Chapter 2 – Therapeutic Communication and Interviewing
Self Reflection Prior to the Interview
Like everyone, nurses are susceptible to stress, sadness, anger, and an array of other emotions. Despite good intentions, your communication will be strongly influenced by your mood, thoughts, and emotions. Self-reflection is an important tool for recognizing your emotional state and minimizing unintentional miscommunication with clients, i.e., non-therapeutic communication. See Figure 2.3.
Figure 2.3: Self-reflection
See Table 2.1 for strategies on how you can self-reflect before commencing the client interview.
Table 2.1: Self-reflecting on emotions and thoughts.
|
Reflective Practice |
Consideration |
|
How are you feeling? |
Nurses are not exempt from life circumstances that can cause uncomfortable emotions like sadness, anger, frustration, as well as other emotions such as happiness and gratefulness. While it may be impossible to put aside your emotions, having a sense of your emotions and their cause is a very powerful tool to avoid inadvertent miscommunication. |
|
What is occupying your thoughts? |
It can be helpful to step outside of the narrative in your mind. It is not abnormal for a thought to pervade your thinking, but suspending such thoughts and being in the moment with the client can assist with better communication. Consider if something is weighing on you. Are you ruminating about an event, a person, an idea? |
|
In what ways are you physically expressing your emotions and thoughts? |
Your emotions and thoughts are sometimes physically expressed through facial expressions, hand gestures, and body language. Can someone tell that you are happy or sad by looking at you? Being aware of the physical expression of your emotions and thoughts can assist you in your communication with others and enable you to convey emotions like empathy, compassion, and concern. |
|
How is your health and wellbeing? |
Often physiological and psychological/emotional events like hunger, fatigue, body aches, and sadness can shape your mood. Reflect on how you are feeling in relation to your body and mind and pay attention to your body’s cues. |
|
What is the environment surrounding you? |
Even when you think you are accustomed to the work environment, subtle triggers can affect your ability to effectively communicate. A beeping machine, foul smell, or bright lights may affect your ability to focus, show concern, and actively listen. Reflect on yourself in relation to the environment and consider what factors you can and cannot control. |
As you self-reflect, consider that the healthcare environment often intensifies emotions for clients and their families. It can be a place where people experience pain, discomfort, and stress. Clients may hear bad news and confront truths about themselves, or experience intense joy and relief. Because such extremes can exist in the healthcare space, the client is often more attune to you (the provider) than you may be aware. The client may be telegraphing your body language or intuiting your choice of words. For this reason, providers need to be self-aware and temporarily suspend their own needs in order to authentically connect with the client.
Points of Consideration
Mindfulness
Mindfulness can be a useful strategy for connecting with clients and authentically being fully in the moment as they respond. It’s easy to get caught up in the fast-pace clinical environment and be distracted by preceding events. Clients pick up on distraction and this can undermine trust.
Mindful meditation has been proven to reduce stress among healthcare professionals, including nurses. Once learned, it can be used at any time, and can improve your therapeutic communication with the client.
