Did You BATHE?. Tools for Effective Communication by Robyn L. Mendoza RN, MSN, FNPs. "The most important practical lesson that can be given to nurses is to teach them: what to observe- how to observe- what symptoms indicate improvement- what the reverse- which are of importance-
Did You BATHE?
Tools for Effective Communication
Robyn L. Mendoza RN, MSN, FNPs
"The most important practical lesson that can be given to nurses is to teach them:
what to observe-
how to observe-
what symptoms indicate improvement-
what the reverse-
which are of importance-
which are of none-
which are the evidence of neglect-
and of what kind of neglect....
But if you can not get the habit of observation one way or other, you had better give up being a nurse, for it is not your calling, however kind and anxious you may be." F.N.
Florence also tells us what nursing is not:
Nursing is not limited to, nor defined by medical acts.
Nurse’s Additional Role
Make sure the patient’s environment is clean, comfortable and safe
Make sure they are “manipulated”: get up, turn, cough, sit up, etc…
Make sure they have adequate nutrition
Help them conserve their energy through supportive interventions
Miss the real point of what is being said
Let personal emotions interfere with judgment
Interrupt or “step on” statements
Think ahead to what we want to say next and miss what is being said now
BATHE-ING the Patient
B = Background
Reveals what is going on with the patient
Do not ask “what is new” or stressful. If they respond “the same old thing” or “nothing” go on to “A”.
A = Affect (the feeling state)
Allows the patient to report their current state of feeling as they are often not in touch with their emotional responses. Expression is highly therapeutic.
T = Trouble
Most important question! Helps you and the patient to focus on the subjective meaning of the situation. May be an “aha” moment for patient.
H = Handling
Gives an assessment of functioning:
helps patients to get in touch with answers they already have, but are not aware of
E = Empathy
Legitimizes the patient’s reaction
Provides acceptance that their response is reasonable under the circumstances.
Patient in the Driver Seat
Sends the message you care
Sends message they are capable of handling their situation
Help engage patient in problem solving: they will become aware they have some control over the circumstances of their lives
They have demonstrated the ability to survive
They are responsible
They can leave a bad situation
They can change a bad situation
They can accept it as it is
They can interpret it differently
Resist Giving Advice!!!
does not empower them