ako. Vitamin B complex + Paracetamol. At saka, calamine lotion.*

Siya: Bakit parang wala ka namang signs and symptoms??

Me: ……..

Alam niyo, nung time na yun, ang sakit pala (emotionally) kapag namamaliit yung nararamdaman mo. Sobrang sakit kasi ng mga blisters ko nun. As in. Pinipigilan ko lang lahat ipakita, kasi ayokong masyadong isipin yung pain na nararamdaman ko. Diversion of attention kumbaga. Sana alam niya na ang pain ay subjective, hindi objective.

The whole time, paulit-ulit lang sa isip ko yung sinabi niyang “bakit parang wala ka namang signs and symptoms?" Tapos yung tono pa ng pananalita niya, sobrang doubtful na wala akong maaninong ni-konting paniniwala sa kanya na may sakit talaga ako.

Tapos, iniisip ko na sana di na lang siya nagsabi na nurse din siya. Sana talaga hindi ko na lang nalaman. Kasi nung time na yun, sabi ko sa sarili ko, ayokong maging nurse na katulad niya at hinding-hinding-hindi ko gagawin yung ginawa niya sa’kin sa kahit sinong magiging pasyente ko.

Nakakawalan ng respeto.

Actually, galit nga ako sa kanya sa sinabi at ginawa niyang yun. Bastos kasi niya. At dati, di ko alam kung paano ko siya mapapatawad kasi tinawanan pa niya ako nun. May kasama siya nun eh, parehas silang nagtawanan. Kaso naririnig ko palagi ang conscience ko na nagsasabing, “forgive someone automatically even if a person asks for it or not, just like how God forgives you.

Kaya kapag duty kami, lagi kong sinusubukan yung hangga’t kaya kong ipakita at sabihin kung gaano ako kaconcern sa pinagdadaanan ng mga namemeet kong patient, gagawin ko.

Dun ko napatunayan kung gaano kaimportante ang therapeutic communication. Hindi yun basta-basta. Ingat din kasi words can hurt. :)

* * * * *

Nurses at future nurses, wag niyong gagayanin si kuya. :) At sa mga tao na makakaencounter ng nurse na tulad niya, forgive lang po. Pagpasensyahan na lang kasi may mga nurse, pero walang pusong-nurse. :)

I WILL LICK MY PLATE UNTIL IT'S SQUEAKY CLEAN
  • Me:Ma oyy. :(( Gikapoy nako'g skwela. Dili ko inspired. Kapoy kaayo ni'ng routine nako kada adlaw. Di nako kabaw mu-suwat. I commit unforgivable grammatical blunders and aaaaaaaaaaggh. I'm a failure. :( I just have too much on my plate right now!
  • Mom:THEN EAT THEM ALL. FINISH YOUR PLATE.
  • Exactly what I needed! I love my motherr!
NCLEX Exam: Psychiatric Nursing 2 (50 Items)

NCLEX Exam: Psychiatric Nursing 2 (50 Items)

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Introduction

This examination about Psychiatric Nursing contains 50 questions. Visit our NCLEX Exam page for more quizzes.

Topics

Topics or concepts included in this exam are:

  • General questions about Psychiatric Nursing
  • Autism
  • Child Abuse
  • Therapeutic Communication
  • Theories and theorists related to Psychiatric Nursing

Guidelines

  • Read each question…

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