Since the dawn of time man has been evolving in the ways we think and interact with each other. What was appropriate a generation ago might not be appropriate today. As nurses we know very intimate details of our patients’ lives, those details can blur the line between a friendly relationship and a professional relationship. Even though you feel you know the patient like you know your best friend you still have to treat them with the utmost respect, and dignity.
Social communication is something we do on a daily basis whether it is with a patient or acquaintance, we refer to it as small talk. In contrast Therapeutic communication skills are very specific and goal oriented, they aren’t skills one is born with, these skills take time to perfect and build on. What is communication? The Townsend text defines it as “an interactive process of transmitting information between two or more entities”.
In any communication there are “preexisting conditions” that affect the intended message and the way it is received, some examples include values, attitudes, beliefs, social status and environment in which the communication takes places (Townsend, 2010). A large part of communication is nonverbal communication, how you present yourself and your body language goes a long way in getting your point across. 70-90 percent of all effective communication is nonverbal (Townsend, 2010). A nurse-patient relationship can have multiple types of communication including non-therapeutic, social, and therapeutic.
If a nurse errs and uses non-therapeutic communication such as rejecting, giving reassurance, or probing, negative outcomes occur. Non-therapeutic techniques discourage further expression of feelings and ideas and provoke negative responses or behaviors in others (Potter, Perry, Stockert & Hall, 2009) On the other hand therapeutic communication techniques such as; using silence, accepting and offering self, encourage feelings and ideas and convey acceptance and respect (Potter, Perry, Stockert & Hall, 2009).
Social communication can be used as small talk on a limited basis. To understand social communication and therapeutic communication we must first define both. social communication can be defined as everyday communication that occurs as the nurse greets the patient and passes the time of day with what is referred to as small talk (Shives, 2008) saying things like “how is your day? ” or “how are you pets? ” are basic statements that aren’t goal specific.
Social communication can elicit a negative response from the patient, if that occurs the nurse would “shift gears” and start a conversation using therapeutic communication techniques. An example would be: Nurse: “Hey how are you doing? The weather outside is beautiful today” Patient: “I don’t care about the weather, I hate it here, I don’t belong here, and I want to go home now! ” To remedy this, the next sentence the nurse could use is:
Nurse: “Oh, I see, what would u like to talk about today? ” That statement gives the patient a broad opening which “allows the patient to take initiative in introducing the topic and it emphasizes the importance of the client’s role in the interaction” (Townsend, 2010) Therapeutic communication on the other hand is defined as a process in which the nurse consciously influences a patient or helps the patient to a better understanding through verbal or nonverbal communication.
Therapeutic communication involves the use of specific strategies that encourage the patient to express feelings and ideas and that convey acceptance and respect (Mosby 2009). In the text Basic concepts of psychiatric-mental health nursing the author uses a very helpful table to compare and contrast therapeutic and social communication, some examples given are: * In social communication a personal or intimate relationship occurs and the identification of needs may not occur. Whereas in therapeutic communication a personal but not intimate relationship occurs.
Needs are identified by the patient with the help of the nurse if necessary. * Personal goals may or may not be discussed and constructive or destructive dependencies may occur, in contrast to therapeutic communication where personal goals are set by the patient and constructive dependency, interdependency, and independence are promoted. * In social communication a variety of resources may be used during socialization, but in therapeutic communication specialized professional skills are used while employing nursing interventions.
In conclusion we see that communication in nursing is being developed as an entirely separate skill, as profession nurses we have the responsibility to ourselves and our patients to understand what is being said and to get the point across in a precise and efficient manner. By comparing and contrasting the two communication styles we see they are vastly different. When using social communication the nurse wouldn’t be unprofessional, but it is up to the nurse to determine the correct time, place, and situation for which each style is appropriate.