How do you communicate with your patient?

Since you already know what you need to get the answers for, see if you can fall into a conversation about those items naturally. The patient usually gives you more information that way than if you just fire off a bunch of questions. For instance I needed some role function questions answered and noticed a woman's husband had an accent. So I asked where he is from and 10 minutes later I knew where he was from, how they met, how long they'd been married, how many kids she has and their ages, plus the grandkids and the oldest boys are playing minor league baseball for the A's and the Marlins I would never have gotten such a juicy answer by going down a list of Yes or No type questions.

I also review everyone's charts to see what I might have in common with them so I could meet them in that place and branch out. If I don't have anything in common I ask them questions about things in their charts that are interesting to me... I can always find a way to my targets to get my data.

I talk to my patients the way that I would want to be talked to if I were the one lying in the hospital bed. Don't talk to them like patients, talk to them like you're truly trying to get to know them. A natural conversation is the best way to get the info you need and the patient won't feel like they're getting drilled with questions. Open-ended questions are a good way to start up a converstion. Ask, "tell me about your family" vs "do you have children?" etc.

I still remember when I was a student and felt the same anxiety. Over the years I learned that the anxiety was only there when I was thinking about myself rather than the patient. So, you need to shift your attention to the patient, give the patient the full respect they deserve as an intelligent, thinking individual. Here are a couple of specific ideas that should help you:

1. Become truly interested in the patient's "story". This is one thing than I learned only recently. If I walk into the room with a real interest in the individual communication flows more freely. Who is this person? What brought them to this hospital bed? Do they have a family support system or are they trying to get through this alone? So, ask yourself as you enter the room - Who is this person?

2. You can speak to the patient honestly. The patient should know you are a student working on an assignment so you and the patient can work together on how to proceed through the questions. So, start with an introduction of yourself and ask them if it alright for you to ask them some questions about their family. Once you have their permission, you can work on the project together. Think of it as having a partner to help you with your homework.

3. If you have been assigned an uncooperative patient and the assignment is part of the daily care/care plan you can still start with the question "Who is this person?" You will just need to modify how you obtain the specific information. Sometimes those individuals respond better to a more straightforward clinical approach. In that case, I would probably use a clipboard and begin by introducing myself and telling the patient that there were some things you didn't find in the medical record and you would like to obtain the information now, asking them if that would be alright. Sometimes, those patients won't smile or look at you but they will usually answer specific questions - What was your father's name, etc. Be prepared for some "I don't know" answers in these cases...

Be interested in the person, be respectful of their intelligence, and be kind.

Remembering these things should help.

If I am not mistaken I would assume we are at the same program! I completely know how you are feeling, since I too am having problems communicating with my patient and getting the answers and genogram filled out for this assignment. You have gotten great advice and I too will be utilizing it. Good Luck!

Also, know WHEN to talk to your patient. Is it a better time right before they are getting ready to have a procedure done or if they have a ton of family around? Probably not.

Also, try and sit down while you talk with them. I don't know if you have ever been a patient at the hospital but I hate when they are talking to me while checking my IV line and writing down stuff on their notebook, etc. It's much easier if they would just sit.

I will be honest with you - when I had to that same stupid assignment (mine was in Peds!), I actually asked the patient/family if they would mind helping me out with a project. They know you are a student, you know? :) I told my patient that I was writing an assessment paper, and I would love it if they would take a few moments to help me out.... and of course assured them that everything would be confidential and that I would use no identifying information. :)

Most people are willing to help out students! Just ask. :)

Communication is one of the most fun parts of patient care. I'm interested in psychosocial though, so it comes naturally to me.

I think that, as NYLady said, the more interested you are in them as a patient, the easier it is to have a conversation. Get to know them, and spend a lot of time in their room, especially if they don't have a lot of family around. They will talk to you more than you think if you are just consistently around making conversation.

Normally I tell my patients that I'm simply working on an assignment when I ask specific questions like, "What is your religion?" or "What vaccines have you had?" because they are harder to work into conversation, but are required parts of a careplan. It's better to be straightforward.

I find that asking, "Can I do anything else for you before I leave?" works wonders and patients love it, plus it keeps them off the call light as much since you're meeting their needs. You also should lay out a plan for the day when you enter the room. I normally say, "Hi, I'm [name]. I'm a nursing student and I will be working with your RN today to provide care. I'll be taking your vital signs at [time] and giving your medications at [time] and [time]. I can also help you out with any questions or concerns, so ask me if you need anything." I put myself in the role of patient advocate completely, especially if you only have one patient.

Do a lot of listening. Go in with the doctor/surgeon/care team when they are doing rounds and take notes, then stay afterward when they have left and ask the patient if they have any questions. Some patients stop listening after getting particular news because they are shocked, but want to know more later, and you are a non-threatening source of information. You also are able to pass along this information to family members and visitors with patient permission (who often want someone in scrubs to explain it).

A lot of this information is useful for 12 hour days. On shorter clinical days, I think that being more straightforward is better because you have less time. Also, don't forget to thank your patient when you leave for the day. I normally go in one last time to let them know I'm leaving, thank them for being cooperative, and that I hope for the best outcome for them. I think that full-circle of patient care is important, and when you're a student, you have the time to do it.