Interviewing and Counselling

Introduction to Interviewing and Counselling in Nursing

Interviewing and counselling form the bedrock of holistic nursing practice in Nigeria and worldwide. While interviewing is a focused, goal-directed conversation used to gather health data, counselling involves providing emotional support, guidance, and education to help patients cope with health challenges. Both processes rely heavily on effective interpersonal communication.

Nurses use these skills daily during admission assessments, bedside handovers, and discharge planning. Mastering them helps uncover hidden fears, promotes treatment adherence, and builds trust between the healthcare team and the patient.

Core Communication Skills and Therapeutic Use of Self

Therapeutic use of self requires the nurse to consciously use their personality, insights, and experiences to structure nursing interventions and establish a relationship with the patient.

Active Listening: Concentrating on what the patient says and observing non-verbal cues without immediate interruption.
Empathy: Perceiving the patient's situation from their perspective while maintaining professional objectivity.
Congruence: Ensuring verbal messages align with non-verbal expressions to foster genuine trust.
Respect: Valuing the patient's worth, beliefs, and right to self-determination regardless of personal background.

The Nursing Interview Process: Phases and Techniques

The nursing interview proceeds through three distinct phases, each serving a unique clinical purpose.

Orientation or Introductory Phase: The nurse introduces themselves, explains the purpose of the interview, and builds initial rapport to reduce patient anxiety.
Working Phase: The core data collection occurs here. The nurse uses open-ended questions to explore the chief complaint, health history, and lifestyle factors.
Termination Phase: The interview concludes with a summary of key points, an opportunity for the patient to ask questions, and an explanation of the next steps.

Establishing a Therapeutic Nurse-Patient Relationship

A therapeutic relationship differs from a social relationship because it is goal-directed, time-limited, and centered exclusively on the patient's health needs. Building this relationship requires consistent reliability, professional boundaries, and unconditional positive regard.

Trust is earned slowly but can be lost instantly if confidentiality is breached or if the nurse appears judgmental. Maintaining clear boundaries prevents role confusion and ensures the patient remains the primary focus of the clinical interaction.

Addressing Barriers to Effective Communication

Communication barriers can severely distort health assessments and patient counselling outcomes. These barriers may arise from physical, psychological, or environmental factors.

Barrier Type	Example in Clinical Practice	Nurse's Action
Environmental	Loud ward noise, lack of privacy	Move to a quiet space, draw curtains
Sensory	Severe hearing loss, visual impairment	Speak clearly, use writing pads or glasses
Cultural	Language differences, differing beliefs	Use a qualified interpreter, respect beliefs
Emotional	High anxiety, acute pain, denial	Address pain first, offer reassuring presence

Ethical and Legal Considerations in Counselling

Nurses are bound by ethical principles and legal statutes when conducting interviews and counselling sessions. Confidentiality is paramount; patient health information must never be shared casually with unauthorized persons. Informed consent ensures that patients understand the nature of any proposed nursing interventions or counselling programs before agreeing to participate.

Nurses must also recognize their scope of practice. When a patient's psychological distress exceeds basic supportive counselling—such as severe clinical depression or suicidal ideation—timely referral to a psychiatric nurse specialist or medical doctor is legally and ethically required.

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