UNIT OF COMPETENCY: MAINTAIN HIGH STANDARD OF PATIENT

SERVICES

LEARNING OBJECTIVE 1. Communicate Appropriately With Patients

Being able to communicate effectively is perhaps the most important of all life skills.
It what enables us to pass information to other people, and to understand what is said to
us. Communication has various meanings, depending on the context in which it is used.
To some, communication is the interchange of information between two or more
people; in other words, the exchange of ideas or thoughts. This kind of communication
uses methods such as talking and listening or writing and reading. However, painting,
dancing, storytelling are also methods of communication. In addition, thoughts are
conveyed to others not only by spoken or written words but also by gestures or body
actions.

Components of the Communication Process

1) SENDER. A person or group who wishes to convey a message to another.
2) MESSAGE. The second component of the communication process is the
message itself – what is actually said or written, the body language that
accompanies the word, and how the word is transmitted.
3) RECEIVER. The third component of communication process is the listener, who
must listen, observe and attend.
4) RESPONSE. The fourth component, the response is the message that the receiver
returns to the sender. It’s also called feedback. Feedback can be either verbal,
non-verbal or both.
Modes of Communication

VERBAL Communication is a type of communication where we use spoken and written

words to get our message and information across the other person. In other words,
whenever we use our words to express ourselves, our feelings, and our thoughts,
we are verbally communicating. Yes, even when we are writing to someone, it is
considered verbal communication.

NONVERBAL Communication is sometimes called body language. It includes

gestures, body movements, use of touch, and physical appearance, including
adornment. Nonverbal communication often talks more about what a person is
feeling than what is actually said, because n0nverbal is controlled less consciously
verbal behavior.

THERAPEUTIC COMMUNICATION
Therapeutic Communication promotes understanding and can help
establish a constructive relationship between the health care worker and the client.
Unlike the social relationship, where there may not be a specific purpose or
direction, the therapeutic helping relationship is client and goal directed.

“Therapeutic communication is an interpersonal interaction between the nurse and the

client during which the nurse focuses on the client’s specific needs to promote an effective
exchange of information. Skilled use of therapeutic communication techniques helps the
nurse understand and empathize with the client’s experience.” – Nurseslabs.com

“Therapeutic communication is essential to the use of the self as an instrument of healing.

It is the use of verbal and non-verbal messages to establish a professional therapeutic
nurse-client relationship that will be the context for meeting the client’s physical and
psychological needs.” – Therapeutic Interaction in Nursing (book)

The healing process for most patients involves a collection of clinical tests
and treatment. But for many patients, therapeutic communication contributes just
as must as to their overall healing. Therapeutic communication, then, is to help
clinician’s build trust with patients while also helping clinicians and patients
collaborate efficiently and effectively toward the patient’s physical and emotional
wellness.
Therapeutic Communication Techniques
1) USING SILENCE – Accepting pauses or
silence that may extend for several seconds or
minutes without interjecting verbal response.
Example: Sitting quietly with the client and
waiting attentively until the client is able to put
thoughts and feelings into words.

2. PROVIDING GENERAL LEAD – Using

statement or questions that (a) encourage
the client to verbalize, (b) choose a topic of
conversation, and (c) facilitate continued
facilitation. Example: “Where would you like
to begin?”, “And then what?”

3. USING OPEN-ENDED QUESTION –

Asking broad questions that lead or invite
the client to explore (elaborate, clarify,
describe, compare, or illustrate) thoughts
or feelings. Open-ended questions
specify only the topic to be discussed and
invite answers that are longer than two
words. Example: “How have you been
feeling lately?” “What is your opinion?”
4. USING TOUCH – Providing appropriate
forms of touch reinforcing caring feeling.
Because tactile contacts vary considerately
among individuals, families, and cultures,
caregiver must be sensitive to the differences
in attitudes and practices of clients and self.

5. RESTATING OR PARAPHRASING –
Actively listening for the client’s basic
messages and then repeating those
thoughts and/or feeling in similar words.
This conveys that the caregiver has listened
and and understood the client’s basic
message and also offers client;s clearer idea
of what they have said. Example: The client
state “I couldn’t manage to eat any dinner
last night, not even the desert”. And the caregiver replied “You have difficulty eating
yesterday”.

6. SEEKING CLARIFICATION – A
method of making the client’s broad
overall meaning of the message more
understandable. It is used when
paraphrasing is difficult or when the
communication is rambling or garbled. To
clarify the message, the caregiver can
restate the basic message or confess
confusion and ask the client to repeat or
restate the message. Caregiver can also
clarify their own message with
statements. Example: “I’m puzzled”.,
“Would you please say that again?”,
“Would you tell me more? ”
 7. PERCEPTION CHECKING OR SEEKING
CONSENSUAL VALIDATION – A method similar to
clarifying that verifies the meaning of a specific
words rather than the overall meaning of a message.
Example: The client states “My husband never gives me
presents”, and the caregiver clarifies “You mean he has
never given you a present for your birthday or
Christmas?”

8. OFFERING SELF – Suggesting one’s

presence, interest, or wish to understand the
client without making any demands or
attaching conditions that the client must
comply with to receive the caregiver’s
attention. Example: The caregiver’s statement
of “I’ll stay with you until your daughter arrives”,
“We can sit here quietly for a while, we don’t
need to talk unless you would like it”.

9. GIVING INFORMATION – Providing in a simple and

direct manner, specific factual information the client
may or may not request. When the information is not
known the nurse states this and indicates who has it or
when the nurse will obtain it. Example: “ Your surgery
is scheduled for 11 am tomorrow”, “You will feel a
pulling sensation when the tube is removed from your
abdomen”.
10. ACKNOWLEDGING- Giving recognition, in a
nonjudgemental way, of a change in bahavior, an effort the
client has made, or a contribution to a communication.
Acknowledgement may be with or withour understanding,
verbal or non verbal. Example: “I notice you keep squinting
your eyes. Are you having difficulty seeing?”

11. PRESENTING REALITY – Helping the client differentiate the real from the unreal. Example:
“Your magazine is here in the drawer. It has not been stolen”, “I see shadows from the window
coverings”.

12. FOCUSING – Helping the cliednt expand on and

develop a topic of inportance. It is importantnfor the
nurse to wait until the client finishes stating the main
concerns before attempting to focus. The focus may
be an idea or a feeling; however, the caregiver
emphasizes a feeling to help the client recognize an
emotion disguised behind words. Example: Client
states “My wife says she will look after me, but I don’t
think she can, what with the children take care of, and
they’re always after her about something-clothes,
homework, what’s for the dinner tonight?” and the
caregiver may reply “Sounds like you are worried
about how well she can manage”.
12. SUMMARIZING AND PLANNING – Stating the main
points of a discussion to clarify the relevant points
discussed. This technique is useful at the end of an
interview or to review a health teaching session. It oftens
acts as an introduction to future care planning. Example:
Tomorrow afternoon, we may explore this further”, In a few
days I’ll review what you have learned about the actions and
effects of your insulin”.
Learning Objective 2. Establish and Maintain Good Interpersonal Relationship
With Patient
In the spirit of clarity, it’s a good idea to take a quick look at the definition of
interpersonal relationships. In short, an interpersonal relationship is a strong or close
association or acquaintance between two or more people that can last from a brief time
period to an ongoing one. This can extend from family to friends, to work associates, to
neighbors, or clubs and on and on. It can be a relationship in any context or situation.
We will briefly touch on developing interpersonal relationships. Best way to
approach it is to be a friend or a good partner as the situation warrants. For instance, if
you are on a new team at work, ensure you are a good person to work with. Do your part
and help others as needed. Be a contributor who is also willing to help out when needed.
As a friend, you simply follow the age-old piece of advice “to have a friend, you must first
be a friend”. If you are on a board or association, it should be something you are interested
in helping out with. That want-to-help attitude will put you with likeminded individuals who
you’ll probably hit it off with. The main thing to remember is great interpersonal
relationships can get formed any place or situation where you interact with other people.
Put a little effort into getting along with others and you’d be amazed at how that pays off.

How to Maintain Powerful Interpersonal Relationships

1. BE OPEN

Any strong relationship needs to have the willingness to be open. This

means the ability and desire to share what you’re thinking and your feelings about
different subjects. It really makes a lot of sense if you think about it. When you
are open and willing to share, it shows the other person that you care about the
relationship; that you are wanting to create a close connection by being truthful
and receptive to the other person’s thoughts and feelings. Think about some of
the conversations you’ve had over the years. When you are speaking to someone
who always seems to hold things close to the vest and shares very little
information, it’s difficult to know what they are truly thinking or feeling. This
creates a sense of distance from that person. On the other hand, when you
interact with someone who is open with how they feel and interactive with you, it
feels much closer. It feels like they care enough and are willing to share thoughts,
ideas, and their feelings with you. This creates a much stronger bond.

2. SHOW EMPATHY

Here’s a saying you may have heard before:

“People will forget what you said. People will forget what you did. People will never forget
how you made them feel.”
Pretty powerful stuff. One of the deepest human desires is to feel understood.
When you show empathy towards someone else, you are showing that you care enough
to understand how they feel. And that goes a really long way in maintaining strong
relationships. Remember to show empathy whenever the opportunity presents itself in
your relationships. This helps all of us feel more supported, understood, and most
importantly, connected.

3. BE RESPECTFUL

It goes without saying that in order to help build and maintain strong relationships,
you will need to be respectful — respectful of the other person’s time, opinion, feelings,
and so on. This is vitally important in one-on-one relationships such as a marriage or
close friendship. The same really holds true in close relationships that involve a group
type dynamic. If you are on a team at work, things will go so much better, and the
friendships will develop stronger if you are respectful to the others in the group. One of
the biggest reasons, besides being the right thing to do, is you want others to be respectful
to your time and opinions as well. It helps develop the sense of bonding and trust. Work
towards being respectful of others in general and certainly in tighter relationships.

4. BE AVAILABLE

Giving your time is like giving a gift. Time is the one thing we all have the same
amount of — same 24 hours in a day, same number of days in a week, etc. How you
choose to spend that time says a lot about you. And being available to someone shows
that you value them enough to spend your time with them. That is absolutely huge.
Being giving of your time shows the other person that you care enough about them and
the relationship to share your most valuable commodity. Being available to someone will
do wonders for maintaining strong personal relationships.

5. ESTABLISH BOUNDARIES

Boundaries are critical for healthy relationships. A boundary is a belief, or way of

life, or conviction that you have. It involves your beliefs, values, and limits. It’s important
to be clear to other people in your life, especially the strong interpersonal relationships,
about what your boundaries are. It helps to create self-esteem and respect in the
relationship. It’s basically showing others what you stand for and what you will and won’t
allow in your life.

6. BE A GOOD LISTENER

I’ve said it before, and I’ll say it again any chance I get. Something most people
tend to forget is that listening is half of all communication. And when we get really good
at listening, it becomes more than half of our communication. That’s because being a
good listener will do wonders for your strong relationships. Showing that you are actively
listening will help boost the other persons self-esteem because it shows that you truly
care about what they are saying, that makes them feel important. It shows that you seek
to understand and that it’s important to you to know how the other person is feeling about
something. It’s like the silent form of flattery to the person you are interacting with. It
makes them feel supported and probably most importantly, valued.

You can learn how to be a better listener in this guide: How to Practice Active Listening (A
Step-By-Step Guide)

7. OKAY TO DISAGREE

It is so beneficial to strong interpersonal relationships to know that it’s okay to

disagree. We are all different and have different feelings and opinions. Strong
relationships actually thrive on some disagreement and conflict. The alternative is not
speaking up when you disagree with something and stuffing it inside.

8. BE APPRECIATIVE

This one makes a lot of sense. Showing you are appreciative of another person in
a good relationship only makes the relationship stronger. We all like to feel appreciated
and understood. When someone thanks you for something you did or said, it makes you
feel good. You feel good because it’s nice to know that your efforts not only make
someone feel better or supported but also that they noticed it. And this will certainly help
to maintain your strong interpersonal relationships.