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-Battery(example nurse hits patient or administers medication against patients will. -False imprisonment(example nurse inappropriately restrains a patient or administers a chemical restraint such as a sedative).CommunicationIntrapersonal communication:“Self-talk”, thinking thoughts, but not verbalizing them.Interpersonal communication:One-on-one communication with another person.Open ended questions:Promotes interactive discussions examples “Tell me more…”Closed-ended questions:Used to obtain specific data. Use sparingly as it can block further communication.Communication techniquesRestating: Repeat the patient’s exact words.Reflecting: Return focus back to the patient.Paraphrasing: Restate patient's feelings to confirm understanding of what patient is saying.Exploring: Gathering more information about something patient has mentioned.General leads: Allows patient to guide discussion.Presenting reality: Communicate what is actually happening, to dispel hallucinations, delusions,false beliefs.Offering self: Limited self-disclosure by nurse. Return Focus to patient as soon as possible.Therapeutic communicationWRONG:-Asking why…?-Offering your opinion. -Giving false reassurance. -Giving advice. Changing the subject. -Minimizing the patient's feelings.RIGHT:-Asking open ended questions (example “Tell me more”, “You seem angry…”) to facilitate discussion. -Maintain eye contact to convey interest. -Sitting / standing at eye level. -Therapeutic touch to convey caring and provide comfort.
190Therapeutic communication older adults-Minimize distractions, discuss health and private setting. -Face the patient when speaking. -Use a lowerpitch of voice. -Begin the interview by asking the patient to identify his / her needs and concerns. -Limit the number of items on a questionnaire when Gathering data. -Allow plenty of time for the patient to respond to the questions.Defense mechanismsAltruism: dealing with stress anxiety by helping others. Sublimation: substitute negative impulses into acceptable forms of expression example workingout hard at the gym. Suppression: voluntary denial of unpleasant thoughts or feelings. Repression:unconscious denial of unpleasant thoughts or feelings. Regression: reverting back to childlike behaviors that are inappropriate for the patient's current developmental level. Displacement:redirecting feelings about a person or situation towards a less threatening object/ person example dad loses his job, destroys his child's toy. Defense mechanismsReaction formation: Demonstrating the oppositebehavior versus what is actually felt (example Ilove nursing exams!!). Undoing: Performing an act to make up for a previous behavior (example bringing home flowersafter domestic abuse). Rationalization: Creating an acceptable excuse for an unacceptable Behavior.