One of the most essential tools that will be of use to a psychiatric nurse in handling a patient with mental disorders such as schizophrenia, dementia, depression etc., is therapeutic communication.  Without effective communication and cooperation of the patient, treatment will not be successful.

The following tips might be of help to aspiring and trained psychiatric nurses in discharging their duties effectively.

1. Fix up a time with the patient and convey them or their caretakers that you, the psychiatric nurse, would like to talk with the patient
2. Introduce yourself with the name and call the patient with his or her first name
3. Avoid staring at the patient during the discussion.   This does not mean that you should not look through the eyes of the patient.  Restrict your eye contact only to the extent the patient can tolerate the same and does not get the feeling that you are staring or gazing at him or her.
4. Being silent during communication is in itself a great tool.  Try to use this weapon occasionally.
5. Allow the patient to talk and listen carefully what he or she has to say or convey, both verbally and non-verbally.
6. Encourage the patient to talk more and freely about his or her feelings; restrict your talk wherever possible and avoid talking about your experiences, other patients and such other things that might not be of interest to the patient.
7. Try to prepare questions for the patient, which are open-ended in nature.  The patient should be encouraged to talk for a longer period and should not give simple one word answer.
8. Do not interrupt the patient while talking and allow him or her to express the feelings freely.
9. Try to use the technique of reflection to ensure that the words uttered and the feelings expressed are the same.  You can try repeating the patient’s statement with a slightly raised tone normally used for questioning to ensure that you had correctly understood what the patient tries to express or convey.  By doing so, the nurse is only trying to validate what the patient has to say, and allow him or her to correct the understanding of the nurse.
10. If, during the conversation, the nurse finds some contradictory statements, he or she can question the same for confirmation and validation.  The tone and the questioning, in such circumstances, should be gentle and involve the patient more.  Questions such as “I heard you say that ….’ Is this what you mean…? – Something of that sort gives more opportunity for the patient to clarify his or her point clearly.
11. The nurse should always honor the patient’s feelings and should not try to use pat phrases for the feelings of the patient.  These might hurt the patient’s feelings and discourage him or her from talking more freely.
12. The nurse should refrain from passing on his or her own opinions or experiences with regard to similar problems to the patient.
13. Humor sense plays an important role in communication.  While interacting with the patient, the psychiatric nurse should use it judiciously without causing uneasiness to the patient.  Most of the patients might not be aware of the humor sense and might react negatively, or presume that they are being teased by the nurse. Do not do such things, as the trust between the patient and the nurse, which is more essential for the treatment, might get spoilt.
14. If, unfortunately, the patient uses any negative comments or express anger during the communication, the nurse should not take it too seriously and personally.
15. If possible, it is advisable on the part of the nurse to give an honest feedback about the conversation to the patient.

By adopting any or all of the simple techniques, a psychiatric nurse can get a good measure of the patient, his or her feelings and approach towards the problems. 

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