Communication and Interpersonal Skills
Communication questions on the exam are judged by one standard: does your response protect the resident's dignity and get accurate information to the right person?
Core concepts
- Therapeutic communication: open-ended questions ("Tell me more about that"), restating, reflecting feelings, silence, and active listening. False reassurance ("You'll be fine"), advice-giving, changing the subject, and probing "why" questions are non-therapeutic.
- Nonverbal cues: sit at eye level, face the resident, uncross your arms, respect personal space, and do not tower over someone in bed.
- Special situations: for hearing loss, face the person, cut background noise, lower your pitch, and do not shout. For aphasia, ask yes/no questions and allow time. For vision loss, identify yourself and narrate before touching. For language barriers, use a facility interpreter rather than a family member when possible.
- Reporting: observations go to the charge nurse, objectively and promptly. SBAR (Situation, Background, Assessment, Recommendation) keeps the report organized.
- Confidentiality: no resident information in hallways, elevators, break rooms, or on social media, even without a name attached.
Traps
Questions often offer a "kind" answer that breaks scope: telling a resident a diagnosis, explaining a surgery, or informing her that her roommate died. Those belong to the nurse or family. Another trap is agreeing to keep a secret when safety is involved. Watch for answers that argue with or blame a confused resident.
Rule of thumb
Report up, not out: information travels up the chain to the nurse, never out to other aides, other residents, or your family.
Worked example
A resident is crying after a phone call. Wrong: "Don't cry, it'll be okay." Right: sit down, offer a tissue, and say, "You seem upset. Would you like to talk about it?" Then report the change to the nurse.