Therapeutic communication for nurses is beneficial and healing, not hurtful, to a person or situation. In nursing, therapeutic communication seeks to help the patient. A nurse in a school has unique challenges and opportunities. Even school nurses in elementary schools should be careful to use therapeutic communication with students.
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It is particularly important for school nurses to show empathy in their therapeutic communication, both empathetic listening and empathetic speaking. According to Kathleen Hassey, Director of the School Health Institute, 91.5 per cent of the students seen by school nurses are treated and returned to class. Since so many students have minor or non-existent reasons for visiting the nurse, it is vital that the nurse listen intently to the student, understand what he says, affirm the value of his feelings, understand the context of his complaints and interpret them correctly. Some of the skills used in empathetic, or active, listening include keeping eye contact, paraphrasing the content of the message, and using appropriate cues to acknowledge that the nurse absorbs what the student says.
One of the most important non-verbal therapeutic techniques for a school nurse is eye contact. For younger students, nurses should get down on the level of the student and look him in the eye as he speaks. Nurses should face the student, and put away any other work while they are attending to the student's needs. Children are aware when adults are only partially attending to them, and will know if a nurse is more interested in the report she is preparing than in the child's symptoms.
Clarity with Parents
Therapeutic communication is important with the student, but also with the parents of the students a school nurse treats. Parents have different ways of dealing with children's health complaints, so it is important to explain symptoms clearly to the parents and to explain any treatment or lack of treatment. While a parent may disagree with the judgment and actions of the nurse, if the nurse explains clearly what he did and why, then the parent can take the action she deems necessary after hearing all the facts. Clarity and empathy in communicating with parents will also help avoid conflicts.
Observation and Prompts
Careful observation of a student, such as watching the eye movement, the posture and the pace of a student's walk, will give the school nurse information about how the student is really feeling, and may give clues to factors outside the student's physical health that may be affecting his well-being. Once a nurse observes the student's behaviour and non-verbal cues, the nurse may use conversational prompts to help a student pinpoint how he is feeling or express himself. For example, a nurse may say, "It looks like you're not very hungry" or "You seem like you might be a little tired," or "Was recess a little difficult today?" then allow the student to respond. Good therapeutic communication mandates that the patient do most of the talking and the practitioner mostly listen.
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