Mental health articles

A patient’s psychiatric disorder can cause barriers to effective communication with a patient. The psychiatric nurse must employ techniques that overcome those barriers to engage the patient in therapeutic communication. Here are some tips to help communicate with patients with specific psychiatric

disorders.

• Delusion: A patient who has delusions has irrational beliefs but believes their beliefs are rational and will aggressively defend their irrational beliefs. The psychiatric nurse should help the patient focus on reality without agreeing with or arguing about the patient’s delusion.
• Thought Disorders: A patient who has a thought disorder is unable to correctly understand the message sent by the psychiatric nurse. The psychiatric nurse should ask simple concrete questions and permit the patient to express themself. The psychiatric nurse should then clarify the patient’s answer by restating the patient’s response.
• Dementia: Dementia is irreversible deterioration of the patient’s mental capacity affecting memory, language, and logical thinking. The psychiatric nurse must reduce distractions from the environment and ask simple, concrete questions that leave no room for misunderstanding by the patient.
• Paranoid Thinking: Paranoid thinking occurs when a patient is mistrusting of the psychiatric nurse and others. The psychiatric nurse should appear nonthreatening and make no movement that could be misinterpreted as a threat.
• Delirium: A patient who is delirious is confused and disoriented and responds inappropriately because the patient misinterprets the psychiatric nurse’s statements. The psychiatric nurse should ask simple, direct questions and reassure the patient that the nurse understands their answers.
• Hallucinations: A hallucination occurs when a patient hears or sees something that is not real such as hearing voices or seeing bugs. The psychiatric nurse should acknowledge that the patient is hearing or seeing something but that what they are hearing or seeing is not real. The psychiatric nurse should also give concise commands to redirect the patient.
• Inappropriate Response: An inappropriate response occurs when the patient changes the topic to avoid answering the nurse’s questions. The psychiatric nurse should listen to what the patient is saying without judging the patient. The psychiatric nurse should return to the original topic after the patient completes their thought.

Tags: therapeutic communication