Nursing Can be Learned or Acquired through Experience

Please respond to the discussion post below. Thank you
1-Provide an example of how therapeutic communication techniques differ between nurses and psychiatric mental health practitioners (PMHNPs).
The art of therapeutic communication can be learned, and other skills can be practiced to gain expertise. Whether therapeutic communication is from nurses or specialized nurses such as PMHNPs, therapeutic communication is a process that will improve with practice. It’s a process to improve an individual’s understanding of the message we are sending through non-verbal and verbal communication. Therapeutic communication between nurses and PMHNPs differs each other from the level of communication, diagnosis (physical or mental illness), crisis (medical or psych), and type of patients (outpatient or inpatients). Generalist nurses are not providers such as PMHNPs. They do not want to do a diagnosis and differential diagnosis, they don’t want to decide the treatment to heal a patient neither, to order the bloodwork to confirm the clinical signs and symptoms. So, therapeutic communication of nurses is establishing the treatment goals and priorities, ensuring interdisciplinary communication, and delivering news with evidence-based: progressing, not progressing, worsening, or bad news. For example, the nurses in general favor good therapeutic communication that facilitates a healing environment that supports the physical and psychosocial needs of the patient, family, and providers. Whereas, for PMHNPs, therapeutic communication is a crucial tool that is used in the mental health setting that gives guidance to elicit optimistic results from patients, for building the PMHNP-client relationship, ventilation of sentiments, and for exploring fundamental aspects of the patients and their disorder. During the interaction with a patient and her/his family, the PMHNP will be able to use multiple therapeutic communication techniques. Examples of individuals with an autism spectrum disorder in an inpatient setting can be challenging to communicate with within clinical settings. Thinking outside the box and employing creative strategies to connect with such patients can be highly effective (J. L. Kouo and T. S. Kouo, 2020). Another recent example was my last overnight shift yesterday. A 35-year-old male who got currently married to a 31-year-old woman with 3 children. He is depressed, anxious, and overwhelmed by being a stepfather of three youth suddenly. He responds inadequately to his new life situation by starting using methamphetamines, Mariyana, and vodka. My job yesterday, when I came across this newly admitted client, is to use therapeutic communication to build an alliance, to involve a natural empathy, and compassion, and to heal him psychologically to trust himself in the parenting position. I do boost him that he can do a good job with the love of his wife and her children.
2-Select one verbal component of therapeutic communication. Discuss the importance of the element in relation to the overall goal of a therapeutic alliance.
An example of an opening ending question is what brings you to this hospital today, as you walk in voluntarily? He said I am here to ask for help, my mind is racing, I am worried too much, and I have parenting concerns. I don’t know if I can do this .... etc. In fact, when I was assigned to communicate with the patient, I really wanted the patient to feel comfortable enough to speak with me and explore the feelings that he wanted to share. As an inpatient psych nurse, I met the client in the dayroom with peers watching TV. An ongoing day shift nurse welcomed the patient into the unit by 5:30 pm. Our day house supervisor has told her to just receive the patient for the night nurse that I am to do the admission interview. I did well because the patient slept through the night for 8 hours after my interaction with him and under PRN Trazodone 50 mg. He told me at the last rounding what the time I spent listening to him and the medication I gave helped him. He said I slept like a baby. So, I assumed the interview went well. He regains his trust in himself.
3- Select one nonverbal component of therapeutic communication. Discuss the importance of the element in relation to the overall goal of a therapeutic alliance.
Components of nonverbal therapeutic communication are expressed through body language and facial expressions. Positive nonverbal communication techniques include relaxed movements, use of open arm gestures, smiles, respect for personal space, and eye contact, touch, Facial expressions, vocal cues, paralanguage, nods when clients talk. Study shows that enhancing nurses’ nonverbal communication has the potential to improve therapeutic relationships and the overall goals of a therapeutic alliance. Nonverbal communication is a broad term consisting of those interactions with or without speech such as how we sound, behave, and what is expressed with each other and our environment (Blanch Hartigan, Ruben, Hall, & Schmid Mast, 2018). In the above 35-year-old male example, the day shift nurse just took his vital signs and told him the oncoming nurse will finish his admission. Since that time no one came to unfold the event of his life that he was worried about. So, I was expected. I met the client and moved him from the hub of the unit, which is the dayroom, where he was watching TV. I introduced myself, my role in the unit, and my reasons for wanting to sit and talk with her. The patient was willing to talk with me and felt relaxed, and at ease talking to me I start to actively listen, focus, and nod my head to communicate agreement or understanding. The fact that my client felt relaxed yesterday and start to describe his parenting concerns, the nods I did, his poor eye contact, and poor concentration, are nonverbal components of therapeutic communication that are an important component in relation to the overall goal of a therapeutic alliance.
4-Discuss one pitfall to avoid when establishing a therapeutic alliance. Identify strategies the PMHNP can use to avoid this pitfall.
When I was interviewing my client, at the beginning of our communication, I was focused; but after 15 min I was looking at the camera and the clock in the hall. I don’t know if my client noticed that I stopped to listen to the narrative description of his story and jumped into another rubric of the interview. Being present, and stopping to be an active listener, looking at the camera, and clock for time management are some pitfalls that the PMHNP should avoid when establishing a therapeutic alliance. My client was feeling overwhelmed, depressed, isolated, and powerless with his stepchildren. He came voluntarily and turned himself to us (Psych hospital) for help and to be on medication. But the first nurse did not have time to do the interview, I did it with pitfalls thinking about all paperwork, charting, having seven established or previous patients, and one more coming admission, because in my unit each psych nurse got 9 patients. However, with tact, I got essential from the interview within 30 min. As the result, he slept through the night for 8 hours.
References
Blanch-Hartigan, D., Ruben, M. A., Hall, J. A., & Schmid Mast, M. (2018). Measuring nonverbal behavior in clinical interactions: A pragmatic guide. Patient Education and Counseling, https://doi(dot)org/10.1016/j. pec.2018.08.013
L. Kouo and T. S. Kouo, “A scoping review of targeted interventions and training to facilitate medical encounters for school-aged patients with an autism spectrum disorder,” Journal of Autism and Developmental Disorders, 2020l