Communicating with patients and families

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Communicating with patients and families
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Communication

• Communication is the very heart of the
  nurse-patient relationship
• Nurses often must communicate with patients and
  families when they are stressed and dealing with
  intensely difficult situations- not an easy job
• Failure to communicate effectively can jeopardize
  the nurses credibility with the patient and
  family

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Doctors vs. nurses

• Patients expect doctors to speak in fancy medical
  terminology
• Patients expect that nurses will speak so that
  they can understand what is being said
• Patients expect that doctors may be aloof and
  distant
• Patients expect that nurses will demonstrate
  caring and empathy in their demeanor

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Impressions are everything

• It doesnt matter to families
• that the nursing staff may have performed the
  most advanced lifesaving techniques for the
  patient
• if the nursing staff comes across
• as cold and distant,
• the patient and family will not feel cared for.

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Non-verbal communication

• Dont underestimate the power of non-verbal
  communication!
• Watch for nonverbal cues that dont match what
  the person is saying-
• Patient says Im fine but is holding on to the
  side rails with a death grip and rocking in pain
• Nurse says Im here to help you while rolling
  her eyes and scowling

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Touch

• Be very careful when using touch to communicate
• Touching a patient who has neuropathy can be very
  painful, especially hands and feet
• Certain cultures forbid men and women to touch,
  while other cultures frown upon shaking hands
• Warn patients before you touch them, and describe
  what to expect- this will feel tight around
  your arm
• Also be careful with gestures- what is acceptable
  to one culture may be offensive to another

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Be honest

• Dont lie to patients- if what you are going to
  do will hurt, say so!
• Patients (especially kids) really resent hearing
  phrases like its just a little poke before a
  shot- its going to hurt and they know it.
• When the nurse does this, the patient loses trust
  in the nurse and then disregards everything else
  that the nurse has to say.

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Giving news over the phone

• Sometimes nurses have to inform family members
  that someone has been injured or has died
• Make sure that you have the correct person on the
  other end of the line!
• Introduce yourself and keep the conversation
  simple while conveying your message
• Try to keep the conversation short- extensive
  explanations can usually wait until the family
  comes to the hospital
• If the family asks if the patient has died, be
  honest but wait to give details in person

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Bad day before work?

• Bad day? Leave it at home!
• Even if you have had a horrible day before coming
  to work, you must leave your bad mood at the door
  to be caring and professional when working with
  your patients!
• Sound tough??? It is!!!

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Putting a good face on

• Shortly after I started working on an oncology
  unit at a metro Detroit hospital, a very good
  friend was diagnosed with a very malignant brain
  cancer.
• My husband and I saw him over the weekend, and
  found out that he would probably die in the next
  year or two.
• When I went to work on Monday, I had to care for
  a patient with cancer that had spread to her
  brain- she was having seizures and could no
  longer talk. Seeing her, I could only imagine
  that my friend would soon be in the same state.

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Putting a good face on

• Even though I was in turmoil over my friends
  cancer diagnosis, I still had to be a
  professional, caring nurse for my patient and her
  family.
• Yes, it was terribly difficult!
• I knew that it would be painful to continue
  working on the oncology unit after that, so I
  soon transferred to a supervisory position
  instead in the hospital.
• My friend died 2 years later.

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Putting a good face on

• No matter how you may be feeling inside, you
  always must put forth a professional, caring
  demeanor for patients and their families
• You will sometimes see horrible-looking wounds or
  experience nasty smells when working with
  patients- you absolutely cannot let the patient
  know how you really feel about it.
• Sometimes nurses have to put on Oscar-winning
  performances to hide negative feelings- but its
  part of being a professional, respectful, and
  empathetic caregiver

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If its really bad

• Some chapstick or Vicks Vapo-Rub under the nose
  will sometimes help mask nasty smells
• If you feel faint, excuse yourself politely and
  go sit down in another room until you feel
  better.
• Surgical masks dont do anything to disguise
  smells- it will only make the patient feel bad
  and very self-conscious about the odor

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If its really bad

• When I am working with a really nasty wound or
  smell, I try to block it out of my mind by
  concentrating on something else- usually a
  conversation with the patient.
• I focus on talking with the patient as I am doing
  the dressing change (or whatever) and that helps
  the time pass more quickly. It also takes the
  patients mind off of the wound and what I am
  doing.

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If its really bad

• If a wound is particularly bad, I try not to
  think about it too much while I am doing the
  dressing change
• When I am all done, then I will go into the
  bathroom or someplace else away from patients and
  vent a bit. You might find it helpful to go talk
  it over with a classmate or co-worker in a
  conference room afterward.

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As you get started

• Listen. You may hear someone talking, but are
  you listening? Too often nurses dont listen to
  what a patient or family member is saying, but
  instead are busy forming a response.
• Maintain eye contact. When you are listening, be
  sure to observe body gestures for signs of
  contradiction to what he or she is saying
  verbally.
• Speak with the family members as well as the
  patient. Try to encourage family interaction and
  questions, especially if a family member is the
  primary caregiver for the patient.

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As you get started

• Don't be judgmental. Listen attentively but
  dont show excessive emotion to what the patient
  or family members is saying. Don't ever say that
  the person's idea is silly. Respond gently
  instead- suggest that there may be another way to
  address the issue and the new approach may work
  better.
• Listen carefully. You can learn much from a
  patient who is willing to share how he or she
  addresses and copes with chronic illness or
  difficult situations. Listening can be a
  tremendous educational experience, especially
  when starting a nursing career.

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As you get started

• Speak clearly. This will also help you speak more
  slowly, making it easier for patients and
  families to understand you.
• Skip the medical terminology. This only confuses
  patients and families. Use terms that are easy to
  understand.
• Allow periodic moments of silence. Silence
  provides an opportunity for the patients and
  families to mull over information that formulate
  new questions for the nurse
• Respect cultural differences. Use caution with
  touch and humor.