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‘I don’t know how to talk to patients’


Can you advise this student nurse?

“I’m halfway through my first placement after spending the first term just in lectures. I was so excited to be out on placement but I’m finding it really difficult to chat to patients.

“I just feel like I’m not sure how I’m supposed to act, how friendly is it ok to be? I think after all the warnings in lectures about “being professional” and “awareness of professional boundaries” that I’m now terrified of getting it wrong.

“I think my shyness is also a factor. I’m comfortable with the practical procedures but when patients ask me anything I panic that I don’t know the answer and then just forget everything I’ve learnt.

“My mentor told me in my mid-placement review that I need to show more compassion, but I really am compassionate, I’m just unsure of myself.

“Any advice?”

- Frances, Manchester

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Readers' comments (7)

  • Hi Frances,
    I am getting the impression that you are quite young from your letter. But please don't worry, this is a common feeling in student nurses of all ages.
    Nursing is a difficult job and we are expected to know it all. But it is ok to say 'I'm sorry I'm not sure, but I can go and find out for you'. Even nurses with years of experience don't have all the answers.
    The shyness will become less apparent in time. I remember feeling like this. The best way I had of dealing with it was to watch how other people acted and copied them. I also found that on the ward elderly patients were often grateful of a nice chat and not at all intimidating. Faking confidence can go a long way in making you actually feel more confident. But you also don't have to talk all the time, perhaps your mentor is more chatty naturally. I am sure your compassion is there in abundance, and show some for your self. You are only a first year, and this is one of the reasons that the course is three years. You will grow not just clinicall and academically but also in confidence as you gain the experience of numerous care settings.
    Don't worry about the professionalism but either, so long as you are friendly and polite that is sufficient for all patient interactions. You sound like a student with great potential to be a lovely compassionate nurse. My main advice would be to give yourself time and the rest will come naturally. It isn't all about talking, sometimes a smile or holding someone's hand is enough.

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  • one can have highly compassionate feelings for others without necessarily showing them, or at least all of the time. I am not sure this is a very helpful criticism of somebody to make and sounds as if it was used as it is currently such a buzz-word. forcing oneself to show it could appear as very superficial.

    talking to people may (but not always) develop with confidence. the more you focus on others and interest you show in them the more this can help. try and find out their needs and interests and talk about those.

    there are some good books on small talk which may be helpful and give some ideas and triggers for conversation. some professional books on the psychology of nursing and interpersonal relationships are also useful.

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  • Hi Frances,You sound like you are a kind person and I think kindness is the most important factor of being a nurse,don't worry that the shyness thingy is a problem,it wont be.As you become confident in knowing how to nurse people you will learn many social skills and this is what will guide you on what to say and how to say it,really you just need to be yourself,all people are different and nurses are no exception.Just imagine how awful it would be if we were all the same.Im just glad people are still wanting to be nurses for the right reasons.The only way to become experienced is to make a few mistakes,mistakes aren't a bad thing,everyone makes them and most are easily rectified,you will learn lots for your patients and I would think they would be very grateful to have a kind ,thoughtful person like yourself looking after them,good luck and stick at it .

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  • Frances, what you are describing is really common and your compassion is demonstrated by your desire to develop good relationships with others. Have you tried raising this with your University? Some health and social care programmes now involve patients in teaching delivery and practice simulation which enables students to practise these skills with real people without the immediate pressure of being on placement. For a good model, have a look at the Bournemouth University carer and service user partnership website

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  • Hi Frances
    You have already been given some excellent advice, but I hope the following might also be helpful to you.

    I am sure this will already have been highlighted by your tutors, but the Nursing and Midwifery Council’s The Code can help you to understand what is meant by professionalism. It also makes clear that as a nurse (student or registered) you must “make the care of people your first concern, treating them as individuals and respecting their dignity”. This is consistent with current guidance published by the Department of Health, NHS England, Care Quality Commission and the NHS Constitution, amongst others. There are also many books and articles that explain how nurses can communicate appropriately, effectively and therapeutically in practice. The information these sources provide can also help you to build confidence that you are ‘doing the right thing’ in practice.

    When you first meet a patient just try to relax and be yourself as Julie also advises. Consider how your patient might be feeling, be aware of their situation, the environment, if they have any specific communication needs, and adapt your style of conversation accordingly. I am sure you will do this anyway, but a good way to start is with introductions e.g. ‘Hello my name is…’ ‘What would you like me to call you?’ First impressions count; so think about what your body language (e.g. eye-contact, facial expression, positioning), what you say (e.g. the content, tone of your voice, the pace at which you talk), and the way your present yourself, might be interpreted by the other person; e.g. will your patient view you as welcoming, friendly, approachable and calming? Remember you are also communicating through your attitude and actions, ability to listen, appropriate use of silence and touch.

    Being professional requires you to present yourself honestly and allows you to use everyday ‘small talk’ when interacting with patients; the aim of this is to make them feel comfortable with you. Small talk is the friendly chat we use in everyday life to acknowledge the presence of another. For example, ’Good morning, how are you (feeling) today?’, ‘Isn’t the weather lovely?’ ‘That’s a nice card’, etc. These, and the responses you get, can be used as openers to further questions such as ‘Are you comfortable?’ ‘I see from your notes you like walking/you have two children/a dog/play football?’ You may also share some information about yourself if this is relevant and appropriate to making a ‘connection’ with that person, for example, you also have a dog/play football.

    These are brief and informal but polite conversations using everyday language that stay within professional boundaries. By acknowledging the presence of the other from the beginning and interacting with them as a human being, this also enables you to start forming a bond/building a rapport with them. Once achieved, this will help them to feel more at ease, able to trust you and share relevant information with you. It will also help you to be more effective in your role, as you will begin to build an understanding of your patient as a person from the information they volunteer about their everyday life. This might include any anxieties or fears they may have, and any expectations, priorities and goals for care planning and treatment. However, the patient’s right to privacy must be always be respected; do not pry, focus on gathering information relevant to their current experience, and be aware that patients may not always want to talk.

    Patients do not expect you to know everything but they do want you to be honest with them and respect them. If you don’t know the answer to something, just say so. It is perfectly acceptable to let your patient, or their family member/carer (or a colleague), know this. But, as Caroline also suggested, always offer to find out or get someone else you know can answer their question to come and see them. Perhaps most importantly, remember that being a patient or a nurse doesn’t stop us from being human, and that your patient, or their representative, is also a person who may feel more anxious, alone or shy than you do. I hope this will help you, and good luck for your future nursing career – by asking for advice you have already demonstrated your potential to become a caring, compassionate and professional nurse.

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  • Please do not worry about feeling like this. I felt exactly the same way when I first started nursing, I had no care experience at all, so I was painfully shy, especially around families as well. I thought I was going to have a nervous breakdown the first time I was going to do a bed bath, thinking what do I say? How to stop them feeling embarrassed etc. Confidence comes with experience, the more you go along, the easier it gets to chat to people. The elderly especially love talking and I adore how interesting they are. Simply asking them How they are? breaks the ice. Asking what did they work as etc. Just be yourself, don't worry how friendly you are, hospitals are an alien environment that patients do not want to be in, so having a kind and friendly nurse looking after them makes them feel better. If you are training to be a nurse, obviously you are a compassionate person, compassion cannot be taught, it's either in us or not, the more you go along, the more it will shine through. You are feeling how everyone does, when they first start out. This is natural, and you might think people at the same stage as you, are so confident, but always remember it's people who are too confident that are most likely to make mistakes. Good luck I know you will be fine!

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  • Frances, you have 2 ears and 1 mouth is all I'll say, listening is the key!

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