Help me talk to patients....

No advice from me, but I'd be interested to see some of the responses. I have the same problem. I tend to use humor that is a bit on a sarcastic side, but never hurtful. I always give a big smile to let the patient know I'm not being serious when I say some things, but some people just don't "get" me. I'm sure a lot of it has to do with the fact that many are elderly and feeling very poorly, and are just not in the mood for jokes (not that I walk in like Jay Leno with a monologue or anything like that LOL!).

Of course, I also can act kindly and not use humor, especially when to do so would be wholly inappropriate. I just can't get into the "small talk" that seems to come so easily to others.

I'm a student, but so far I've found it's always good to start with "how are you feeling today?" and really listen to their answer. Then it's good to go from there. If they're watching T.V., ask them what's going on with the program. I think the way to small talk is to focus on the other person and what's going on with them. People really do like to talk about what is up in their lives. Talking about what you're doing at that moment (med education, procedure education) can also be a gate to conversation. Hope that helps.

i LOVE to talk to my patients!! if i could have an hour each morning to sit and visit with my patients, i would love it. i remember being somewhat nervous at the beginning of my first semester, but it will come naturally once you get going. talk to your patients about little things. ask them how they slept the night before. look outside and talk about the weather. look up at the tv and talk about what they are watching. ask them if they have family close by, grandkids, kids, pets etc. talk about sports. with each patient that you talk to, it will get easier and easier. just relax and realize that most patients are more than willing to have someone there to listen to them and talk to them. and for some patients it may mean the world to them because you may be the only person in their life that they have to talk to.

"So.......how'd you get yourself into this mess

For the right person that might actually work.

Seriously, people find hospitalization a traumatic experience and they need to talk about what happened, how they got there, what led up to it. If you get them to talk about themselves they perceive you as caring and you can get the bits of information that others might not catch- makes you look smart.

Always, always, be yourself.

I enter the room and say "hi, I'm Hopalong(first name) and I'll be your nurse today." Then I tell them I need to do an assessment, and while doing that I ask them any pertinent questions that I've predetermined from report of the last shift. As the shift progresses I may chit chat, time permitting,but they appreciate that I'm there to help them with there health issues and not to socialize.

I also, as is my nature try to inject a little humor when appropriate. I've actually had patients and family call me "Patch Adams" which I consider a compliment.

By the way, off duty I'm a very private person and don't socialize much at all. Come to think of it neither did Florence Nightingale. Hmmmm

1. Don't tell really, really funny jokes to people who just had a big abdominal surgery. It hurts to laugh.

Other than that, tencat gave really good advice. If you just start the ball rolling with a couple questions, they'll usually talk and you can listen. Just take your cue with their energy level, if they are feeling pretty bad, talking is tiring, so you might need to talk more, just be pleasant, be compassionate and come (if you can) when they push their call button. If they know you are trying to do a good job, and want to help them, that's a very good start...

I think the key is to listen, and empathize with what you hear. When I am with the patient, I keep it all about them. By that I mean that who they are, what they are going through, their physical emotional and psychological needs are my "task focus"...the benefit is that I see all these things incorporated into the simple task of giving a bath (I am a NA) and the great thing is if I am not thinking of me, I cant be to self conscious, can I? Usually the pt will respond to you by inviting you to share something about you....which is great...their reaching out to you has a healing effect: it brings them out of themselves, distracts them from some of their discomforts.

In short: it's not about you!

Was in class the other day and someone noted their anxiety regarding "messing up" while talking to their patients. I offered up my experience from being a patient...

You sit in a room for 24+ hours. During that time, the Dr. sticks his/her head in the room for all of 10-15 minutes (on a good day). Throw in the vitals checks, blood draws, med visits and status checks, you probably have an aggregate of an hour, maybe two, of interaction with other breathing individuals during the course of a day. Even if the depth of the conversation is limited to the trivial, it was usually a nice break in the monotony. So, short of insulting me, I'm not sure it was possible for the nursing staff to "mess up" a communication.

As a student nurse, the stuff I've been trying to get better at is taking note of the particular condition and background of the patient. For example, a recent patient had lost his leg as a result of an MVA. So I asked about his family/friends. He told me of his wife, kids, workmates and job. He also noted that his buddies had constructed a ramp to get in the house, etc. So from that, I could deduce that there was at least some level of support for him once he was discharged. I also used the opportunity to see if he'd gotten any information regarding outside support groups. He said he hadn't and when I offered to gather some info on those subjects, he gratefully accepted. Later, info regarding the patient's level of support proved to be of some interest to the physician as he was weighing the pro's and con's of a discharge. The whole experience with this person was sort of an "ah ha" moment for me. Seemed to be a step in the right direction. (for the seasoned nurses out there.. was that the right idea?)

I guess I'm just trying to get the hang of helping patients with how they respond to their health situation. Find out if they are having feelings of helplessness, loneliness, fright, frustration, etc. Once some of those clues are in hand, I start to explore what I might be able to do to assist them, even if it's just to give them the chance to vent.

When I started school, I was mostly focused on the "technical" side of nursing. I hadn't thought too much about this more "human" aspect and how doing it well could make such an impact on care. I guess this is where the "art" of the craft comes into sharp relief. At least for me, anyways.

Good luck, thrashej! I hope you come back to relate how your first experiences in this area turn out.

The replies to your question are all good. I used to be in the same situation -- difficulty making friends and generating conversation topics. But the key lies in asking questions.

This applies whether you're in a patient's room or at a cocktail party. Truth is, people generally love to talk about themselves. They like the attention. And you can learn a lot!

If you're worried about a question being too insensitive, just ask something lighter, and wait until you get to know the person better.

Just a few tips. Smile, as you introduce yourself by name and give the detail that you are a student. A smile says so much.

Ask "how are you feeling to day" and really listen to the answer by being present to the person as they reply. Take the answer as the cue for continuing the conversation. Listen very attentively to what your patients say. If they are sad, upset ... dont be afraid to stay with them in that place ... a silent comforting presence and a listening ear is often all they need. Remember too you dont have all the answers and nurses can't always "fix it". It's good to try to get to know the PERSON who just happens to be a patient at that time. If elderly ask about where they come from originally, what they did for a living, etc, It's amazing the great stories you will hear. Humour is great and always plays a part in patient care but you need to judge it carefully and how to use it appropriately. Turn it on yourself is a good way to start and by doing this you wont cause any unintended offense to the person. Lastly I think its perfectly fine once you have engaged with the person to share your insecurities ---- remember you are human too so don't be too hard on yourself. Just be real , be genuine and dont feel obliged to fill silence all the time. Most of all listen and observe the non - verbals as much as what is said. Good luck.

:wink2:

Hi everyone,

I am a student nurse entering Block 1 of clinicals. I am very, very nervous, especially in the area of communication skills. I have never felt I was very good with "small talk" and don't have a wide circle of friends. Because of this, I feel that my communication skills need some help.

Specifically, how do you strike up a conversation with your patient? What sorts of things are exceptable to talk about? I am wondering what I will talk about when I give my first bed bath or shower? I just feel sooo uncomfortable. I find myself always wanting to talk about what is wrong with them (what they are in for, LOL) like, "So.......how'd you get yourself into this mess???":lol2: . But I know this is innapropriate, however, this is how I would talk to a friend. I am curious, sometimes too much so...

Any advice would be appreciated. Please help me alleviate some of this anxiety. Thank you!!!:kiss

Oftentimes I will get pieces of information about them from their chart that I can talk with them about. For example, I might read that a patient's husband has been in a lot(i.e. medication discussed with patient and husband), or that my pt's daughter will be coming to pick the pt up for discharge. I can use those to talk to them, i.e. "So do you live around this area?" or "Do you have any children"(usually I'll only ask this if I know that my patient has a child, or if it is brought up casually some other way) followed by "do they live far away" and "what do they do" or "wow you have 6 kids and are a new grandma as of last week, what's the new baby's name?" or "So how long have you known your husband". Another poster mentioned that you can talk about what is on their TV. In our area our sports team is big, so I'll ask the pt if they have been following our team. Many people just want their story to be heard.

Yah, baths can be awkward, but always remember it is usually 100x more awkward for the patient if this is one of their first times in the hospital. One of the men I gave a bath too a while back was talkative during the whole bath, but then at the very end burst into tears and gave me a big hug saying the whole process of having to depend on others for things like baths was so embarrassing; it wasn't anything I'd done, but just his situation he was very unused to. Something I'll talk about a lot is asking if their feet are ticklish when I'm washing in between their toes. A lot of people are, and if I can focus them on their laughter sometimes it helps them forget that they may feel embarrassed. These little things often springboard onto other subjects as well.

Another big thing I talk about is the things they have in their room! You can ask who the people in their pictures are, or comment on how beautiful their flowers are, or ask about who gave them their balloons.

Some patients just don't want to talk either. If you ask the basic questions and they don't give anything else besides a couple words as a response, they may just want time alone to rest.

You'll get the hang of it! In my opinion, it is one of the best parts of the job because through small talk, you can really discover the great strength of people to perservere. It is very humbling to hear about what people have been through, and to see the amazing things people are capable of.

I've learned that as a student you have great opportunities to sit down and talk with your patients and practice communication skills.

How many patients are you given?

When I did my clinicals, we had one or two patients- let me tell you I miss those days!! I found it so much easier to sit down and talk with patients then..once you graduate you really dont have the time. As horrible as that sounds I'm sure every RN/LPN would agree.

I would say the best thing to do, is go into a room, introduce yourself, and just ask the patient how they are feeling and let them do the talking.

While you do your assessment you can ask questions too. Listen to lung sounds, and ask the patient if they are short of breath. Listen to bowel sounds, ask the patient when their last BM was, last void was, etc. That also helps to remember to do things.

I hated having to go back into rooms when I forgot things!

However, if you just sit down and talk with your patients, they really do appreciate it. Most of the patients I had in nursing school told me that. They would thank me for sitting and talking with them, even if It was just 5 minutes.

Somebody mentioned humor before- I love using humor, you just have to make sure you use it on the right patient!! I've found that most people are receptive to it though. It makes them feel more at ease.

Just be yourself :) And you'll do wonderful from there.