Reminding noncompliant patients of the importance of follow-through. Delegating tasks to other employees. Talking to management. Nurses are often in positions where they must deal with difficult conversations. Here are some communication tips for nurses.
A Little Background on Communication in Difficult Times
As humans, we are prone to having emotional responses when we interact with the world and the people around us within it. As nurses, our emotions are an important part of what makes us good at our jobs. We have the ability to have compassion, empathy for our patients. Nevertheless, sometimes our emotional responses make some necessary conversations difficult. The difficult conversations may be necessary to have with our patients or their family members, with colleagues, or outside of work in our personal lives. We may feel dread, anger, fear, or another less comfortable emotion when we anticipate one of these scenarios. However, these negative emotions don't take away our responsibility.
It is stressed throughout nursing school that a good nurse will have good communication skills, but what does good communication look like when you're preparing to have an uncomfortable conversation? When those negative emotions rise up it can be even more challenging to wade through them in order to say what must be said and to actually listen to the responses.
Here are some nursing tips to help you with these tough talks.
Examine Your Feelings and Thoughts First
Take a moment to examine your feelings about the topic. Identify those feelings specifically, and look for their motivations. Do you have a bias about the person or situation? Do you have your own trauma or triggers? Acknowledging these feelings and biases helps you to prepare so that you aren't caught off guard if you feel yourself having an emotional reaction to the conversation. Identifying and acknowledging your feelings prior to the conversation can also help you to set them to the side in order to better stay calm, and focused when you need to be.
Make sure that you want the conversation to be successful and don't enter it with a mind or attitude that is looking for conflict. Your intentions can come through whether you mean for them to or not.
Avoid "We Need to Talk" Phrase
"We need to talk." Shudder. Have you ever heard those four words and thought, "Oh goody, I can't wait!"? Definitely not. Those four words almost always portend negative things, and we all know it. It may be a direct statement, and wholly true. You do need to talk, after all. Unfortunately, it doesn't offer enough information on its own and it allows our brains to imagine all sorts of hypothetical scenarios. That phrase is steeped in negative conclusions and immediately sets a person up to be defensive, anxious, or even angry.
Instead, be direct and honest, and provide more information. For example, "I need to talk to you about your treatment. When is a good time for you?" That way, you haven't left them wondering, and you've opened the door for them to choose when to walk through.
Make the Time
One of the worst things you can do when having a tough talk is seem impatient for it to be over with. One of the frequent criticisms of our medical industry from patients is often that they feel like healthcare workers don't have enough time or the desire to actually listen, and in return they feel rushed. If the person you're talking to feels like you're in a hurry it will make them defensive at the very least, and at worst will cause them to be reticent in sharing what could be important information.
This might be the 100th time you've had this type of conversation, but it may be the very first time your patient is having it. What you say may dramatically change their life as they know it, and they deserve your patience.
Give Your Undivided Attention
Within the rules and guidelines of your job, turn off any devices that can be a distraction. This ties in with the prior tip about making time for your patient to have this conversation, they need to feel not only like you aren't hurrying them, but that they have your full attention.
Open Your Mind and Listen
A lot of the time when we're talking with someone else, as they talk our brain is already putting together a response. Try to stop yourself when you sense your brain formulating a response or simply preparing to move on to the next thing you have to say. You need to wait and really listen to what they have to say.
It's entirely possible you won't like everything they have to say, you may disagree with it professionally (or even personally). Nevertheless, do not interrupt. Take notes, if that helps you focus on listening.
Body Language Speaks as Loudly as Our Brains
Be mindful of your body language. Arms crossed or hands on your hips might simply feel comfortable to you, but it can convey to the other person impatience, power, and/or distance. Try to keep your body language open; which means your arms uncrossed and your body upright.
Eye contact doesn't have to be constant, that would be supremely uncomfortable for both of you, but it is necessary. If you can't make eye contact with your patient it sends a message that you are either distracted, unfocused, or uncomfortable. Eye contact can convey sincerity, respect, and compassion.
Check Your Tone and Remember Your Breathing
Everyone knows yelling is a bad idea, but it's easy if someone is yelling at you, to want to yell back. Keep hold of your tone of voice by keeping it level. It's actually pretty hard to keep yelling at someone who won't yell back. Remember to breathe deeply, if you feel an angry emotion rise up your breathing will quicken. Focus on maintaining even breaths to help regulate your emotions.
Likewise, if you're having anxiety about a soon-to-happen conversation, take some deep long breaths in private to help settle your mind and your anxiety.
Do a Training
These are just some tips for you to prepare for uncomfortable or difficult talks, but should not be a replacement for actual training about how to handle verbal or even physically threatening altercations in the workplace. Unfortunately, nurses do encounter verbal abuse and even workplace violence, and knowing that we strongly encourage nurses to do the free course offered by the CDC titled, "Workplace Violence Prevention for Nurses" and consider other courses as well.