Unit 1: Communication
Phases of the Helping Relationship
1. Pre-interaction phase: before meeting the patient
a. Collect information about the patient
2. Orientation phase: when nurse and patient work together and get to know each other
a. Outline the goals of the relationship
3. Working phase: when nurse and patient work together to solve problem and accomplish goals
a. Encourage patient to express feelings about their health, provide information needed to understand and
change behavior, take actions to meet goals
4. Termination phase: occurs at the end of the relationship
a. Remind the patient that the termination is near; evaluate the goals that have been established
Levels of Communication
 Intrapersonal: using self to talk in preparation to deal with something; “I can do this”
 Interpersonal: which 2 or more nurses communicate with each other in order
 Transpersonal: occurs with a person’s spiritual domain; “higher power”
 Small Group: when a nurse interacts with 2 or more people; staff meetings, patient care conferences, teaching
 Public: interacting with an audience
Therapeutic Communication
 Active listening: sit, observe, lean, establish, relax
 Empathy: feeling with the person, rather than feeling like the person; reflect understanding, nonjudgmental
 Therapeutic communication techniques: sharing humor, hope, using touch, clarifying, silence, focusing
 Non-therapeutic communication techniques: failure to listen, changing the subject