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Nurses told to improve communication skills


Nurses are being told to take a “long hard look” at how they communicate after a national survey found many patients felt nurses spoke over them and gave conflicting advice.

The annual inpatients survey, carried out by the Care Quality Commission, found 22 per cent of patients said nurses talked in front of them as if they were not there, a figure that has not improved for four years.

Anglia Ruskin University principle lecturer in nursing Sarah Kraszewski said while nurses were busier than ever, there was “never any excuse for talking over patients.”

The figures revealed the need for nurses, even those with many years of experience, to reflect on how they communicate with patients, she said.

She told Nursing Times: “You can never assume that because someone’s grown-up they know how to communicate effectively. It’s good for us all to stand back and take a long hard look at ourselves.”

In the CQC survey, just over a fifth of patients said they could not find anyone on the hospital staff to talk to about their worries and fears. One in 10 said there were rarely or never enough nurses on duty to care for them.

Ms Kraszewski said nurses on busy wards could adopt body language that encouraged patients to discuss concerns.

She said: “We have a far more demanding clinical environment than we’ve ever had and sometimes it’s difficult to give people the attention they need.

“But it’s very important to make patients feel we have time for them by not checking our watch, fiddling with our pockets or looking around. That’s part of the professionalism of nursing.”

When patients were asked whether they found one member of staff would say one thing and another would say something quite different, 35 per cent agreed – up from 31 per cent in 2002.

But overall, 97 per cent of respondents said they had confidence and trust in the nurses treating them.

Royal College of Nursing chief executive and general secretary Peter Carter said there was “no room for complacency” and that the government must ensure hospitals and community services have the right number and balance of nursing staff.


Readers' comments (9)

  • Sadly, but it's true. Unfortunately demands on nurses make it quite impossible to give our patients that precious time to talk, we know they need it and with all the will in the wold, but it's difficult to make it a priority in an acute setting. Over time we loose the habit and our nursing ethos alters so that even when we do have a quiet moment there's no guarantee that patients will get that one to one talk time with nurses. On the other hand it's all down to the individual personality of the nurse, some will go that extra mile while others won't.

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  • Patient's are being sold the perfect dream of Utopia with regard to their care and time nurses are afforded to talk on a one to one basis and discuss their fears. When was the last time that Ms Krazsewski worked a 12 hour shift on a busy acute ward and found time to sit and chat with her patients? Not recently, l would hazard to guess. Furthermore, l would suggest that when totally physically and mentally drained at the end of a gruelling shift, if anyone cam manage to portray a body language that says anything other than shattered and ready for bed, they are worthy of an Oscar and should hasten to Hollywood immediately!!

    We in the profession love what we do, it is the poor working conditions, lack of understanding from our seniors, who have moved on, out of the hands on clinical setting and top heavy management that demoralise us. How can it be right that some IT departments have comparable numbers of staff, who, by the way are more highly paid than most staff nurses?

    Let's go back to the old adage " try walking a mile in my shoes for a day before passing judgement"

    Rant over, sorry but sometimes l just have to vent my anger at such nonsense!

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  • I feel that because of the high demands that are expected of us, we feel that if we do sit and spend time talking to a patient then the other nurses will think that you are being lazy.

    As a student nurse I have experienced this, when a patient is in pain they sometimes do not tell you and when you ask them why they reply with "because you look really busy". If we spent time communicating with patients more, things like pain will be treated sooner, not only that you can answer any concerns or worries they have, provide reassurance to them.

    If this isn't being done then what kind of duty of care are we providing for the patients within our care?

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  • It seems from the survey that whether we talk to patients is a separate issue from how we talk to patients. So to focus on the time issue ignores the wider issue of attitude and how we relate to people in our care, and then how we express that.
    in my experience it is a normality of medical life to be talked over or shouted down. It is more the rarity to be listened to, heard and then spoken with rather than at.
    I would argue that referring to people as patients continually objectifies our relational attitudes rather than subjectifying patients as people, with feelings which we are able to respond to with respect and humanity.
    I also think we take on too much responsibility for the lack of staffing and resulting time, by coping with the chaos and inadequacy of the management choices.

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  • Martin Gray

    My own belief is that 12 hour shifts are too long, especially on busy acute wards, ITUs, HDUs and A&E. This results in over worked pressurised staff, and a lck of staff with the right skill mix.
    I'm glad to say that I'm retiring from nursing after over 30 years in the profession, although as an ANP I may do some locum work. Our profession has changed so dramatically over the past 20 years, numbers have decreased, the debate about degree nurses being better than or just as good as the old enrolled and registered nurses has just divided the profession, and the lack of quality management at all levels within the NHS has finally defeated me.

    Talking to patients was always considered a vital part of training as we gleaned so much from such communication; in doing so we met most if not all of the patients needs as well as forming a strong porfessional bond essential in caring for people. Now academic status and achievement, poor staffing and a decline in recruitment and retention has led to a sorry state of affairs where complaints are far more common than compliments.

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  • How about this for an eloquent expression of my communication skills ... stick your orders up your patronising ****!

    Get us more staff on the floor, reduce our paperwork and day to day workload, reduce our clinical workload and give us more pay, THEN we will see moral improve and time freed up to talk to patients!

    The survey itself showed that even the patients said that there were not enough staff, yet somehow the Nurses are once again being blamed?

    I'm getting the hell out and emigrating, and not a moment too soon!

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  • In the real world time to communicate is getting harder & harder, the only time I find I spend time talking to a patient is if I am removing a drain, doing a dressing, doing medication rounds, but with sickness on our busy acute surgical ward at an all time high, we as nurses can just about manage running round like headless chickens trying to provide a caring, efficient the managers care if we are understaffed & struggling, NO, get on with it we are told, no monies for extra staff, why don't they just take a stick to us..... they are doing that verbally anyway..... yeah it would be lovely to actually have the time to communicate...these people want to try a shift on a busy surgical ward!!!!!!.......

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    Referring to the comment about calling the patient a patient ,what would he/she rather we called them ,they are in hospital ,we are nurses and doctors they are patients. look at the senario doctor calls patient Mrs jones, Patient calls doctor Mr Brown, for a start who on earth is going to remember all the doctors and nurses real names. the person is ill in hospital,the word patient is generic. a while ago ,it was inferred that nurses be called health facilitators, just imagine the patient iis feeling sick and she usually calls out nurse, new name ,help nurse faccilitator i am feeling sick. Duh

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  • Hi there,

    communicating with patients is very important in any health sector. But what I have realised is that there is poor communication in any setting nowadays. Nurses especially needs to know more about their patients. Therefore by doing so then patients can let them know how they feel as while as any fear about whatever they are going through. It is about holistic care that nurses needs to know. I mean there is alot of rush through everything in nursing care. But without communicating effectively to your patient then why are nurses there? most of the nurses thinks that patients know nothing therefore they must be avoided in their care which is very wrong. And therefore nurses forgets that without patients they will be no job and no money. Therefore patients should be communicated to properly and effectively as they might also be in the same boat one day.

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