How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 95
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the nurse utilising the patients history and case record, reminding the patient what had happened
before, and tempering their suggestions into a realistic applicable plan about what should happen in
the scenarios most likely to recur: ‘how do you want us to work with you in that situation … how
would you want us to approach you … what happens if you say no?’ If such negotiation and
planning has already been done and the patient is highly aroused now, then the advance directive
should be implemented. The presence of such a planned strategy makes the situation much more
predictable for the patient as well, and there ‘not quite so scary for them’, and because of that, less
likely to end in a struggle of some kind.
Lessons for practice
Summary of findings
Analysis and reanalysis of the interviews found that the interaction techniques reported divided into
seven natural domains: the moral foundations for interacting; preparation; being with the patient;
nonverbal aspects; emotional regulation; getting things done; and talking about symptoms.
The moral foundations incorporated a complex mix of sometimes countervailing imperatives, such
as notice and do not ignore the patient, nevertheless avoid intruding and respect their privacy. Also
included were values emphasising warmth, care coupled with a high degree of