By Anna Rodriguez, BSN, RN, CCRN

As an introvert, I sometimes find it exhausting to communicate with others (especially strangers, for some reason)! Do you ever have to give yourself a little pep talk before calling to make an appointment with a new doctor’s office? Do you ever stress about going to a party because you know there will be people wanting to do that small-talk chit-chat? And then you spend your weekend in solitude, perhaps reading a good book, trying to recharge your energy that you’ve been using all week to have all those interactions? Or maybe it’s just me?

I suppose you can imagine then, sometimes my work as a nurse can be overwhelming. I’m communicating with co-workers, doctors, managers, patients and their families, just to name a few. Communication can be stressful AF, especially when someone’s life is on the line! The stress response in the body can actually negatively affect your communication abilities- some people clam up and go silent, others get angry and blow up. I want to share a few things that I learned early on that will help you manage your stress so you can communicate effectively.

1. Be clear. Be concise. Stick to the script.

As a nurse, I’ve seen all sorts of communication tools that various employers have recommended.  It’s mostly tools to help staff communicate with patients, like AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank), GREAT (Greet, Relate, Explain, Ask, Thank), or SBAR (Situation, Background, Assessment, Recommendation). It doesn’t matter what tool you use, what matters is that you gather your information and you communicate with purpose and intention. You can reduce the anxiety you feel by mentally or physically preparing your “script.” If you’re about to call a doctor about an elevated blood pressure, it would be helpful to know what the heart rate is and what medications the patient is taking that effects the blood pressure BEFORE you call, because you don’t want to have a doctor on hold while you look up information they’re likely to ask for. So be prepared and remember that with anything, you get better with practice!

2. Be an Advocate

Don’t let people with, let’s say, “difficult personalities,” stop you from communicating! You are the patient advocate and you are their voice. If you’re every having to diffuse a tense family situation or call a grumpy doctor at night, it’s okay to remind them that we’re all on the same team and return the focus back to the patient. If you’re having difficulty getting your message across or if someone is “taking it out on the messenger,” feel free to work up your chain of command. The charge nurse, the manager, the supervisor- whoever your resources are, don’t hesitate to use them when you need to! I hate confrontation, so having those kind of conversations can be hard and a HUGE source of stress. Never, ever take it personally. While there’s no excuse for incivility, recognize the stress those families and physicians are under and know that their reaction would’ve been directed at anyone in your position and it’s not a reflection of YOU as a person.

3. You Can Never Over-Communicate

In my opinion and experience, there can never be too much communication. It’s why we learn to use closed-loop communication for code blue situations. It’s why we check back with the people we delegate things to and make sure it got completed. It’s why we read back physician orders on the phone to make sure we got it taken down correctly. It’s also why we fill out white boards in the patient’s room so they (and their family) will remember who their medical team is and what the goals of the day are. And it’s why we do a “time-out” prior to performing a procedure to verify that we have the right patient and performing the right procedure to the right body part. Mistakes happen, we’re all human, but the quality of our communication can help reduce those errors.

4. Use Terms that They'll Understand

It also helps to use terms that the person you’re speaking to will understand. I remember one instance when things escalated with a daughter of a patient who had suffered a heart attack. The medical team had been using words like “coronary occlusion” and “myocardial infarction (MI),” and it wasn’t until someone used the words “heart attack” that she fully understood what was happening. Taking time to have the patient or family repeat back what they heard is a useful tool in ensuring that they understand what’s being said.

5. Know When to Zip It

There are moments when the best form of communication is not saying anything at all. Instead of stressing about how to respond, simply LISTEN. I’ve found that you can learn all sorts of stuff about a person by just letting them talk about whatever is on their mind. To be fair, some of the things that come out of a person’s mouth are things you really didn’t want or need to know! Other times it can be extremely helpful. You may think their biggest concern is getting their infection treated, but they might be anxious about their cat at home or how they’ll get the trees pruned if they’re stuck in the hospital. Even if you can’t actually do anything to address their concern, maybe a listening ear and acknowledgment is what they need in that moment.

There will be difficult moments when you won’t know what to say. It’s okay to say nothing and just be with them. Have you ever watched the Empathy TED talk from Dr. Brené Brown? It’s like, 3 minutes, go check it out.  I love the part when the bear says to the fox, “I don’t even know what to say right now, I’m just so glad you told me.” Because, like she says, a response rarely makes something better. A connection on the other hand, now THAT can make a difference.

I hope these tips help you with your communication at work! It’s all about managing your stress and channeling that energy to help you effectively communicate your message. You got this!

BONUS: Take this quiz to see what your style under stress is!

By Anna Rodriguez, BSN, RN, CCRN

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