How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 71

This book is in B&W, not color - Print page in Grayscale for Correct view! The addition of humour was seen as an expression of ‘friendliness’, as having the capacity to diffuse tension, anger and anxiety. The fundamental concept here was that the nurse was trying to raise a smile from the patient, rather than utilising patients or others as the butt of mutual humour. Because expression of humour might be interpreted as belittling or disrespectful, nurses expressed a degree of caution about recommending it, indicating that the content, timing and fundamental relationship had to be right for this to work well. Without the pre-existing ‘good relationship’ it was not felt that humour could readily be risked, and being able to use humour appropriately and well was regarded as a ‘sophisticated’ technique. More simple uses of humour, such as ‘telling a joke’ were less risky. Interestingly, utilising humour was mentioned in relation to all symptom areas except delusions and hallucinations, perhaps reflecting the acute sensitivity of patients to criticism of these symptoms. In talking about their own ‘sense of humour’, nurses also meant their need not to take personally or necessarily too seriously all of the things patients said, particularly their hostility. “I’m not saying make light of the situation. But you can be a bit more jovial about a situation. But that’s something that you would have to have established a very strong relationship with before you could do that.” Apathy/withdrawal specific Comfortable silence (9/28) Sitting with the patient, communicating attention nonverbally, and ‘waiting for them to make the first move’ or simply ‘just being with somebody and being able to accept being with somebody in silence’, as well as making a greater use of pauses in silences in what conversation is achieved. “Maybe just sitting with them first of all, just so that they’ve got the physical presence of somebody there for a while with them first of all.” One nurse mentioned sitting with a patient for 30 minutes without them talking. To accomplish this requires ‘not having any expectation that anything’s going to happen quickly’, ‘tolerating silence’ and guarding against ‘hammering out questions’ because of ‘your own anxiety’. “And just having silence at times but not in a kind of dynamic silence … trying to find a kind of a medium so that people are not feeling bombarded, but at the same time you’re not just sitting ignoring each other. So feeling you’re engaging with someone and trying to get that fine tune to a level that’s comfortable.” One-sided conversation (3/28) Here the nurse makes all the effort and all the running, sitting next to the person and chatting regardless of the non-response of the patient ‘just like I’m having a conversation with them and they’re just not answering but, and I can keep that up actually for quite a long time’. All the time the nurse keenly attends to and watches the patient seeking the smallest response, maybe a ‘flicker of a glance’ or a ‘smile’. Be creative (1/28) “So clients I've known, for example, who might be into music but they're just too withdrawn or apathetic to request or organise music in their room, I might get the radio for example and maybe say, well look N, if you want to switch it off, I’ll go away and I’ll come back in ten minutes see if it's still, and do something like that.” For [email protected] Property of Bookemon, do NOT distribute 73