Question about Bedside Manner

akulahawkRN, ADN, RN, EMT-P · Nov 18, 2012

It is OK to be more reserved. You don't have to be friendly... just don't be cold. You don't have to touch your patients any more than you need to. Being a guy, I have to be especially careful about that. So, every time I touch a patient, it's for a specific purpose, and that purpose makes sense for what I'm assessing at that moment in time. Therapeutic touch doesn't always mean you have to put a hand on a shoulder. It can be as simple a thing as shaking their hand when you introduce yourself to the patient, and holding it for a moment while you finish your introduction. It also gives you an idea about how receptive the patient is about being touched by someone else. Just those few seconds can give the patient the impression that you are real and that you care enough to properly introduce yourself. You get the bonus of checking skin signs, motor function, how alert the patient is and how they respond to changes in their environment.

This isn't rocket science... it's something far more nebulous and just as important. Just don't put an act on because it'll look exactly like you're putting on an act. That's more off-putting than anything. Just be you.

NurseDirtyBird · Nov 18, 2012

I know a lot of nurses who are introverts, shy, reserved, and don't like to touch people. I'm one of them. I'm also a pretty good nurse (if I may say so...haha). I am different at work than I am in any other setting. I am not outgoing, or "perky" or whatever in any setting, but I find it easier to talk to people in patient care environment. My role is prescribed: I am the nurse, they are the patient. I have a job to do, and I have to talk to them in order to do it. There are strict boundaries in the nurse-patient relationship, and I find I am very comfortable working within them. There's structure, focus and expectations and that takes the guesswork, and hence the anxiety, out of the equation.

That's not to say I'm all business all the time. You take your cues from your patient. Sometimes it's ok to joke. It's always ok to show compassion and kindness.

When you gain some experience in nursing, you will feel more confident about your competency and your interactions with patients. You will have to practice and see what works for you and what doesn't. Don't try pretending you're something you're not, patients will see right through that and may not trust you.

As for the touching, when you're a nurse, you can get away with touching people only with gloves on (in most places).

decembergrad2011, BSN, RN · Nov 18, 2012

You will find your own way of dealing with patients with experience. As far as what you are taught in school, I'm sure it varies, but we learned therapeutic communication in my program. We also had a semester of clinicals in a psych setting to practice motivational interviewing.

My simple points:

1. Be patient centered. All conversations should be in the benefit of the patient. You can tell stories or joke and sometimes that is absolutely vital to connecting, but it should be for their benefit.

2. Emote your care and compassion, especially with a smile. I smile a lot at my patients naturally because I'm a smiler, but if you aren't, make an effort to smile.

3. Watch your body language. Eye contact, nodding, and facial expressions play a large part in communication.

4. Listen twice as much as you talk. The only time you should be speaking more than listening is when you are providing patient education. Of course, sometimes you get a quiet patient

5. Use notes like a brain sheet to jot down requests, questions, etc from the patient that you are not able to get at that moment, then follow up when you complete them.

6. Be politically correct in the majority of cases. But enjoy the patients that don't expect you to be "on" for 12 hours straight.

7. Utilize your ancillary staff such as chaplains and social workers.

There is nothing wrong with being shy. Plenty of patients prefer a calm, relaxed bedside manner and will appreciate a quieter nurse. Again, you'll learn as you go. Good luck.

rubato, ASN, RN · Nov 18, 2012

You do not need to be outgoing to be a good nurse, but I do think that touch is powerful. I am not a touchy-feely person at all. My first patient, I was funny and polite and attentive with,but when my instructor came into the room, all it took was a touch and this patient just started bawling. Turns out, she was afraid of her upcoming surgery and I just wasn't getting it. I now make it a point to make physical contact with all my patients and it has opened doors. They especially love back rubs after being in bed all day.

Clovery · Nov 18, 2012

I felt awkward when I started nursing school too. I find it amazing that as I end my nursing school career (graduate in a few weeks!), talking with the patients and offering touch comes very naturally, without thinking about it. It'll probably take a couple of semesters, but once you realize your role as a nurse and how your patients see you, you will just know what's appropriate and it won't be awkward anymore. It's just something that takes practice and experience. Some people don't want to chat or be touched. Others need it. You will learn to recognize what your patients need from you, and you'll find yourself doing it automatically. Don't fret about it now.

chorkle · Nov 18, 2012

Emma--

Because of the way I was raised (that's my excuse, anyway), I'm pretty reserved, and what I call social lubrication still requires conscious effort.

But practice makes some things easy, eventually, and then second nature. At one hospital job, it was decreed that on entering a patient's room, we would introduce ourselves, and briefly characterize our position in the organization--i.e., how we relate to the patient, & why we're there, just now.

So--Hi, my name is John, & I'm a tech here. I came to see you, to . . .

At first, this felt awkward. After a while, it became easy. Eventually, it seemed just right & proper. Today, it's automatic.

HTH

mariebailey, MSN, RN · Nov 18, 2012

You don't have to be gregarious to convey compassion, interest, & respect. As a patient, I prefer the silent type to a "Chatty Cathy". As long as you're being sincere and professional, I would think being yourself would be totally permissible.

blt99 · Nov 18, 2012

I was dead nervous about having to talk to patients during my first clinicals. The best advice I was given my first semester was to just be yourself. Do what is comfortable for you, but every day challenge yourself to do one tiny new thing. Touching is a good start for me, and I'm getting more comfortable with it every day.

gentlerain · Nov 19, 2012

I believe as long as you have a sincere caring nature (which you described yourself to possess) and dedication to work hard to benefit others, this career suits you! The patient can see through any facades and understand that you truly want to help them.

Stoogesfan · Nov 19, 2012

I am a very shy person and that was the thing that concerned me most starting my journey into nursing school. I have just finished my first med surg clinical today, and honestly I found I was much more comfortable touching and talking to my clients than I thought. My advice would be to just attempt and give it time. It really does take practice for some people. You sound like you really do care, and if a nurse is caring then I think it shows and the client respond to that.

HeyYogaGirl · Nov 19, 2012

I'm a very outgoing person but oddly enough I really relate to your post! I want to use touch to help my patients but sometimes putting my hand on a tiny little shoulder of one of my thinner female patients feels awkward! Then I realized that it's because I am used to putting my hand on my boyfriend's big muscley shoulder and something throws me off about the way it feels. So what works for me is practice. I see you tried practicing with your fam which is a good idea, but I would try practicing with toddlers...in a completely appropriate way of course! I volunteer in my church's nursery and I get so much practice consoling tiny shoulders hehe it really helps! And kids don't get awkward like adults do. If you don't console them the right way, they don't act like you are weird or anything. I hope this isn't coming off creepy, I just find that it helps me to practice with kids...gosh it is sad how you have to worry about like everything you say being misconstrued nowadays. Another thing I try is to add soft touch when I am already touching the patient for a procedure. Like when I am putting the BP cuff on, I gently put a hand on their shoulder and arm and tell them they can relax their arm. This works for me because I take vitals every day so it's a good time to practice, and also it makes sense because they do need to relax their arms! Hope this helps! And hopefully we both can get used to this soon :)