Listening Leads to Superlative Nursing Care

By Keith Carlson via Multibriefs

It's been said that we have two ears and one mouth so that we'll listen twice as much as we talk. As nurses, we work with patients at their most vulnerable and frightened. So, are we listening enough or talking too much?

Listen first

When a nurse wants to know how a patient's lungs are doing, she uses her stethoscope to listen to the patient's breath sounds. If the nurse tries to talk with the patient while auscultating the lungs, the usefulness of the lung assessment is compromised.

Similarly, if a nurse asks a patient how he feels and then busies herself with tasks or note-taking as the patient speaks, the nurse loses the opportunity to truly listen and hear the patient's concerns.

When we ask a question, we need to actually listen to the answer. This is increasingly difficult in this age of information saturation and constant distraction.

Decrease distraction

During nurse-patient interactions, try to decrease distractions in the interest of speaking and listening with total attention. Here are some factors to bear in mind during patient care:

• In a hospital setting, is it possible to close the door for privacy and noise reduction?
• Can televisions and radios be turned off during conversations?
• During home care visits, can pets and children be removed from the room where patient care is performed?
• In any care setting, can the nurse silence all mobile devices in order to be fully present?
• Can pens, paper, clipboards and computers be set aside for certain portions of the visit? Can the nurse listen without taking notes?

We may feel we're present while taking notes, but this can be a distracting factor during nurse-patient communication. If the nurse needs to take notes, perhaps she can put down her pen or laptop during portions of the conversation, then verbally reassure the patient that when she needs to write something down, she'll resume eye contact as soon as possible.

Open listening

• Open listening can be nurtured and practiced with relatively simple techniques. Eye contact was already mentioned above, and here are several additional suggestions for creating an environment where the patient will feel both seen and heard.
• Crossed arms and legs are perceived as "closed" postures. Uncross your limbs and maintain an open posture.
• Lean forward slightly rather than leaning back. This shows interest and engagement.
• Nod while looking in the patient's eyes to show that you hear what is being said.
• Paraphrase and empathize in relation to what the patient has shared. You can say, "Mr. Smith, I hear that you're feeling frustrated with your pain level. Let me talk to the surgeon and see what we can do to make you more comfortable."

Listen more

If you approach patient conversations with the idea that you should listen twice as much as you speak, you can powerfully change the nurse-patient dynamic. Patients want to feel heard; they also want to feel your empathy, even if you're not able to offer an immediate solution.

Listen with open ears and an open mind, and use your words to communicate empathy, understanding of the patient's point of view and a willingness to truly listen. This is a powerful tool in the nurse's communication toolbox.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway and a widely read freelance nurse writer. Keith is also the co-host of RNFM Radio, a popular Internet radio station devoted to the nursing profession. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.