Ch 11 Clinical Interview And Communication Skills

Front 1

who decides the content and direction of the clinical interview

Back 1

Client decides

Front 2

What skills you should employ in a clinical interview?

Back 2

communication skills and active listening (attention to body language, facial expression and vocal tone)

Front 3

Nurse provides the client the opportunity to reach a specific goal during a clinical interview. List 4?

Back 3

To feel comfortable and understood
To identify and explore problems relating to others
To discuss healthy ways of meeting emotional needs
To experience a satisfying interpersonal relationship

Front 4

How does a nurse increase ability to use communiation skill and interviewing skills?

Back 4

work under supervision or observe more experience clinicial through modeling

Front 5

what is more important for the success of therapeutic outcome?

Back 5

strong therapeutic relationhip

Front 6

Setting of an interview

Back 6

can be anywhere but ideally in a health care setting, conference room or quiet part of the unit that has relative privacy but is w/in view of others is ideal. Client's home but depends on the degree to w/c the nurse and client feel safe; close to a door and don't position yourself between the door and client should not be position between the nurse and the door

Front 7

acquired skills and basic ingredients of a therapeutic nurse-client relationship

Back 7

communication and interviewing techniques

Front 8

Seating of the Interview

Back 8

chairs arrange that conversation can be carried in a normal tone of voice, eye contact maintained or avoided, assume same ht in sitting or standing, avoid face to face stance, 90-120 angle position or side to side position is less intense that the nurse/client can look away from each other w/o discomfort; setting is always is close to door access, client should not be position between the nurse and the door
avoid desk barriere between the nurse and the client

Front 9

Introduction of the clinical interview

Back 9

follow orientation goals, introduce yourself (name, name of school) , state your purpose, how long and what time is the meeting, discuss confidentialityy and ask the client how they want to be addressed

Front 10

What is the imporatance of asking a client what they want to be addressed?

Back 10

conveys respect and gives client direct control over an important ego issue(some like being called by last names/1st)

Front 11

How to start an interview

Back 11

offering lead and acceptance statements (uh-huh)

Front 12

Tactics to Avoid

Back 12

don't:
argue, praise the client or give false reassurance, interpret to the client or speculate teh dynamics of the client's problem, question the client about sensitive areas, try to sell the client on accepting treatment, join in attack with the client on his/her parents, friends, or associates, participate in criticism of another nurse or any other staff members

Front 13

What can you do instead of arguing with the client?

Back 13

focus on the facts and clients perceptions

Front 14

What can you do instead of praising and giving false reassurance to the client?

Back 14

make observation about the client behavior, change is always possible

Front 15

What can you do instead of interpreting to the client or speculate on the dynamics of the client problems?

Back 15

listen attentively, use silence and clarify

Front 16

What can you instead of questioning the client about sensitive issues?

Back 16

pay attention to nonverbal communication, strive to keep the clients anxiety decreased

Front 17

what can you do instead of trying to sell the client on acceptable treatment?

Back 17

ENC the client to look at the pors and cons

Front 18

what can you do instead of joining attacks of the client to others?

Back 18

focus on facts and clien'ts perceptions; be aware of nonverbal communication

Front 19

what can you do instead of participating in criticism of other staff?

Back 19

focus on facts and client's perception; check out serious accusations with other staff, have the client meet with the nurse or staff member w/ senior stafff to clarify perception

Front 20

Helpful guidelines in conducting interview

Back 20

speak breifly, if you don't know what to say say nothing, when in doubt focus on feelings, avoid advice, avoid relying on questions, pay attention to nonverbal cues and keep the focus on the client

Front 21

what is the focus in clinical supervision

Back 21

focus is on the nurse, nurse supervisor and nurse examine & analyze the rn’s feelings and rxn to client and the way they affect the rn-clt relationship; can be a therapeutic process for nurse; can ventilate; examining interactions, obtain insights and device alternative strategies for dealing w/ various clinical issues enhances your clinical & professional growth and minimizes frustration and burnout

Front 22

What is process recording?

Back 22

most common method of evaluating nurse-client interactions in academic setting, way to ID patterns in the student’s and clt’s comm. It’s a written record of a segment of rn-clt session that reflects as closely as possible the verbal and nonverbal behaviors of rn &clt
Disadvantage:
relies on memory and its subject to distortion

Front 23

Specific client behaviors that may pose a challenge to nurse during a clinical interview?

Back 23

client, crying, asking the nurse to keep a secret, threatening to commit suicide, client leaves before the session is over, client doesn't want to talk or wants to prolong the interview, giving the nurse a present, and asking personal questions

Front 24

The client is crying, what are the useful responses?

Back 24

stay with the client, tell them its ok to cry, this is the time when the client's feelings is closest to the surface and can be identified; offer tissue when appropriate

Front 25

The client ask you to keep a secret, what are useful responses?

Back 25

can't make such promise; info may be important to the health and safety of the client or others; tell the client that you can't make that promise and it might be important to me and to other staff

Front 26

The client stated he wants to kill himself, what can you do?

Back 26

assess if the client has a plan and lethality of the plan;discuss feelings and circumstances that led to this decision
this is serious Mr.X, I don't want any harm to come to you, I will need to share this information with other staff

Front 27

The client says he doesn't want to talk?

Back 27

ask the client if its okay to spend time with him, and that they don't have to talk; spend short frequent periods with the client

Front 28

the client ask you a personal question?

Back 28

say nothing or answer with 1 or 2 words then refocuses back on the client

Front 29

What are the components of communicaton process?

Back 29

stimulus, messenger, media, receiver, feedback
communication process is complex involving factors such personal and environment that can distort the sending and receiving messages

Front 30

Factors affecting communication process

Back 30

personal, environmental and relationship factors