patient interactions

[micro, RN]

Just a question especially in nursing. How do we as "professional nurses" talk to our patient's and their families. How do we talk to each other. How do we talk to the doctors, other disciplines. Already see that I could be asking a way too broad question, so will attempt to narrow my focus. Anyone else can take it anywhere they want to as long as it stays within our practice as professional nurses and nursing personnel.

I tend to speak rather informally to my patients, but with this informality, I have developed my professional style.

(i.e. If I am asking an patient if (he) has voided, I quickly will add urinate or even pee'. I want to ensure that my patient understands the goal of the question, not be impressed with my medical lingo.

If I have to initiate/insert a foley cathether, I will ask my patient if they have had a foley catheter before, and usually quickly add a tube into the bladder, etc.

If I am starting an iv, I will first offer local anesthetic as procedure now dictates.......then I will talk with the patient about what I am doing in general(if they seem open to such) or I will just let them talk or "talk about the weather" and then say, "all done".

If I have to do a procedure of a rather personal nature to a patient.........I am aware that it is probably nothing to me(done it too many times to remember...................), but to

the patient......it is extremely private,

so I make a point of saying exactly what I will be doing and use correct anatomical terms, as the patient understands.......

I have found that this lowers the patient's anxiety and increases the communication between the nurse and patient toward to goal of their optimum health.

It is entirely different from the "Other Side of the Rail",

any thoughts, how do you communicate

any things that have helped you

or in retrospect hindered you.....

I know my communication ability has grown with years,

but even today.....

you have to be flexible in your communication style

you have to be aware of individual differences and meet that individuality in your patients.

micro

[adrienurse, LPN]

When you are working with those with dementia, you have to try to reflect how you sense they want to be treated. Hard to discribe. I am motherly to some and jokey with others who still have an intact sense of humor. I definately have an "at-work" persona that takes over when I walk into the building. I am the consumate über professional towards my co-workers.

I've had people tease me about how different I am "after hours" when I go to staff dinners and parties as "myself".

[dianah, ASN]

I try to explain everything r/t procedure (and reinforce during procedure) in a manner consistent with the patient's level of understanding and temperament (the feeling you get about just where the pt is right now [terrified, calm, denial, focussed on pets at home rather than on illness, etc] and how much pt can absorb to allay fears rather than escalate them). All people are different and need different approaches. Some with whom I've taken a lighthearted approach, will thank me {us} for the chatter (we always include the pt) and the explanations, saying we were professional but helped them relax, that they enjoyed the banter (I always reassure them I take their care very seriously).

I had a very by-the-book, scary instructor for clinicals while in nursing school, that EVERYONE was afraid of. She was squarely built, with short dark hair and dark, piercing eyes that missed nothing. We trembled when she fired questions at us. "You just hope you don't get Miss ---- for your first foley placement," everyone groaned to the others. (It so happened I DID have to place my first foley under her guidance, and with all my fellow students breathing down my neck . . . 'nother thread)

During semester break we heard she'd had a bx done (you know how things travel thru the grapevine). When we returned from break she briefly told us about her experience. "As you may have heard, I had to go into the hospital to have a biopsy done. And you know, as I lay on my bed, waiting to go for the procedure, I didn't think about critiquing the nurses who came into the room, or watching their technique, to make sure things were done right." She paused. "All I wanted was for them to be good to me, that's all."

That little speech made such an impression on me, -- that even she, the "hard, cold" instructor, was human after all --- as are we all(!!), and that when people are in the scary hospital for possibly life-threatening conditions, that's when nursing is, as others on this BB have posted, an ART, combining the book larnin' knowledge and clinical expertise with just being good to people. (Yeah, I know what reality is like -- ya do what you gotta do for the good of the pt. And then you add a little more.)

Kinda rambly, sorry.

I'm with micro: Keep on keepin' on. -- D

[sjoe]

I always use last names with titles (Mr. Mrs. Dr.), or "sir" and "ma'm" if I don't know their last names for everyone except small children (and then it's often "young man" or 'young lady"). This professional formality contributes to a professional interaction.

[Nurse Ratched, RN]

Body language is big with me. Since patients lose so much control in the hospital, I don't like to hover or tower over them. I always try and get at eye level or below.

I tend to do as micro does - use the jargon and then translate immediately afterward. I guess it's my way of trying to expose the pt to some medicalese in case they start hearing stuff that they don't understand later.

First thing in the door, I wash my hands so *they* know it was done. Then I usually offer a handshake to the guys (sexist of me, maybe, but they seem to respond well to it.)

[jevans]

Micro

I have to say that I adopt a simular style to your self. Yes I do use "medical jargon" but always backed up with layperson's terms

I am concerned that some do not use language that our patients understand so I personally use both for their future reference.

I often feel as if I need to bridge a gap

j

[Brownms46]

I have found joking with most pts...who are alert/oriented or course...helps me get thru to a lot of people. I also ask them what happened, and how they came to be in the hospital. Most enjoy talking about themselves...and this breaks the ice most of the time. I try to explain procedures, and why I'm doing a procedure...and let them ask questions. I also tell them, that I know how it feels to be in that bed, and to not hesitate to call if they need me for anything! I explain how often their pain med is ordered, and when I give them their med, I write on the board the next time they can have more. If they have a med for breakthrough pain, I explain that. If they have scehduled pain med...I explain how that works also. I present a plan of action, and if they agree...that is how I proceed. I use whatever it takes to get the pt. to understand what is being done, or want needs to be done. But I find humor works well many times..

I have walked into rooms where people are looking very concerned...and most times by the time I leave...they, and the family members are smiling. One pt. recently told another staff member.....he thought I was the best nurse that he had..had since they arrived. He stated....if you knew my wife,...and seen the way she handled her...you would know what I'm talking about. Funny thiing he said that in just enough time...before the said wife walked up...:chuckle!

I still do get complainers...but they are far and few between! Just goes to show you can't please everyone..:)

[SmilingBluEyes]

I find it is good to learn patients' and families' communication styles to figure which way is best. Everyone is different; you simply cannot apply the same style and verbage to EVERYone w/o leaving many out. Some folks are more comfortable than others w/formal speech and interchanges. I have learned almost ALL would appreciate being treated like family; with the same compassion and caring as we would extend any of our own loved ones. I also find cultural differences affect how i interact w/patients and their loved ones.

I have a very good reference book regarding cultural practices/beliefs among many religious/ethnic groups that outlines what certain voice inflections, body language and other important *NONVERBAL* cues can do to effect positive communication. It is in invaluable to remember our NONVERBAL cues are at LEAST as important as WHAT we say and how we say it! Be VERY aware of what your BODY language and facial expressions are saying if you want to get your point across in the way you mean it!

[RNinICU]

When interacting with patients I try to fit my communication style to the situation, and the patient's needs. I use a style similar to Micro when talking about their disease process or any procedures i am performing, but when I am just talking with them, I am less formal. Like Brownie, I like to use humor to make them feel more comfortable.

When communicating with physicians and coworkers, I also try to fit my style to the person and situation. I always try to be professional with docs when communicating patient information, but I am also friendly with some of them and can be less formal at times.

[WashYaHands]

Years ago, before I became a nurse, when I was a new mom, my 2 month old baby developed a temp. It was 2am and I called the nurse advise line. One of the questions that the nurse asked me was, "Is your baby afebrile?" At the time, I had no idea what "afebrile" meant. That was 16 years ago, and the situation stuck with me, which is why I try to match my communication with the level of understanding of the patient. Like Jevans, if I catch myself using medical terms, I try to define that term in laymens language. Micro, on another thread you asked me if I was a teacher. I'm not formally an educator, but part of my personal nursing philosophy is that all nurses are teachers, as we provide patient education on a daily basis.

Now, communicating with doctors, community leaders, etc. is an entirely different level of communication.

Linda

[MollyMo]

I've had patients tell me that they appreciate how I walk into the room. They say most nurses rush around like a whirlwind, but I'm very laidback and relaxed. I joke with my patients to put them at ease. I sometimes tell them personal stuff if it will help keep them calm. I speak in the simplest terms so there's no misunderstanding especially since most of my patients have very limited English. I accept no rudeness or profanity because I won't give it to them. I'm learning to be more calm with Alzheimer's patients. The ones I've dealt with do well if given a choice instead of being told what to do but I guess that's the same with anybody.

[micro, RN]

and you could take care of me anytime, if I needed to be on "The other side of the rail"

well, it is back to work for me today.....put my:nurse: back on

I am glad that other people think about this subject. Communication is vital. Such good points made, after my wandering first one.

----having your nursing persona

----not using medicalese or immediately translating it

----doctors, lawyers, instructors, nurses=just people when patients

----no disrespect intended, when talking to patients or families, but use simple words.....maybe it is the stress of the situation, or maybe there is a communication barrier, or maybe.....

----being open and flexible to the people under your care

----sense how the patient would like to be treated, ad, know what you mean, hard to explain, but you can do it

----ask what they would like to be called

----use of humour when appropriate, something else you just know if you are open to it

----eye contact, eye level or below.....

so much truth in the importance, that you all state.......

thanks for the tips and sharing......

we all have much to learn from one another.........:)

sorry, all on a roll,

trying to get my nursing face back on over my cup of coffee,

this weekend, been a bit selfcentered.......

hey, I especially like the handshake comment.....

I am a handshake kind of person with just about all my patients and families.....introduce myself as I extend my hand.....

great icebreaker and a great connection to communication......

wasn't taught that in nursing school..........:)