Developing a good bedside manner is just as important as improving clinical skills in expanding your role. Whether it’s dealing with the embarrassing medical complaint, the overly nervous teenager, the anxious new mother or the 30-year-old man who would rather be anywhere else but in the pharmacy, getting patients to open up, trust you and give you the information you need is vital for providing a high level of service.
#1: Focus
You may feel you are needed in 20 different places at once, but it is vital patients get the attention they deserve. If someone comes in asking in a low whisper about hemorrhoids, you need to give them your full attention. That means avoiding simultaneously filling out forms or answering the phone. If necessary, ask them to wait five minutes while you can finish what you are doing so you have time to deal with their query properly.
#2: Really Listen
The teenage girl struggling to ask about the morning-after pill may just want information on contraception. The patient with poor asthma control may just want reassurance about her treatment. But by not listening properly, you may make the wrong assumption about the nature of their problem. The query may not be immediately apparent but instead hidden in a long description of symptoms, so listen first and then repeat back to check you have understood to establish exactly what the patient wants.
#3: Ensure Privacy
Nurses used to dealing with embarrassing medical problems on a daily basis can easily forget how uncomfortable it can be for the patient to talk about certain conditions. Offer a private consultation area if someone is asking for advice about a sensitive issue.
Use the patient as a guide – are they fidgeting, speaking very quietly or blushing? They may be asking about a condition you have never thought of as embarrassing, but they may find it very difficult to talk about. For example, some mothers are mortified to be asking about head lice.
On the other hand, some patients will shout out personal information at the top of their voices or start stripping off to show you a rash. Offering such patients privacy is still important in saving the blushes of other patients, though, and it will help you focus on the problem.
#4: Be Observant
Keeping an eye on the patient’s body language will allow you to get the most out of every conversation and consultation. You can’t help someone if you’re not paying attention to them.
Be aware of how the patient is presenting themselves. If they are speaking very quietly, looking at the floor or fiddling with their phone or bag, they are likely to be asking you about a topic they find hard to talk about.
By physically matching the patient’s body language, by speaking quietly or bobbing down to their level, you can make them feel happier with the situation and slowly boost their confidence. For example, if someone is speaking very quickly because they are nervous you too can speak quickly and gradually slow down your voice to help them calm down. The same goes for someone speaking very loudly, or someone not wanting to come too close.
#5: Strike the Right Pose
It is just as important to be aware of your own body language. Avoid defensive poses such as crossing your arms, make eye contact and try not to fiddle or fidget with, say, your pen. Being relaxed and confident in your body language will help the patient feel more relaxed and confident. Be careful not to invade their personal space. When speaking to the patient make eye contact. Nod and be interested in what they are telling you.
#6: Don’t Judge
We all make snap judgments about people – it is human nature. But it is important to be aware of this to make sure that it does not show in your body language, tone of voice or, most importantly, in your advice.
Try to remember you may not know everything about the patient’s circumstances. You may be quick to cast aspersions on the 15-year-old asking for emergency contraception, but how would you feel about that teenager if you knew she was being abused?
It is your job to be professional, make the patient feel they can talk to you freely, and provide the right advice and information for them. Remember, even if they are being arrogant or cocky it may have taken a lot of courage to come to you for help.
#7: Use Open Questions
“How does it feel?” is a far better question than “Does it hurt?” The first will encourage the patient to be descriptive about their problem, perhaps giving you information you did not expect, but the second simply leads to a “Yes” or a “No”, which is unlikely to give you the information you need. Prompting the patient to give long, detailed answers will enable you to be far more attuned to their needs and even build rapport by making it clear you are interested in their problem.
#8: Offer Reassurance
If the patient feels comfortable with you, they are more likely to get what they want out of the interaction and go away satisfied. But making someone feel at ease is not as simple as it seems.
It is important to put yourself in the other person’s shoes, but you are aiming for empathy not sympathy. Beware of the phrase “I know how you feel” – that could well make the patient feel patronized. Give them space, remind them you are bound by confidentiality, leave yourself open for further consultations and ensure they know you are always there if they have further questions.
#9: Choose Words Carefully
Try to be positive rather than negative. Avoid too much medical jargon. This will hopefully prevent the patient from becoming overly concerned. For example, it is far better to say “everything is fine” than “there’s nothing wrong” or “there’s not a problem,” because although the phrases may be identical in meaning, the patient will be fixate on negative words such as “problem” or “wrong.” Likewise, when warning a patient of a potentially dangerous side effect, you need to make sure they are aware of when to seek help without alarming them. Saying it is “important” to go to the doctor if they feel unwell is better than using words such as “emergency,” “dangerous” or “severe.”
#10: Stay In Control
You are busy, so it is important to remain in control of the situation. There will always be patients who want to spend all day talking about their problems. Do not be rude and bear in mind the need to listen to the patient and not brush them off – but do have some stock phrases ready to finish the conversation. If they are talking too much or offering too much detail, be prepared to bring them back on track. That way everyone gets a better quality of service.
This article was republished with permission from SCRUBS Magazine.
All good advice. I would like to add a few I have learned over the years.
I find sitting face to face, knees at knees and leaning a bit forward, creates a better connection with the patient. Any barrier between you, like a desk or counter, or you standing over a patient looking down on them, will often block your making a connection.
Being present in the moment is so important, as you said above. Mirroring back statements confirms you have understood correctly and tells the patient you really are listening.
Invoke these two tools I use in life….
1. use the power of the pause, meaning hesitate before replying, give yourself a minute to analyze what you are gong to say, or let your brain catch up before letting it fall out of your mouth.
2. Think to yourself, what purpose will these words serve? If you find the answer to that is anything but positive and productive, change your mind on what words you will use.
And my last tidbit comes from working with lower education levels in adults and patients who’s first language is not English, all too often these patients do not want to appear dumb or unable to speak English, so they will shake their head yes, or say yes but really are not understanding. I usually in these situations, ask them to tell me what they felt I was saying so we can be sure we are all one the same page. Often times I put it off on me by saying you know I tend to speak nurse and forget not everyone speaks nurse, so I want to make sure I did a decent job of explaining things, if not I will try again. You can really help me learn not to speak nurse so often (this puts it all on me and they feel they are helping me out) I usually chuckle a bit as I say that and they laugh and relax and are always willing to “help me out”.