In hospitals, clinics, and other healthcare settings, nurses use various communication techniques to establish rapport with their patients and to build trust. As it is often nurses who spend the most time with patients, this can be an advantage in providing care and gaining a deeper understanding of a person’s condition. There are many ways in which active listening can be practiced. The right techniques to use will depend on the individual patient and the situation. When done well, it does not just improve a patient’s clinical outcomes. It makes people feel comfortable during their treatment and leaves nurses feeling more satisfied in their roles.
What does therapeutic communication entail?
The type of communication that nurses use focuses on the emotional and mental wellness of their patients, as well as their physical health. Nurses can give patients information about their condition and provide support in trying times, but they always maintain professional distance and perspective. Practices such as repeating information to clarify its meaning, remaining silent at times, and using statements to prompt a patient’s response are part of what is known as therapeutic communication. This approach can reveal more about a patient’s needs, as well as provide security and reassurance.
Why is this style of communication so important?
Therapeutic communication methods are vital because they are useful when it comes to nurses forming positive relationships with patients. This quickly creates a trusting atmosphere in which people feel confident enough to share their feelings about their treatment. By speaking openly and encouraging patients to do the same, nurses can spot important changes or symptoms that might have been missed, and then relay this information to the rest of the healthcare team. This helps nurses and other professionals to design and implement the best possible care strategies and deliver medical support of the highest quality.
In the Elmhurst University Master of Science in Nursing program, students are taught all the vital communication skills they need to excel in the higher levels of healthcare or non-hospital rn jobs. They can study online to accommodate their work commitments and graduate within a year. Along with promoting excellent medical outcomes, therapeutic communication means nurses can nurture an atmosphere of security and inclusion in which people feel able to express their thoughts and concerns. This helps nurses to support the people they care for and contributes to a better clinical experience overall.
How are these techniques used in practice?
There are many ways that therapeutic communication can be incorporated into the daily work of a nurse. Most happen naturally, while others are more purposeful. Here are some examples:
- Allowing silences to happen
Not every moment of contact needs to be filled with words. Instead, silence gives the patient and the nurse time to process the situation and think about what they might say next. It could also encourage a patient to speak about a new topic that they find awkward or uncomfortable. Alternatively, they might have a question that they had previously forgotten about. Either way, nurses will give patients a chance to break the silence.
- Accepting a patient’s concerns
When a patient knows that their nurse accepts their worries and their explanations of what is wrong, it can make them feel at ease. This process is not about agreeing with a patient who has generalized anxieties about their care, especially when their fears appear unfounded. Rather it involves a nurse making eye contact and confirming that they have heard and understood. By demonstrating receptiveness to a patient’s thoughts, they are more likely to foster a receptive attitude and aid the recovery process.
- Recognizing their efforts
Giving recognition when a patient’s behavior is positive can be better than offering compliments. Sometimes, a person feels talked down to when a medical professional gives a compliment, especially when the praise is offered for a simple task like getting out of bed or taking medication. However, by drawing attention to a patient’s actions in a straightforward manner, for example, by saying, “I see you have taken today’s meds already”, the behavior is encouraged without a compliment being given. This works to motivate a patient and, in time, to enhance their health outcomes.
- Keeping a patient company
Many people can feel bored and even lonely when they have a medium to long-term hospital stay. By giving their time, as well as their medical know-how, nurses demonstrate that they value their patients. Friendly company can also help people get used to their new surroundings, whether by having a quiet chat, bringing over a drink, or sitting for a while and watching TV together. Being a calming influence can leave patients feeling relaxed and in a better place to begin healing.
- Asking open-ended questions
Open-ended questions allow a patient to direct the conversation and choose the topic. Nurses could start by asking, ‘What would you like to talk about’ or ‘What are you feeling right now’ to give patients a chance to discuss their thoughts openly. This process can give a nurse insights into what their patient is experiencing and what they can do to improve their recovery.
- Listening in an active way
Using non-verbal actions, like nodding, for instance, will reassure a patient and can get them to keep talking. Facial expressions, words of support, and gestures can all be part of a compassionate response, whether nurses are speaking with patients or their families. They show the nurse cares and that they are engaged with what is being said. To take things a stage further, nurses can ask leading questions, such as ‘What happened next?’ or ‘How did that make you feel?’ to guide the flow of conversation and keep the patient talking. Relevant questions like these show the nurse is listening and is committed to making the situation better for their patient.
- Asking a patient to clarify their statements
Sometimes a patient might have important information to convey, but they struggle to do so clearly. Nurses can help by asking a series of questions that help their patient to find a way to answer. They could simply explain that they find the patient’s statement hard to understand or ask for a lengthier explanation. Occasionally, a timeline will need to be established for the medical events that led to a situation. By going over this with a patient, the nurse can get a clearer picture of what happened and maybe prompt a patient to recall further information of significance. This ensures the nurse knows what the patient is saying and gives the patient the space to think through their feelings more carefully.
- Making frequent observations
Not all patients can identify a problem, and some will have trouble expressing themselves fully. Therefore, the ability to draw conclusions based on appearance, mood, and behavior can be a great asset for a nurse. A tired patient may not be sleeping because they are in pain, and a patient who frequently needs the toilet may be developing a new symptom. By chatting politely about their observations, a nurse allows patients to disclose more details about their condition.
- Encouraging a patient to describe their experience
Patients who are experiencing certain sensory issues may have hallucinations that frighten them. Nurses can help by asking about these symptoms in a calmly and politely and not being judgmental or negative in their responses. They could learn more details about the patient’s experience, which might result in changes to the patient’s therapy and a speedier recovery.
- Summing up their opinions
Patients are not always completely clear when they try to explain a problem or a symptom. By summarizing what has been said just after the patient has spoken, nurses can clarify the information and encourage them to expand on their initial thoughts. This demonstrates to the patient that their nurse is listening and cares. It also means the nurse can document a conversation that might be of use when adjusting or formulating a care plan. Repeating back what a person has said, then ending the chat with a sentence such as ‘Does that sound right?’ ensures they understand and makes the patient feel heard.
- Asking a patient to reflect
Throughout their career, nurses are asked for their opinion or their advice by curious or worried patients. By turning this around and asking patients what they think or what they would like to happen, nurses can encourage a sense of accountability. Furthermore, they can show patients their opinions are important and motivate them to think more deeply about the situation. Moving forward, fostering the concept of self-reflection might help a patient to find healthy solutions of their own to their less complex medical issues.
- Focusing on important clues
Being in a hospital can be stressful and may leave patients with a less-than-objective view of what they are experiencing. They might not know what symptoms or experiences are relevant to their treatment and therefore neglect to mention them. An attentive nurse will pick up on these points if they crop up during a conversation and ask their patient for more details. They could also ask questions that guide a patient onto a particular topic, particularly if it could assist in their recovery.
- Expressing doubt in the right context
Done gently, voicing doubt can help a patient to re-examine their more negative or incorrect notions. This can only be done after an initial bond of trust has been established, and the patient is able to listen. By disagreeing with a far-fetched idea, nurses can challenge an inaccurate assumption and present a more realistic approach. Performed in a caring way, it could assist a patient with a fixed idea about their condition or someone who engages in destructive behavior.
- Using humor to manage a patient’s fears
To keep their patients feeling positive about their treatment and recovery, nurses can use humor to lighten the mood. A hospital stay can be stressful and worrisome, but nurses can diffuse tension and create a good relationship with their patients by remaining cheerful. Once a person is relaxed, they are likely to be more responsive when it comes to their treatment, as well as take on the suggestions of their medical team.
- Changing the style of communication
Older or younger patients, those from a specific cultural background, and those with certain religious beliefs will benefit from different communication styles. Nurses are careful to consider all these factors and more when they approach a patient. They may need to learn a person’s correct pronouns to make them feel comfortable, or they may need a translator to help a patient whose first language is not English. An awareness of difference and a dedication to inclusivity makes patients feel accepted and confident in their care team.
- Being aware of non-verbal clues
As well as using non-verbal communication skills, nurses need to understand these cues when they come from a patient. Movements, eye contact or lack of it, and other actions can indicate how a person is feeling. The ability to understand and interpret these silent clues gives nurses a head start when it comes to diagnosis and treatment planning.
- Being authentic during interactions with patients
Patients feel more comfortable when their nurse appears to genuinely care about their treatment. Nurses can show their dedication by revealing a little of their true personality in chats and quiet moments on the ward. This nurtures a connection that encourages patients to be equally open regarding their thoughts and feelings. Nurses can use this to learn more about their patients and provide optimal care.
- Asking a patient to repeat an instruction
If a nurse is not sure that they have explained a concept well enough, they can ask a patient to repeat it back to them. Whether it is a diagnosis, advice on taking medication, or tips on using a medical device, this can help a patient remember an important instruction or piece of guidance accurately.