ACU NRSG139: Reflection on Therapeutic Communication Assessment

This report provides a reflection on the application of therapeutic communication techniques in a healthcare setting, as experienced by a nursing student. The student utilized the Gibbs reflective cycle to analyze their experience in a practical classroom setting, focusing on building a nurse-patient relationship and demonstrating the application of therapeutic communication. The report details the student's feelings, evaluation of the practice, critical analysis of their skills, and a conclusion with an action plan for improvement. The student reflects on the importance of trust, active listening, and comprehensive assessment in providing quality patient care. The student also discusses the challenges faced and the areas where further practice is needed, in line with the Registered Nurse Standards for Practice and the ANSAT tool.

Introduction
Health care practitioners should act like patient advocates in maintaining and upholding
professional and therapeutic patient-nurse relationships with clear boundaries. Karolak (2016)
claim that communication being complicated in nature, it involves different types which play a
great role in ethical care. The National Commission on Correlational Health Care (2011) define
therapeutic communication as a one to one interaction between a nurse and a patient with the aim
of improving and advancing the emotional and physical well-being of the patient. Health care
professionals apply different therapeutic communication techniques to support and provide some
information to the patients. These techniques are important to achieving a high quality health
care services. Correlational nurse should however be conscious of the nature of therapeutic
relationship between them and the patient. The first step in establishing a strong nurse patient
relationship is by building trust. The nurse through honesty, compassion, caring, openness and
respect to the patient should instill trust among them (Abdolrahimi, Ghiyasvandian,
Zakerimoghadam and Ebadi, 2017). After trust has been created, there is need to maintain and
develop this trust through the patient’s stay in the health care facility. When the patient trusts the
nurse, they can express and ventilate their feelings, discomforts, anxieties and fears. Poor
therapeutic communication between a nurse and patient leads to damages and misinterpretation
of information, reducing the quality of care offered, build negative attitudes among patients and
also lead to patient dissatisfaction (Mac-Donald-Winks and Levett Jones, 2012). In this paper I
am going to discuss a therapeutic communication scenario while applying Gibb’s reflective
cycle.

Description
As part of this assessment, I am required to reflect on one of the skills we have tackled
in class and also practiced in relation to in relation to offering quality health assessment to a
patient. I have chosen to reflect on therapeutic communication between a nurse and the patient. I
am going to relate therapeutic communication, its techniques and whatever I have learned in
class to show I can build a nurse patient relationship and also demonstrate the application of this
technique in offering a quality health care to the patient. I am also going to apply the Gibb’s
reflective cycle in explaining my experience with this technique. In one of the lectures on
classroom and practical nursing labs, we were divided in different pair groups so that every
group could demonstrate and discuss application and importance of therapeutic communication
in the health care setting. We demonstrated how a nurse should be welcoming to a patient and
how the nurse should apply different therapeutic techniques such as recognizing the presence of
the patience, offering oneself for the service of the patient, active listening, seeking clarification
and also encouraging description of perception (Purtilo, Haddad and Doherty, 2014).
Feelings
This practice was designed for us to imagine being in a health care setting. The
imagination of being a nurse, receiving and starting a communication with a patient made be
nervous. It is very true that some of these skills grow with time and since this was my first
experience in such a setting (though imagined) made me wonder where to start with the patient
(my colleague). I therefore noticed that the nurse is supposed to show a lot of courage so as to
build an effective relationship with the patient and also attain patient’s trust (Amoah et al. 2019).
I started by greeting my “patient” the welcomed him. His response gave me more courage to
continue with the process. He explained his issues to the “nurse” while I applied the relevant

therapeutic techniques. It was such a tremendous experience that it gave me more insight in
pursuing my career.
Evaluation
In this practice, I noticed the importance of creating trust with the patient. I had
achieved this my introducing myself to him and ensuring him that I would offer a quality health
care service. He was now in a position to freely explain his problems as well as what he thought
was best for him. I would ask him for clarifications where I felt needed and nodded my head
whenever I got his explanations. I keenly and actively listened to him and noticed that I could
understand his feelings. Before the session was over, I knew what my “patient” needed. We had
also created kind of a bond through my respect an openness to him
Critical analysis
It is the duty of a health professional to offer quality, safe and goal oriented health care
and also be competent with the skill of assessing the patient. The nurse should also possess the
ability to notice any deviations from the required results and also emphasizes the essence of a
timely and accurate assessment (Ossenberg, Dalton and Henderson, 2016). In this practice, I
think I needed more exposure to such practices so as to build by courage but in terms of technical
skill I think I did my best. I was able to apply both my verbal and non-verbal communication
techniques to assess my colleague. I also made him feel safe while expressing his need. I
however though I needed more practice to improve my levels of concentration as some of the
explanations passed me due to poor concentration (Lin, Li, shieh, Kao, Lee and Hung, 2016).
Conclusion

According to the Nursing and Midwifery Board of Australia (2016) a nurse is supposed
to be accurate in conducting a systematic and comprehensive assessment to the patient. My
assessment was in accordance to these standards however I notices my weaknesses during the
practice. I needed to improve on my concentration skills as well as some aspects of therapeutic
communication skills such as active listening. I also faced a challenge I creating the trust needed
in such a setting which would also improve with more practice.
Action plan
Burke (2018) explains the importance of attentive and active listening as a techniques in
therapeutic relationship. These techniques are far much beyond just hearing or remaining silent
as the client speaks. They include the nurse hearing, processing and understanding every verbal
and non-verbal signals the client sends. In my practice I should consider the registered nurse
standards for practice so as to offer quality care.
Conclusion
Therapeutic communication is a crucial tool in the health care setting. Much of the
responsibility in therapeutic communication falls on the nurses and plays an important role the
experience of a patient in the health care. It includes both verbal and non-verbal communication.
With application of different therapeutic communication techniques, the nurse could create a
tremendous nurse-patient relationship. The nurse should clearly and attentively listen to the
patient and draw what the patient wants.

References
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