Patients may perceive things very differently than we might think about health care they receive and family members also may perceive things differently than we would expect by what they observe when care is delivered to their loved ones. Therefore, we must assume the attitude of a healthcare provider is quickly filtered through the client’s lens of perception. From a client’s point of view, if things don’t go a planned, they may experience fear, feelings of disappointment, frustration, and even anger. Their anger is frequently directed at the healthcare provider in general. Little things appear large in the client’s eyes and any healthcare provider who happens to be present may be the target of the client’s fear, frustrations and possibly anger.
A nurse’s thoughts may include: “I can’t do anything about how they feel.” To a certain extent, this may be true; however, there are actions nurses can take and should keep in mind to offer reassurance their clients. I have also experienced that some clients can be extremely difficult to care for reasons that may not ever be clearly understood. Their attitude may be less than stellar but, nurses must always remember that the patient is the one who is seeking care for a health issue that may be extremely difficult for them to accept or cope with.
A diagnosis of coronary artery disease many times requires a change in lifestyle or habits. Lifestyle changes will impact individuals in a variety of ways: socially, financially, occupational impact, and self-esteem, any of which their emotions may be manifested in the form of anger and frustration toward anyone who happens to be around them. Many times, nurses become the sounding board for life’s stressors that our clients are experiencing and may be having difficulty coping with. I am certain there are many other real life situations nurses have experienced. We must reflect back to our training in therapeutic communication and revive some of the effective skills that will help client’s to cope with challenges in their life that have been exacerbated by a change in their health status.
Nurses should strive to have patience, communicate professionally, and have empathy. Remember, if the client “feels” you are rude, inconsiderate, impatient, or don’t care, your risk of being sued if significantly greater if things do not go as planned. NOW HEAR THIS: it doesn’t necessarily mean you did anything wrong. It may be all about the client’s perception!
Tips To Increase Rapport With Patients
1. Self-awareness and effective communication skills include the following:
- Verbal communication is typically considered the spoken words.
- Nonverbal communication includes gestures, expressions, and body language.
- Nurses should use positive body language, such as sitting at the same eye level as the client with a relaxed posture that projects interest and attention. Leaning slightly forward will help engage the client. It is generally best to not cross your arms or legs during communication with your clients because this posture erects barriers to your interaction with them. Uncrossed arms and legs projects openness and a willingness to engage in the conversation. Make sure your verbal responses are consistent with your nonverbal messages.
2. Nurses assess and interpret all forms of patient communication.
- Silence and Listening are a couple of the most difficult but often the most effective communication techniques to use during verbal interactions.
- Passive listening is letting the client do the talking, but,
- Active listening reflects on what the client is talking about.
3. Techniques that inhibit therapeutic communication include:
Advice – telling a patient what to do
Agreement – agreeing with a particular viewpoint of a client (the client may not want to change their mind if they thing it opposes what the nurse agrees to)
Challenges – disputing the client’s beliefs with arguments, logical thinking, or direct order (a nurse belittles a client).
Reassurance – telling a client that everything will be OK (this statement may not be true)
Disapproval – judging the client’s situation and behavior (nurse belittles the client).
Remember, a patient’s perception of the care they received is not necessarily what they got! Right or wrong. It starts with a perception which is “real” to the client.