One of the most essential skills for any healthcare professional is communication. In nursing, we call it therapeutic communication, which has been called the “secret sauce” for nurses. This type of communication is more than just chatting or social conversation. The goals of therapeutic communication are building trust with patients, understanding their needs, and providing emotional support. Good communication can make patients feel heard and understood, significantly impacting their healing process. Mastering this type of communication can help navigate the complexities of patient care, leading to better outcomes and stronger patient-nurse relationships.
While social conversation can be used to start a discussion, nurses must learn to seamlessly move into therapeutic communication when speaking to their patients. This will allow nurses to connect with patients on a deeper level, fostering trust and understanding. It enables nurses to help patients cope with stress and fears, clarify their needs, and enhance their overall experience. Using therapeutic communication can turn routine interactions into comforting, healing encounters. A nurse’s words can be as powerful as their medical skills.
What is therapeutic communication?
Therapeutic communication involves active listening, empathy, and honest communication. When fully present and attentive, nurses can understand their patients’ concerns, fears, and needs. Trust and rapport are more easily built, which is crucial for effective care. Clear communication also enhances the work environment, ensures everyone is on the same page, minimizes errors, and improves patient outcomes.
Most nursing students learn various communication techniques early in their nursing courses. At first, they may seem a bit canned or fake, but with practice, they can really assist a nurse to handle almost any situation. Even the dreaded “process recording” assignment (writing down a patient conversation and analyzing how the nurse/nursing student responded) can actually be helpful in this learning process.
Here are some of the most common techniques. (For more, see a nursing resource text or this open nursing resource. Of course, to make any communication therapeutic, the nurse must consider not only what is said, but how the nurse is saying it. Think of facial expression, eye contact, tone of voice, and body position or body language when speaking to patients. One can’t convey caring or encourage a patient to open up about their concerns if one if not looking at the patient to show they are listening, looking cross or upset, or crossing their arms as if defensive.
Here are some common verbal techniques:
- Open-ended questions or statements encourage the patient to expand on a statement. These questions might be something like: “How are you feeling now?” or “Tell me more about …” These are opposite of closed ended questions where a patient can answer with one word, such as yes or no.
- Clarifying: Asking for more information from the patient. Examples: Can you explain what you meant by…?” or “What do you mean when you say you feel punky?”
- Rephrasing or restating: Expressing a similar statement to the patient to confirm understanding and allow them to discuss the topic further. Example: Patient: “I get so upset when I have to take pills.” Nurse: “You are upset by taking medications.”
- Reflection: Echoing the patient’s feelings and thoughts encourages further discussion. “You seem to be feeling overwhelmed by the situation. Let’s talk about this more.”
- Silence: By not responding, the nurse gives the patient time to reflect on what they have said and further expand on the topic. To use this technique, the nurse must show through their body language that they are actively listening to the patient.
- Focusing: Redirecting the patient back to the topic of concern if they seem to be changing it. Example: “You said you experience pain in your leg at times. Let’s discuss that further.”
These are just a few examples of the therapeutic techniques. Using them shows you care about what the patient is experiencing and want to know more about them. A few of the techniques also direct a patient to deal with truth or reality. Light touch may also be used to show. support or empathy.
In addition to avoiding the nonverbal barriers to communication mentioned above (facial expressions, tone of voice, etc.), one must also avoid certain types of statements. Try to avoid arguing with a patient, blaming them for health issues, or changing the subject during the conversation. Nurses shouldn’t talk about their own personal lives too much or give patients their personal opinions (“If I were you, I would …). Asking “why” questions should be avoided as it can make patients defensive (“Why didn’t you take better care of yourself?”). Humor may be appropriate at times, but is generally not a therapeutic technique. One also might feel like they want to make a patient feel better but using false reassurances (“Everything will be fine.) may not be true and a patient may feel their concerns are not being appropriately addressed.
Therapeutic communication is a purposeful and patient-centered method of communication. The techniques encourage patients to share important information, feelings, and thoughts, thus allowing for more effective care. The techniques help the nurse to build trust with patients, show empathy, and create a healing environment. They will enable the patient to actively participate in decision-making. With practice, those new to nursing can face almost any patient situation confidently.
Resources
- Ernstmeyer, K. & Christman, E. (eds.). (2024). Nursing Fundamentals 2e. WisTechOpen. Nursing Fundamentals 2e – Simple Book Publishing
- Lindig, A., Klee, S., & Krumm, N. (2024). Evaluation of a patient-centered communication skills training for nurses (KOMPAT): Study protocol of a randomized controlled trial. BMC Nursing, 23(1), 2. doi: 10.1186/s12912-023-01660-8
- Kwame A, Petrucka PM. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1):158. doi: 10.1186/s12912-021-00684-2
- Sharkiya SH. Quality communication can improve patient-centered health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023 Aug 22;23(1):886. doi: 10.1186/s12913-023-09869-8