Nurse - Patient Communication

  1. I am a first year nursing student and am about to start my first assignment. It is to discuss the important of communication. It asks me to
    - Focus on verbal and non verbal skills
    - Explain the rationale for using different approaches to communication with patients.
    - Explain why a Philosophy of Care is important in communication.

    If anyone could point me in the right direction, or tell me some web-sites that are worth looking in to it would be greatly appreciated.
    •  
  2. 6 Comments

  3. by   ceworden
    Let me see what I can remember from school...
    1. Verbal & Non Verbal Skills---
    Make eye contact with your patient and maintain that all times possible.
    Introduce yourself and what you will be doing with the patient. EX:Vital Signs
    If you have a patient that is hard of hearing, touch them gently if they do not answer you when you come in the room. Keep eye contact with these patients and speak in a normal tone of voice and speak clearly. If they have hearing aids assist them to put them in to help with the communication.
    Use open-ended questions instead of the closed-ended questions(ones with just a yes or no response). There are some questions that you must use that are considered closed-ended, but the best approach is those that will allow the patient to let you know what is going on with them.
    When you ask a question, if the patient appears not to understand, ask them if they have a question regarding what you just said.
    One very important point is before you leave a patients room, make sure they are able to reach the call light, if side rails need up make sure they are, offer them a drink of water(if they are allowed), ask if they need to use the bathroom, etc. If you tell them you will be back within a certain time frame, make sure you are, even if it is only for a minute. Patients are very responsive to a Nurse that gives a caring attitude.

    2. Rationale for using different approaches to communication with patients----
    Each patient is an individual and needs to be treated as an individual. You will in time learn the patients that are responsive to one technique of questioning may not apply to another patient. Another thing to do is research the differant ethnic backgrounds of patients. I worked in a hospital where most of the patients were of American Indian Heritage. These patients, especially the elderly, will tend not to speak with you because of their upbringing. They are also some who will have certain personal articles that they do not want you to touch due to their beliefs. Also check their religious preferance. This also is a factor in dealing with a patient for certain religions forbid cetain types of Medical Care. By being able to know some background on the patient besides the medical part of their problem will aide in effective communication with your patient.

    3. Philosophy of Care----
    Every individual has the right to understand what is being done to them. By being informed and able to answer any questions they may have will help with your communication. Remember, patients are usually scared because they are uncertain of what is goin on around them, this includes all age groups. If you are unable to address any of their questions, make sure that you seek out another colleque to help with the answer.

    I hope this helps some. I know there is more and if you have any more direct questions please feel free to e-mail me at:
    cherrie_pie0@yahoo.com
    The most important thing to remember is to treat the "Whole Patient--Holilistic Care" not just the problem.

    You also might wish to go to www.nurse.com and click on links and see if there is any info there to give you some answers. Good Luck and welcome to the Wonderful World of Nursing!!!

    MNM--A Step for Our Future, 2001

    ------------------
    CEWorden, LPN
    Proud to be a Nurse
  4. by   ceworden
    Forgot to mention something....
    If a family member is present make sure you address them also. This will aide in helping to ease the patient and with most patients it is usually the family member that is more involved then the patient.

    ------------------
    CEWorden, LPN
    Proud to be a Nurse
  5. by   JillR
    There are a couple of communications suggestions that I picked up from others and have found very useful.

    Never ask a why question, or I should say don't use the word why. It puts people on the defensive. Instead of saying "Why did you stop taking your Lasix?" ask "What happened that made you decide to stop taking your Lasix?" Just change the way you ask the question. If you think about it, this makes sense.

    Another thing is something I picked up while doing a clinical day in an ICU with this really amazing ICU nurse. She always explained evething that she was going to do and the reason she was going to do it, to not only the patient, but the family. But the best thing I observed from her is the fact that she asked both the patient and the family if they had any questions everytime she was in the room. She would make sure that she asked this before leaving the room.

    I also never answer a question, if I am unsure of the answer. I will tell patients that I don't know the answer, but will try to find out. People can tell if you are trying to snow them to save face, and it really ruins the trust they may have in you. If I feel it a question that the doctor should be answering and not me, I will tell them this and offer to have the doctor give them a call, or whatever they prefer.

    One other thing I do before I leave patients room is to ask if they are comfortable and what can I do to make you comfortable, and is there anything I can do for you right now?

    Again it all comes back to trust. If a patient or family feels that you care about them, there concerns and comfort they are more apt to trust you and this opens the way to honest communication.

    Oh and another one....acknowledge their feelings. Even if you can't actively do anything about how the person is feeing. For example a patient with COPD is having an anxiety attack and you have done everything medically possible for the person just saying something like "It must be very frightening to feel like you can't breathe" lets the patient know you care about how they are feeling even if you can't do anything about the problem.

    These are all little things that I can think of off the top of my head. If I come up with more, I will let you know. Good luck on your assignment. Maybe looking up something about Therapeutic Communications would help. Good Luck.

    Jill

    [This message has been edited by JillR (edited October 29, 2000).]
  6. by   Patchies
    Originally posted by ceworden:
    Let me see what I can remember from school...
    1. Verbal & Non Verbal Skills---
    Make eye contact with your patient and maintain that all times possible.
    Introduce yourself and what you will be doing with the patient. EX:Vital Signs
    If you have a patient that is hard of hearing, touch them gently if they do not answer you when you come in the room. Keep eye contact with these patients and speak in a normal tone of voice and speak clearly. If they have hearing aids assist them to put them in to help with the communication.
    Use open-ended questions instead of the closed-ended questions(ones with just a yes or no response). There are some questions that you must use that are considered closed-ended, but the best approach is those that will allow the patient to let you know what is going on with them.
    When you ask a question, if the patient appears not to understand, ask them if they have a question regarding what you just said.
    One very important point is before you leave a patients room, make sure they are able to reach the call light, if side rails need up make sure they are, offer them a drink of water(if they are allowed), ask if they need to use the bathroom, etc. If you tell them you will be back within a certain time frame, make sure you are, even if it is only for a minute. Patients are very responsive to a Nurse that gives a caring attitude.

    2. Rationale for using different approaches to communication with patients----
    Each patient is an individual and needs to be treated as an individual. You will in time learn the patients that are responsive to one technique of questioning may not apply to another patient. Another thing to do is research the differant ethnic backgrounds of patients. I worked in a hospital where most of the patients were of American Indian Heritage. These patients, especially the elderly, will tend not to speak with you because of their upbringing. They are also some who will have certain personal articles that they do not want you to touch due to their beliefs. Also check their religious preferance. This also is a factor in dealing with a patient for certain religions forbid cetain types of Medical Care. By being able to know some background on the patient besides the medical part of their problem will aide in effective communication with your patient.

    3. Philosophy of Care----
    Every individual has the right to understand what is being done to them. By being informed and able to answer any questions they may have will help with your communication. Remember, patients are usually scared because they are uncertain of what is goin on around them, this includes all age groups. If you are unable to address any of their questions, make sure that you seek out another colleque to help with the answer.

    I hope this helps some. I know there is more and if you have any more direct questions please feel free to e-mail me at:
    cherrie_pie0@yahoo.com
    The most important thing to remember is to treat the "Whole Patient--Holilistic Care" not just the problem.

    You also might wish to go to www.nurse.com and click on links and see if there is any info there to give you some answers. Good Luck and welcome to the Wonderful World of Nursing!!!

    MNM--A Step for Our Future, 2001
    Non-verbal
    Don't forget to smile, look pleasant and interested. Don't look out the window, at your watch, stand at the door with your hands on your hips. Non-verbal says a lot more than words.
    Your Philosophy of Care will come through in your non-verbal
    Care for every one like you really care for them and you will not go wrong.
    Observe the patient - these are big cues to whether he/she is a touchy, feely, or hands off, don't look me in the eyes person
  7. by   Jenny P
    You have received some excellent advise in the preceeding postings, but it is also important to be culturally sensitive to the patient, especially if they aren't fluent in your language. For some Asian cultures, it is impolite to stare at others; maintaining eye contact can be perceived as being rude. And for some people, smiling while you are doing a painful procedure (starting an IV) may be an insult. Try to gain your patients' trust, but be aware of their culture. What works in one instance may not work in another. Each patient (or person) is unique and needs to be treated that way- as an individual.
  8. by   Tina Harrington
    Monkeyboy Ya wanna try Sue Hincliff "Teaching Clinical Nursing" pages 158 to 170, shes really easy to read and you should find most of what you need on these pages, although tis under the heading of "psych: Nursing" the info is all about communication skills Good Luck from a fellow UK Nurse

close