Question

Skills required to engage and support a person with mental health needs in a hospital environment?

My thought about this question is communication techniques like active listening, attending, prompting, silencing...etc. But sometimes patient with mental disorders would find it difficult to communicate with others, so what else skills can a health professional employ to engage and support the person?

Answer 1

Mental Health Nursing always need effective strategies for ensuring the support from the client for the achievement of therapeutical goals.

Client engagement with the therapeutic plans and interventions are also essential for the achievement of client needs.

Effective communication is key to psychiatric nursing. Mental health nurse's communication with a client must revolve around needs, wants and interest. Various factors can affect verbal communication , including clients and nurses previous experiences, background , and feeling. Use words appropriate for the clients educational level. Avoid medical terms as much as possible. If the patient speak a foreign language or uses ethnic dialect , obtain an interpreter to help you communicate. Avoid appearing as if you are discounting the patient's feelings, as by changing the subject abruptly. Otherwise , the patient may get the impression that you are uninterested, anxious, or annoyed or what you are judging him.

If the patien's thought patterns are incoherent or irrelevant , he may be unable to interpret messages correctly, focus on the interview, or provide appropriate responses. When assessing him, ask simple questions about concrete topics, and clarify his responses. Encourage him to express himself clearly.

Approach a paranoid patient in a non threatening way. Avoid touching him, which he may misinterpret as an attempt to harm him. Also, keep in mind that a paranoid patient may not mean the things he says.

An hallucination patient can not hear or respond appropriately. Show concern but do not reinforce his hallucinatory perceptions. Be as specific as possible when giving commands. For instance, if he says he has hearing voices, tell him to stop listening to the voices and listen to you instead.

A deluted patient defends irrational beliefs or ideas despite factual evidence to the contrary. Some delusions may be so blizzare that you will recognize them immediately. Others may be hard to identity. Neither condemn nor agree with delusional beliefs, also avoid dismissing a statement because you think it is delusional. Instead, gently emphasize nearly without arguing.

A delerious patient experiences disorientation, hallucinations, and confusions. Misinterpretation and inappropriate responses commonly result. Talk to him directly, ask simple questions, and offer frequent reassurance.

The patients with dementia may experience changes in memory and thought pattern. His languages may become distorted or slurred.

When interviewing him, minimize distractions. Use simple concise language. Avoid making statements that could be easily misinterpreted.

Indirect approaches like reflection, open ended questions, focusing on a patient presenting reality are more effective when the problems are not obvious. Avoid evaluative, hostile, probing questions and use understanding responses , which may help the patient to explore the feelings.

Listening is an active process. The nurse should take time and energy to listen to what the patient is saying. She must be sympathetic listener. Attentive listening is always essential. Face the patient, acknowledge him and maintain eye contact. Stay relaxed with legs and arms uncrossed, possibly leaning forward slightly. Convey accectaptance when the patient speaks. Do not interpret or argue , but provide verbal feedback as appropriate.

Ideally , the patient's nonverbal and verbal messages should be congruent.

Silence is a strategic communication tool . It can be used to give the patient time to talk, think, and gain insight to into problems. Requires practice and timing, using it too much or at the wrong times could the impression of lack of interest or judgement.

Other aspects

1. Validating

Reviews and rephrasing key patient statements.

2. Clarifying

Shows desire to understand patient statements.

3. Sharing impressions.

Describe patients feeling and then seek corrective feed back from him.

4. Focusing

Redirect patients attention towards something special.

5. Suggestive collaboration.

Give patient chance to explore pros and cons suggested approach.

6. Offering

Explains components or purpose of activity or procedure.

Non therapeutic skills can also effective like,.

1. Attacking or defending

2. Casting judgement

3. Interrogations

4. Minimizing

5. Playing ann landers

6. Pressuring

7. Running off at the mouth

8. Rushing

9. Taking sides.

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