Ineffective nursing communication occurred at one hospital as illustrated in the following example: A patient complained that no one had been in all night to check on her. The Patient Relations Rep went to find out if that was true. She found out that the patient's nurse had in fact been into the room four times, doing things for or to the patient each time. Four times! The nurse had been there physically and felt caring, yet the person who was the patient did not feel she received any quality contact or caring from the nurse.
Nurses are caring. It's a given. Yet, in today's pressured work environment of endless multi-tasking and multiple priorities, they run the risk that their caring may not come across effectively to the patients and families they serve. Connection to their caring mission can fade because of the stress of endless to-do lists and intense workloads. This is anxiety-provoking for patients and draining for nurses and the organization.
Clearly, spending more time with patients is not the answer. The fact is, unless barriers are removed and staffing and processes improved, there is no more time for nursing communication. Any suggestion that nurses should spend more time – time that they do not have – is maddening and breeds resistance to improvement strategies. Therefore, it's helpful to focus not on the quantity of time nurses spend, but on the quality of that time with their patients and families. The challenge is to make certain that their caring comes across to the people they serve during the precious time they do spend with them.
So how can nurses make certain that their caring is felt by patients and families during the precious time they spend with them?
If I could advance one skill in nursing communication that would create breakthroughs in the patient experience and job satisfaction, it would be the skill of "presence." This learnable skill involves controlling your attention so the person on the receiving end feels like the center of your universe during the precious moments you have with them. The payoffs: Patients feel your focus and caring, you connect with them, and your work becomes more meaningful. When you practice presence, the patient feels important – that they are your sole focus. They also feel like your soul focus. This helps them feel supported, less anxious and they actually heal faster. Also, when you are fully present, you do not miss valuable cues about the person's thoughts and feelings – cues that help you meet people's needs exceptionally well.
The pivotal skill of presence does not take more of your time. It makes every moment of connection with the patient precious so your caring comes across loud and clear.
Tips for Practicing Presence
- Take a deep breath. Bring your attention to the present moment.
- Physically shift to a posture of presence. Place your legs evenly on the floor. Open your palms. Face the person fully. Aim your heart at theirs.
- Lean in.
- Tune in.
- Smile and make eye contact.
- Open your ears, eyes and heart. Listen to the person's thoughts and feelings.
- If you become distracted, take notice and tell yourself to return your focus and caring to the person in the present moment.
NOT Being Present: The Signs
- Eyes wandering; looking away
- Maintaining eye contact, but not really listening
- Doing something else while someone is talking to you
- Chatting with a coworker while customer is waiting
- Allowing interruptions by any and all people or calls
- Allowing an important interruption without excusing yourself and explaining
- Acting tired, bored or distracted
- Looking at your watch
- Interrupting the person talking
- Turning your back without apologizing or explaining
- Walking away with no explanation or goodbye
Help your team enhance nursing communication through the pivotal practice of presence. Ask them to experiment with a small number of patients and family members. Then set a date to discuss the results.
The Impact Is Amazing
In my experience working with teams who have focused on the practice of presence, I have seen how energizing it is for the staff and how healing it is for patients and families – when nursing communication is grounded in the nurse's caring presence.