Why is it important for the nurse to assess both verbal communication and nonverbal behaviors?

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Listening to a patient is important to understanding a patient, but patients also communicate nonverbally. Oftentimes a health care provider will learn more from observing a patient's nonverbal cues than from listening to a patient's verbal communication. Understanding nonverbal communication is especially important for nurses providing care to patients with limited language skills.

Modes of Nonverbal Communication

Nonverbal communication or body language includes physical appearance, physical distance between caregiver and patient, tone of voice, and facial expressions. Understanding nonverbal messages is a valuable care-giving skill because body language is usually a more reliable indicator of a patient's condition than his verbal responses. Utilize nonverbal communication skills by observing the patient's manner of dress, manner of speech and reactions to being touched during examination.

Significance of Facial Expressions

Gestures, nods, smiles, grimaces and frowns are facial expressions that you must interpret when communicating with a patient. The ability to interpret facial expressions leads to a better understanding of your patient's condition.

Use of Space

You must provide treatment and care that often requires close personal contact. Remember that you are invading the patient's personal space as you examine him. Different patients will have different zones of comfort. Determine you patient's personal comfort zone. Be respectful and ensure that the patient is comfortable with any procedures that you will perform. Be especially careful when conducting examinations of individuals with schizophrenia or other psychiatric illnesses. These individuals may become anxious and violent as the nurse invades their comfort zone while examining them.

Other Elements of Nonverbal Communication

The patient can communicate using silence, gestures, eye movement, posture and vocal cues. Vocal cues refer to pauses, loudness and tone of speaking voice, which can indicate a range or emotions from anger to nervousness. The nurse interprets behavior such as fidgeting, clenching fists, avoidance of eye contact or physical contact and responds to the nonverbal message.

Using Body Language

The nurse must explore further if the patient's nonverbal message does not match his verbal message. Verbal and nonverbal messages should match in both the patient and the caregiver. If an individual's body language doesn't match his spoken message, the recipient of the message will be confused.

Caregiver's Body Language

Smiling, leaning forward, eye-gazing and touching are elements of body language that the nurse can use to improve her relationship with the patient. Be aware that your body language communicates messages to your patient and ensure that you are respectful and considerate in speech and movement. Use your body language to communicate effectively with the patient and her family.

As a nurse, you have important conversations regularly, and your body language (nonverbal communication) contributes to those conversations whether you realize it or not. When you're speaking to a patient or a co-worker, it's import to pay attention to the nonverbal signals you're sending. A person might pay more attention to your nonverbal communication than your words, especially if your body language is saying something different than your words. If you focus on improving in this area, you may see an improvement in your ability to communicate effectively. Here are some things to keep in mind as you communicate throughout your career as a nurse.

Be more aware of your body language.

Many of your mannerisms are subconscious reactions,1 meaning that you really don't know when you're doing them. They become a part of your personality and may be hard to change without a lot of concentration and effort. In order to improve your body language, you need to become more aware of how you stand and present yourself in conversations. Try to pay more attention to what you do when you speak, and what mannerisms you tend to repeat a lot. Maybe you twist your hair when you're making small talk, or maybe you wring your hands when you're talking about something stressful. By becoming more aware of your nonverbal tendencies, you'll be able to target the ones that need to be improved. To determine what needs to be worked on, consider how the same body language affects you when you observe someone else doing it. You can also ask your peers if a particular body language that you've noticed about yourself is distracting or negative to them.

Show that you're listening.

It's always important to listen to others when you're in a conversation. Equally important is your ability to purposely show that you're listening. Try not to multitask when speaking with patients or doctors. Stopping what you're doing to pay direct attention to an important conversation shows respect, and you might remember the details of the conversation better. Avoid any urges to check the time or look around the room. Turn your torso to face the person directly and maintain eye contact throughout the conversation.2 Slightly lean in toward the person when they're speaking and use simple, subtle nodding throughout the conversation to show you understand and don't have any questions.

If you're waiting for your chance to speak, your body language may reveal it. Raising your eyebrows, holding your breath, and pressing your lips together could be interpreted as signs that you're not fully listening and waiting for a chance to interrupt. Limiting those nonverbal cues will help convey that you're giving the other person your full attention by listening.

Use your hands with purpose.

To communicate a friendly, welcoming nonverbal signal, present your hands face-up while you speak. Palms to the side while you speak (like the hand position when you shake hands) is often interpreted as being slightly in control but still approachable. And palms down while speaking can often be interpreted to mean you're in control and being commanding. Therefore, greetings and friendly conversations are ideal for palms-up nonverbal communication. Collaboration between peers may be an ideal situation for palms to the side, to show confidence in communication. And palms down might be used to communicate something very important about patient care. Be very careful not to overuse palms-down communicating. It can be received as being bossy. If you want to come across as a very approachable nurse, concentrate on using palm-up hand gestures while communicating as often as possible.3

Keep smiling.

Nursing may involve some tough emotional situations. Because of this, it's important that you become somewhat of a cheerleader and practice smiling when you talk. Negative facial expressions can actually trigger your brain into thinking that what you're doing is difficult, which can raise your stress levels.4 Spend time with friends and in front of the mirror, working on your ability to smile during all kinds of conversations. Not only does it reduce your own stress levels, but it helps others relax too.

1. http://www.wisebread.com/you-are-what-you-do-16-ways-to-improve-your-body-language

2. http://www.amanet.org/training/articles/10-Powerful-Body-Language-Tips.aspx

3. http://www.forbes.com/sites/carolkinseygoman/2013/08/21/12-body-language-tips-for-career-success/

4. http://www.inc.com/jeff-haden/8-powerful-ways-to-improve-your-body-language.html

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