Nontherapeutic Communication Analysis

My preferred method of interacting with a patient is therapeutic communication and how I communicate with patients daily. Consequently, communication with a patient can be verbal, written, body language, gestures or nonverbal. Avoiding nontherapeutic communication is best practice, as I feel giving a false reassurance is of no benefit and asking “why” questions, is uncomfortable and can make patients and/or family members defensive. A nursing instructor years ago taught me not to tell a patient “you will be fine”, as that is a promise you cannot keep. Instead, I always tell patients “we will take very good care of you”.

Recently, I scheduled a follow-up appointment with a surgical patient that suffered a massive stroke after a large thoracic

Unfortunately, his daughter felt his condition was not as acute as it appeared. The fact that the monitor showed his heart rate in the 150’s, he was diaphoretic and dehydrated did not seem to register with his daughter. Nevertheless, his daughter continued offering several arguments attempting to change what she was being told. As this quagmire went on for what seemed like hours, I stood at the head of the stretcher attempting to comfort him with a warm smile and a gentle touch. Again, I felt him talking to me with his eyes. his silence spoke loudly. Finally, the surgeon expressed concern that he needed to be admitted to the hospital or he most likely would not survive the next few days. At which point his daughter finally agreed to a hospital admission. He looked at me and slowly closed his eyes for a few seconds, I felt he was saying “thank you”. Was this non-verbal therapeutic communication? I not sure, but it felt like he was talking to me during the entire process. Using the Russian interpreter, we explained to him that he was being admitted to the hospital, at which point he nodded his head up and down for yes. Using a gesture or body language is considered therapeutic