Communication and Interpersonal Skills
Therapeutic communication
The goal is to help the resident express needs and to confirm you understood. Use active listening, open-ended questions, restating, clarifying, and reflecting feelings. Sit at eye level, face the resident, keep your voice calm, and allow silence for processing. Good messages are short, concrete, and respectful.
What to avoid
Blocking and false reassurance shut communication down. "Don't worry, everything will be fine" or "You'll feel better tomorrow" dismisses real fear. "Why did you do that?" sounds judgmental and invites defensiveness. Arguing with a confused resident, giving advice, changing the subject, or using medical jargon all create distance. Never promise confidentiality you cannot keep, and never share your own problems at length.
Special situations
For hearing loss, face the person, get their attention, lower your pitch rather than shouting, reduce background noise, and use written notes if needed. For a resident with aphasia, allow extra time, ask yes-or-no questions, and use gestures or a communication board. Use a qualified interpreter and speak to the resident, not the interpreter. When a resident is angry, acknowledge the feeling before solving the problem.
Documentation
Chart objectively: what you saw, heard, measured, and did. Quote the resident when words matter. Record promptly, use black ink and facility forms, sign each entry, and correct errors with one line and initials, never white-out or scribbling.
Worked example
Resident says, "I hate this place, nobody cares." Poor reply: "That's not true, we all care about you." Better: "You sound really frustrated. Tell me what happened today." You acknowledge, invite detail, then address the actual issue and report it.
Traps
Exams reward a reply that reflects feeling and gathers information, not one that reassures, argues, or explains policy.