8 Tips for Tough Conversations with Patients

Informing patients of abnormal assessment findings or lab values can be hard. On the one hand, you want to be honest and forthcoming, yet, you don't want to cause unnecessary stress or alarm for the patient. How do you go about delivering this information in a seamless manner that meets all of the above?

Here are a few tips you can put into practice today that will help you when discussing tough conversations with your patients.

Pay Attention to Tone

When you're talking to your patient about their test results, they're likely hanging on every word. And, it's not just the words you use, but the way you use them that they interpret. The tone of your voice communicates what you're feeling when you speak.

Tone can be changed by other factors, such as how you're feeling that day or other things on your mind. You might not be good at understanding your own tone of voice when you speak. Whatever the reason, be sure that your words are correct and your tone is conversational and caring.

Speak Clearly, Not Loudly

Have you ever witnessed a conversation where someone didn't understand the information being given, and instead of changing the message, the speaker started talker louder? Unfortunately, we've all done this. When communication starts to get off track, you might naturally change your tone and volume without even knowing it.

The next time you're having a difficult conversation with a patient, be sure to speak slowly and clearly. Keep the volume of your voice at a moderate level.

Avoid Acronyms or Big Medical Words

You talk fluent nurse, but your patients don't. Try to avoid acronyms and big medical words whenever possible. If you must use either, be ready to explain what they mean in simple terms.

Know Your Audience

This is one of the best communication tips for any type of communication. It doesn't matter if you're giving a lecture to nurses or talking to a patient - you should always know your audience. This means you might need to ask a few questions to gauge the patient's current level of understanding of their disease process.

This can come in handy if the patient is a health care provider too. Remember that just because the patient is a nurse, doctor, or another clinician - they still need to be taught about their illness. And, they may have family or other caregivers with them, who need to understand the information so that they can support the patient.

Stop Talking and Listen

You might think that you need to tell the patient everything before you stop to assess where they are in the journey of understanding, but this might not be the best strategy.

Try to pause after small bits of information and allow a little silence to enter the space between you and your patient. This gives them the opportunity to express understanding or ask questions. Listening is one of the best communication skills to know what your patient is understanding. And, you might also connect with them on a different level if you use active listening.

Use Reflection to Gauge Understanding

Also known as the "teach-back method," reflection gives your patient the opportunity to demonstrate to you what they've learned. To use this method, ask the patient to restate, in their own words, what you taught them. This allows you to check their level of understanding of the information you provided.

Remember Your Body Language Speaks Too

You walk past the nurse's station and notice a coworker talking to a family member. Your co-worker has their arms crossed over their chest, and they're looking down the hall at another nurse. You later hear them tell the unit manager they have no idea why the family member expressed concern about their communication skills. You silently replay the scene you saw earlier and thing to yourself - "it was your body language."

Always strive to match your body language, words, and the intent of the conversation. If you want your patient to open up - you need to mimic this through your words and behaviors. Keep your arms down to your side or in your lap to show that you are open to receiving feedback. Maintain good posture and eye contact. Pay attention to the expression on your face, and smile, when appropriate.

Assess For Communication Needs

I recently witnessed an interaction between a registration staff member and a non-English speaking patient. First, the registrar increased the volume of her voice when she thought the patient wasn't understanding. Then, her tone changed, until she finally realized the patient didn't speak English.

She quickly got on the phone with an interpreter, but while waiting to get this process started, the registration staff working with this patient ignored them. She didn't engage with the patient at all. In fact, she actually turned her back to the patient and even told another staff member, "They don't understand, so I'm just not talking to them."

While the patient didn't understand the words, they certainly understood the body language and the message being sent by the staff member turning their back on them. Once the patient heard the interpreter speak their native tongue, everything about them changed - they smiled, their body language relaxed, and they maintained eye contact with the interpreter on the video call.

This was an excellent example of what not to do when you have a patient with special communication needs. Remain open when communicating with patients so that you can recognize these needs. If a patient doesn't understand you, change your approach and then consider if there are special needs that you're not meeting.

No matter how good your communication skills are, you can always improve. Challenge yourself to consider using just one of these tips the next time you're in a difficult conversation with a patient.

Do you have other tips? Place your thoughts in the comments below, we would love to hear them.