Communicating with clients who have

special needs:
1.Clients who cannot speak clearly
-listen attentively, be patient, do not
interrupt
-ask simple questions
-allow time for understanding and
response
-use visual cues
-do not shout or speak too loudly

2. Clients who are cognitively

impaired
-Reduce environmental
distractions
-Get clients attention prior to
speaking
-Use simple sentences
-Be an attentive listener

3. Client who are unresponsive

-call client by name during
interactions
-communicate both verbally
and by touch
-Provide orientation to person,
place, and time

4. Communicating with hearing

impaired client
-establish a method of
communication
-pay attention to clients nonverbal cues
-always face client when
speaking

5. Client who do not speak

english
-Speak in normal tone of
voice
-Provide interpreter
-Develop communication
board, pictures, or cards
-have dictionary available.

Levels of communication:
1.Small group
communication
2.Public communication
3.Intrapersonal
4.Interpersonal
5.transpersonal

Therapeutic
relationship
-Helping relationship between the
nurse and a client focusing on
meeting the needs of the client
-Patient centered
-Professional relationship
-Structured
-Goal directed

Phases of therapeutic
relationship:
1.Pre-orientation
-.Self awareness
-.Data gathering

2. Orientation
a.Establish
boundaries and
acceptance
b.Establish trust

3. Working
a.Problem
identification
b.Exploitation

4. Termination
-begins when the
client problem is
resolved

Therapeutic
technique

Offering self
-making self

available and
showing interest
and concern

Active listening
-paying close
attention to what
patient is saying by
observing both verbal
and non-verbal cues

Exploring
-delivering further
into a subject or
idea

Giving broad
openings
-allowing client to
take initiative in
introducing a topic

Silence
-planned absence of
verbal marks to allow
patient and nurse to think
over what is being
discussed and to say more

Giving observations
-verbalizing what is
observed in the
patient, for validation
and to encourage
discussion

Summarizing
-reviewing the main
points of discussions
and making
appropriate
conclusions

Presenting reality
or confronting
- Stating what is real
and what is not
without arguing with

Seeking clarification
- Asking patient to
restate, elaborate, or
give examples of ideas
or feelings to seek
clarification of what is
unclear

Verbalizing the
implied
-rephrasing the patients
words to highlight an
underlying message to
clarify statements

Reflecting
-throwing back the
patients statement in a
form of question helps
the patient identify
feelings

Restating
-repeating the exact
words of patients to
remind them of what
they said and to let
them know they are

General leads
- Using neutral
expressions to
encourage patients
to continue talking

Asking openended question

-achieve relevance
and depth in
discussion

Focusing
-pursuing a topic
until its meaning
or importanceis

Suggesting
collaboration
-offering to help
patients solve
problems

Non-therapeutic
Communication
techniques

-agreeing/ disagreeing
-approving/
disapproving
-advising
-probing
-challenging
-changing topic