Therapeutic communication is type of communication that use for patients to

establish good rapport with them. Interacting skills and listening skills are used
there. There are some strategies that can be used for effective communication with
patients. They are ; using silence , being specific and tentative , using open ended
questions , using touch , restating , seeking clarification , perception checking ,
acknowledging , giving information , clarifying time or sequence , presenting
reality , focusing , reflecting , summarizing and planning .

In this assignment it considered five of therapeutic skills .They are ; clarification ,

conflict resolution , active listening , giving information and using touch of the
patient .

The writer describes touching skill here with little scenario in detail. “ my right
arm is very painful and can not bear for more ” said Mrs Perera. “Did you have
your pain relief medication on time ”replied the nurse. “ Yes, the nurse in previous
shift offered some tablets but none of them answered my pain ”. “ Ok, please wait
until I check your BHT”. After checking the BHT the nurse went at Mrs Perera and
touched her right arm gently. “ Do not worry . I will give you the medication to
reduce pain ”. After taking the medication the patient seemed to be more
comfortable and she thanked the shift nurse like this. “ My pain reduced within
half and hour . Now I can hold on my right hand easily”. The above scenario
shows how touching enhanced patient comfort and reduced complaints from the
patient when same medication given by two nurses . In that manner every shift
nurses can utilize the therapeutic communication skill called touching for better
service. It helps to build trust among patient and nurse.

Moreover, Silence as therapeutic communication skill is popular among nurses . it

demonstrate attentiveness by minimizing interrupting the patient. The writer uses
following scenario to show how it used by a shift nurse in a particular situation. Mr
Amal , 25 years old patient was admitted to hospital for his abnormal behavior . He
expressed that others are not believing whatever he says and worried about that
always. He was very weak and lethargic in appearance. Not taken proper meal for
many days. None of family members could afford to feed him. Family members
also supposed to be anxious and had quarrel with him as he was more agitated in
behavior. “ These people want me to suicide. No one hear me” said Mr Amal. “
No, we do every thing for you. But you blame us always” replied the father of Mr
Amal. In this situation the shift nurse had to discuss with the father of the patient
and let him in corridor of ward as she planned to give her fully attention on the
patient. In this situation the primary goal of the nurse was to normalize the patient.
She used the strategy of being silence and active listening for that. The nurse
reached at the patient and said “ Mr Amal you looks very smart guy, I would like
to know about your problem. I’m here to listen to you. Please tell me now”. Then
the patient was silent for a moment and wanted to make sure the nurse give
attention on her . “ Do you stay here for me?” said the patient. “ Sure, that is why
I’m here. Please tell me ” replied the nurse. After few moments , the patient told
the nurse everything about her. The nurse did not disturb the patient and kept
silence through out whole time. Active listening and being silent through out this
time helped the nurse to recognize the actual problem of the patient. He had break
through of love affair and it made him anxious. The problem was severe as no one
to listen him and everyone wanted to give their own opinions. The nurse referred
the patient to a good counselor.

Further, the writer uses summarizing and planning as a communication skill . Here
the nurse collect information together for documentation. It clue the patient a sense
of understanding. More, it is concise review of key point during interaction. It
brings a sense of closure too. The scenario related to that is as follows.

Ms Somalatha , 55 years old , with obesity met a doctor for long time skin lump
which move here and there. Fine Needle Aspiration done and she was diagnosed to
have breast cancer. Also, she had past medical history of hypertension. She
expressed her feelings to the shift nurse . She had many socio economic problems .
They were; children stay home alone and no one to look after them, her husband
was a heavy drunker, she had no money for her essential medications , her children
were not schooling because of economic problems. More, she could not earn her
living as she can not engage on farming because of her ailments. Altogether her
matters were complicated and the shift nurse used the strategy of summarizing and
planning for her comfort. The nurse concluded her matters and expressed her back
all her matters in concise way. It helped to create trust among both parties. She was
almost happy and nurse could refer her to the close by clinic for further treatments.
So, above scenario provide the good use of the summarizing and planning for
complicated matters in effective way.
Next , the writer uses perception checking as a therapeutic skill. In brief it link you
to check your understanding of someone’s words or behavior. It helps the nurse in
many ways. To decode messages more accurately which build mutual
understanding , to go down defensiveness which helps to assume much. It consist
of three parts. First , it provide a description of the behavior. Then it provide two
possible interpretations. Finally request for clarifications. Following scenario
reveals how the writer used perception checking as a therapeutic skill , effectively.

56 years old male, Mr Siripala was a kidney patient with multiple symptoms. He
was admitted due to decreased urine out put, odema , loss of appetite..etc. This is
his second admission as he was discharged one month ago. The patient was
agitated and began to yell at hospital staff saying “ I want to hang to night ”. The
nurse realized the suicidal risk of the patient. The nurse replied “ I’ m not sure you
are going to suicide because of your ailment or because you have no way to earn
living for being the bread winner of the family. The nurse requested Mr Siripala to
tell the accurate reason for him being so upset . Through out this technic the health
personnel could realized that all of his anxiety was related to his prevailing socio
economic problems.