Communication and Interpersonal Skills
Two channels, one message
Communication is verbal and nonverbal: tone, facial expression, posture, and touch often carry more than words. Therapeutic communication is purposeful, respectful, and resident-centered. It uses open-ended questions, active listening, restating, clarifying, reflecting feelings, silence, and empathy.
Concepts to know cold
Barriers include medical jargon, false reassurance, "why" questions that sound accusatory, changing the subject, and giving advice. Adjust for sensory loss: face a hearing-impaired resident, speak clearly at a slightly lower pitch, do not shout, and avoid covering your mouth. For a resident with aphasia, ask yes-or-no questions, allow time, and use gestures or a communication board. Use a qualified interpreter, not a family child. For dementia, approach from the front, use short sentences, and allow time.
Documentation and reporting
Chart objectively, factually, and promptly - what you did, what you observed, what the resident said. Record in the correct chart, sign it, and correct errors with a single line, date, and initials; never use correction fluid. Report changes using SBAR: Situation, Background, Assessment, Recommendation.
Traps
- Saying "Don't worry" or "I know exactly how you feel." Both close the conversation.
- Charting opinions such as "resident was difficult" or charting care before you gave it.
- Using unapproved abbreviations or charting for a coworker.
- Discussing a resident in a public area.
Rule of thumb
If it was not charted, it was not done - and chart what you did, not what you assume. When in doubt, report up the chain: charge nurse, then supervisor.