Therapeutic communication is at the foundation of the nurse-client relationship as reflected in Figure 2.1. It is different from the conversations you have with friends, peers, family, and colleagues. Therapeutic communication has a specific purpose within the health care context. It is intended to develop an effective interpersonal nurse-client relationship that supports the client’s wellbeing and ensures holistic, client-centered, quality care.

The word “therapeutic” is related to the word therapy: it means having a restorative and healing effect on the mind and body as well as doing no harm. It is important to consider how communication can affect the client.

In this chapter, you will first learn about nurses’ accountability related to therapeutic communication. Then, you will learn about the principles, approaches, and strategies used in therapeutic communication in the context of a client interview.

The Client Interview

The client interview is an important component of nursing practice and involves several sources as reflected in Figure 2.2. It involves communicating with the client – who is considered the primary source – to collect subjective data (i.e., information that the client shares with you or the client’s family and friends). The client interview may also involve collecting data from secondary sources such as family, friends, care partners, and other health care providers. It is part of your assessment in which you learn about the client and combine these collected data with objective data (information that you collect when performing a physical exam).

The importance of good communication cannot be overstated. It is a foundational pillar of a good interview. The interview often gives the nurse information about which therapeutic actions to use. For example, without a client disclosing chest pain, it would be difficult for you to interpret what is wrong or ailing the client. The care provided by nurses is contingent on the accuracy of the data they collect, so nurses must develop their relational skills to accurately and holistically gather useful data from clients. If data are lacking, nurses are limited in providing effective care. For example, clients may not share certain problems if they are unsure whether you care or are interested. Also, clients may be afraid to reveal relevant health information because they fear judgment or ridicule, which could impede your ability to address their health issue.

The nature of the interview is influenced by the purpose of the interview. For example, an interview may be short and focused, or it may be more detailed and comprehensive. It all depends on the client’s current health needs or reason for seeking care. The interview purpose is often influenced by where you work, for example an acute or primary care setting. No matter what the purpose, there are common principles and strategies to incorporate when conducting the interview, as detailed in the upcoming sections.

Preparing for the Interview

You should review the client’s existing health record or chart (if applicable) so that you have a general overview of the client’s main health needs or reason for seeking care and health history. If the client is already admitted, this review will not only give you an overview of their health history, but also their last 24 hours. This is an important first step for several reasons:

• It conveys your interest and competence as a provider.
• It allows you to follow up on missing data.
• It saves the client from repetition.
• It allows you to identify any changes in the client’s health status.

You should also consider how to leverage the environment of the interview location and your position within the space. The client interview is often conducted in locations such as clinic rooms, hospital rooms, emergency rooms, and community spaces such as the client’s home. You should pay attention to the following principles:

• Create a quiet location so that both you and the client can hear and communicate. Some possible strategies to reduce sound may include closing the room door, closing the curtains, and turning off radios and televisions.
• Establish a welcoming environment, which may include offering the client a place to sit and avoiding physical barriers between you and the client such as a desk.
• Address the client’s physical comfort, which may include offering them a drink of water and inviting them to take their coat off or have a place for them to put their bag or purse. Additionally, if they are in bed, you should ensure that they are comfortable and ask if they want to sit up, if they are permitted.
• Create an inclusive space in which care partners are invited to be part of the interview based on the client’s wishes.
• Ensure a private space so that the client feels comfortable to share personal information and that this information is kept confidential. Sometimes it will not be possible to ensure a completely private space, such as when a curtain is the only barrier. In this case, try to avoid using the client’s name and other client information loudly so that others can’t overhear.
• Maintain professional boundaries as this facilitates a trusting and therapeutic relationship between nurse and client. You must understand your professional role and ensure that your relationship with the client does not become personal (such as meeting the client outside of work hours, disclosing personal information, or accepting and exchanging gifts).

In preparation for the client interview, you must first be aware of the legislation and nursing standards concerning privacy and confidentiality. The Personal Health Information Protection Act (2004) states that clients have the right to have their personal health information kept private, and health care professionals are legally required to keep this information confidential. You must emphasize that client data is kept confidential and only shared with relevant members of the health care team directly involved in the client’s care. You may want to re-emphasize confidentiality when addressing sensitive interview topics such as trauma and violence, sexual health, and substance use. The client owns their personal health information; as a custodian of this information, you must request permission before disclosure. However, there are certain situations where consent for disclosure is not required (such as “to eliminate or reduce a significant risk of harm to a person”).

Self Reflection Prior to the Interview

Like everyone, nurses are susceptible to stress, sadness, anger, and an array of other emotions. Despite good intentions, your communication will be strongly influenced by your mood, thoughts, and emotions. Self-reflection is an important tool for recognizing your emotional state and minimizing unintentional miscommunication with clients, in other words non-therapeutic communication. See Figure 2.3.

See Table 2.1 for strategies on how you can self-reflect before commencing the client interview.

Table 2.1: Self-reflecting on emotions and thoughts.

As you self-reflect, consider that the health care environment often intensifies emotions for clients and their families. It can be a place where people experience pain, discomfort, and stress. Clients may hear bad news and confront truths about themselves, or experience intense joy and relief. Because such extremes can exist in the health care space, the client is often more attune to you (the provider) than you may be aware. The client may be telegraphing your body language or comprehending your choice of words. For this reason, providers need to be self-aware and temporarily suspend their own needs in order to authentically connect with the client.

Beginning the Interview

There is a standard way to begin interviews so that the client knows who you are and why you are there.

Introducing yourself and addressing the client

Begin by introducing yourself by name and category to the client, and determine how the client wants to be addressed. Also, best practice has shifted to include your own pronouns and ask what pronouns the client uses in order to create an inclusive environment. For example, a nurse may say, “Hello, I am Mac Li Ken Ji. I am a registered nurse. Please call me Mac. My pronouns are he/him. How would you like me to refer to you and what pronouns do you use?” It is important not to use the term “preference” when referring to pronouns and gender as these are not preferences.

Identifying the purpose of the encounter

Part of the introduction phase of the client interview is to identify your role including the purpose of the encounter. You should also notify the client that any information collected will be kept confidential and if applicable, identify who the client’s information will be shared with. Nurses often let clients know that they will also be taking notes.

Here are some examples:

• Example 1: I want to interview you about your illness. It will take about 10 minutes and will begin with me asking you some questions about how you are feeling. Is that okay? [client: yes]. I also want to let you know everything that you share will be kept confidential between myself and the health care team who are involved in your care. [client: okay]. Please do note that I will be taking notes as we talk and I will be asking you questions that help me understand your health concerns and how best to care for you today. If you have any questions, feel free to ask at any time.
• Example 2: I see that you came into the clinic because you have been coughing. Before the physician comes in, I want to ask you a few questions related to your cough. It will take about 10 minutes. Is that okay? [client: yes]. I also want to let you know everything that you share will be kept confidential between myself and the health care team who are involved in your care, which includes myself and your physician at this point. [client: okay]. Please do note that I will be taking notes as we talk and I will be asking you questions that help me understand how you are feeling, your health concerns, and how best to care for you today. If you have any questions about my questions, feel free to stop me and ask.

Types of Interviewing Questions

There are three types of questions that guide the client interview.

1. Closed-ended questions
2. Open-ended questions
3. Probing questions

Closed-ended questions are direct questions that you ask when you are seeking precise information. These types of questions typically generate a short answer and do not facilitate a dialogue. Here are some examples in which the answers are typically one word:

• “Do you smoke?”
• “Have you been tested for tuberculosis?”
• “What year were you born?”
• “Do you take the medication as directed?”
• “When did your rash start?”

Open-ended questions are types of questions that invite the client to share descriptive answers, open up about their experience, and answer in a way that is most relevant or comfortable from their perspective. In response to open-ended questions, clients typically talk in sentences and may even tell stories (as opposed to the short answers to closed-ended questions). Although clients may provide a short answer, this type of question still provides the opportunity for you to probe further. Here are some examples:

• “What was going on in your life when you first started feeling depressed?”
• “Tell me about when you first started smoking.”
• “How have you been feeling in the past week?”
• “Tell me about the challenges you are having with your medication regimen?

You should listen to the answer carefully so that you can authentically respond to what the client said and possibly probe further.

Probing questions are types of questions and statements that allow you to gather more subjective data based on a client’s response. These types of questions can also be used to summarize and clarify a client’s response or resolve discrepancies that you identify. These questions and statements can be open- or closed-ended. Here are some examples:

• “Tell me more.”
• “How did that affect you?”
• “When talking about your health, you said ‘don’t cross the bridge till you come to it,’ can you tell me what you mean by that?”
• “You said that you have been doing ‘well’ since your partner’s death, but I noticed that you are teary-eyed as you are speaking about them. Can you talk a bit about that?”

Communication Strategies

There are many communication strategies that should be used to facilitate therapeutic communication. See Table 2.2 for a list of these strategies and considerations and examples on how they build the therapeutic relationship.

Table 2.2: Communication strategies.

Non-Verbal Communication Strategies

Non-verbal communication strategies are ways you communicate without speaking, for example through facial expressions, hand gestures, eye contact, and body language. See Figure 2.5.

In many situations, much of your communication occurs through non-verbal behaviors. Non-verbal communication can be a useful strategy for communicating emotions like empathy, compassion, and acceptance. It is often how nurses respond, rather than what they say, that leaves a lasting impression on clients, so it is important to be aware of how you communicate using non-verbal behaviors.

Non-verbal behaviors must align with your verbal behaviors so that clients clearly understand what you are saying. For example, it would be confusing for the client if you had a somber tone of voice, distancing posture, and avoided eye contact while attempting to maintain a therapeutic relationship with the client.

Try to ensure positioning where you are both at the same vertical level and a slight angle towards one another. This positioning conveys an open and non-confrontational and non-authoritative space. Whenever possible, avoid standing over the client if they are sitting or lying in bed. It is better to sit down, which also conveys that you have time to listen to them.

There are many models to inform your non-verbal communication. One helpful model is called SURETY (Stickley, 2011) reflected as a modified version in Figure 2.6:

Cultural Considerations

Therapeutic communication with clients and families requires attention to a person’s culture. It is important to note that:

• People are cultural beings. At a basic level, culture includes a person’s beliefs and values. It refers to a person’s practices or their way of life. It includes a person’s ethnicity, spirituality, and religion, but it is much more than these components.
• Culture is deeply embedded in each person and everything they do, including how they communicate and what is meaningful to them. It is essential to understand because it shapes the way we think, feel, and behave. It can determine what is considered taboo, appropriate, and meaningful.
• Culture is socially transmissible (Kashima, 2019) meaning that it can be passed from one person or generation to the next, making verbal and non-verbal communication a vital way to impart and share culture. Often, from an Indigenous perspective, culture is not merely the sum of a person’s individual characteristics; “it is an emergent property of individuals interacting with their natural and human environment” (Kim, Park, & Park, 2000, p. 67). As a result, culture is not static – cultural patterns are dynamic and shift throughout a person’s life.

Cultural safety is an important component of therapeutic communication, because culture is so dynamic and deeply embedded in a person’s way of being. In the context of therapeutic communication, you must examine your own culture and how it affects the ways you communicate with clients. This self-awareness is vital to provide culturally safe care to clients and facilitate health equity (Curtis et al., 2019).

A relational approach can facilitate communication that embraces cultural safety because it relies on your dialogical engagement with the client. In other words, nurses should suspend what they assume they know about culture, and let clients direct nurses with regard to how culture is meaningful to them. This approach encourages you to consider the relational interplay (Doane & Varcoe, 2015) of communication, the client’s culture, and your own culture. Like everyone, nurses are cultural beings with ethnocentric tendencies – you will tend to view the world and your client from your own cultural perspective. From a relational perspective, you must understand your own culture and your ethnocentric tendencies so that you are positioned to recognize and understand the client’s culture.

Part of a relational approach also involves positioning yourself as an inquirer who is in a “space of knowing or not knowing, being curious, looking for what seems significant” (Doane & Varcoe, 2015, p. 6). See Table 2.3 on how to develop yourself as an inquirer and understand the interplay of your culture and the client’s culture.

Table 2.3: Understanding culture.

Developmental Considerations

A person’s age needs to be considered when conducting the client interview. Most importantly, you need to consider a client’s developmental stage. A client’s developmental stage does not always align with a client’s chronological age. With regard to communication, a focus on developmental stage includes attention to areas such as language and cognitive and socio-emotional development. At times, you may need to modify your communication so that you are appropriately engaging with the client at a level they understand.

There are many ways to construct chronological age categories. Broadly, children are considered anyone under 18 and adults are considered anyone 18 and older. More specifically, you could consider the categories used in this resource:

• Newborns and neonates: newborns are birth to a few hours old and neonates are up to 28 day.

• Young children: clients who are 5 years and younger, including infants (28 days to 1 year), toddlers (1–2 years), and preschoolers (3–5 years).

• Older children and adolescents: clients who are 6–17 years, including older children or school-age children (6–12 years) and adolescents (13–17 years).

• Adults and older adults: clients who are 18 years and older, including adults (18 years and older) and older adults (65 years and older).

Young Children

You should use a combination of verbal and non-verbal communication with infants. Be constantly aware and adapt your use and choice of communication strategies based on the infant’s response.

Most babies enjoy hearing the human voice. This is how they learn and make sense of language. You should talk to them in a relaxed and pleasant tone of voice even though they cannot verbally respond. It’s also okay to use baby talk with infants as it can help with language development: Baby talk is a type of speaking where you use enhanced vocal intonation and hyperarticulation of sounds such as vowels and consonants.

In terms of non-verbal communication, you should have a relaxed body posture, smile, use appropriate eye contact, and gestures with your hands; these techniques are important with all children because non-verbal language can facilitate their sense of safety.

With children, you should adapt your communication to their developmental stage. Tailor your language to a level that children will understand, avoiding long complex sentences and instead using short sentences with simple words. Although you may use baby talk with infants, you should use a different approach with toddlers, who often want to be included in the conversation. As children get older, they enjoy receiving compliments and encouragement to connect with them ( “look how much you have grown” or “great job!”).

Because care partners (typically parents) are usually present with young children, it’s important to involve them so that the child feels safe. Here are some points to consider with care partners:

• While communicating with a parent, the infant or toddler may sit on their parent’s lap and/or play with a toy. This introductory communication can help the child get familiar and comfortable with you, particularly at the first meeting.

• Children may behave differently because they are afraid or not feeling well. For example, they may hide behind the care partner, refuse care from the health care provider, cry or scream. These behaviors can create stress for the care partners, so it’s important to be patient and demonstrate unconditional positive regard.

• Some or all the client interviews will be conducted with the care partner when the child is unable to speak or fully articulate. Because care partners are considered a secondary source of data, you should ask them to clarify and elaborate how they know what they are sharing with you. For example, if they say that their baby is in pain, ask how they know this.

• At times during the interview, it may be appropriate to interview the parent without the child present, particularly when talking about sensitive topics.

Older Children and Adolescents

Older children and adolescents are usually at a stage where they can participate in the client interview in a more active way and articulate their experiences, emotions, and needs. Thus, it is important to address them as the client first, as opposed to the care partner. Care partners are often still involved, but you should offer the child or adolescent the opportunity to speak with you privately at times. For example, you might say to the client: “At this age, I often like to provide time to speak with you alone. Are you okay if I ask your mom or your dad to step out for a few minutes?”

You should continue to use a combination of non-verbal and verbal language and communication strategies. In terms of non-verbal communication, use eye contact with a relaxed and open posture that demonstrates interest in what they are saying. Smiling may be appropriate depending on the topic. You should also facilitate the interview using strategies such as nodding and statements that encourage the client to continue sharing (“uh huh” and “tell me more”). Be aware of your facial expression and vocal intonation to ensure you are conveying empathy, acceptance, and a non-judgmental attitude. You may want to include fun objects or games, or include the child in the assessment process (“would you like to try tapping on your own knee with this reflex hammer?”).

Adolescents are in a transitional stage where they are still children but are moving closer to adulthood. It is important to recognize and respect their self determination. Additionally, emotional and cognitive capacity will vary from adolescent to adolescent and from situation to situation. Therefore, your communication strategies will need to shift based on the adolescent and the situation. Overall, you should convey acceptance, honesty, and respect. Avoid talking to them as a child, as this is often interpreted as demeaning. Some adolescents are old enough to make their own decisions regarding some aspects of their health care: in many jurisdictions, this capacity to consent, which includes being able to understand and weigh risks and benefits, is determined by maturity level rather than by age.

When discussing sensitive and intimate topics, it is important to recognize that adolescents often feel self conscious, embarrassed, and have a fear of being judged. Your communication strategies should convey acceptance and understanding of what they are experiencing. You should have an open and non-judgmental attitude so that you can cultivate a trusting relationship with the client. Permission statements can be particularly useful as they can help normalize what an adolescent may be experiencing.

Adults and Older Adults

Adulthood is a large age category including everyone 18 years and older, but there is great diversity within this group. Some adults will have had minimal encounters with nurses and others will have had extensive encounters. Younger adults in their late teenage years and early twenties may share characteristics with adolescents, so you may use many of the same communication strategies. You should also examine and acknowledge your own biases and tendencies to stereotype older adults and constantly reassess your own assumptions so that they do not negatively affect your communication.

With older adults, it is important to give them time to process and answer questions, as they may have a slower response time. Avoid making assumptions about their hearing or vision or cognitive capacity. Rather, speak in a clear voice and face them while you speak as you would with all clients. It can be helpful to write down instructions or educational information for older adults, as they are often dealing with substantial quantities of health information.

Some older adults may have a care partner present with them because they are managing multiple illnesses and may have cognitive or physical impairments that cause disabilities. When a care partner is present, you should engage in an inclusive communication approach. After engaging in the introductory phase with the client, ask about who the person with the client is. If appropriate, you should consider the client and care partner as a dyad in which both are recipients of care, but the client should be your main focus during your assessment. Avoid assuming that care partners can better answer questions for older clients. For example, direct your questions to the client even though the care partner may help answer some of the questions.

Additional Considerations

As a nurse, you will encounter other populations and situations that will require you to thoughtfully consider how to best communicate in a way that is respectful, effective, and therapeutic. You might not even know when you are caring for certain populations, because it may not be obvious, so it is always best to ground your communication in best practices. For example, it is not necessarily readily apparent when a patient has a language discordance, is experiencing intense emotions, or has a disability. 

Language discordance

There will be times when you and the client and/or family do not speak the same language. In this case, you need to carefully assess and evaluate their understanding.

Here are some strategies to address language discordance:

• Speak directly to the client using simple language (no jargon, no medical language).

• Be aware of your non-verbal language and consider how gestures may help the client understand what you are trying to communicate.

• Use pictures and/or have a paper and pen for them to write down notes and questions.

• Consider how best to incorporate the care partner into conversations if they speak the same language as you, but the client does not. Care partners can be an integral part of the care processes and may be constantly translating what is going on for their loved one. Thus, in everyday communication, you may consider engaging the care partner in interpreting for you and the client. For example, it may be appropriate to ask them to interpret when introducing yourself and asking the client about benign and less sensitive topics (“Are you hungry?” “Can you sit up?”).

• However, sometimes the use of an interpreter is needed. Many health care institutions have access to interpretation services, but these can be expensive. You may also have professional colleagues who are trained in the ethics of interpretation and can help.

• Consider using a translating app such as Google Translate that can help you translate one language into another. Although you may not speak the other language, you can show the written translation to the client so that they can read it. Additionally, the client can also type concerns, responses to your questions, and their own questions into the translating app.

Emotions

Clients commonly experience sadness, anger, fear, anxiety, embarrassment, and other emotional responses in the context of health and illness. It is important that you cultivate a therapeutic environment where clients feel comfortable to open up about their emotions. Open-ended questions like “Tell me about how you are feeling” can facilitate discussions about a client’s emotional response. Additionally, you might consider using permission statements to help normalize how the client is feeling and provide an opening for them to speak about emotions. For example, “Clients often experience sadness or anger when they are diagnosed, how are you feeling?”

It is important that you acknowledge the client’s emotions and provide space for them to experience the emotions. Avoid changing topics. Give the client time to voice their emotions or even cry. Using silence and active listening are effective communication strategies during these circumstances.

Violence and trauma

Many clients will have experienced violence and trauma in their lives such as abuse, bullying, grief or loss of a loved one,  natural disasters, or war. You will often not even be aware that they have experienced violence or trauma, so it’s best to use a trauma-informed approach with all clients. Approach all clients with the assumption that they may have experienced violence and trauma at some point in their lives. Reflect on how best to help them feel safe and provide them as much choice and control in the clinical encounter as possible.

Some communication strategies that are consistent with a trauma-informed approach include:

• Introducing who you are and why you are there.

• Explaining each step of what you are doing.

• Asking permission to touch.

• Giving the client options on what topic to discuss first.

Communicating with clients about violence and trauma requires knowledge, skill, and experience. This field of study is vast and deep. As you develop foundational communication skills, you will have opportunities to build knowledge about trauma-informed communication. For now, recognize that there is much more to know about trauma-informed approaches and that an in-depth understanding is needed to best care for these clients.

Hearing and visual impairment

You can inquire about the presence of any hearing or visual impairment and what is best for the client in terms of communication. For people with hearing and visual impairment, begin by minimizing any background noises or distractions. You should speak in a clear, slightly louder voice, steady tone with a deeper pitch. Avoid shouting and using a high pitch as this can distort sounds and make your words more difficult to hear. You should face the client directly and clearly articulate your words so that they can read your lips and observe non-verbal cues as necessary. If the client has an assistive device (glasses or a hearing aid), make sure that they have access to the device.

Intellectual impairment

Some of your clients will have intellectual or cognitive impairments that may result in disabilities affecting their ability to learn and reason (Down syndrome, fetal alcohol syndrome). You should consider how each client can best participate in communication ( listening, talking, understanding and processing information). You should engage in active listening and determine what is important to the client. Speak clearly and ask simple questions. Speak in a positive tone with a steady pace and avoid speaking slower as this can come across as patronizing. You may encourage them to bring someone with them that they trust, such as a care partner. You should still focus your attention on the client, but also create an inclusive space for the care partner to be involved.

Substance impairment

A client under the influence of drugs and substances (alcohol, cannabis, prescribed medications, and/or illegal street drugs) can have altered capacity to think, reason, and communicate. Although some of these substances may be illegal and non-prescribed, it is important to maintain a non-judgmental attitude and convey unconditional positive regard. As a nurse, it is not your job to judge a client. Rather, you should use a relational inquiry approach to understand the circumstances that have influenced their choices and respect that each client has agency and self-determination.

While the client is under the influence of a substance, use communication strategies that facilitate their capacity to understand what you are saying and communicate with you while maintaining safety. Thus, you should speak clearly and in short simple sentences. Focus on the reason for seeking care or the priority issue. There will be time for a collaborative discussion and health promotion after the effects of the substances have dissipated.

Escalation

Communication is a particularly important strategy to use when your purpose is to de-escalate a situation. Escalation can occur in any health care situation when clients are encountering intense emotions and experiences entangled with stress, fear, anger, uncertainty, pain, and lack of control. This can lead to the client spiraling out of control, agitation, aggression, and even violence. Contextual factors may include clients who have received bad news such as a diagnosis, clients who are under the influence, and/or clients who are having a mental health crisis. Attend to your own safety and be aware of the potential risk factors. It is important to notify a colleague(s) when interviewing a client who is at risk of, or has a history of, escalating.

De-escalation includes ways to reduce and/or prevent escalation. De-escalating communication strategies include:

• Acknowledge and value how the client feels and be non-judgmental.

• Avoid downplaying or judging how the client feels.

• Engage in active listening to understand the situation and explore the reason for the escalation.

• Offer genuine interest, concern, and empathy.

• Remain calm and do not allow your voice or non-verbal communications to demonstrate rising emotions.

• Recognize the client’s self-determination and collaborate with them on how to address the issue.

• Maintain your safety, but do not act afraid.

• Maintain your professionalism and do not take the situation personally.

Inappropriate communication from the client

There will be times when clients engage in inappropriate communication. This kind of communication may include verbal and non-verbal language such as inappropriate physical touch, violent or aggressive behavior, harassing language (such as name-calling, threats), and sexualized language.

Consider these strategies when responding to inappropriate client language:

• If applicable, ensure your personal safety. Depending on the situation, this may involve moving toward the doorway or having it in your sight, leaving the room, or calling for help.

• Acknowledge the language and behavior and clearly let the client know that it is inappropriate, do so in a professional and non-judgmental manner.

• Remind the client that as a nurse you only engage in professional relationships with clients and families.

• Ask the client if their language has something to do with the effects of their health or illness.

Concluding the Interview

Concluding the interview has three main purposes:

• First, to ensure that you have understood everything necessary in order to best care for the client.

• Second, to ensure that the client has had the opportunity to share what is important to them and add any additional information.

• And finally, to ensure that the client knows what the next steps are with regard to their care. Be specific and don’t assume the client knows what to expect. Offer them handouts if available so they can review information at home.

As part of the conclusion, you should provide a brief summary of the data you have collected. This summary should reflect and paraphrase what the client said.You might start the summary off by saying “The interview is coming to a close and I would like to share a summary of what we discussed.” The length of the summary will depend on the comprehensiveness of the interview and the complexity of the client’s needs, but it is usually a few sentences summarizing the pertinent data. This can be followed up by a couple of questions such as “Did I capture what you said accurately?” and “Is there anything else that you would like to share with me that is important to your care?”

Finally, you should discuss the next steps related to the client’s care. For example, these may include a physical assessment or having another health professional come in to talk with them. Make sure you ask the client if they have any questions before concluding the interview. Finally, close the interview in a therapeutic way, which may involve using the name that they prefer to be called and thanking them for sharing their information.

Key Takeaways

Resources to Facilitate Interprofessional Communication

There are numerous resources to facilitate interprofessional collaboration and teams, including interprofessional communication.

Ideally, all healthcare professionals including nurses would speak up for the sake of clients, clearly state what they think is happening in a specific situation, and explain what and why they think certain actions should be taken (Lyndon et al., 2011). However, some healthcare professionals may struggle to voice their concerns and their perspectives, particularly if they feel less empowered or marginalized by another healthcare professional. One objective of interprofessional communication tools is to provide structure and clarity to convey succinct, comprehensive, and relevant information to another healthcare professional to improve client care.

Several standardized tools have been developed to facilitate interprofessional communication (Canadian Medical Protective Association, 2011) and prevent and manage harassment, errors in the workplace, and miscommunication. The SBAR tool, and its variations including ISBAR, is one common communication tool that can facilitate effective verbal communication when communicating with another healthcare professional about a client or during handover. It provides a framework so that communication is focused, concise, and complete.

ISBAR, detailed in Figure 3.7, is an acronym for Introduction, Situation, Background, Assessment, Recommendation. It was first introduced by the military in the United States to facilitate communication (NHS Improvement, n.d.) and has since been taken up in the healthcare arena to enhance client safety by facilitating communication among healthcare professionals and ensure the most important information is included (NHS improvement, n.d.; Spooner et al., 2016).

Think about what you want to say and how you want to say it before you say it. Organize your thoughts first. This is a skill that gets easier with practice.