What do you hope for your patients?
- Want your pulmonology patients to wear their CPAP.
- Want your orthopedic patient to participate in a home exercise program.
- Want your prenatal patients to think about a birth plan.
When speaking with our patients, we often focus on what we need our patients to do, and not on how to support them along their journey.
What Is Motivational Interviewing?
Motivational interviewing is a technique that many nurses use to help their patients make meaningful lifestyle changes.
According to motivationalinterviewing.org: “Motivational interviewing (MI) is a guiding style of communication, that sits between:
- Following (good listening)
- Directing (giving information and advice)”
The concept of motivational interviewing is founded on facilitating others to draw out their own “meaning, importance, and capacity for change.”
Remote nursing jobs also may use motivational interviewing. You may consider how you have used it in your past nursing roles so you can feel comfortable listing it as a skill or qualification on your resume to help you land a new remote nursing job.
Therapeutic communication is a term you probably became familiar with in nursing school or your healthcare training. It’s a type of communication that focuses on the sender (you) conveying empathy and compassion with verbal and nonverbal cues to the receiver (usually a patient or patient family member).
Motivational interviewing builds off the techniques of therapeutic communication. While motivational interviewing certainly does employ empathy, the main goal is to facilitate meaningful change, rather than simply convey compassion.
You can remember these techniques through the abbreviation ‘OARS,’ which stands for:
- Open-ended questions. Rather than asking, “Do you like going for walks?”, which has a closed answer (either ‘yes’ or ‘no’), try asking, “When you walk, how do you feel?” which may elicit a more thoughtful response.
- Affirmations. Celebrate the patient’s abilities and successes to build up their confidence.
- Reflections. Use active listening and repeat your understanding to the patient to understand why they are saying it to you.
- Summarizing. Reinforce the key points both you and the patient have made.
Here is a summary of the differences in therapeutic communication vs. motivational interviewing:
|To help someone feel heard and respected
|To help someone feel motivated
|Examples of techniques
|Active listening, building rapport, non-verbal cues, etc.
|Understanding barriers, supporting self-efficacy, resolving ambivalence, etc.
|Delivering news, teaching about a diagnosis
|Facilitating a change in habit or participation in a care plan
Motivational Interviewing at the Bedside
Many bedside and clinic nurses use motivational interviewing in their roles without realizing it.
As nurses, we are highly invested in our patient’s well-being and focus on educating them about improving their health. Both of these goals fit in with the concept of motivational interviewing.
According to motivationalinterviewing.org, the nature of motivational interviewing should be both engaging and focused. Some of the critical intentions of the conversation are to:
- Evoke: This is to help your patient explore why they want to change, what ideas they have, and what their barriers are.
- Plan: This involves helping your patient plan a task or intervention to help them achieve their goal. They might need more time to be ready and willing for the planning phase in every interaction.
Motivational Interview Example: A Short Script
Here is a few-minute-long conversation with a patient who needs to quit smoking before an elective knee replacement. Here is a brief example of how the techniques might be used:
Nurse: Hi, John. How was your grandson’s baseball game last weekend? (building rapport)
John: It was alright, just feeling a bit stressed out.
Nurse: I understand. Quitting smoking can be a stressful process. What are some of the things that are causing you stress right now? (open-ended question)
John: I’m just feeling a lot of pressure at work, and it’s hard to resist the urge to smoke when I’m feeling so anxious.
Nurse: I hear you. It can be tough to resist that urge, especially when you’re feeling stressed out. Have you thought about what you could do instead of smoking when you’re feeling anxious? (developing discrepancy)
John: I’ve been trying to go for a walk or do some deep breathing exercises, but it’s not always easy to find the time.
Nurse: That’s understandable. It can be challenging to make time for self-care, especially when you’re busy with work. How do you feel when you do take a few minutes to go for a walk or practice deep breathing? (reframing)
John: It does help me feel a bit more relaxed and focused.
Nurse: That’s great to hear. It sounds like taking a few minutes for yourself can be really helpful. Is there anything else you’ve found that helps you manage stress without smoking? (supporting self-efficacy)
John: I’ve been trying to meditate, but I’m not very good at it yet.
Nurse: That’s okay. Meditation can be a challenging practice, but it can also be really helpful for managing stress. Maybe we can work on some meditation techniques together at our next appointment. How does that sound? (collaboration)
John: That sounds good to me.
Nurse: Great. I’m looking forward to it. Keep up the good work, John. You’re doing great. (positive reinforcement)
Motivational Interviewing With A Remote Nursing Job
Like bedside nursing, motivational interviewing in a remote setting is equally important to help others meet their goals.
Since you likely have used motivational interviewing in your bedside nursing practice, you can put it on your resume if you have used it and feel comfortable with the skill.
This might set you apart from your competition, especially if motivational interviewing is listed in the job skills or qualifications in a remote nursing job.
Often, these roles are metric-based. Your management will provide metrics, possibly including how many phone calls you make, how many calls someone answers, or a specific patient outcome. Regardless of the metric, motivational interviewing techniques may help you meet these goals.
Hopefully, meeting your metrics means you have increased patient outcomes, which can help you feel more fulfilled in your role as a nurse (more than likely why you became a nurse in the first place!) and help you reach your professional goals.
Examples of using motivational interviewing in a remote nursing job include:
- Making a phone call to a new diabetic patient to check in on their food log
- Helping a triage patient understand the importance of completing their prescribed antibiotic
- Teaching a new chronic kidney disease patient the importance of following their diet
Using Motivational Interviewing with Coworkers
Motivational interviewing may be used with coworkers or those that you manage in a remote setting. You may be precepting a newer nurse or be trying to facilitate an operational change.
By using motivational interviewing techniques, you may be able to foster an environment where open communication is part of the team culture.
Using Motivational Interviewing with Yourself
Although not a traditional facet of motivational interviewing, you can use these techniques on yourself. For example, since changing to a remote schedule, have you noticed your exercise routine is less consistent?
You can use these techniques to find what you think about your exercise routine, what barriers you have, and what inspiration you have for a new exercise routine. You can apply this to exercise, or anything that enhances your health, well-being, and career goals or reduces burnout.
How to Learn More
Learning more about motivational interviewing can help you improve your communication skills, leading to better patient outcomes and increased job satisfaction. By using motivational interviewing techniques, you can establish rapport and build trust with your patients, even when you are not physically present with the patient.
Several resources are available to learn about motivational interviewing, including online courses, webinars, and conferences.
Some professional organizations, such as the International Motivational Interviewing Network of Trainers (MINT), offer training and certification programs for healthcare professionals. You can also check out an affordable course like the one provided at Udemy so you can put the certification on your resume.
Overall, learning more about motivational interviewing can be a valuable investment in improving your communication skills and motivating your patients to take an active role in their health care. Using motivational interviewing techniques, you can help patients overcome barriers to behavior change and improve their overall health outcomes.
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