Role Play 3 : Speaking

Role Play 2 : Question and Answer about Therapeutic Communication

1. What is Therapeutic Communication ?

Answer : 

     Therapeutic communication is a collection of techniques that prioritize the physical, mental, and emotional health of the patient. Nurses provide patient support and information while maintaining professional level of distance and objectivity. With therapeutic communication, nurses often use open statements and questions, repeat information, or use silence to ask patients to solve their own problems.

2. Why therapeutic communication is essential for nurses and patients ?

Answer :

    Because therapeutic communication helps the patient in clarifying and reducing the burden of thoughts and feelings for basic action to alter the situation when the patient believes in what is needed. Assist effective action, strengthen the interaction of both parties, between patients and nurses professionally and proportionally in order to help solve clien.

3.  Define some skills that you know to be used in therapeutic communication ?

Answer :

     Here are some techniques that are used in therapeutic communication 

a. Listen attentively

     Nurses try to listen to clients and deliver verbal and non-verbal messages, to show that nurses are concerned about clients needs and problems. Listening intently is an attempt to understand all the verbal and non-verbal messages that are being communicated.

b. Shows acceptance

            Accepting here does not mean to approve. Accepting means being willing to listen to others without showing any doubt or disagreement. Nurses do not always have to accept all client behavior. Nurses should avoid facial expressions and body movements that show disagreement, such as frowning or shaking their heads as if not believing.

c. Asking related questions

    The purpose of the nurse asks is to get spesific information about the client. It is best if the question is related to the topic being discussed and by using words in the client's cultural context. Things to watch out for, questions are asked in order.

d. Repeating the speech of the client with his own words

     This fourth therapeutic communication technique can be explained that by repeating the client's speech, the nurse provides feedback, so the client knows that the message is understood and expects the communication to continue.

e. Clarification

     In case of misunderstanding, the nurse can stop the conversation to clarify by equating perception. In order for the message to arrive correctly, the nurse needs to provide a concrete and understandable example of the client.

f. Focusing

    This method is done with the aim of limiting the conversation, so it is more specific and understandable. The nurse should not stop the conversation when the client presents the problem, unless the conversation continues without new information.

g. Convey the results of observation

     Delivering what the nurse has observed from the clients verbal and non-verbal message  can be used as feedback on what the client has said. This often makes the client can communicate clearly, without having to increase by focusing and clarifying message that have been delivered.

h. Offer information

    This additional information enables deeper appreciation for clients of their circumstances. Providing additional information means providing health education for clients. In addition, it will increase the client's trust in the nurse. The nurse should not advise clients when offering information, but facilitate clients to make decisions regarding their circumstances.

i. Be quiet

   Silence gives nurses and clients time to organize his thoughts. The use of the silent method requires skill and timeliness, otherwise it will cause uncomfortable feelings. Silence allows the client to communicate with himself, organize his thoughts, and process information. Silence is especially useful for clients when it comes to making decisions

j. Summarize

      Summarizing is a repetition of a major idea that has been briefly communicated. Summarizing the conversation can help the nurse repeat an important aspect of the interaction so that it can continue to spread on related topics.

4. Roleplay about Therapeutic Communication 


"In a room in the hospital, there are patients who have wounds and nurses will do wound care"

Nurses 1 and 2            : "Good morning"
Patient                         : "Good morning, what is it ?"
Nurse 1 and 2              : "Introduce me Nurse Ai and Rahmi We will take care of mother from 7 am to 4 pm. Looks like mother's bandage should be replaced and mother's wound must be cleaned too, what if I clean?"
"But the patient refused to clean his wound and the nurse tried to persuade him"
Patient                         : "But I do not want to because it will hurt"
Child Patients              : "Mothers wounds must be cleaned in order to recover quickly"
Nurses 1 and 2                        : "Yes it's true that the wound must be cleaned to dry quickly and recover quickly"
patient                          : "But I still do not want nuns"
Child Patient                : "Mom only briefly and definitely will not hurt"
Nurse 1 and 2               : "Yes it's just a little while and even though it hurts I'm sure you can hold it for a while, if the maternal bandage is not replaced and the mother's wound is not cleansed it can cause a slow healing process and will cause a new wound"
Patient                          : "Is that true?"
Nurse 1 and 2               : "Yes right then the wound must be cleaned and the bandage must be replaced to recover quickly"
Patient                          : "Yeah well I want my wound cleaned"
"Finally, the patient's wound was cleaned and the bandage changed, because the nurse explanation about the importance of wound care so that the patient who did not want the wound was cleaned and the bandage in the end finally want to do wound care"
Nurse 1 and 2               : "Well sir, the wound I've cleaned and the bandage I've changed How do you feel now?"
Patient                          : "I feel better"
Nurse 1 and 2               : Okay because the maternal wound care is over, we want to go back to the room and when the mother needs us, the mother can call us in the nurse's room. "
Child Patient                : "Yes Sisters Thank You"
Nurses 1 and 2             : "Yeah are the same"
 "The patient feels better and the nurse leaves the patient's room"
Conclusion   : We as a nurse must be skilled in communicating with the patient and provide an explanation of the actions to be performed as clearly as possible.

Role Play 1 : Question and answer about Assertiveness

1. What is assertiveness?

Answer : 

      Assertiveness is a skill regularly referred to in social and communication skills training. Being assertive means being able to stand up for your own or other people’s rights in a calm and positive way, without being either aggressive, or passively accepting ‘wrong’. Assertive individuals are able to get their point across without upsetting others, or becoming upset themselves.  

2. Why Assertive skill is essential for nurse ?

Answer :  

       Assertiveness skills are essential for the nurse because the nurse's role as a nursing care giver, client advocate, as an educator, as coordinator, collaborator, consultant who is required to provide the best for his client and provide clear and clear information both to the client and to his / her family.

3. What are DESC in assertive skill ?

Answer :    

D – Describe the behaviour

E – Explain the effect of the behavior

S – State the desired outcome

C – Consequence: say what will happen if the behavior continues 

(Cox 2007)

Some people prefer to memorize the key words that represent this model because it gives them a consistent structure to follow: 

D  When . . . 

E I feel . . . because . . . 

S Therefore, I want/need . . .

C So that . . .

4. Roleplay to show assertiveness 
     "The mood in the Jasmine Room as usual before conducting the examination to the head room patient will give direction to make the more conducive" 
Chief of  the Room : " Good Morning, you are now in the morning shift ?"
Nurse 1 and 2          : " Yes, we are in the morning now"
Head of Room         : " Can we get together for a while ?"
Nurse 1 and 2          : " Yes, well miss "
" The head of the room and the nurse enteredthe room to give direction "
Head of Room         : " As usual before we take action, we should first check the state of the patient to ensure what action will be given "
Nurse 1 and 2          : " Yes, well miss "
Head of Room         : " It seems that's all, good work "

Nurse 1 and 2          : "  Yes, ma'am "
" The nurse came out of the room and suddenly the patient's family came to him "
Family of Patients   : " Nurse, Nurse, please my sister from overnight fever "
Nurse 1 and 2          : " Yes, fine, Wait a minute I'll be right there "
Patient's Family       : " Fast yes, nurse! "
" The nurse was spatial patients and immediately checked it "
Nurse 1                    : " Assalamu'alaikum "
The Patients Family : " Wa'alaikum salam, this my sister nurse, for last night the fever did not go down "
Patients                     : " Nurse, I dizzy and shiver "
Nurse 1                     : " Let me check first "
Patient family           : " How is nurse ? "
Nurse 1                     : " The patients body temperature check is very high"
Patient's Family        : " Last night i've been compressing but not down too "
Nurse 1 and 2           : " Preferably not only by compressing, but drink plenty of water and also if it will compress better in the armpit or abdominal area because it is more effective at lowering the heat" 
Family of Patient      : " yes, good nurse "
Nurse 1                     : " and this I give hot-tasting drugs to drink after eating yes, ma'am "
Patient                       : " oke, thank you Nurse ! "
Nurse 1 and 2            : " You're welcome "

Conclusion                : " So we as nurse must have a firm attitude in communication so that no errors in communicating and in providing services "