Make yourself available to the pt.

" I'll stay with you if you would like to talk" 

Ask neutral questions, using when, where, how, and what, that encourage the pt. to discuss concerns.

" What makes the pain worse"

Asking for general information

Allow the pt. to take the initiative to introducing the topic using a specific open-ended question.

"What would you like to discuss?"

Pt. states what he wants to talk about.

General leads let the pt. know you are listening , engaged in the conversation and prompt the pt. to continue.

"Go on,.. I see"

Put into words what the pt. has only implied of indirectly stated.

"Pt. It's a waste of time to talk to my doctor.  Nur. Are you feeling that no one understands ?"

Clarify the relationship of events in time to view them in perspective.

" When did your symptoms become worse in relationship to beginning your exercise program?"

Ask the pt. to compare similarities and differences in ideas, experiences, of interpersonal relationships.

" Tell me how your blood sugar levels compared to when you were on the diet and when you were not?"

Use general statements based of observations and assessments of pt. to initiate discussion.

" I noticed that you seemed sad after speaking with the doctor."

Pt, states what they want to talk about. Focus the pt. with these.

Repeat to the pt. the various content of his of  her conversation typically using the same words. Restatement communicates that the nurse is listening but it also communicates that the nurse is playing an active role. Pick out the primary thought or feeling to restate. Overuse of this technique produces a "mimic effect".

" Pt. I'm worried about my potential disability." " Nur. you're worried about you ability to function?"

Reflection

Identify the various emotional themes in a conversation and direct these back to the pt.

( see the sheet)

Guide the pt. to narrow in on key concerns. Can be termed "exploring" when delving further into a subject, idea, experience, of relationship without probing.

" You've told me about your support system; tell me more about who will assist you when you first get home from the hospital."

Getting narrower on the problem, needs previous discussion.

Assist the pt. to put into words unclear thoughts of feelings. Seeking clarification decreases the potential for the nurse to guess and/or assume incorrectly. The nur. can clarify the pt 's words of can clarify assumptions about the pt's non-verbal behaviors. 

 "Help me understand your expectations of the tx."

Successful clarification makes a good psych. nur., helps pt  clarify too.

Giving Information

Share with the pt. relevant information about his or her health-care and well being. Provide pt. ed.

" I'm going to review the side effects of this new medication"

Teaching

Looking at Alternatives

Help the pt. see options and participate in the decision-making process.

"How do you think you can best stay on your diabetic diet."

Can be open ended questions

Highlight the importance of a conversation by condensing what was said. Can be used to evaluate learning. Summarizing represents a set of feelings that might have been communicated over a period of minutes. It is a paraphrase that pulls together several feelings.

"We have reviewed the side effects of this medication; how to take it , and how to store it"

...Review...