Nonverbal Patient Communication Tactics

Loo17 · Nov 2, 2014

My ED recently bought rolling stools and are encouraging nurses and providers to sit eye level when appropriate.

tyvin, BSN, RN · Nov 4, 2014

During clinical rotation at the end of my first year in school I was observing two RNs standing over a man in the ICU, they were talking over him. One nurse on one side of the bed, and the other RN on the other side. I was at the foot of the bed; a nursing student at the time. The patient was triple A and unconscious. One nurse looks at the other and says "He's circling the drain", and as they both look up at the same time shaking their heads, they simultaneously say "ah hum" as the other RN says "Yep...looks like he's not going to make it"

I distinctly remember thinking, who in the world do they think they are, didn't they realize that the gentleman might some how have sensed them, in a some manner? We all left the room and I asked them if they didn't realize that the man could have sensed their conversation over him? They both laughed and indicated that it was impossible. I respectfully disagreed.

During this time at school, I had some idea of non-verbal communication (NVC), but not much. Second year was coming up and I needed an elective for my BSN so I was able to enroll in non-verbal communication 101. It literally changed my life in a way I can't explain.

According to certain theories of NVC, as humans, we use and depend on NVC anywhere from 70% to over 90% of the time in our communication with each other. Mind boggling I know, and many people will never believe that. Take a real course in it over a semester or 2 quarters and you'll improve your communication skills drastically.

Purple_roses · Nov 4, 2014

tyvin thank you! That sounds like an extremely usual class to take. I don't believe it's offered at my school. Was it a class specifically geared toward health care workers?

mluvsgnc · Nov 4, 2014

tyvin- hearing is the last sense to go...shame on those nurses!

All my patients are nonverbal (I'm a PDN in pediatrics). One pt. is deaf and half blind as well. Facial expressions are big, and we have also developed our own sign language when communicating with him (certain signs for "are you ready?" "Let's walk" "Time for bath" etc.). My other pt. we use eye signals ("look up for yes" "look at pink if you want that one or blue if you want that one"). Body language is really important, too, as stated above. Not crossing your arms when talking to someone and maintaining eye contact are important. With children (and anyone, really), coming down to their eye level shifts the dynamic from that of a power position to one of more equality.

As a nurse, working with nonverbal pts. has honed my assessment skills. I can look at my pts. and know something is going on simply by a facial tic or their affect or one side of the face is slightly puffy which means X. I can make determinations without them telling me :)

tyvin, BSN, RN · Nov 19, 2014

tyvin thank you! That sounds like an extremely usual class to take. I don't believe it's offered at my school. Was it a class specifically geared toward health care workers?

Purple_roses; the class was part of the universities 'Communication's Department'

In order to receive the bachelor, the student must complete a required x amount of credits in x amount of multiple disciplines that are non-nursing.

The non-verbal communications class was part of the Communications Department's various communication degrees. I was able to include it into my agenda as part of my schooling.

I believe it's critical for a nurse to be proactive in their lives in order to be successful in their career with things like taking courses that improve the communication between patient and nurse.

allnurses Guide · Nov 20, 2014

My ED recently bought rolling stools and are encouraging nurses and providers to sit eye level when appropriate.

Sitting down not just puts you at eye level, it also indicates you are going to take enough time to concentrate on this person, as opposed to being on your feet ready to run out the door.

KelRN215, BSN, RN · Nov 22, 2014

tyvin- hearing is the last sense to go...shame on those nurses!
All my patients are nonverbal (I'm a PDN in pediatrics). One pt. is deaf and half blind as well. Facial expressions are big, and we have also developed our own sign language when communicating with him (certain signs for "are you ready?" "Let's walk" "Time for bath" etc.). My other pt. we use eye signals ("look up for yes" "look at pink if you want that one or blue if you want that one"). Body language is really important, too, as stated above. Not crossing your arms when talking to someone and maintaining eye contact are important. With children (and anyone, really), coming down to their eye level shifts the dynamic from that of a power position to one of more equality.
As a nurse, working with nonverbal pts. has honed my assessment skills. I can look at my pts. and know something is going on simply by a facial tic or their affect or one side of the face is slightly puffy which means X. I can make determinations without them telling me :)

When I saw the title of this thread, I thought it was going to be about communicating with non-verbal patients as well since I've always had non-verbal children as a significant percentage of my patient population.