4 Ways to Incorporate Active Listening Techniques into Patient Care

• Active listening techniques are one of the most impactful keys to effective communication. 
• Effective nurse-to-patient communication can result in better patient satisfaction, an increased feeling of safety and wellbeing, and an increase in trust. 
• If you don’t feel confident in your communications with your patients or their families, seek out advice from your preceptor, mentor, or others in leadership. 

Nursing school places emphasis on many things. We spend years ensuring that we know the pathophysiology of different disease processes. We memorize the class, indication, contraindications, and side effects of various medications. We run through multiple scenarios of how to manage our time and prioritize care for multiple patients. However, administration of medication is not the only means of bringing healing to our patients

Facilitating healing is holistic. It taps into improving our emotional intelligence, caring for the emotional and psychological wellbeing of our patients, and trying our best to alleviate their fear of the unknown. To do that, one of the most important components of being a nurse is learning how to effectively communicate with patients and their families. With the prevalence of social media, virtual meeting platforms, and text messaging, in-person communication has been affected in some ways. This article highlights some practical ways to effectively communicate with our patients and families.

Challenges to Patient Communication

A common challenge for nurses is finding time to connect with the patient and /or their families. It is not realistic to spend long periods of time in a patient’s room listening to their backstory. There are competing priorities, other patients that need you, and only eight to 12 hours in a shift.  

However, you can make small changes to your communication style to connect with patients and create the feeling of being heard and understood — and decrease the amount of time spent in the patient’s room. In 2011, a pilot study was conducted to determine patients’ perception of the provider’s time at the bedside when the provider was sitting versus standing.

Providers sitting at eye level during bedside communication were perceived as being in the room longer than if the provider was standing. The patients also reported a more positive conversation in which they understood their medical condition better. The interesting part of this study and similar studies is that the time spent at the bedside for the sitting provider was not any longer than time spent at the bedside by the standing provider.

Yet, the position and posture of the sitting provider yielded a greater result. Why is that significant? Human beings have a common, basic need to feel heard and understood. When distractions are eliminated and the patient is given undivided attention, the time needed to gain essential information is shortened. 

Active Listening Techniques for Nurses

One of the most impactful keys to effective communication in nursing is active listening. The technique goes deeper than a head nod and an, “I understand”. Here are some ways to incorporate active listening during your shift: 

Give your undivided attention

Nurses, by nature, are multitaskers. Prioritization and time management are ingrained in us early in nursing school so we can learn to juggle many tasks. However, sometimes that propensity to multitask can be a barrier to effective nurse-to-patient communication. If a patient is communicating with a nurse and the nurse is documenting or even straightening up the room during the conversation, it may convey the message that the nurse is not paying attention. If possible, reserve a small amount of time to talk to your patient without documenting on your workstation or performing other tasks at the same time. If you feel short on time and need to document while talking to the patient, explain what you are doing and assure the patient that you’re listening. Also, challenge yourself to listen to understand instead of listening to respond.

Maintain an attitude of empathy and cultural awareness

While listening, try to put yourself in the patient’s shoes. People express anxiety, pain, discomfort, joy, excitement, and other feelings in different ways. Some people’s expression of these emotions could be mistaken for aggression. Be aware of your own cultural biases and knowledge gaps. Consider that you may need to alter your communication style based on the communication style, culture, gender, age, level of knowledge, and understanding of your patients. For instance, if you notice that a patient does not want to make eye contact, consider whether it’s a sign of withdrawal, anxiety, discomfort, disinterest, or just a cultural norm. If a patient refuses a certain treatment, consider the “why” behind it. Is it a lack of knowledge? Is it a fear of the unknown? Is it a cultural decision? Is it a financial issue? Have they had an undesirable experience in the past?

Give a moment of silence before responding

Taking a moment of silence gives the patient or family member a chance to finish their sentence if they may have taken a pause. Silence also gives us a moment to process what we heard and think before we speak.

Repeat what you heard and ask clarifying questions

After giving the patient time to speak without interruption, repeat what you heard. Two people can interpret a statement in two different ways. For example, a nurse greets his patient and asks the patient what she did during the weekend before being admitted to the hospital. The patient says, “The weather was beautiful! We went kayaking, fishing, and laid on the boat.” The nurse responds: “Yes, the weather was beautiful. It’s great to hear you love fishing and kayaking.” The patient then says, “I never said I love fishing and kayaking. I hate it, actually. My husband steered the kayak while I sat pretty. He fished while I enjoyed laying on the boat. The weather was gorgeous though. Thanks for asking.” The nurse, repeating what he heard, accomplished two things. It gives the patient a chance to correct anything you might have misheard or misinterpreted. Subsequently, the patient feels heard, as the nurse took the time to understand what was being said. At this point, you can ask clarifying questions. 

The Bottom Line

The hospital is not a fun place to hang out as a patient or a family member. Effective nurse–to–patient communication can result in better patient satisfaction, increased feeling of safety and wellbeing, an increase in trust, an increased understanding of condition and treatment, an increased willingness to be compliant, and subsequently better patient outcomes. If you feel like you’re not confident with effective communication skills, seek out advice and feedback from your preceptor, mentor, or other leadership. Ask for honest feedback and adjust your communication accordingly. There are always opportunities to improve and new personalities to encounter each day. Do your best! 

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