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The nursing profession has since gained more significant improvement since when emphasis has been on patient-centered care. The therapeutic care has been one of the major tools towards these achievements. According to (Sherko., Sotiri&Lika) therapeutic and communication are two complex words that portrays different meanings. Therapeutic-refers to science and art of healing while communication is a medium through which information is exchanged. The amalgamation of these words has since created a tool and since formed the basis of nursing care during health promotion, illness, healing and recovery.
This paper explores the definition, goals, components, promotion, necessity and the impacts of good therapeutic communication on the patient's safety.
Therapeutic communication involves strategic techniques that allow the clients to voluntarily express their thoughts and feelings and its also which that projects acceptance and respect. (Sherko., Sotiri&Lika} JaHR vol. 4 no. 7 2013, pg 457&8). It is a face-to-face method of interaction which emphasis is geared towards the holistic well-being of clients.
Kimmel(2020). Therapeutic communication occurs when there is an exchange of information. This can either be a verbal or non-verbal communication. The verbal communication takes cognizance of the conversation that occurred, the location, time, physical, social, emotional and the cultural environment while the non-verbal communication is expressed during the verbal communication through body language, eye contacts and facial expression to communicate the client's thoughts, feeling, needs, and concerns to the registered nurse (Sherko., Sotiri&Lika).
The central goals of therapeutic communication is to satisfy the patient's needs, ie it is a patient centered form of therapy.
This is often achieved when a close relationship is formed to promote healing, support and to enhance functionality. It is health focused with set boundaries. (Sheldon, 2005). It also aims at skillfully collecting both subjective and objective information that forms cues to a particular illness. It's ease during assessment gives a clear information if interventions were to be carried out or modified for a favorable outcome. Sometimes, it helps determine if it was necessary to provide health education(Kimmel, 2020).
Key Components of Therapeutic Communication. The therapeutic relationship between the registered nurse and the client will determine if clients would be willing to have confidence in revealing intimate issues. In that regard, there are some key components of an effective therapeutic communication. Therefore, if every communication contains these components, it can provide astounding results that clients were not aware could be achieved. Power: The registered nurse has an influence over client as the service provider who has authority associated with her position and with her specialized knowledge. She is privileged to access the client's information and this makes the client vulnerable due to care needs from the RN. When this imbalanced power occurs in this relationship, it (Nurses' Association of New Brunswick, 2015). Trust: Clients view RN's as professionals who is knowledgeable, skilled, competent, dependable and ethical in behavior. Clients tend to entrusts their care needs to be taken care of. When there occur a breach in trust, care and confidentiality on this premise, the therapeutic aim will be forfeited((Nurses' Association of New Brunswick, 2015). Respect: RN's show respect when they avoid interventions that are contrary to the patient's beliefs, view, ideas and culture. Therefore it calls for careful exploration of the client's emotions in assessing burdens, psychological feelings. These assessment clue will aid in diagnosis, which can help the RN prioritize client's care needs(Hashim, M. 2017, vol 95, pg 31).
Empathy: RN must have the capacity to comprehend and relate to the client's emotions and experience. This can be expressed gestures of touch that is culturally appropriate, observing silence, and can offer a box of tissue in a teary situation. These acts conveys a great message to the client of having someone to lean upon and who would be willing to resolve every of their pains(Hashim, M. 2017, vol 95, pg 32). Professional Intimacy: This form of intimacy occurs when both the RN and the clients explored the genesis of the illness, during treatment options dialog, and at the time a compromise is reached based on the client's interests. This is also a period the RN's would help clients make more informed choices, risk factors and benefits of treatment options can be discussed and if necessary, health promoting education can be offered during this time(Hashim, M. 2017, vol 95, pg 32).
An incompetent skills in therapeutic communication may deter results. A RN who is more skilled at the cognitive competency than in the affective may end up losing the patient. The following are the major promoters/blocks to effective therapeutic communication. A good listener: An RN Listening indicates all attention is focused on the client. If all attention is not gained during communication implies a break in trust in the therapeutic relationship. It usually send a negative message to the client such as, 'I am busy'', 'Your problem is not a big deal or could be interpreted to mean ' a less valued client''. (Mikanowicz, C. & Gmeiner, A 2015). Therefore a RN must constantly give value and importance to any communication held with the client to solidify the trust established during the relationship.
Advice Giving: RN's takes the role of an advocator. It is unhealthy to give advice to clients because it withdraws their right to making decisions regarding their health status and make them less of human, it usually results into loneliness and powerlessness (Mikanowicz, C. & Gmeiner, A 2015). . This is one of the rights of the clients, and to establish a therapeutic communication, this must not be withdrawn.
Belittling Expressed Feelings: Every form of gesture displayed by the client must be considered important. If the RN ignores the emotions and feelings of the client, it sends a wrong signal that they are not important or being ignored because their problems are of no significance. (Mikanowicz, C. & Gmeiner, A 2015). this act further implies that the RN-client relationship would be lost. Probing/Prying: Often times, RN's needs to set a limit to moving into client's space. When this is done, client's decision, feelings and thoughts are to be respected. Any attempt to dig further to matters not relating to the main client's problem and which is not ready to share may lead to communication breakdown. According to (Mikanowicz, C. & Gmeiner, A 2015). 'Prying can be destructive to the therapeutic relationship as the client feels he cannot trust the nurse and the only real purpose prying has is to satisfy the need for control and power and most probably, gratification of their own needs.'' Therefore it is a major skill to be learnt in order to foster a therapeutic communication.
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