Nursing is a caring profession. It is also a profession that is more and more evidenced based in practice. In
as much as the scientific aspects of nursing is increasing due to the
complex technological advancement of medicine and the machinery that is
used at the patients bedside, the fact remains that the nurse is the
first person that the client usually comes in contact with in any
emergency or hospital setting.
Having said this,
the term, "caring" is an essential emotion that all nurses, for that
matter, all individuals in the health profession must possess. With caring comes the trained ability of the nurse to facilitate therapeutic communication. One might ask, what is therapeutic communication? To better answer this question, the term communication should first be defined.
Communication can be defined as "The Process of transmitting messages and interpreting meaning." (Wilson and others, 1995) With
therapeutic communication, the sender, or nurse seeks to illicit a
response from the receiver, the patient that is beneficial to the
patients mental and physical health. Just as stress has
been proven to adversely affect the health of individuals, the
therapeutic approach to communication can actually help. In any given situation everyone uses communication.
Everyone has seen the individual that looks like they are either angry, stressed, feeling ill or maybe sad. These emotions are communicated to others not always by words, but by gestures and facial expressions. A
nurse must always be aware of these expressions in clients, for these
expressions may be the only way that the nurse can tell if there is
something else going on that needs their attention. The term given to this type of non-verbal communication is called, meta-communication. In
meta-communication, the client may look at their amputated stump and
say that it doesn't really look that bad, while at the same time tears
are rolling down from their eyes.
In a case such as this the nurse should stay and further explore how the person actually feels. There are many factors associated with the healing and comforting aspects of therapeutic communication. Circumstances, surroundings, and timing all play a role in the effect of therapeutic communication. If
a client is being rushed down for an emergency surgery there might not
be time for a bedside conversation, but the holding of a hand could
convey much more than words to the client at such a moment.
Ideally, for therapeutic communication to be effective the nurse must be aware of how they appear to the client. If
a nurse appears rushed, for example, they are speaking quickly, their
countenance looks harried, and they are breathing heavily, their eyes
not on the client but perhaps on an intravenous bag on the client in
the next bed. In a case like this, there is nothing that
this nurse could say to the client in a therapeutic manner that the
client would believe. The helping relationship has not been established and therefore therapeutic communication cannot be facilitated. Some
of the emotions associated with therapeutic communication include but
are not limited to the following: Professionalism, Confidentiality,
Courtesy, Trust, Availability, Empathy, and Sympathy. (Potter, Patricia
A., Perry, Anne G., Co. 2003, Basic Nursing Essentials for Practice,
pg. 123, Mosby)
All of these emotions go into the client nurse
relationship, which must be established by the nurse as soon as
possible upon first meeting the client. To begin to
establish this nurse client relationship, the nurse must assess the
overall message that the client is communicating to the nurse, such as
fear, pain, sadness, anxiety or apathy. The nurse should be trained in keying into the message that the client is sending. Only then can the nurse determine the best therapeutic approach. Anyone that has to be thrust in to a hospital or emergency room environment has level of anxiety.
This
level can go up considerably when the client feels that they have been
abandoned or that there is no one there that really cares about how
they feel. When a client is the recipient of therapeutic
communication from a caring individual, a level of trust is achieved
and more than, that the clients entire countenance can change for the
better. Their blood pressure, respirations and levels of stress can simultaneously decrease. When this takes place, the management of pain, if any is involved, can be resolved more quickly. The goal for a nurse is to become proficient in the medical
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