1. Effective Communication Mary Ann Hudson, MA, MFA, RN The Ohio State University College of Nursing Nursing 385, Nursing 301

2. Application of Skills in Clinical Practice  Theory and practice of excellent communication—what’s the difference?  Communication theories like active listening and motivational interviewing provide the background and confidence you need to enter the client’s space to teach and learn.  The practice of excellent communication adds SKILLS to the theory and requires the nurse to be flexible and adapt to the situation at hand. SKILLS can be practiced once the theories are learned.

3. Practicing the Skills--CSI  Nursing 301 provides a terrific opportunity to practice the skills associated with with excellent communication in the form of the CSI—Critical Student Investigation. With the theoretical knowledge of a concept like active listening in your scrub pocket, the CSI activity will provide you the opportunity to talk to a number of patients in a number of different scenarios. The CSI is a good reminder that while the technical/psychomotor skills of nursing are important, the MOST important skill to patient recovery, safety, and rehabilitation is effective communication between the nurse and the patient.

4. Effective Communication  Motivational Interviewing  Motivational interviewing is the practice of first, identifying the most important outcome of the teaching you are doing with the patient and second, discovering what will motivate the patient to achieve that outcome.  This method asks the nurse to approach the patient and what motivates them completely without bias and to be flexible enough to teach from that motivation.  Example of the mother and the asthma medicine (motivation:time over health of daughter)

5. Effective Communication  Active Listening  You will learn a great deal about this method in Nursing 301 as it is the hallmark of effective nursing.  Active listening requires the complete presence of the nurse, and the nurse should work to create a physical environment that supports it (removing distractions, establishing trust, making sure the patient is ready to communicate and learn).  Your learning is as important, as an active listener, as the patient’s learning.

6. Effective Communication  Teachable Moment  Finding a teachable moment is a challenge as a bedside nurse. There are a great deal of distractions and physical and mental upsets in the healthcare setting. Frequently monitoring your patient and actively listening to them will uncover moments where the patient will be most receptive to teaching and learning.  Will you be ready to take advantage of the teachable moment?

7. Effective Communication  Body Language  Patients are acutely sensitive to how you approach them in their space. Appropriate body language indicates your readiness to listen and can maintain the patient’s dignity.  Get yourself to the patient’s level, avoid “closed-off” body language, lean forward to indicate your comfort and acceptance of them. Use therapeutic touch where appropriate, and make sure your words and your face agree.  As much as 75% of what we understand from others comes from body language.

8. Effective Communication  Efficient, accurate, and compassionate speaking  For complex teaching and communication, you may need teaching aids and materials, or to make notes to yourself. Realize you ALWAYS have a very limited amount of time. Make sure you have both materials to help you and appropriate materials to leave with the patient to review later.  If you don’t know, ASK, and then get back to the patient immediately.  Avoid negativity/slang/swearing, judgment words, and keep your voice clear, loud enough to be heard, and professional in tone. When in doubt, stay close to the diagnosis as written and to the materials provided by the patient.

9. Communication on the Floor  Everything that is true for patient communication is also true for communication with your colleagues. You should be able to repeat what you discuss with colleagues to the patient.  Ask questions, and find answers.  Check yourself before you wreck yourself— how much do you really know?  Even with difficult interactions and colleagues, find ways to have respect for the colleague and for the situation. How can you be most clear about your needs?