communication in nursing powerpoint presentation

Understanding Communication in Nursing (With Examples, Importance, & How to Improve)

Communication is one of the most powerful tools nurses use when providing patient care. Because communication can impact every aspect of work and nurse-patient relationships, nurses must learn how to improve communication in nursing and implement measures for effective communication. In this article, you will learn the importance of therapeutic communication and find 18 useful tips to improve communication in nursing.

Who Do Nurses Communicate With?

7 reasons why communication is so important in nursing, 1. effective communication in nursing is essential in assessing a patient’s response to treatment., 2. communication with patients and their loved ones helps relieve stress and improves patient outcomes., 3. effective communication among the healthcare team can help reduce the risk of errors in patient care., 4. effective communication in nursing care is necessary to advocate for patients., 5. communicating with patients and their families will help identify special needs., 6. communication with your patients will help you identify and understand the social determinants impacting their health., 7. effective communication in nursing is vital for understanding the status of your patient's emotional and physical well-being., what are the 8 essential components of good communication in nursing, 1. eye contact:, 2. an attentive listener:, 3. a clear message:, 4. patience:, 5. being receptive:, 6. body language:, 7. understanding:, 8. feedback:, examples of bad communication vs. good communication in nursing, 1. scenario:, bad communication:, good communication:, 2. scenario:, 3. scenario:, 4. scenario:, how to improve communication in nursing, 1. use the right tone when speaking to others., 2. be aware of others’ body language., 3. be mindful of your own body language., 4. show interest in what others say., 5. be patient., 6. demonstrate a positive attitude., 7. create an atmosphere conducive to effective communication., 8. practice active listening., 9. exercise emotional intelligence., 10. ask open-ended questions., 11. be attentive to your patient’s efforts at communicating with you., 12. practice cultural awareness., 13. ask for input from colleagues., 14. be mindful of your patient’s situation., 15. exercise diverse types of communication., 16. incorporate role-play when appropriate., 17. involve your patient’s friends and/or family., 18. show compassion., 7 consequences of bad communication in nursing, 1. miscommunication of vital patient information:, 2. poor communication skills in nursing can cause increased workload pressure., 3. patients may not understand important information such as when to take a medication or possible side effects to report., 4. when there is bad communication in nursing, there is an increased risk to the patient's safety., 5. when nurses communicate poorly with one another, there is an increased risk of malpractice suits., 6. poor patient satisfaction scores:, 7. increased chance of medication errors., useful resources to improve communication in nursing, • the importance of listening in healthcare, • empowering communication, • therapeutic communication, calming people down and dealing with patient complaints, • how can i improve my communication skills with my patients, • communication mishaps between patients and nurses, youtube videos, • nursing fundamentals: therapeutic communication & coping, • nurse to nurse communication skills, • therapeutic communication for nurses: avoid these 5 traps, • nursing standard: inclusive communication and how to avoid making assumptions, • stitcher: healthcare communication- effective techniques for clinicians, • audible: healthcare communication solutions, • therapeutic communication: knowing what to say when, • communication for nurses: how to prevent harmful events and promote patient safety, • 4 essential keys to effective communication, my final thoughts, frequently asked questions answered by our expert, 1. as a nurse, how do i know if i am a good communicator, 2. will lack of communication impact my nursing career, 3. usually, how long does it take for a nurse to improve the skill of therapeutic communication, 4. do all types of nurses require very good communication skills, 5. as a nurse, do i need to be good at all types of communication.

Presentation skills for nurses

Affiliation.

• 1 Berkshire Cancer Centre, Royal Berkshire NHS Foundation Trust, Reading, England.
• PMID: 25690236
• DOI: 10.7748/ns.29.25.52.e9488

This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters.

Keywords: Communication; communication skills; handover; nurses; nursing; personal development; presentation; presentation skills; professional development; share knowledge.

• Communication*
• Education, Nursing, Continuing*
• Professional Competence / standards*
• United Kingdom

Pump up your PowerPoint® presentations

As nurses , we use our education skills to deliver health messages every day. We teach patients about specific diseases or interventions in clinical settings. We advise colleagues on how to use new technology. And we serve as preceptors to nursing students or novice nurses.

But while one-on-one teaching may come naturally to us, giving a gripping visual presentation may be a challenge. We’ve all seen PowerPoint® presentations. Some are so engaging that time flies from the instant they begin to the moment we exit. But in others, the presenter fails to engage the audience, leaving session objectives unmet—and leaving audience members counting the minutes until the presentation ends.

Using engagement strategies combats boring presentations and keeps the audience attentive. These strategies turn passive audience members into active participants of the interactive discussion. We’re moving away from traditional lecture formats where a “talking head” delivers information to deposit into others’ brains. Promoting interactivity, encouraging questions, and using visual aids in an interesting way are more effective strategies for delivering content and helping the audience understand it. Similarly, using multiple teaching strategies lends itself to individuals with different learning styles.

PowerPoint software can transform simple words on a single slide into a captivating, dynamic presentation. This article discusses specific PowerPoint features to consider using for your next presentation.

Keep slide design simple

After you complete the outline for your presentation, you’ll need to choose a slide background or design. A simple design is ideal. Busy backgrounds can interfere with the text and images you add to the slide. Use dark-colored text with a light background, or vice versa. Also, use transitions to add a progressive effect when moving from one slide to the next.

Avoid too many animations on any one slide, as this can distract the audience. If you want to use animations, use the same type for all slides. For example, don’t have text “fly” in from the bottom of one slide, then from the top on the next slide, then from the left, and so on. Choose one type of animation and stick to it.

Write succinct titles

Titles help readers visualize a road map for the “journey” of your presentation. Keep titles short and concise, using no more than a few words. If you’re using graphics, charts, or graphs, your titles should highlight the main focus.

Use transition slides

Usually, transitions to new content are presented orally. But you can also use “title” slides, containing only the title of the next section. Besides signaling the audience that you’re moving on to a new topic, these slides remind you to bring closure to the previous topic.

Choose a readable font

Choose a clean font for readability. Font size should be large enough so people at the back of the room can read all the copy on the slide. Font color should be black or another dark color to contrast the light background—or if you’ve opted for a dark background, use a white font. Avoid yellow, red, and orange fonts because they can be hard to read.

Stick to the 6-by-6 rule

Think back to the last presentation you sat through. Was there too much text on the slides? Did the presenter read the text verbatim rather than let the presentation serve as an outline? To avoid this mistake in your presentations, follow the 6-by-6 rule: On any given slide, use no more than six bullet points and no more than six words per bulleted statement.

State the objectives

To better engage your audience, share your learning goals with them. Specify exactly what they should learn by the end of your presentation. Objectives are statements that set goals. To write objectives, start with an action verb and end with a content statement; for example: “Describe needle lengths for different types of injections.” The objective starts with the action verb “Describe” and ends with the content statement “needle lengths for different types of injections.” For each objective, tell the audience how you will meet it. When you come to the end of your presentation, you can use these objectives to evaluate how much the audience learned.

Use graphics effectively

When teaching patients, nurses typically use handouts, pictures, or demonstrations based on the patient’s learning style (visual, auditory, or kinesthetic) and learning needs based on age, reading level, and language. Using graphics captures most learning styles and needs.

Put a graphic on most slides to illustrate the point you’re trying to make. Limit graphics to one per slide to help your audience focus on what you have to say as you refer to that image. If you want to call attention to a specific part of the image, you can add an arrow, shape, or textbox. (See Replacing text with images by clicking the PDF icon above.) Be aware that PowerPoint has a feature called SmartArt, which converts text into linear, progressive, or circular visual aids.

Keep in mind that charts and graphs are a great way to present statistics. For example, you can show percentages with a pie chart or depict trends over time with a line graph.

Vary your teaching strategy

During your interactive presentation, vary your teaching strategy every 10 minutes. To do this, you can use links to websites, videos, or games. For example, share a short YouTube video to add a visual and auditory component.

Another way to vary your strategy is to post a discussion question on a slide and take responses from the audience, or give them a group activity to work on, with activity instructions shown on the slide. Polls are another way to engage the audience. Although normally placed at the beginning of the presentation, polls can be useful anywhere. You can post a question on a slide and ask the audience to raise their hands in response to each answer option. Or you can add true/false, multiple-choice, or fill-in-the-blank questions throughout your presentation to evaluate learning. That way, you can get immediate feedback on the audience’s understanding of the content you’ve presented.

Use online tools if appropriate

If you wish to include an online interactive tool in your presentation, make sure your computer or tablet is connected to the Internet to access those resources. Also, share additional credible and reliable resources on your reference page so audience members can access them afterward.

Include interactive dialogue variations

Many of us can recall narratives or anecdotes from a presentation we’ve seen. I vividly remember certain stories told by faculty members in my academic career; their application of content helped me connect the knowledge to real life.

Similarly, you can place a word, phrase, or picture on your slide to remind you of an anecdote or narrative you want to share. Instead of putting the entire anecdote or narrative on the slide word for word, use the slide only to prompt you to relate it to the audience orally.

Create “empty” handouts

When I last attended a nursing conference, the presenter gave the audience handouts. Then she turned her back to us and simply read from her slides. With each slide, I grew less engaged. Eventually, I left to attend another presentation. Why not? All of the content was on the handout, word for word.

To avoid this situation, create a second, slightly different version of your presentation that contains information not included on the slides you’ll present—what’s commonly called an “empty” outline or handout. Save this second version on your computer under a new filename to avoid confusing it with the full presentation; then make printouts of the “empty” version to hand out to the audience. Doing this keeps the audience engaged as they fill in answers to test questions, grids, and discussion questions. For example, you may want to ask the audience the advantages and disadvantages of using the deltoid muscle for intramuscular injections. Leaving the corresponding slide empty encourages them to think on their feet. Later, you can share the correct answers on the slide or verbalize the correct answers during your presentation. (See The“empty” slide or handout by clicking on the PDF icon above.)

Although your audience will need to take notes to complete their handouts, you don’t want them to have to write too much. Balance the need to give them enough content to stay engaged with the need to not reveal your entire presentation.

Other presentation tips

Ultimately, PowerPoint can only go so far in helping you engage your audience. As the presenter, you must be able to “read” your audience—and this comes with experience. For instance, if you “read” that some people are getting bored, consider giving the audience breaks, changing activities, or asking discussion questions to keep them attentive.

Here are some other helpful tips for both novice and expert presenters:

• Present one idea per slide.
• Keep your talk to no more than 1 to 2 minutes per slide.
• Use a pointer or the pen highlighter feature to highlight important content.
• Use narratives and anecdotes for a more appealing presentation. For example, when sharing a story about your experience administering injections, use the “W” or “B” key on the keyboard to either white out (“W” key) or black out (“B” key) the screen, respectively, when visuals aren’t needed. The audience will look up from their handouts and focus on you, the presenter.

Above all, remember that the slides are meant to serve as an outline. As the nursing expert and content expert, you are the primary focus of the presentation. You become the primary focus by demonstrating knowledge and letting your slides serve as an outline—all the more reason to design the most engaging presentation you can.

Click here for a complete list of references.

Tresa Kaur Dusaj is an assistant professor of Nursing and Health Studies and coordinator of the MSN Nursing Education Track at Monmouth University in West Long Branch, New Jersey.

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Chapter 2 Therapeutic Communication and the Nurse-Client Relationship

2.1. introduction, learning objectives.

• Review basic concepts of client-centered communication
• Outline effective therapeutic communication techniques
• Describe barriers to effective therapeutic communication
• Explore guidelines for effective communication during teletherapy

Nurses engage in compassionate, supportive, professional relationships with their clients as part of the “art of nursing.” [ 1 ] This chapter will review the nurse-client relationship, therapeutic communication, and motivational interviewing. It will also introduce teletherapy and telehealth.

2.2. BASIC CONCEPTS OF COMMUNICATION

Communication standard of professional performance.

The Standard of Professional Performance for  Communication  established by the American Nurses Association (ANA) is defined as, “The registered nurse communicates effectively in all areas of professional practice.” [1] See the following box for the competencies associated with the  Communication  standard.

ANA’s Communication Competencies

The registered nurse:

• Assesses one’s own communication skills and effectiveness.
• Demonstrates cultural humility, professionalism, and respect when communicating.
• Assesses communication ability, health literacy, resources, and preferences of health care consumers to inform the interprofessional team and others.
• Uses language translation resources to ensure effective communication.
• Incorporates appropriate alternative strategies to communicate effectively with health care consumers who have visual, speech, language, or communication difficulties.
• Uses communication styles and methods that demonstrate caring, respect, active listening, authenticity, and trust.
• Conveys accurate information to health care consumers, families, community stakeholders, and members of the interprofessional team.
• Advocates for the health care consumer and their preferences and choices when care processes and decisions do not appear to be in the best interest of the health care consumer.
• Maintains communication with interprofessional team members and others to facilitate safe transitions and continuity in care delivery.
• Confirms with the recipient if the communication was heard and if the recipient understands the message.
• Contributes the nursing perspective in interactions and discussions with the interprofessional team and other stakeholders.
• Promotes safety in the care or practice environment by disclosing and reporting concerns related to potential or actual hazards or deviations from the standard of care.
• Demonstrates continuous improvement of communication skills.

Review basic communication concepts for nurses in the “ Communication ” chapter in Open RN  Nursing Fundamentals .

Nurse-client relationship.

Establishment of the therapeutic nurse-client relationship is vital in nursing care. Nurses engage in compassionate, supportive, professional relationships with their clients as part of the “art of nursing.” [2] This is especially true in psychiatric care, where the therapeutic relationship is considered to be the foundation of client care and healing. [3] The  nurse-client relationship  establishes trust and rapport with a specific purpose; it facilitates therapeutic communication and engages the client in decision-making regarding their plan of care.

Therapeutic nurse-client relationships vary in depth, length, and focus. Brief therapeutic encounters might last only a few minutes and focus on the client’s immediate needs, current feelings, or behaviors. For example, in the emergency department setting, a nurse may therapeutically communicate with a client in crisis who recently experienced a situational trauma. During longer periods of time, such as inpatient care, nurses work with clients in setting short-term goals and outcomes that are documented in the nursing care plan and evaluated regularly. In long-term care settings, such as residential facilities, the therapeutic nurse-client relationship may last several months and include frequent interactions focusing on behavior modification.

Read more about crisis and crisis intervention in the “ Stress, Coping, and Crisis Intervention ” chapter.

Phases of development of a therapeutic relationship.

The nurse-client relationship goes through three phases. A well-known nurse theorist named Hildegard Peplau described these three phases as orientation, working, and termination. [4]

Orientation Phase

During the brief orientation phase, clients may realize they need assistance as they adjust to their current status. Simultaneously, nurses introduce themselves and begin to obtain essential information about clients as individuals with unique needs, values, beliefs, and priorities. During this brief phase, trust is established, and rapport begins to develop between the client and the nurse. Nurses ensure privacy when talking with the client and providing care and respect the client’s values, beliefs, and personal boundaries.

A common framework used for introductions during patient care is AIDET, a mnemonic for Acknowledge, Introduce, Duration, Explanation, and Thank You.

• Acknowledge:  Greet the patient by the name documented in their medical record. Make eye contact, smile, and acknowledge any family or friends in the room. Ask the patient their preferred way of being addressed (for example, “Mr. Doe,” “Jonathon,” or “Johnny”) and their preferred pronouns (e.g., he/him, she/her, or they/them).
• Introduce:  Introduce yourself by your name and role. For example, “I’m John Doe, and I am a nursing student working with your nurse to take care of you today.”
• Duration:  Estimate a timeline for how long it will take to complete the task you are doing. For example, “I am here to perform an admission assessment. This should take about 15 minutes.”
• Explanation:  Explain step by step what to expect next and answer questions. For example, “I will be putting this blood pressure cuff on your arm and inflating it. It will feel as if it is squeezing your arm for a few moments.”
• Thank You:  At the end of the encounter, thank the patient and ask if anything is needed before you leave. In an acute or long-term care setting, ensure the call light is within reach and the patient knows how to use it. If family members are present, thank them for being there to support the patient as appropriate. For example, “Thank you for taking time to talk with me today. Is there anything I can get for you before I leave the room? Here is the call light (Place within reach). Press the red button if you would like to call the nurse.”

Working Phase

The majority of a nurse’s time with a client is in the working phase. During this phase, nurses use active listening and begin by asking the reason the client is seeking care to determine what is important to them. They use assessment findings to develop a nursing plan of care and plan patient education. If a care plan has already been established on admission, nurses use this time to implement interventions targeted to meet short-term outcomes and long-term goals. During the working phase, clients begin to accept nurses as health educators, counselors, and care providers. Nurses use therapeutic communication techniques to facilitate clients’ awareness of their thoughts and feelings and mutually develop goals and an individualized plan of care. Nurses provide reflective and nonjudgmental feedback to clients to help them clarify their thoughts, goals, and coping strategies. [5] Therapeutic communication techniques used during this phase, including motivational interviewing, are discussed later in this chapter.

Termination Phase

The final phase of a nurse-client relationship is the termination phase. This phase typically occurs at the end of a shift or on discharge from care. If the previous working phase has been successful, the client’s needs have been successfully met by collaboration among the client, nurses, and interprofessional health care team members. The nurse should be aware the client may try to return to the working phase to avoid termination of the relationship. During the termination phase, the nurse can encourage the client to reflect on progress they have made and review post-discharge goals. The nurse also makes community referrals for follow-up and continuation of support in meeting goals.

• American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association.
• Ross C. A., Goldner E. M. Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature. Journal of Psychiatric and Mental Health Nursing. 2009; 16 (6):558–567. [ PubMed : 19594679 ] [ CrossRef ]
• Hagerty T. A., Samuels W., Norcini-Pala A., Gigliotti E. Peplau’s Theory of Interpersonal Relations: An alternate factor structure for patient experience data? Nursing Science Quarterly. 2018; 30 (2):160–167. [ PMC free article : PMC5831243 ] [ PubMed : 28899257 ] [ CrossRef ]

2.3. THERAPEUTIC COMMUNICATION

Therapeutic communication has roots going back to Florence Nightingale, who insisted on the importance of building trusting relationships with patients. She taught that therapeutic healing resulted from nurses’ presence with patients. [ 1 ] Since then, several professional nursing associations have highlighted therapeutic communication as one of the most vital elements in nursing.  Therapeutic communication  is a type of professional communication defined as the purposeful, interpersonal, information-transmitting process that leads to client understanding and participation. [ 2 ] Read an example of a nursing student using therapeutic communication in the following box.

Example of Nurse Using Therapeutic Listening

Ms. Z. is a nursing student (as simulated in Figure 2.1 ) [ 3 ] who enjoys interacting with patients. When she goes to patients’ rooms, she greets them and introduces herself and her role in a calm tone. She kindly asks patients about their problems and notices their reactions. She provides information and answers their questions. Patients perceive that she wants to help them. She treats patients professionally by respecting boundaries and listening to them in a nonjudgmental manner. She addresses communication barriers and respects patients’ cultural beliefs. She notices patients’ health literacy and ensures they understand her messages and patient education. As a result, patients trust her and feel as if she cares about them, so they feel comfortable sharing their health care needs with her. [ 4 ]

Nursing Student Using Therapeutic Communication

Therapeutic communication is different from social interaction. Social interaction does not have a goal or purpose and includes casual sharing of information, whereas therapeutic communication has a goal or purpose for the conversation. An example of a nursing goal before using therapeutic communication is, “The client will share feelings or concerns about their treatment plan by the end of the conversation.”

Therapeutic communication includes active listening, professional touch, and a variety of therapeutic communication techniques.

Active Listening

Listening is an important part of communication. There are three main types of listening, including competitive, passive, and active listening. Competitive listening occurs when we are mostly focused on sharing our own point of view instead of listening to someone else. Passive listening occurs when we are not interested in listening to the other person, and we assume we understand what the person is communicating correctly without verifying their message. During  active listening , we communicate both verbally and nonverbally that we are interested in what the other person is saying while also actively verifying our understanding with them. For example, an active listening technique is to restate what the person said and then verify our understanding is correct. This feedback process is the major difference between passive listening and active listening. [ 5 ]

Nonverbal communication is an important component of active listening.  SOLER  is a mnemonic for establishing good nonverbal communication with clients. SOLER stands for the following [ 6 ]:

• S:   S itting and squarely facing the client
• O:  Using  o pen posture (i.e., avoid crossing arms)
• L:   L eaning towards the client to indicate interest in listening
• E:  Maintaining good  e ye contact
• R:  Maintaining a  r elaxed posture

Professional touch is a powerful way to communicate caring and empathy if done respectfully while also being aware of the client’s preferences, cultural beliefs, and personal boundaries. Nurses use professional touch when assessing, expressing concern, or comforting patients. For example, simply holding a patient’s hand during a painful procedure can effectively provide comfort.

For individuals with a history of trauma, touch can be negatively perceived, so it is important to ask permission before touching. Inform the person before engaging in medical procedures requiring touch such as, “I need to hold down your arm so I can draw blood.”

Nurses should avoid using touch with individuals who are becoming agitated or experiencing a manic or psychotic episode because it can cause escalation. It is also helpful to maintain a larger interpersonal distance when interacting with an individual who is experiencing paranoia or psychosis.

Therapeutic Communication Techniques

There are a variety of therapeutic techniques that nurses use to engage clients in verbalizing emotions, establishing goals, and discussing coping strategies. See Table 2.3a for definitions of various therapeutic communication techniques discussed in the  American Nurse , the official journal of the American Nurses Association.

Therapeutic Communication Techniques [7]

Nontherapeutic Responses

Nurses must be aware of potential barriers to communication and avoid nontherapeutic responses. Nonverbal communication such as looking at one’s watch, crossing arms across one’s chest, or not actively listening may be perceived as barriers to communication. Nontherapeutic verbal responses often block the client’s communication of feelings or ideas. See Table 2.3b for a description of nontherapeutic responses to avoid.

Nontherapeutic Responses [8],[9]

See the following box for a summary of tips for using therapeutic communication and avoiding common barriers to therapeutic communication.

Tips for Effective Therapeutic Communication

• Establish a goal for the conversation.
• Be self-aware of one’s nonverbal messages.
• Observe the client’s nonverbal behaviors and actions as ‘cues’ for assessments and planning interventions.
• Avoid self-disclosure of personal information and use professional boundaries. (Review boundary setting in the “ Boundaries ” section of Chapter 1.)
• Be patient-centered and actively listen to what the client is expressing (e.g., provide empathy, not sympathy; show respect; gain the client’s trust; and accept the person as who they are as an individual).
• Be sensitive to the values, cultural beliefs, attitudes, practices, and problem-solving strategies of the client.
• Effectively use therapeutic communication techniques.
• Recognize themes in a conversation (e.g., Is there a theme emerging of poor self-esteem, guilt, shame, loneliness, helplessness, hopelessness, or suicidal thoughts?).

Common Barriers to Therapeutic Communication

• Using a tone of voice that is distant, condescending, or disapproving.
• Using medical jargon or too many technical terms.
• Asking yes/no questions instead of open-ended questions.
• Continually asking “why,” causing the client to become defensive or feel challenged by your questions.
• Using too many probing questions, causing the client to feel you are interrogating them, resulting in defensiveness or refusal to talk with the nurse.
• Lacking awareness of one’s biases, fears, feelings, or insecurities.
• Causing sensory overload in the client with a high emotional level of the content.
• Giving advice.
• Blurring the nurse-client relationship boundaries (e.g., assuming control of the conversation, disclosing personal information, practicing outside one’s scope of practice).

Recognizing and Addressing Escalation

When communicating therapeutically with a client, it is important to recognize if the client is escalating with increased agitation and becoming a danger to themselves, staff, or other patients. When escalation occurs, providing safety becomes the nurse’s top priority, and the focus is no longer on therapeutic communication. Read more information in the “ Crisis and Crisis Intervention ” section of the “Stress, Coping, and Crisis Intervention” chapter.

Cultural Considerations

Recall the discussion from Chapter 1 on how cultural values and beliefs can impact a client’s mental health in many ways. Every culture has a different perspective on mental health. For many cultures, there is stigma surrounding mental health. Mental health challenges may be considered a weakness and something to hide, which can make it harder for those struggling to talk openly and ask for help. Culture can also influence how people describe and feel about their symptoms. It can affect whether someone chooses to recognize and talk openly about physical symptoms, emotional symptoms, or both. Cultural factors can determine how much support someone gets from their family and community when it comes to mental health. [ 10 ]

Nurses can help clients understand the role culture plays in their mental health by encouraging therapeutic communication about their symptoms and treatment. For example, a nurse should ask, “What do you think is wrong? How would you treat your symptoms?”

Read more about providing culturally responsive care in the “ Diverse Clients ” chapter of Open RN  Nursing Fundamentals .

2.4. motivational interviewing.

Patient education and health promotion are core nursing interventions.  Motivational interviewing (MI)  is a communication skill used to elicit and emphasize a client’s personal motivation for modifying behavior to promote health. MI has been effectively used for several health issues such as smoking cessation, diabetes, substance use disorders, and adherence to a treatment plan. [ 1 ]

The spirit of motivational interviewing is a collaborative partnership between nurses and clients, focused on patient-centered care, autonomy, and personal responsibility. It is a technique that explores a client’s motivation, confidence, and roadblocks to change. During motivational interviewing, nurses pose questions, actively listen to client responses, and focus on where the client is now with a current health behavior and where they want to be in the future. [ 2 ]

Motivational interviewing uses these principles [ 3 ]:

• Express empathy.  Use reflective listening to convey acceptance and a nonjudgmental attitude. Rephrase client comments to convey active listening and let clients know they are being heard.
• Highlight discrepancies.  Help clients become aware of the gap between their current behaviors and their values and goals. Present objective information that highlights the consequences of continuing their current behaviors to motivate them to change their behavior.
• Adjust to resistance.  Adjust to a client’s resistance and do not argue. The client may demonstrate resistance by avoiding eye contact, becoming defensive, interrupting you, or seeming distracted by looking at their watch or cell phone. Arguing can place the client on the defensive and in a position of arguing against the change. Focus on validating the client’s feelings.
• Understand motivations.  Uncover a client’s personal reasons for making behavioral changes and build on them.
• Support self-efficacy.  Encourage the client’s optimistic belief in the prospect of change and encourage them to commit to positive behavioral changes. Ask clients to elaborate on past successes to build self-confidence and support self-efficacy.
• Resist the reflex to provide advice.  Avoid imposing your own perspective and advice.

When implementing motivational interviewing, it is important to assess the client’s readiness for change. Motivational interviewing is especially useful for clients in the contemplation stage who are feeling ambivalent about making change. Recall these five stages of behavioral change [ 4 ]:

• Precontemplation:  Not considering change.
• Contemplation:  Ambivalent about making change.
• Preparation:  Taking steps toward implementing change.
• Action:  Actively involved in the change process.
• Maintenance:  Sustaining the target behavior.

Identify clients who are ambivalent about making a behavioral change or following a treatment plan by listening for the phrase, “Yes, but.” The “but” holds the key for opening the conversation about ambivalence. For example, a client may state, “I want to take my medication, but I hate gaining weight.” The content in the sentence after the “but” reveals the client’s personal roadblock to making a change and should be taken into consideration when planning outcomes and interventions. [ 5 ]

See the following box for an example of a nurse using motivational interviewing with a client.

Example of Motivational Interviewing [ 6 ]

Mr. L. had been in treatment for bipolar I disorder with medication management and supportive therapy for many years. He had a history of alcohol dependence but was in full recovery. Mr. L. was admitted to the intensive care unit with a toxic lithium level. He had been seen in the emergency room the preceding evening and was noted to have a very high blood alcohol level. The next day the nurse asked the client about his alcohol use using motivational interviewing.

Client:  I am so sick of everyone always blaming everything on my drinking!

Nurse (Using reflective listening):  You seem pretty angry about the perception that you were hospitalized because you had been drinking.

Client:  You better believe it! I am a man! I can have a few drinks if I want to!

Nurse: (Expressing empathy and acceptance): You want to be respected even when you are drinking.

Client:  I have had some trouble in the past with drinking, but that is not now. I can quit if I want to! Compared to what I used to drink, this is nothing.

Nurse (Rolling with resistance):  So you see yourself as having had drinking problems in the past, but the drinking you’ve done recently is not harmful for you.

Client:  Well, I guess I did end up in the hospital.

Nurse (Using open-ended questioning):  Tell me more about what happened.

Client:  I was pretty angry after an argument with my girlfriend, and I decided to buy a bottle of whiskey.

Nurse (Exploring):  And then?

Client:  Well, I meant to have a couple of shots, but I ended up drinking the whole fifth. I really don’t remember what happened next. They said I nearly died.

Nurse (Summarizing):  So after many years of not drinking, you decided to have a couple of drinks after the argument with your girlfriend, but unintentionally drank enough to have a blackout and nearly die.

Client:  I guess that does sound like a problem…but I don’t want anyone else telling me whether or not I can drink!

Nurse (Emphasizing autonomy):  Tell me how the choice to drink or not continues to support or oppose your health goals.

View the following supplementary YouTube videos about motivational interviewing:

Introduction to Motivational Interviewing [ 7 ]

Motivational Interviewing – Good Example – Alan Lyme  [ 8 ]

Complete Western Region Public Health Training Center’s  Motivational Interviewing  course and receive a certificate of completion.

2.5. teletherapy and telehealth.

Telehealth  is the use of digital technologies to deliver medical care, health education, and public health services by remotely connecting multiple users in separate locations. Nurses must be aware of potential barriers affecting client use of telehealth (such as lack of Internet access or lack of support for individuals learning new technologies), as well as state and federal policies regarding telehealth and their nursing license across state lines.

Read more about telehealth licensing requirements and interstate compacts at the  Telehealth.hss.gov webpage .

Teletherapy  is mental health counseling over the phone or online with videoconferencing. COVID-19 has led to reduced access to medical and mental health care, so delivering behavioral health care via telehealth is one way to address this issue. When using teletherapy, nurses should treat clients as if they are sitting across from them and focus on eye contact and empathetic expressions to build a connection, just during a face-to-face encounter. [ 1 ]

Group therapy can be accomplished via telehealth. Connecting clients through telehealth creates a group dynamic that can build community, reduce feelings of isolation, and offer new perspectives. Group therapy via telehealth can create a sense of belonging and build a trusted support system.

Here are a few guidelines for group therapy telehealth sessions [ 2 ]:

• Prescreen group members:  Group members may have various needs, experiences, or personalities. It is helpful to screen each potential client to ensure every member can benefit from group therapy and that their needs match the goals of the group.
• Require completion of online consent forms:  Group telehealth sessions involve multiple people and are conducted outside of a controlled setting like an office. Client consent forms should be required and available online. The consent forms should outline any associated risks, benefits, and limits to confidentiality.
• Develop group guidelines:  Make clear ground rules covering what is acceptable and what is not acceptable. Some common ground rules include requiring all participants to have their camera on, attend from a room where they can be alone during the session, and use the digital “raise hand” feature (or raise their hand) when they want to speak. Prohibiting recording of the session is a common ground rule to protect confidentiality. Address logistical topics like how many missed sessions are allowed and how to contact the group leader(s).
• Select your settings and technology:  Choose the telehealth video platform that best suits your needs for encryption and privacy, user controls, and more. Go through all of the settings ahead of time to select the options that provide the highest level of privacy. Think about what will help you and the group communicate effectively such as screen sharing options or a virtual whiteboard.
• Be engaging:  When you are on screen instead of in person, it is even more important to be conscious of the group dynamic and take steps to keep group members interested, energized, and engaged. Start with introductions and greetings using first names only for privacy. Make eye contact with group members by looking into the camera and use body language and hand gestures to help express your ideas. Build in moments for clients to interact and contribute to the conversation, such as breakout rooms or paired discussions.

2.6. LEARNING ACTIVITIES

II. GLOSSARY

Communicating both verbally and nonverbally that we are interested in what the other person is saying while also actively verifying our understanding with them.

A communication skill used to elicit and emphasize a client’s personal motivation for modifying behavior to promote health.

A relationship that establishes trust and rapport with a specific purpose of facilitating therapeutic communication and engaging the client in decision-making regarding their plan of care.

A mnemonic for effective nonverbal communication that stands for the following [ 1 ]:

• S: Sit and squarely face the client
• O: Open posture
• L: Lean towards the client to indicate interest in listening
• E: Eye contact

The use of digital technologies to deliver medical care, health education, and public health services by remotely connecting multiple users in separate locations.

Mental health counseling over the phone or online with videoconferencing tools.

A type of professional communication defined as the purposeful, interpersonal, information-transmitting process that leads to client understanding and participation. [ 2 ]

Licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/ .

• Cite this Page Open Resources for Nursing (Open RN); Ernstmeyer K, Christman E, editors. Nursing: Mental Health and Community Concepts [Internet]. Eau Claire (WI): Chippewa Valley Technical College; 2022. Chapter 2 Therapeutic Communication and the Nurse-Client Relationship.
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• INTRODUCTION
• BASIC CONCEPTS OF COMMUNICATION
• THERAPEUTIC COMMUNICATION
• MOTIVATIONAL INTERVIEWING
• TELETHERAPY AND TELEHEALTH
• LEARNING ACTIVITIES

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Communication in Nursing

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Professional Communication in Nursing

Sep 23, 2014

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Professional Communication in Nursing. Communication. Human interaction Verbal and nonverbal Written and unwritten Planned and unplanned Conveys thoughts and ideas Transmits feelings Exchanges information Means various things. Communication, continued. Effective communication

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Communication • Human interaction • Verbal and nonverbal • Written and unwritten • Planned and unplanned • Conveys thoughts and ideas • Transmits feelings • Exchanges information • Means various things

Communication, continued • Effective communication • Intrapersonal level  self-talk • Clear communication essential • Client safety • Collaboration with diverse team challenged by • Current health care environment • Professional communication and collaboration • Cultural gaps • Available resources and technology

The Communication Process • Sender • Source-encoder • Message • What is actually said/written, body language • How words are transmitted  channel • Receiver • Listener  decoder  perception of intention • Response  Feedback

Verbal Communication Pace and intonation Simplicity Clarity and brevity Congruence Timing and relevance Adaptability Credibility Humor

Nonverbal Communication Body language Gestures, movements, use of touch Essential skills: observation, interpretation Personal appearance Posture and gait Facial expression of self, others; eye contact Gestures Cultural component

Electronic Communication Advantages Fast Efficient Legible Improves communication, continuity of care Disadvantages Client confidentiality risk HIPPA Socioeconomics

Electronic Communication,continued • Do not use e-mail • Urgent information • Jeopardy to client’s health • Highly confidential information • Abnormal lab data • Other guidelines • Agency-specific standards and guidelines • Part of medical record • Consent, identify as confidential

Effective Written Communication Does not convey nonverbal cues Same as verbal AND Appropriate language and terminology Correct grammar, spelling, punctuation Logical organization Appropriate use and citation of resources

Factors Influence Communication Process Development & gender Sociocultural characteristics Values and perception Personal space and territoriality Roles and relationships Environment Congruence Attitudes

Development Language and communication skills develop through stages Communication techniques for children Play Draw, paint, sculpt Storytelling, word games Read books; watch movies, videos Write

Gender Females and males communicate differently from early age Boys  establish independence, negotiate status Girls  seek confirmation, intimacy

Sociocultural Characteristics Culture Education Economic level

Values and Perception Values  standards that influence behavior Perceptions  personal view of an event Unique personality traits, values, experiences Validate

Personal Space Defined as distance people prefer in interactions with others Proxemics Intimate distance frequently used by nurses Personal distance  less overwhelming Social distance  increased eye contact Out of reach for touch Public distance

Territoriality Space and things Individual considers as belonging to self Knock before entering space May be visible Curtains around bed unit Walls of private room Removing chair to use at another bed

Roles and Relationships Between sender and receiver First meeting versus developed relationship Informal with colleagues Formal with administrators Length of relationship

Environment Can facilitate effective communication Key factors Comfort Privacy

Congruence • Congruence • Verbal and nonverbal aspects match • Seen by nurse and clients • Incongruence • Sender’s true meaning in body language • Improving nonverbal communication • Relax; use gestures judiciously • Practice; get feedback on nonverbal

Attitudes • Interpersonal attitudes • Attitudes convey beliefs, thoughts, feelings • Caring, warmth, respect, acceptance • Facilitate communication • Condescension, lack of interest, coldness • Inhibit communication • Effective nursing communication • Significantly related to client satisfaction • Respect

Barriers to Communication • Rejecting • Changing topics • Unwarranted reassurance • Passing judgment • Giving common advice Stereotyping Agreeing and disagreeing Being defensive Challenging Probing Testing

Therapeutic Communication • Interactive process between nurse, client • Helps client overcome temporary stress • To get along with other people • Adjust to the unalterable • Overcome psychological blocks • Established with purpose of helping client • Nurse responds to content • Verbal, nonverbal

Therapeutic Communication Techniques • Empathizing • Empathy is process • People feel with one another • Embrace attitude of person who is speaking • Grasp idea that what client has to say important • NOT synonymous with sympathy • Interprets clients feelings without inserting own

Empathy • Empathy • Four phases of therapeutic empathizing • Identification • Incorporation • Reverberation • Detachment • On guard against over-distancing or burnout

Listening • Attentive listening • Mindful listening • Paying attention to verbal, nonverbal • Noting congruence • Absorbing content and feeling • Listening for key themes • Be aware of own biases • Highly developed skill

Blocks to Attentive Listening Rehearsing Being concerned with oneself Assuming Judging Identifying Getting off track Filtering

Attending • Physical attending • Face the person squarely • Adopt an open posture • Lean toward the person • Maintain good eye contact • Try to be relatively relaxed

Silence • Using silence • Encouraging the client to communicate • Allowing client time to ponder what has been said • Allow client time to collect thoughts • Allow client time to consider alternatives • Look interested • Uncomfortable silence should be broken • Analyzed

Reflection • Reflecting • Repeating the client’s message • Verbal or nonverbal • Reflecting content repeats client’s statement • May be misused, overused • Use judiciously • Reflecting feelings • Verbalizing implied feelings in client’s comment • Encourages client to clarify

Just the Facts • Imparting information • Supplying additional data • Not constructive to withhold useful information • Line between information and advice • Avoid personal, social information • Client participation in decision making  positive mental health outcomes • Take in and understand information • Educated empowered client

Deflection • Avoiding self-disclosure • Deflect a request for self-disclosure • Honesty • Benign curiosity • Refocusing • Interpretation • Clarification • Feedback and limit setting • Assess and evaluate responses

Clarification • Clarifying • Attempt to understand client’s statement • Ask client to give an example • Paraphrasing • Nurse assimilates or restates in own words • Fives nurse opportunity to test understanding • Checking perceptions • Sharing how one person perceives another

Question and Define • Questioning • Very direct way of speaking with clients • Open-ended questions focuses the topic • Close question limits choice of responses • Careful not to ask questions that steer answer • Structuring • Attempt to create order, establish guidelines • Define parameters of nurse-client relationship

Pinpoint and Link • Pinpointing • Calls attention to certain kinds of statements • Relationships • Point to inconsistencies • Similarities, differences • Linking • Nurse responds to client • Ties together two events, experiences, feelings • Connect past experiences with current behaviors

Giving Feedback • Nurse share reaction to what client said • Give in a way that does not threaten client • Risk of client experiencing feedback • Personal rejection • Nurses should be open, receptive to cues

Focus Feedback On behavior, observations, description On more-or-less, rather than either/or On here-and-now: what is said, not why Sharing of information, ideas Exploration of alternatives Value to client Amount of information client able to use Appropriate time and place

Confronting • Deliberate invitation to examine some aspect of personal behavior that indicates discrepancy between actions and words • Informational confrontation • Describes visible behavior • Interpretive confrontation • Draws inferences about the meaning of behavior

Six Skills in Confronting Use of personal statements Use of relationship statements Use of behavior descriptions Use of description of personal feelings Use of responses aimed at understanding Use of constructive feedback skills

Summarize and Process • Summarizing • Highlighting the main ideas expressed • Conveys understanding • Reviews main themes of conversation • Use at different times during interaction • Don’t rush to summarize • Processing • Direct attention to interpersonal dynamics

Therapeutic Communication Mistakes • Common mistakes • Giving advice • Minimizing or discounting feelings • Deflecting • Interrogating • Sparring

Barriers to Communication Failure to listen Improperly decoding intended message Placing the nurse’s needs above client’s

The Therapeutic Relationship • Growth-facilitating process • Help client manage problems in living • More effectively • Develop unused, underused opportunities fully • Help client become better at helping self • May develop over weeks or within minutes • Influenced by nurse and client • Personal and professional characteristics

Relationship Characteristics • Characteristics of therapeutic relationship • Intellectual and emotional bond • Focused on client • Respects client as individual • Respects client confidentiality • Focuses on client’s well-being • Based on mutual trust, respect, acceptance

Therapeutic Relationship Phases Preinteraction Introductory Working: stage 1 and stage 2 Termination

Introductory Phase • Preinteraction phase • Introductory phase • Orientation, pretherapeutic phase • Nurse and client observe each other • Open relationship • Clarify problem • Structure and formulate contract • Client may display resistive behaviors

Introductory Phase, continued • By end of this phase client begins to • Develop trust in nurse • View nurse as honest, open, concerned • Believe nurse will try to understand, respect • Believe nurse will respect client confidentiality • Feel comfortable talking about feelings • Understand purpose of relationship, roles • Feel an active participant in plan

Working Phase Stages • Stage One • Exploring and understanding thoughts and feelings • Empathetic listening and responding • Respect, genuineness • Concreteness • Reflecting, paraphrasing, clarifying, confronting • Intensity of interaction increases • Stage two • Facilitate and take action • Collaborate • Make decisions • Provide support • Offer options

Termination Phase Difficult, ambivalent Summarizing Termination discussions Allow time for client adjustment to independence

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Download the "Cycle Diagrams Theme for a Medical Breakthrough" presentation for PowerPoint or Google Slides.Treating diseases involves a lot of prior research and clinical trials. But whenever there’s a new discovery, a revolutionary finding that opens the door to new treatments, vaccines or ways to prevent illnesses, it’s great news....

National Library of Medicine

How many books about medicine can there be? And medical centers? We can't give you an exact number, but what we can offer you is a template for Google Slides and PowerPoint to present your medical center. In a simple, but direct style, you can talk about your center, where...

Anatomy & Physiology Medical Center

Download the "Anatomy & Physiology Medical Center" presentation for PowerPoint or Google Slides. Hospitals, private clinics, specific wards, you know where to go when in need of medical attention. Perhaps there’s a clinic specialized in treating certain issues, or a hospital in your area that is well-known for its state-of-the-art...

Pastel Palette Doctor Theme

Presentations on health and medical topics can be challenging to create, but this Google Slides & PowerPoint template is here to rescue you! This multi-purpose layout is designed with blue pastel tones, providing a professional and calm environment to showcase your medical expertise to colleagues, students, or patients. The template...

Health Benefits of Combat Sports

Download the Health Benefits of Combat Sports presentation for PowerPoint or Google Slides. Healthcare goes beyond curing patients and combating illnesses. Raising awareness about diseases, informing people about prevention methods, discussing some good practices, or even talking about a balanced diet—there are many topics related to medicine that you could...

Patients and Nurses Medical Theme

As the backbone of every healthcare system, nurses play an integral role in providing top-notch patient care. Whether it's administering medication, monitoring vital signs, or simply holding a hand, these dedicated professionals are the ones keeping our loved ones safe and comfortable during their time of need. But let's not...

World Health Day Medical Newsletter

Download the "World Health Day Medical Newsletter" presentation for PowerPoint or Google Slides. Attention all marketers! Are you looking for a way to make your newsletters more creative and eye-catching for your target audience? This amazing template is perfect for creating the perfect newsletter that will capture your audience's attention...

Alcoholism Treatment Drugs Breakthrough

Drug addictions are a difficult condition to treat, but thanks to the investigations and studies conducted by health professionals, new breakthroughs are appearing to help people who suffer them. Speak about it with this visual design for breakthrough news and share the treatment you have discovered with the medical community!...

Clinical Case 01-2023

Present your clinical case to the medical community with this dynamic and engaging presentation by Slidesgo. Who said science can’t be creative and fun?

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