Communication and Interpersonal Skills
Therapeutic communication
The goal of therapeutic communication is to help the resident express feelings and needs. Use open-ended questions ("Tell me more about that"), active listening, restating, clarifying, silence, and empathy. Avoid "why" questions, which feel like blame; avoid false reassurance ("Don't worry, you'll be fine"); avoid changing the subject or giving advice. Keep your voice calm and your body relaxed, sit at eye level, and honor personal space and culture. Avoid medical jargon and speak at an unhurried pace.
Adjusting for sensory and language needs
With hearing loss, face the person, get their attention, speak slightly lower and clearer, do not shout, and use writing if needed. With vision loss, identify yourself, say what you are about to do, and place items in consistent spots. With aphasia, be patient, ask yes/no questions, do not correct the words, and use gestures or a picture board. Use a qualified interpreter for limited English - not a family child. For a resident with a tracheostomy or on a ventilator, provide a call method and allow time to lip-read or write.
Team communication
Give report that is organized and factual: what changed, what you did, what to watch. Report immediately for sudden changes. Ask questions when you do not understand an instruction, and repeat back to confirm. Disagreements with coworkers are handled privately and through the nurse, never in front of residents.
Traps
Questions love to offer "reassure the resident that everything will be fine," "ask the resident why they are upset," "explain the diagnosis yourself," or "talk about the resident in the break room."
Rule of thumb: listen more than you talk, and respond to the feeling before the facts ("That sounds frightening. Tell me more.").