Reflecting

Directing client actions, Client: Do you think I Reflection encourages

thoughts, and feelings should tell the the client to recognize
back to the client doctor….? and accept his or her
own feelings. The nurse
Nurse: Do you think you indicates that the client’s
should? point of view has value
and that the client has
the right to have
opinions, make
decisions, and think
independently.
Restating
Repeating the Client: I can’t sleep. I The nurse repeats what the
main idea expressed stay awake all night. client has said in
approximately or nearly the
Nurse: You have same words the client has
difficulty sleeping. used. This restatement lets
the client know that he or
she communicated the idea
effectively. This encourages
the client to continue. Or if
the client has been
misunderstood, he or she
can clarify his or her
thoughts
Seeking Information
Seeking to make clear I’m not sure that I The nurse should seek
that which is not follow. clarification throughout
meaningful or that which interactions with clients.
is vague Have I heard you Doing so can help the nurse
correctly? to avoid making
assumptions that
understanding has occurred
when it has not. It helps the
client to articulate thoughts,
feelings, and ideas more
clearly.
Silence
Absence of verbal Nurse says nothing Silence often encourages
communication, which but continues to the client to verbalize,
provides time for the maintain eye contact provided that it is interested
client to put thoughts or and conveys interest and expectant. Silence
feelings into words, to gives the client time to
regain composure, or to organize thoughts, direct the
continue talking topic of interaction, or focus
on issues that are most
important. Much nonverbal
behavior takes place during
silence, and the nurse
needs to be aware of the
client and his or her own
nonverbal behavior
Suggesting Collaboration
Offering to share, to strive,
and to work with the client
for his or her benefit
Perhaps you and I The nurse seeks to offer a
can discuss and relationship in which the
discover the client can identify
triggers for your problems in living with
anxiety others, grow emotionally,
and improve the ability to
form satisfactory
relationships. The nurse
offers to do things with,
rather than for, the client
Summarizing
Organizing and You’ve said that…… Summarization seeks to
summing up that bring out the important points
which has gone of the discussion and to
before increase the awareness and
understanding of both
participants. It omits the
irrelevant and organizes the
pertinent aspects of the
interaction. It allows both
client and nurse to depart
with the same ideas and
provides a sense of closure
at the completion of each
discussion.
Translating into feelings
Seeking to verbalize Client: “I’m dead.” Often what the client says,
client’s feelings that he or Nurse: “Are you when taken literally, seems
she expresses only suggesting that meaningless or far removed
indirectly you feel lifeless?” from reality. To understand,
the nurse must concentrate
on what the client might be
feeling to express himself or
herself this way.
Verbalizing the implied
Voicing what the client has
hinted at or suggested
Client: “I can’t talk to Putting into words what the client
you or anyone. It’s a has implied or said indirectly
waste of time.” tends to make the discussion less
obscure. The
Nurse: “Do you feel nurse should be as direct as
that no one possible without being unfeelingly
understands?” blunt or obtuse. The client may
have difficulty
communicating directly. The
nurse should take care to
express only what is fairly
obvious; otherwise, the nurse
may be jumping to conclusions or
interpreting
the client’s communication.
Voicing Doubt
Expressing “Isn’t that unusual?” Another means of responding to
uncertainty about the distortions of reality is
reality of the client’s “Really?” to express doubt. Such
perceptions expression permits the client to
“That’s hard to become aware that others do not
believe.” necessarily perceive events in
the same way or draw the same
conclusions. This does not mean
the client will alter his or her point
of view, but at least the nurse will
encourage the client to
reconsider or reevaluate what
has happened. The nurse neither
agreed nor disagreed; however,
he or she has not let the
misperceptions and distortions
pass without comment.