Communication and Interpersonal Skills
Therapeutic communication is purposeful: it helps the resident express what they feel and need. Use open-ended questions such as 'Tell me more about how your back feels,' restate and reflect what you hear, and allow silence and time. Sit at eye level, face the resident, keep your voice calm, and use touch appropriately. Report what you observe in objective terms, and hand off with a structured tool such as SBAR - Situation, Background, Assessment, Recommendation.
Know the barriers. Avoid false reassurance ('Don't worry, you'll be fine'), giving advice, changing the subject, 'why' questions that sound accusatory, and medical jargon. Do not argue with a resident's feelings. For a resident with hearing loss, face them, get their attention, speak clearly at a normal volume in a lower pitch, and cut background noise - shouting raises pitch and makes understanding harder. For a resident with aphasia, ask yes-or-no questions, allow time to answer, and use gestures, pictures, or a communication board; never pretend to understand. Use a qualified interpreter for a resident with limited English, not a child, and avoid using family when a neutral interpreter is available.
Confidentiality applies to conversation too: discuss care in private, not in the hall, elevator, or cafeteria, and never on social media.
Trap: questions that reward explaining to a resident that the nurse is too busy, or that treat a resident's anger as a personal attack rather than a message about unmet need.
Rule of thumb: listen more than you talk, and answer the feeling before the facts.