using silence
-gives the person time to collect thoughts or think through a point
ex. Encouraging a person to talk by waiting for answers.
accepting
-indicates a person has been understood.
-doesn't necessarily mean you agree, but it nonjudgemental.
ex. Yes, uh-huh, I follow what you're saying.
giving recognition
-Indicates awareness of change and personal efforts.
-Doesn't imply good or bad, right or wrong.
ex. I see that you've eaten your breakfast.
offering self
-offers presence, interest, and a desire to understand.
-NOT offered to get a person to talk or behave in a certain way.
ex. "I'd like to spent time with you.
offering general leads
-Allows other person (patient) to take direction in the discussion.
ex. "Go on.... , And then?, Tell me about it
giving broad openings
-clarifies that the lead is to be taken by the patient.
-Nurse discourages pleasantries and small talk.
ex. "Where would you like to begin?"
"What would you like to discuss?
Placing the events in time or sequence
-puts events and actions in better perspective
-notes cause and effect relationships and identifies patterns of interpersonal difficulties
ex. When did this happen? Did this happen before or after?
Making observations
-calls attention to the person's behavior.
-encourages the patient to notice the behavior
ex. You appear tense
I notice you're biting your lip.
You appear nervous when John enters the room
Encouraging the description of perception
-increases the nurse's understanding of the patient's perceptions.
-talking about feelings and difficulties can lessen the need to act them out inappropriately
ex.
What do these voices seem to be saying?
What is happening now?
Tell me when you feel anxiou
Encouraging comparison
-brings out recurring themes in experiences or interpersonal relationships.
-helps patient clarify similarities and differences
ex. Has this ever happened before?
Is this how you felt when...?
Was it something like...?
Restating
-Repeats the main idea expressed
-gives the patient an idea of what message has been communication and gives them an opportunity to correct it.
ex.
- I can't sleep, I stay awake all night.
-You have trouble sleeping?
-I don't know, he always has some excu
Reflecting
-directs questions, feelings, and ideas back to the patient. Encourages patient to accept his or her own ideas and feelings.
-encourages the patient to think of self as a capable person.
ex. what should i do about my husbands affair?
-what do you think yo
Focusing
-Concentrates attention on a single point
-useful when patient jumps from topic to topic.
ex. This point you make about leaving school, it seems worth looking at more closely.
You've mentioned many things... Let's go back to your thinking of "ending it al
Exploring
-examines certain ideas, experiences, or relationships more fully.
-Nurse doesn't probe or pry.
ex. Tell me more about that...
Would you describe that more fully for me?
Could you talk about how it was that you learned your mom was dying of cancer?
Giving information
-makes facts available to client and supplies knowledge from which decisions can be made or conclusions drawn.
ex. My purpose for being here is...
This medication is for...
This test will determine....
Seeking clarification
-helps patients clarify their own thoughts and maximize mutual understanding between nurse and patient
ex. I am not sure I follow you.
What would you say the main point of what you just said is.
can you give an example of a time you thought everyone hated
presenting reality
-indicates what is real
-nurse doesn't argue or try to convince the patient, just describes personal perceptions or facts in the situation.
ex. That was Dr. Todd, not a man from the mafia.
That was the sound of a car backfiring.
Voicing doubt
-undermines the patients beliefs by not reinforcing the exaggerated or false perceptions.
ex. Isn't that unusual?
That's hard to believe...
That would be really rare...
Seeking consensual validation
-clarifies that both the nurse and the patient share mutual understanding of communications.
-helps patient become clearer about what he or she is thinking about
ex. "Tell me whether my understanding agrees with yours...
Verbalizing the implied
-puts into concrete terms what the patient implies, making the patient's communication more explicit.
ex. I can't talk to you or anyone else, it's a waste of time...
Do you feel that no one understands?
encouraging evaluation
-puts into concrete terms what the patient implies, making their communication more explicit.
-"how do you feel about that?"
"what did it mean to you when he said he couldn't stay?
attempting to translate into feelings
patient: "I am dead inside"
nurse: "are you saying you feel lifeless?
suggesting collaboration
-"perhaps you and i can get to the bottom of what causes your anxiety..."
"perhaps by working together we can find ways for you to communicate better with your spouse
summarizing
during the past hour... you and i have talked about... A, B & C...
encouraging formulation of a plan of action
what could you do to let anger out harmlessly?"
"what are some other ways you could approach your boss over having to work overtime?