science

Nurse Communication (Verbal & Non-verbal)

Client communication (Verbal & Non-verbal)

Nurse’s Thoughts &

Feelings Related to the Interaction

Communication Technique (Therapeutic/Non-Therapeutic)

Alternative or Revised Response

1.

Nonverbal: Knocks on the door, enters room, smiling, washes hands, SOLER (Morgan, 2020).

Verbal: Good morning sir, my name is Courtney, and I will be your nurse today. I’m interested in getting to know you. Do you mind if I come in and sit with you?

Nonverbal: client is sitting in a chair staring out the window, appears sad and tearful.

Verbal: Yes, I guess you can come in.

I am nervous since this is my first encounter with the client. I want to know what’s going on in his mind. I don’t want him to shut down.

Therapeutic: self. This is the orientation phase of the client-nurse relationship.

offering

Same response

2.

Nonverbal: I am checking his name band and looking in the client’s MAR to verify I have the correct client.

Verbal: Keep your chin up Mr. Jones. Before we begin, can you please verify your full name and date of birth?

Nonverbal: Mr. Jones is watching me while I check his name band.

Verbal: My name is Russel Jones, my date of birth is April 20th, 1952.

Okay, Mr. Jones is alert and orientated to self. Mr. Jones is confirming his identity which confirms that I am talking with the correct client, and I am addressing him by his correct name.

Nontherapeutic: making stereotyped comments, this a cliché expression and is meaningless in the nurse-client relationship.

This is an inappropriate therapeutic response. I should not tell Mr. Jones to keep his chin up. Instead, I would suggest saying “I am here to help you and we shall get through this together.” Talking about his loss of his

wife is reiterating his actions.

3.

Nonverbal: SOLER (Morgan, 2020).

Verbal: Mr. Jones, how are you feeling today?

Nonverbal: He is sitting in his chair and looking out the window. Mr. Jones looks at me.

Verbal: “fine I guess….”

I am generally concern that something is going on with Mr. Jones. He doesn’t seem like he is doing very well.

Therapeutic: opening, this Mr. Jones to initiative in th discussion.

broad

Instead of asking Mr. Jones how is feeling today, the nurse could have said “tell me what you are thinking about?”

allows

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4.

Nonverbal: Nodding, looking at client.

Verbal: That’s good Mr. Jones, I’m glad that you are feeling okay.

Nonverbal: staring at the ground

Verbal: “Meh, I just don’t feel like talking this morning.”

Mr. Jones doesn’t want to talk this morning. Maybe I can ask him what is bothering him?

Nontherapeutic: approving or disapproving, the nurse is denouncing Mr. Jones behavior. She is accepting this behavior.

This is not therapeutic approach instead I could ask Mr. Jones “Mr. Jones, we all have those days when we don’t want to talk to anyone. Is there anything I can do to make you feel better?”

5.

Nonverbal: Remain silence, nodding.

Verbal: Everything will be alright Mr. Jones…

Nonverbal: angry, short, and agitated. Looks away from me.

Verbal: No, it won’t, I just want to get out of here. I don’t belong here!

Mr. Jones is getting very agitated and angry. He believes that he doesn’t belong here.

Nontherapeutic: giving reassurance, the nurse is devaluing the client’s feelings

Instead of telling Mr. Jones everything will be alright I could use a more therapeutic techniques broad opening which allows

the client to initiate the topic and interaction.

6.

Nonverbal: Concerned, nodding, looking at client.

Verbal: Mr. Jones, you feel angry that you don’t belong here, and you want to go home. Can you explain more why you feel angry?

Nonverbal: tearful while looking at nurse

Verbal: Well last night, I locked myself in the bathroom and refused to come out. I have been sad and lonely since my wife died. My daughter thought I was going to harm myself which she called the police and brought me here.

The reason Mr. Jones is angry is because he is sad and lonely that his wife passed away. His daughter thought he was going to harm himself.

Therapeutic: the nurse is focusing on why Mr. Jones feels angry.

focusing

,

Asking him what brought him in earlier may have provided a more therapeutic response which could have resulted in him not becoming angry.

7.

Nonverbal: nodding and

Nonverbal: Looking at nurse

Mr. Jones feels like his

Nontherapeutic:

This is not an

looking at client.

Verbal: What made you lock yourself in the bathroom and refuse to come out?

and staring out the window.

Verbal: I feel like my daughter doesn’t care about me and how I am feeling since my wife passed away.

daughter doesn’t care about him and his feelings about the loss of his wife. He is trying to get attention from his daughter.

indicating the existence of an external source of power, this allows Mr. Jones to blame his daughter for his actions instead of accepting the responsibility.

appropriate therapeutic response for Mr. Jones instead I should offer him silence and allow him to explain. Listening to everything he has to say is key.

8.

Nonverbal: Nods in understanding.

Verbal: Ok, Mr. Jones, Do I understand correctly that you said, “your daughter doesn’t care about you, and she doesn’t understand your

feelings since your wife passed away?”

Nonverbal: nodding and shaking his head.

Verbal: Yes. My daughter hasn’t been around much lately since my wife died.

Mr. Jones is feeling lonely because his daughter is not around much since his wife passed away. He wants some attention from his daughter.

Therapeutic:

seeking

I was able to clarify with Mr. Jones that I heard him correctly. If I didn’t clarify the

question, he may have thought that I didn’t understand what he was saying which could make him frustrated or stop talking.

clarification and

validation

. The nurse

is trying to clarify the feelings and increase between Mr. Jones

meaning of his the understanding and the nurse.

9.

Nonverbal: Nodding, SOLER (Morgan, 2020).

Verbal: What you really mean is that it’s been difficult since the loss of your wife and your daughter hasn’t been around for support?

Nonverbal: shaking his head.

Verbal: Yeah, my wife and I have been together for 45 years. She was my soulmate and whole world. We would do everything together. My daughter works so much

lately, I guess I just feel like she would be better off without me.

Mr. Jones is having a hard time coping with the loss of his wife.

His daughter seems to be someone he uses for a support system, but she isn’t around.

Nontherapeutic: interpreting, the nurse

is trying to tell the client the meaning of his thoughts.

Instead of interpreting how the client feels I should allow Mr. Jones to let him tell me how he feels.

Nurse Communication (Verbal & Non-verbal)

Client communication (Verbal & Non-verbal)

Nurse’s Thoughts &

Feelings Related to the Interaction

Communication Technique (Therapeutic/Non-Therapeutic)

Alternative or Revised Response

10.

Nonverbal: looking at the client.

Verbal: Okay, Mr. Jones. Please explain why you feel like your daughter would be better off without you.

Nonverbal: looking at the ground

Verbal: Well since she’s just so busy I figured that she didn’t need me anymore. I may have told her that I would

Mr. Jones is having a hard time not connecting with his daughter. She is a huge support system for him since his wife is gone.

Therapeutic: exploring, the nurse is trying to further gain information about the client’s feelings without pushing or probing the client to

Same response. However, it may be therapeutic to have a conversation with Mr. Jones and his daughter to clear the air.

rather not be here on earth anymore so I can be with my wife again.

not disclose information.

11.

Nonverbal: looking at the client.

Verbal: Why did you do that?

Nonverbal: embarrassed while looking at the ground.

Verbal: I guess I shouldn’t have told her that I would rather not be here on earth anymore. That probably made her worried and thought that I would harm myself.

Mr. Jones recognizes that what he said is wrong. He feels embarrassed of his actions.

Nontherapeutic: requesting an explanation

Using more of an exploring technique may have him tell me more about what happened in why he wanted to harm himself.

12.

Nonverbal: looking directly at the client.

Verbal: Mr. Jones, there is no one else in the room but you and me, would you ever physically harm yourself?

Nonverbal: shaking his head and tearful

Verbal: No, I don’t think I could physically harm myself. I know that my wife wouldn’t want that for me. I just miss her so much and thought that I was being a huge burden on my daughter.

Mr. Jones doesn’t want to hurt himself. He understands that his wife wouldn’t want that for him. He is sad that she is gone and doesn’t have enough support.

Therapeutic:

presenting reality

Same response. Mr. Jones tells me that he wouldn’t physically harm himself because he knows that his wife wouldn’t approve of his decision. He needs a safety plan as he does not currently have suicidal ideation.

13.

Nonverbal: Nod’s and looks at client.

Verbal: Okay Mr. Jones, tell me how you feel like a burden towards your daughter since your wife passed.

Nonverbal: nodding

Verbal: Well, you see my daughter use to come over twice a week when my wife was alive. Now, she barely comes over once a week. She is always working and when

we talk, I just feel like I’m not important to her.

Mr. Jones is feeling alone and doesn’t have any support from his daughter.

Nontherapeutic:

probing, the nurse is pushing the client to for answers. This could make the client defensive.

Allowing Mr. Jones to “go on” since he stated before that he feels like he is a huge

burden on his daughter would be more therapeutic.

14.

Nonverbal: remains silence, allowing Mr. Jones to provide more information.

Verbal: Go on….

Nonverbal: staring at nurse

Verbal: I just feel like I am not important to her because she doesn’t come over anymore. I want to spend more time with her because she is the only family I have left.

Mr. Jones feels that he is unimportant because his daughter doesn’t want to spend time with him. She is his only support system since his wife is gone.

Therapeutic: general lead

offering a

Asking Mr. Jones is he has any other family members or friends around may allow him to not focus on his daughter.

15

Nonverbal: Nodding.

Verbal: Unconsciously you’re saying you have been sad and lonely since your wife passed away. You don’t want to harm yourself. You feel like you’re a huge burden on your daughter, and you want to spend more time with your daughter since she is the only family you have.

Nonverbal: shakes his head

Verbal: Yeah, that pretty much sums it up.

Mr. Jones agrees that the information he has

provided is correct. I am going to propose some ideas that would make him feel less lonely or possibly having a talk with his daughter when she comes in.

Nontherapeutic:

interpreting, the nurse

is telling the client the meaning of his feelings and thoughts.

I should restate what Mr. Jones has told me so I can develop a trusting and working relationship with Mr. Jones. Then together we can develop a safety plan that benefits him. Either providing him with National Suicide prevention lifeline (1800-273-8255) or counselor.

16.

Nonverbal: maintain eye contact and smiling.

Verbal: Mr. Jones sounds like you have felt deep loss and grief about losing a loved one recently while having to be here. That must be very difficult for you.

Nonverbal: Nod’s head

Verbal: It really has been difficult. She was my soulmate for 45 years. I just feel like a piece of me is missing since she’s gone.

This has been a

difficult time for Mr. Jones. He has been feeling so much pain and loss from losing his wife. I need to ask him different questions, so we don’t focus on his suffering but willing for him to grieve.

Therapeutic:

verbalizing the implied

At this time, asking Mr. Jones to come up with a plan of care would be more beneficial for the next time he feels sad and lonely.

17.

Nonverbal: Nodding, providing eye contact, touches Mr. Jones hand.

Verbal: Mr. Jones, everybody feels like a piece of them is missing when they lose a loved one. I understand how you feel.

Nonverbal: uncertain and nods his head in agreeance

Verbal: If you say so….

Mr. Jones is now confused and feels that he is compared to others.

Nontherapeutic: belittling feelings expressed, this can cause the client to feel insignificant and unimportant.

I don’t understand how he feels. Instead, I should ask Mr. Jones if I could stay with him for a while to make him comfortable.

18.

Nonverbal: looking at client.

Verbal: Mr. Jones, what could you do differently if you are faced with this situation in the future?

Nonverbal: looks at nurse

Verbal: Well, I guess I could go for a walk. I used to like going for walks in the evening.

Mr. Jones use to like going for walks in the evening. I can encourage him to do activities that make him happy instead of being sad.

Therapeutic:

I should have noticed while he was staring out the window during our conversation that he was watching the people outside walking. I could have asked him earlier if this is something he enjoyed doing.

19.

Nonverbal: remains silent, looking at the client, nodding.

Verbal: That’s good. I’m glad that you have found a solution that works for you.

Nonverbal: smiling

Verbal: Yes, me too.

Mr. Jones seems excited about how to cope with this new solution.

Nontherapeutic: approving, the client may be trying to please the nurse.

Using silence would encourage Mr. Jones to organize his thoughts and how he feels about using this new coping method.

20.

Nonverbal: smiling and excited.

Verbal: That sounds beautiful Mr. Jones. I am happy that we have a plan. I will come back in an hour to check on you. Please let me know if you need anything.

Nonverbal: smiling and nodding

Verbal: Okay, I don’t need anything, but I will let you know if I do. Thank you, Courtney, I am glad we talked. I feel much better about things.

Mr. Jones shared a lot of information about himself and how he can cope with his loss. He doesn’t want to die but he feels lonely. Mr. Jones is learning how to deal with his coping

skills and will be successful when he can be discharged.

Therapeutic:

self. Mr. Jones is aware that I am her for him and that he i not alone.

offering

s

I am happy with my conversation with Mr. Jones. We were able to develop a plan in which he is comfortable with. I could have offered different solutions

earlier in the conversation however Mr. Jones was able to create a plan on his own.

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