Nursing Communication: How to Make Sure Patients Feel Our Caring

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    Ineffective nursing communication occurred at one hospital as illustrated in the following example: A patient complained that no one had been in all night to check on her. The Patient Relations Rep went to find out if that was true. She found out that the patient's nurse had in fact been into the room four times, doing things for or to the patient each time. Four times! The nurse had been there physically and felt caring, yet the person who was the patient didn’t feel she received any quality co

    Nurses are caring. It’s a given. Yet, in today's pressured work environment of endless multi-tasking and multiple priorities, they run the risk that their caring may not come across effectively to the patients and families they serve.

    Connection to their caring mission can fade because of the stress of endless to-do lists and intense workloads. This is anxiety-provoking for patients and draining for nurses and the organization.

    Clearly, spending more time with patients isn't the answer. The fact is, unless barriers are removed and staffing and processes improved, there is no more time for nursing communication.

    Any suggestion that nurses should spend more time -- time that they don’t have -- is maddening and breeds resistance to improvement strategies. Therefore, it's helpful to focus not on the quantity of time nurses spend, but on the quality of that time with their patients and families. The challenge is to make certain that their caring comes across to the people they serve during the precious time they do spend with them.

    So how can nurses make certain that their caring is felt by patients and families during the precious time they spend with them?

    If I could advance one skill in nursing communication that would create breakthroughs in the patient experience and job satisfaction, it would be the skill of "presence."

    This learnable skill involves controlling your attention so the person on the receiving end feels like the center of your universe during the precious moments you have with them.

    The payoffs: Patients feel your focus and caring, you connect with them, and your work becomes more meaningful. When you practice presence, the patient feels important -- that they are your sole focus. They also feel like your soul focus. This helps them feel supported, less anxious and they actually heal faster. Also, when you are fully present, you don’t miss valuable cues about the person's thoughts and feelings -- cues that help you meet people's needs exceptionally well.

    The pivotal skill of presence doesn't take more of your time. It makes every moment of connection with the patient precious so your caring comes across loud and clear.

    Tips for Practicing Presence

    • Take a deep breath. Bring your attention to the present moment.
    • Physically shift to a posture of presence. Place your legs evenly on the floor. Open your palms. Face the person fully. Aim your heart at theirs.
    • Lean in.
    • Tune in.
    • Smile and make eye contact.
    • Open your ears, eyes and heart. Listen to the person’s thoughts and feelings.
    • If you become distracted, take notice and tell yourself to return your focus and caring to the person in the present moment.

    NOT Being Present: The Signs

    • Eyes wandering; looking away
    • Maintaining eye contact, but not really listening
    • Doing something else while someone is talking to you
    • Chatting with a coworker while customer is waiting
    • Allowing interruptions by any and all people or calls
    • Allowing an important interruption without excusing yourself and explaining
    • Acting tired, bored or distracted
    • Looking at your watch
    • Interrupting the person talking
    • Turning your back without apologizing or explaining
    • Walking away with no explanation or goodbye

    Help your team enhance nursing communication through the pivotal practice of presence. Ask them to experiment with a small number of patients and family members. Then set a date to discuss the results.

    The Impact Is Amazing

    In my experience as a healthcare consultant, working with teams who have focused on the practice of presence, I have seen how energizing it is for the staff and how healing it is for patients and families -– when nursing communication is grounded in the nurse's caring presence.

    By Wendy Leebov
    Last edit by Joe V on Jan 12, '15
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    About Wendy_Leebov

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  3. by   Tampa121
    Thank you for the great advice, I needed this! Happy Easter!
  4. by   Wendy_Leebov
    Thank you for your post and Happy Easter to you too!

    I am thrilled the advice was helpful. I know that learning to be PRESENT has made a big difference in my work and my relationships outside of work… If you try some of the skills mentioned in my first posting and have any questions or want additional tools, please let me know.
    Wendy Leebov
    Last edit by Wendy_Leebov on Apr 13, '09
  5. by   TERESAKIM77
    This is a great post!! Thank you for your advices!!!
  6. by   sassyson_989
    I work in a nursing home, and this information is so valuable. Although the time we have is limited, if you practice this way of communication with your residents the outcome is great!! I will pass this on to my DON, in hopes that she will make copies and hand them out at our next meeting!! Thank you for putting into words what I do on a daily basis!!
  7. by   diane227
    Great Post!!!! and good reminders for all of us. Touch, eye contact, and a smile when appropriate. Also, the use of humor when the time is appropriate. Thanks, Diane
  8. by   Wendy_Leebov
    Quote from sassyson_989
    i work in a nursing home, and this information is so valuable. although the time we have is limited, if you practice this way of communication with your residents the outcome is great!! i will pass this on to my don, in hopes that she will make copies and hand them out at our next meeting!! thank you for putting into words what i do on a daily basis!!
    i'm so glad to hear that you liked the article on presence and want to circulate it. i'm working with two assisted living facilities and nursing homes right now and see how critical presence is in connecting to residents heart-to-heart.... so they feel caring attention. also i personally see the power of presence with my mother who is 91. she has become very anxious ---about everything! and when i am really present to her, i see her anxieties fade at least for those precious moments.

    thank you again for your post.

  9. by   Purple_Scrubs
    Awesome tips! As a school nurse, sometimes I realize that I have not even made eye contact with a student when they are in my office: as they tell me their complaint, I am writing down their name, the time, the complaint, etc. and thinking ahead to my assessment and how to get this kid back in class asap. This article has made me realize that I need to focus on the child, not the documentation and make them feel my caring for them. Thank you!
  10. by   Wendy_Leebov
    Terrific! I'm so glad it struck a chord with you. The kids will certainly benefit and you will hopefully feel more connected and better about your job. I want my grandkids to have YOU as their school nurse!

  11. by   Purple_Scrubs
    Awww shucks, thanks! I actually printed out your Tips for practicing presence and have it taped on my desk as a reminder!
  12. by   Wendy_Leebov
    That's great! I have found that reminders really help in staying focused on implementing new skills.

    Wishing you success,
  13. by   tracyd77
    This is sooooo very important! Thanks for laying it all out!
  14. by   fyka ennara
    great.. thanks for advice.. i like it...