In nursing school, I didn’t understand why we were required to read a whole chapter on communication. I felt confident in my ability to talk to people. Later, I realized that few of us needed to learn much about talking. We needed to learn plenty about listening in healthcare communications.
Early in my career, I worked with a remarkable family practice physician. Whereas other doctors ordered seemingly every diagnostic test known to medical science, he did not. Yet, he rarely misdiagnosed a problem. I once asked him why he ordered so few tests. I’ve never forgotten his response. He said, “Because 85% of everything you need to know you can learn by asking the patient the right question, and then listening.” Later, I learned that William Osler, often called the father of modern medicine, told his students: “Just listen to your patient; he is telling you the diagnosis.”
If your listening skills are less than stellar, you can improve by using these simple tips.
Focus on listening
You’ve probably heard the familiar quote from Epictetus: “We have two ears and one mouth so that we can listen twice as much as we speak.” How true! Listening in healthcare situations starts by focusing. Simply resolve to listen more than you speak.
Listen for content, listen for feelings
Clients can use lots of words or sentences. However, their messages boil down to two themes: content or feelings. Knowing the difference guides you in using active listening techniques. When clients are simply recounting what has happened or describing what might happen, you’ll want to reflect content. When their words and actions are full of emotion, you’ll want to reflect feelings.
While listening in healthcare interviews, you’ve probably noticed that clients don’t always use a word to identify their feeling(s). From time to time, I review Plutchik’s Wheel of Emotions. It helps me to become more aware of the possible emotions, and identify what the client is trying to express.
Learn basic listening techniques
When I was in graduate school, I learned many excellent techniques for listening in healthcare situations. I’ve integrated several of those techniques into my Comprehensive Lactation Course so that I can help others to do the same. If you can’t come to my course, consider purchasing two outstanding books which will help you to gain those skills.
The classic text is The Helping Relationship: Process and Skills by Brammer and MacDonald. A more recent but outstanding text is Motivational Interviewing by Miller and Rollnick. I have read both, several times. In addition, a newer book is Listening Well: The Art of Empathic Understanding by Miller. Some of the techniques in these books are basic; others are more advanced.
Are you hoping to listen more effectively in real-life healthcare conversations? Or perhaps you want to correctly answer the many communication questions on the IBLCE exam? If so, honestly evaluate whether you have acquired adequate listening techniques. Know the difference between attentive listening and active listening, open-ended and closed-ended questions, guiding and leading, clarifying and interpreting, and more.
Optimal listening in healthcare interactions depends on using these basic techniques. Mirroring (which at first seemed really cheesy to me) is a more advanced technique that takes a lot of practice in order to be authentic.
Watch body language when listening in healthcare situations
Listening in healthcare situations is ineffective when our body language says, “I’m not interested.” In a previous post, I described a prenatal patient whose doctor’s hand was on the doorknob. Also, beware of when you might lose eye contact with the patient, or you have a closed posture (e.g., crossing your arms over your chest).
Get feedback
We might not recognize how often we speak, interject probing questions, or try “fix” things rather than just listening in healthcare interactions. We need some sort of feedback. Doing role play (as we do in my course) with an observer, or videotaping interactions are two ways to get feedback, and hopefully, improve.
In my recent interview with Rebecca Ruhlen, she emphasized the need for healthcare professionals, or even volunteers, to listen. But they also need to help the client feel ‘listened to.’ Ruhlen says she never wants a client to leave without feeling that she has been heard.
Lately, I’ve wondered if listening in healthcare settings has become a completely lost art. What is your opinion? Comment in the space below!
No doubt, listening is definitely overlooked in healthcare. There is such a rush to do more with less time (as well as work with less staff). In essence, the patient ends up “paying.” It’s the saddest part of healthcare. This year I will have been a nurse for 40 years. My favorite part is just this: listening to what the patient is trying to tell me. If successful in doing so, the patient feels empowered (helping her to identify issues), and motivated.
Additionally, it is when the nurse can feel confident, knowing that she was using her skills to help the patient. Patients know when you are “listening” or if you are in a hurry to “get the job done.” Time taken to truly listen, “says” to her “You are worth my time, your concerns are important to me.”
Lastly, when you take time to understand more about a patient and her concerns it is so rewarding. This, I think is truly what NURSING is all about. I go home feeling very fulfilled when I have taken time with patients. It is then that I feel like I have “done a good job.”
Debbie, right on! Over the years, I’ve had multiple conversations with patients. Some were short and shallow; enough to enable me to do the appropriate documentation. But the meaningful conversations were those where a true transformation occurred. Not only was the patient in a better place as a result of the conversation, but I was in a better place, too! So to your point, those conversations were what nursing is all about. Thank you for such an insightful comment.
listening to our patients and their family has become lost in the technological world we live in today. I am a 45-year experienced RN, seasoned, as some would say. I often find that many important information tidbits came to me via the auxiliary staff, housekeeping, food service, even sometimes engineering…mostly because those staff members spent more TIME in the patient’s room!
Oh Georgeanne, sooooooo true! (And I assume you have as many gray hairs as I do!) And you make such a good point here about the the ancillary staff. Right on, Georgeanne! (And as a friend of mine told me years ago, “bedside nursing is exactly that!” (Meaning, NOT sitting at the nurse’s station!)