Scenario:

Maria, a 65-year-old woman, lies anxiously in her hospital bed, awaiting surgery for a hip fracture. Her eyes dart around the room, her breathing shallow and rapid. Nurse Sarah enters, a gentle smile gracing her lips.

Nurse Sarah (Therapeutic verbal communication): “Hello Maria, it’s good to see you again. I know you must be feeling worried about your surgery today. Is there anything specific you’re feeling concerned about?”

Maria (Non-therapeutic verbal communication): “Oh, everything! What if something goes wrong? What if I never walk again? I’m too old for this!” (Her voice trembles with fear.)

Nurse Sarah (Therapeutic non-verbal communication): Sarah pulls up a chair next to Maria’s bed, leans in slightly, and maintains eye contact with a warm expression.

Nurse Sarah (Therapeutic verbal communication): “It’s completely understandable to feel anxious before surgery. It’s a big decision. Do you mind if I hold your hand for a moment?” (Sarah extends her hand gently.)

Maria (Non-therapeutic non-verbal communication): Maria hesitates for a moment, then hesitantly places her hand in Sarah’s. Her shoulders soften slightly.

Nurse Sarah (Therapeutic verbal communication): “I want to assure you that Dr. Lee is an excellent surgeon with years of experience in these procedures. He has a very successful track record, and your case has been thoroughly discussed beforehand. We’re all here to support you every step of the way.”

Maria (Non-therapeutic verbal communication): “But what if they can’t fix it? What if I’m just a burden to everyone?”

Nurse Sarah (Therapeutic verbal response): “Maria, you are not a burden. You are a valuable member of our community, and everyone here cares about your well-being. Recovery can take time, but we’ll be there every step of the way with you, providing you with the therapy and support you need to regain your strength and independence.”

Maria (Therapeutic non-verbal communication): A tear rolls down Maria’s cheek, but her grip on Sarah’s hand tightens. A small, hopeful smile flickers on her lips.

Analysis:

Therapeutic Communication Techniques and Responses:

• Open-ended questions: “Is there anything specific you’re feeling concerned about?” encourages Maria to elaborate on her fears.
• Active listening: Sarah demonstrates attentive listening through eye contact, body language, and verbal cues like “I understand.”
• Validation: “It’s completely understandable to feel anxious…” acknowledges Maria’s emotions and reduces the pressure to suppress them.
• Offering support: “We’re all here to support you…” conveys shared responsibility and strengthens the care relationship.
• Normalizing: Mentioning Dr. Lee’s experience and positive track record normalizes anxieties and instills confidence.
• Reassurance: “You are not a burden…” directly addresses Maria’s negative self-talk and reaffirms her value.

Non-Therapeutic Communication Techniques and Responses:

• Ignoring or minimizing emotions: Avoiding Maria’s concerns could have further fueled her anxiety.
• False reassurances: Guaranteeing a perfect outcome, while well-intentioned, could set unrealistic expectations and lead to disappointment.
• Changing the subject: Abruptly shifting away from Maria’s worries could undermine her sense of safety and trust.
• Offering unsolicited advice: Telling Maria what to do instead of validating her feelings could come across as patronizing.

Contribution to a Safe and Therapeutic Environment:

The therapeutic communication employed by Sarah creates a safe and therapeutic environment for several reasons:

• It fosters trust and rapport: Maria feels heard and understood, building trust and a sense of security with Sarah.
• Reduces anxiety and promotes emotional clarity: Openly discussing her concerns helps Maria process her anxieties and clarify her needs.
• Empowers Maria and encourages cooperation: The focus on shared responsibility and support empowers Maria to actively participate in her recovery.
• Strengthens the nurse-client relationship: Open communication fosters a stronger therapeutic bond, crucial for optimal care and healing.