In the free clinic where I work, patient outcomes are often disappointing. Sometimes simple changes or observations bring about notable results. This year, the change for me was learning to always close my interactions with patients—both in-clinic and in phone conversations post-visit, with a question: “Do you have any questions?”
Remarkably, a patient or family member often does have a question.
- My mother died from skin cancer. Is that something I should worry about?
- Can I use my husband’s/mother’s/brother’s prescription instead of getting my own?
- Can I get the flu from the flu vaccine?
- Are those numbers on my lab work bad?
- When my blood pressure’s normal, I don’t need to take the medicine, right?
Communication is gold. In a Medscape podcast, physician Benjamin Levy offered worthwhile tips for improving communication with our patients. Here are some of his ideas.
Be an Active Listener
Let the patient know you’re listening carefully and fully.
Ask Questions That Resonate with Patients
Bring out accurate information from a patient by asking in different ways. For example, ask how their pain is affecting their quality of life. Query whether they’ve been able to find and cook foods of the special diet they’ve been given. Ask how more than why. “How can you see getting more exercise this month?” versus “Why aren’t you exercising regularly?”
What’s the Patient's Language Preference?
Interpreter, language phone lines, and video conferencing are options.
Use Simple Language
Explain using simple words and terms. Offer analogies: “Your heart is a pump" or word pictures: “When you breathe in smoke, the asthma makes your breathing tubes swell up and make thick, sticky mucus. Then you can’t get enough air.”
Assess, not Assume, Health Literacy
Some patients or can't read well or have vision problems. Discharge instructions and education handouts should be written on a third-grade level. If the person is non-literate, use symbols on medication instructions (draw a sun to show a morning dose, a moon for an evening dose.)
Carefully read over instructions with the patient and family.
Include a Family Member as Patient Advocate
Family members can be instrumental to improving your patient's medication use, diet, exercise, etc. You can give a Hispanic patient a diet plan to improve diabetes, but if his wife does the cooking and doesn’t understand the plan or why it matters, the diet may be unchanged.
Identify Barriers to Care
What work does your patient do? What’s her home life like? Ascertain stresses. Could transportation need or childcare affect his or her treatment success? Is an inconsistent work schedule making insulin dosing erratic?
Dr. Levy’s tips don’t include spiritual care. However, communication related to a patient’s faith is always pertinent, whether commenting on their religious jewelry as a point of conversation or responding warmly and affirmatively when a patient thanks you for the nursing care (as they frequently do at our clinic) with “God bless you.” While these might seem minor, these interactions tend to strengthen the nurse-patient relationship and provide later faith-related conversations.
Levy, B. H. (2023, August 1). 10 tips for boosting patient communication. Medscape Perspective. https://www.medscape.com/viewarticle/994512
Karen Schmidt, BA, RN, is a nurse at a free clinic in Stanwood, Washington, and is grateful to keep learning from patients as well as from her work as a contributing editor with the Journal of Christian Nursing.
Grow your nursing knowledge and spiritual care skills—read the Journal of Christian Nursing. Print and online subscriptions are part of NCF membership!